The War Within: Suicide Prevention in the U.S. Military

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confidence: 99%

Heterogeneity in Short‐Term Suicidal Ideation Trajectories: Predictors of and Projections to Suicidal Behavior

Grös

Lancaster

Saulnier

et al. 2018

“…Despite historical trends for lower suicide rates among U.S. military personnel relative to the U.S. general population, since 2004 the military rate has steadily risen, such that suicide is now the second‐leading cause of death among military personnel (Ramchand, Acosta, Burns, Jaycox, & Pernin, ). Among military veterans, the relative risk for suicide is approximately 1.5 times higher than for the U.S. general population rate (adjusted for age and gender), although for young veterans between 17 and 24 years of age the relative risk of suicide is almost four times higher than the general population (Gibbons, Brown, & Hur, ).…”

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confidence: 99%

“…Among military veterans, the relative risk for suicide is approximately 1.5 times higher than for the U.S. general population rate (adjusted for age and gender), although for young veterans between 17 and 24 years of age the relative risk of suicide is almost four times higher than the general population (Gibbons, Brown, & Hur, ). Data further suggest that suicide attempts have increased, although data regarding suicide attempts may be less reliable than statistics regarding suicide deaths due to inconsistencies in tracking and reporting (Ramchand et al., ). Over the past decade, research has confirmed that many empirically supported suicide risk factors also apply to military and veteran populations, such as psychiatric disorders (American Psychiatric Association, ; LeardMann et al., ; Nock et al., ) and relationship stressors (American Psychiatric Association, ; Bryan, Clemans, Leeson, & Rudd, ; Bryan & Rudd, ).…”

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confidence: 99%

“…The rise in suicides and suicide attempts among service members and veterans during a time of sustained combat operations in Iraq and Afghanistan has led to speculation about the possible influence of deployments and combat exposure in particular (Hoge & Castro, ; Ramchand et al., ). Unfortunately, studies considering the possible link between deployment‐related variables and suicide‐related outcomes have yielded mixed results to date, which has contributed to considerable scientific and public debate (Bryan & Clemans, ; Hoge, LeardMann, & Boyko, ; Larson, Ritter, & Adams, ; Nevin & Ritchie, ).…”

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confidence: 99%

See 1 more Smart Citation

Combat Exposure and Risk for Suicidal Thoughts and Behaviors Among Military Personnel and Veterans: A Systematic Review and Meta‐Analysis

Bryan

Griffith²,

Pace

et al. 2015

151

122

Due to seemingly mixed empirical results, questions persist about the possible role of deployments and combat exposure. We conducted a narrative review and meta-analysis of 22 published studies to integrate findings regarding the relationship of deployment-related predictors (i.e., deployment, deployment to a combat zone, combat experience, and exposure to specific combat events) with suicide-related outcomes (i.e., suicide ideation, attempt, and death). Across all predictors and outcomes, the combined effect was small and positive, r = .08 [0.04, 0.13], and marked by significant heterogeneity, I = 99.9%, Q(21)=4880.16, p < .0001, corresponding to a 25% increased risk for suicide-related outcomes among those who have deployed. Studies examining the relationship between exposure to killing and atrocities (k = 5) showed the largest combined effect, r = .12 [0.08, 0.17], and less heterogeneity, I = 84.4%, Q(4)=34.96, p < .0001, corresponding to a 43% increased risk for suicide-related outcomes among those exposed to killing or atrocity. Implications for theory, research, and clinical practice are discussed.

“…Despite widespread implementation of screening (Appenzeller, Warner, & Grieger, ; Warner et al., ,b) and prevention (Ramchand, Acosta, Burns, Jaycox, & Pernin, ) programs, identifying soldiers at risk of suicide ideation, attempt, or death remains a significant challenge. These efforts could be improved by leveraging the vast array of objective, administrative data the Army collects on its soldiers.…”

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confidence: 99%

Neurocognitive Function and Suicide in U.S. Army Soldiers

Naifeh

Nock

Ursano

et al. 2016

This prospective cohort study used administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) to examine associations between neurocognitive functioning and subsequent suicidal events among Regular Army enlisted soldiers during the years 2004–2009. Cases were all soldiers who completed the Army’s Automated Neuropsychological Assessment Metrics (ANAM) computerized testing battery prior to documented suicide attempt (n=607), ideation (n=955), or death (n=57). Controls were an equal-probability sample of 9,893 person-months from other soldiers. Exploratory factor analysis of five ANAM tests identified a general neurocognitive factor that excluded the mathematic processing test (MTH). When examined separately in logistic regression analyses that controlled for sociodemographics and mental health diagnosis, both the general neurocognitive factor (β= −0.197 to −0.521; p<0.01) and MTH (β= −0.024 to −0.064; p<0.05) were associated with all outcomes. When both predictors were examined simultaneously, the general neurocognitive factor continued to be associated with all outcomes (β= −0.164 to −0.417; p<0.05) and MTH continued to be associated with suicide attempt (β= −0.015; p=0.046) and ideation (β= −0.014; p=0.018). These clear and robust associations suggest that future research must continue to examine the extent to which objective neurocognitive tests may enhance understanding and prediction of suicide risk.