Predictors of Suicidal Ideation Across Deployment: A Prospective Study

Cigrang, Jeffrey A.; Balderrama-Durbin, Christina; Snyder, Douglas K.; Talcott, G. Wayne; Tatum, JoLyn; Baker, Monty T.; Cassidy, Daniel; Sonnek, Scott; Heyman, Richard E.

doi:10.1002/jclp.22192

Cited by 10 publications

(5 citation statements)

References 45 publications

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“…To the best of our knowledge, this is the first prospective study examining the contribution of marital adjustment to SI among partners of war veterans and ex-POWs. Our results are consistent with most previous studies indicating that low marital quality and high marital distress (Robustelli et al, 2015) are related to high levels of SI, rather than those reporting no such association among veterans (e.g., Cigrang et al, 2015). It has been suggested that ex-POWS’ wives might have been compelled to take on the role of their husbands (i.e., child support, main provider) and thereby pushed aside or neglected their own needs (Zerach & Solomon, 2016).…”

Section: Discussionsupporting

confidence: 93%

“…However, the contribution of marital adjustment to suicidality is underresearched, with inconsistent results. Although most studies have shown that low marital quality and high marital distress (Robustelli, Trytko, Li, & Whisman, 2015) are related to high levels of SI, some studies among veterans have revealed no such association (e.g., Cigrang et al, 2015). Evidently, marital adjustment among spouses changes over the duration of the marriage.…”

mentioning

confidence: 99%

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The role of marital adjustment in suicidal ideation among former prisoners of war and their wives: A longitudinal dyadic study.

Zerach¹,

Levi‐Belz²,

Michelson³

et al. 2019

Psychology of Violence

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Objective: Posttraumatic stress symptoms (PTSS) are implicated in high suicidality and low levels of marital quality among traumatized veterans and their wives. However, the role of marital quality in suicidal ideation (SI) of war veterans and their spouses remains relatively unexplored. The current study examined the longitudinal associations between marital adjustment and SI among ex-prisoners of war (ex-POWs) and their wives. Method: Through opportunistic data collection, a sample of 233 Israeli couples (142 ex-POW couples and a comparison group of 91 veteran couples) were assessed at 2 time points: Time 1 (T1; 2003) and Time 2 (T2; 2008), 30 and 35 years after the 1973 Yom Kippur War. Participants completed self-report measures of PTSS, depression, dyadic adjustment, and SI. Results: Among both husbands and wives, higher levels of marital adjustment were related to lower levels of SI. Surprisingly, an actor-partner interdependence modeling analysis revealed that for both ex-POW and control groups, husband's marital adjustment moderated the contribution of his PTSS to his SI, while controlling for prior SI in T1. Moreover, only for control couples did the husbands' marital adjustment moderate the wives' PTSS contribution to the husbands' SI. Conclusions: Ex-POWs' and their wives' marital adjustment are longitudinally related to their SI. Improving couples' marital adjustment may buffer the detrimental implications that both partners' PTSS bears for veterans' SI.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

The role of marital adjustment in suicidal ideation among former prisoners of war and their wives: A longitudinal dyadic study.

Zerach¹,

Levi‐Belz²,

Michelson³

et al. 2019

Psychology of Violence

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“…Our findings also indicate that the impact of nonsexual harassment is substantially greater when experienced concurrently with combat exposure, resulting in a higher risk for negative mental health outcomes—almost 4 times greater for PTSD symptoms and problem drinking and up to 6 times greater for depression. These numbers are compelling given the strong empirical support for existing associations between problem drinking, depression, and suicide (Cigrang et al, 2015). When considering studies indicating that suicide mortality ratios among female veterans are higher than in male veterans (1.87 vs. 1.66, respectively; McCarthy et al, 2009), higher in female veterans than female civilians (Kaplan et al, 2012), and are increasing (American Foundation for Suicide Prevention, 2016), it is imperative that nonsexual harassment be examined more closely.…”

Section: Discussionmentioning

confidence: 99%

Combat exposure and mental health outcomes: The incremental impact of nonsexual harassment on women veterans.

Stanton¹,

Creech²,

Snyder³

et al. 2022

Psychological Trauma: Theory, Research, Practice, and

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Objective: This study investigated the impact of combat exposure and nonsexual harassment (verbal and nonverbal behaviors that convey negative and harmful attitudes on the basis of minority status) on mental health functioning in female veterans who were deployed Afghanistan and Iraq. Method: Participants (N = 134) completed measures of combat exposure, nonsexual harassment, PTSD, depression, and alcohol use. Results: Binary logistic regression models indicated nonsexual harassment was significantly associated with later symptoms of PTSD and depression, but not problem drinking; combat exposure was significantly associated with symptoms of PTSD and alcohol use, but not depression. Relative risk ratios indicated that for women with even minimal exposure to combat, experiencing nonsexual harassment significantly increased the likelihood of manifesting PTSD, depression, and problem drinking symptoms that met at least minimum threshold for clinical diagnoses. The impact of nonsexual harassment resulted in an almost 4 times greater risk for PTSD symptoms and problem drinking and up to 6 times greater risk for depression when experienced concurrently with combat exposure. Conclusions: Although nonsexual harassment does not pose the same physical threat as assault from enemy fire, findings suggest that it does pose an invisible threat to mental health and contribute to understanding and contextualizing the impact of nonsexual harassment on female veterans' psychological well-being. Clinical Impact StatementThis study identifies nonsexual harassment is a potential target for prevention and early intervention to reduce the likelihood of experiencing mental health problems following deployment. This study also illuminates the compound risk of experiencing combat exposure and harassment, alerting primary care providers and clinicians alike to the potential threat of these comorbid experiences in female veterans.

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“…Service members who demonstrate alcohol misuse prior to deployment are at greater risk of experiencing family-reintegration difficulties; hence, screening and early intervention regarding alcohol misuse may promote healthier family reintegration for partnered service members. In separate analyses using this same sample, predeployment alcohol misuse has also been implicated in other serious postdeployment mental health disturbances, including suicide risk (Cigrang, Balderrama-Durbin et al, 2014). Moreover, concurrent posttraumatic stress symptoms, alcohol misuse and, to a smaller degree, depressive symptoms, were all related to difficulties with family reintegration, with alcohol misuse demonstrating an incremental impact on family reintegration exceeding the effects of depressive and posttraumatic stress symptoms.…”

Section: Discussionmentioning

confidence: 99%

Coming home: A prospective study of family reintegration following deployment to a war zone.

Balderrama-Durbin¹,

Cigrang²,

Osborne³

et al. 2015

Psychological Services

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The consequences of deployment extend beyond the service member to impact the entire family. The current investigation evaluated the unique challenges of family reintegration for partnered service members using a prospective design. In total, 76 partnered service members who deployed on a year-long, high-risk mission to Iraq were assessed across the entirety of the deployment cycle, i.e., pre-, during, and postdeployment. At follow-up, nearly 1 in 5 partnered service members reported moderate to severe difficulties in multiple aspects of family reintegration. Prospective interpersonal indicators such as preparations for deployment as a couple, shared commitment to the military, and predeployment relationship distress predicted postdeployment family reintegration difficulties. Significant interpersonal risk factors were medium to large in their effect sizes. Airmen's willingness to disclose deployment- and combat-related experiences, and postdeployment relationship distress served as concurrent interpersonal correlates of difficulties with family reintegration. Intrapersonal factors, including posttraumatic stress symptoms and alcohol misuse were concurrently related to challenges with family reintegration; predeployment alcohol misuse also predicted subsequent family reintegration difficulties. Additional analyses indicated that pre- and postdeployment relationship distress, combat disclosure, and postdeployment alcohol misuse each contributed to family reintegration when controlling for other intra- and interpersonal risk factors. Implications for prevention and early intervention strategies as well as future research are discussed.

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Predictors of Suicidal Ideation Across Deployment: A Prospective Study

Abstract: Predeployment problem drinking may serve as a modifiable target for early intervention of suicidal ideation. Findings illuminate the compound risk of comorbid depressive symptoms and moderate problem drinking in predicting suicidal ideation.

Cited by 10 publications

References 45 publications

The role of marital adjustment in suicidal ideation among former prisoners of war and their wives: A longitudinal dyadic study.

The role of marital adjustment in suicidal ideation among former prisoners of war and their wives: A longitudinal dyadic study.

Combat exposure and mental health outcomes: The incremental impact of nonsexual harassment on women veterans.

Coming home: A prospective study of family reintegration following deployment to a war zone.

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