Predicting Suicide Ideation in the Military: The Independent Role of Aggression

Start, Amanda; Allard, Yvonne; Adler, Amy B.; Toblin, Robin L.

doi:10.1111/sltb.12445

Cited by 17 publications

(17 citation statements)

References 49 publications

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“…Findings of this report are consistent with the emerging literature linking anger to suicidality (Ducasse et al, 2017; Hogstedt et al, 2018; Start et al, 2019). In a recent report, Hogstedt et al (2018) found that likelihood of completed suicide and suicide attempts over a 35‐year follow‐up were 2.1 and 2.8 times higher in male Swedish conscripts with severe anger symptoms versus those with no anger symptoms at index visit.…”

Section: Discussionsupporting

confidence: 90%

“…In a recent report, Hogstedt et al (2018) found that likelihood of completed suicide and suicide attempts over a 35‐year follow‐up were 2.1 and 2.8 times higher in male Swedish conscripts with severe anger symptoms versus those with no anger symptoms at index visit. Similarly, Start et al found that presence of anger/aggression in active duty service members was associated with fivefold greater likelihood of reporting SI (categorized as score ≥2 on suicide‐related item of the 9‐item Patient Health Questionnaire) (Start et al, 2019). Remarkably, associations of anger with these measures of suicidality were significant, even after controlling for the presence of psychiatric illnesses and severity of depressive symptoms in both these studies (Hogstedt et al, 2018; Start et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

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Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Jha

Fava

Minhajuddin

et al. 2020

Depression and Anxiety

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Background: This report evaluates whether anger attacks (sudden uncharacteristic bouts of anger that are associated with autonomic arousal and/or aggression) in patients with major depressive disorder (MDD) are associated with elevated suicidal ideation (SI; active suicidal thoughts and plans). Methods: Participants of Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study who completed Massachusetts General Hospital Anger Attack Questionnaire (AAQ) at baseline were included (n = 293). Levels of SI (suicidal thoughts factor of Concise Health Risk Tracking) were compared at baseline with generalized linear models, and during Stage 1 (baseline-to-week-8) and Stage 2 (week-8-to-week-16) with repeated-measures mixed model analyses. Covariates included age, sex, race, ethnicity, site, and treatment arm. Results: At baseline, participants with (n = 109) versus without anger attacks (n = 184) had higher levels of SI (Cohen's d effect size [d] = 1.20). Those with ≥9 anger attacks in the past month had significantly higher SI than those with 1-2 (d = 1.21), 3-4 (d = 1.48), and 5-8 (d = 0.94) anger attacks in the past month. Furthermore, participants with anger attacks at baseline reported higher SI at each post-baseline visit (both Stages 1 and 2) of EMBARC study (d = 0.39-0.77; all p < .05). Associations between anger attacks and SI were significant even after controlling for irritability, hostility, anxious arousal, depression, suicide propensity, and self-reported pain at baseline and lifetime suicidal tendencies. Similar results were found in participants with aggressive behaviors. Conclusion: Anger attacks in outpatients with MDD may be associated with chronically elevated SI.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Jha

Fava

Minhajuddin

et al. 2020

Depression and Anxiety

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“…In a school-based sample of rural Chinese adolescents, participants with high levels of total aggression had 4.31 times higher risk of suicidal ideation compared to subjects with low level of total aggression [ 14 ]. In a study of military service members in the USA, those reporting aggression were significantly more likely to report suicide ideation than those reporting no aggression [ 15 ]. On the other hand, the low back pain association with suicidal ideation found in the present study agrees with results of a previous study.…”

Section: Discussionmentioning

confidence: 99%

Association Between Suicidal Behavior and Clinical Features of Premenstrual Syndrome and Menstrual History: A Cross Sectional Study

Alvarado‐Esquivel

2018

J Clin Med Res

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BackgroundThe link between suicidal behavior and premenstrual syndrome has been poorly studied. This study aimed to determine the association of suicide attempts, and suicidal ideation and signs and symptoms of premenstrual syndrome and menstrual history in women in Durango City, Mexico.MethodsUsing a cross-sectional study design, 437 women were interviewed to obtain clinical data about their premenstrual period, menstrual history and suicidal behavior. Logistic regression was used to assess the association between suicide behavior and clinical features of women. Odds ratio (OR) adjusted by age, presence of mental illness, and residence area, and 95% confidence interval (CI) were obtained.ResultsOf these women, 29 (6.6%) had a history of suicidal ideation, and 15 (3.4%) had a history of suicide attempts. Logistic regression showed that suicidal ideation was associated with the variables: presence of irregular periods (OR = 2.89; 95% CI: 1.10 - 7.55; P = 0.03), low back pain (OR = 4.57; 95% CI: 1.31 - 15.92; P = 0.01), desire to eat certain food or eat a lot (OR = 2.47; 95% CI: 1.10 - 5.57; P = 0.02), guilty feeling (OR = 2.43; 95% CI: 1.06 - 5.59; P = 0.03), and aggressiveness (OR = 3.19; 95% CI: 1.42 - 7.13; P = 0.005). Whereas logistic regression showed that a history of suicide attempts was associated with the variables: presence of irregular periods (OR = 9.57; 95% CI: 1.23 - 74.44; P = 0.03), and desire to eat certain food or eat a lot (OR = 3.08; 95% CI: 1.04 - 9.15; P =0.04).ConclusionsIn this first study on the link of suicide behavior and clinical features of premenstrual syndrome, results suggest that suicidal ideation and suicide attempts are associated to specific signs or symptoms of premenstrual syndrome. Further research to confirm the findings of this study is needed. Results might help for an optimal planning of preventive measures against suicide.

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“…In military and veteran personnel, problematic anger has been associated with mental health conditions, including posttraumatic stress disorder (PTSD [3,5];), unhealthy habits and unnecessary risk taking [6], as well as relationship dysfunction [7]. Problematic anger and aggression are also risk factors for intent to harm others [5], interpersonal violence [8] and suicide-related outcomes [9]. While there is evidence that problematic anger is a significant concern in the civilian community [10], it is particularly important to understand the extent of problematic anger in military personnel and veterans and the key factors that contribute to its development and expression.…”

Section: Introductionmentioning

confidence: 99%

Magnitude of problematic anger and its predictors in the Millennium Cohort

et al. 2020

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Background: Problematic anger is intense anger associated with elevated generalized distress and that interferes with functioning. It also confers a heightened risk for the development of mental health problems. In military personnel and veterans, previous studies examining problematic anger have been constrained by sample size, cross-sectional data, and measurement limitations. Methods: The current study used Millennium Cohort survey data (N = 90,266) from two time points (2013 and 2016 surveys) to assess the association of baseline demographics, military factors, mental health, positive perspective, and self-mastery, with subsequent problematic anger. Results: Overall, 17.3% of respondents reported problematic anger. In the fully adjusted logistic regression model, greater risk of problematic anger was predicted by certain demographic characteristics as well as childhood trauma and financial problems. Service members who were in the Army or Marines, active duty (vs. reserves/national guard), and previously deployed with high levels of combat had increased risk for problematic anger. Veterans were also more likely to report problematic anger than currently serving personnel. Mental health predictors included posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and comorbid PTSD/MDD. Higher levels of positive perspective and self-mastery were associated with decreased risk of problematic anger. Conclusion: Not only did 1 in 6 respondents report problematic anger, but risk factors were significant even after adjusting for PTSD and MDD, suggesting that problematic anger is more than an expression of these mental health problems. Results identify potential targets of early intervention and clinical treatment for addressing problematic anger in the military and veteran context.

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Predicting Suicide Ideation in the Military: The Independent Role of Aggression

Cited by 17 publications

References 49 publications

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Association Between Suicidal Behavior and Clinical Features of Premenstrual Syndrome and Menstrual History: A Cross Sectional Study

Magnitude of problematic anger and its predictors in the Millennium Cohort

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