Suicide Incidence and Risk Factors in an Active Duty US Military Population

ArticleinAmerican Journal of Public Health 102 Suppl 1(S1):S138-46 · March 2012with28 Reads
DOI: 10.2105/AJPH.2011.300484 · Source: PubMed
Abstract
The goal of this study was to investigate and identify risk factors for suicide among all active duty members of the US military during 2005 or 2007. The study used a cross-sectional design and included the entire active duty military population. Study sample sizes were 2,064,183 for 2005 and 1,981,810 for 2007. Logistic regression models were used. Suicide rates for all services increased during this period. Mental health diagnoses, mental health visits, selective serotonin reuptake inhibitors (SSRIs), sleep prescriptions, reduction in rank, enlisted rank, and separation or divorce were associated with suicides. Deployments to Operation Enduring Freedom or Operation Iraqi Freedom were also associated with elevated odds ratios for all services in the 2007 population and for the Army in 2005. Additional research needs to address the increasing rates of suicide in active duty personnel. This should include careful evaluation of suicide prevention programs and the possible increase in risk associated with SSRIs and other mental health drugs, as well as the possible impact of shorter deployments, age, mental health diagnoses, and relationship problems.
    • "Thirty-two percent of soldiers (weighted N = 108,076) were classified as heavy drinkers. Heavy drinkers were more likely to be younger (17–25 years; χ 2 [3] = 72.38, p < 0.001), unmarried ( χ 2 [1] = 79.90, p < 0.001), enlisted ( χ 2 [1] = 25.28, p < 0.01), and to have a lower education level (high school or less; χ 2 [2] = 72.50, "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: High levels of alcohol use and alcohol-related problems are associated with suicidal behaviors (i.e., seriously considering and/or attempting suicide) in military and civilian populations. Examination of reasons for drinking alcohol may identify subgroups of soldiers who may either be at risk for suicidal behaviors or resilient to suicidality. Method: We examined the associations among reasons for drinking, level of alcohol use, and past year suicidality in 3,813 U.S. Army soldiers using the Department of Defense Survey of Health-Related Behaviors among Active Duty Military Personnel. Results: Six percent of soldiers reported suicidal thoughts and behaviors within the past year. Those who reported the highest level of alcohol use were more likely to have seriously considered and/or attempted suicide. Drinking to avoid rejection/"fit in" was associated with suicidality, even after adjusting for level of alcohol consumption, post-traumatic stress disorder, and depression. Although unadjusted analyses revealed a relation of pleasure-seeking drinking motives to suicidality, this association did not remain significant after controlling for covariates. Conclusions: Drinking to avoid rejection/"fit in" is associated with suicidality above overall alcohol consumption. Screening for this reason for drinking may be useful for suicide prediction and prevention.
    Article · Aug 2016
    • "Military and Veteran suicide prevention strategies may need to be culturally appropriate to ensure they reach those at risk. Major depression and/or psychological distress were risk factors for suicidal ideation in both groups, which also has been found in other military, Veteran, and civilian studies (Ilgen et al., 2010a; Logan et al., 2011b; Hyman et al., 2012 Hyman et al., , 2012 Ireland et al., 2012; Nock et al., 2014). However, our finding that perception of unmet mental health care needs was a much stronger risk factor for suicidal ideation among Veterans versus civilians was novel. "
    [Show abstract] [Hide abstract] ABSTRACT: Suicidal Ideation among Afghanistan/Iraq War Veterans remains a health concern. As young Veterans adjust to civilian life, new risk factors might emerge and manifest differently in this group versus those in the general population. We explored these differences. With 2013 National Survey on Drug Use and Health data, we examined differences in risk of past-year suicidal ideation between Veterans of the Afghanistan/Iraq War periods aged 18-34 years (N=328) and age-comparable civilians (N=23,222). We compared groups based on individual and socio-environmental risk factors as well as perceptions of unmet mental healthcare needs. We report adjusted rate ratios (aRRs); interaction terms tested for between-group differences. PY suicidal ideation rates for Veterans and civilians did not differ (52 versus 59 per 1,000, p=0.60) and both groups shared many risk factors. However, drug problems and perceived unmet mental health care needs were vastly stronger risk factors among Veterans versus civilians (interaction terms indicated that the aRRs were 3.8-8.0 times higher for Veterans versus civilians). Other differences were discovered as well. Past-year suicidal ideation rates did not differ by Veteran status among young adults. However, different risk factors per group were detected, which can inform Veteran suicide prevention efforts.
    Full-text · Article · Aug 2016
    • "The threat of, or actual, separation was the most frequent reason given for a suicide attempt among both genders (Lorensini and Bates, 2002) with Fieldsend and Lowenstein (1981) finding that separation, as a reason for suicide, was more frequent in men. Separation or divorce also showed consistent association with suicide across active duty personnel (Hyman et al., 2012), with younger age samples also attributing the attempted suicide to disappointments such as " being abandoned by a boyfriend " (Krajnc et al., 1998). Furthermore, Weyrauch et al. (2001) reported that for all of their participants, a background of interpersonal loss and disruption occurred in the year preceding the suicide attempt. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: A systematic review was conducted to identify the impact of intimate partner relationships on suicidality. The aim of the review was to identify factors within intimate partner relationships that influence suicidal ideation, attempts and completion. Method: Fifty-one articles were identified through Scopus, PubMed and PsycINFO databases. Due to the high heterogeneity of the included studies, a narrative data synthesis was conducted. Results: The research drew attention to specific contingents of the population, for example examining suicide risk in individuals under the age of 35 or lesbian, gay, bisexual and transgender (LGBT) individuals who are experiencing relationship discord, and in males who have recently separated. Limitations: Interpretation of these findings is constrained by methodological limitations prevalent in much of the literature. Limitations of the existing literature and corresponding directions for future research are discussed. Conclusions: Relationship separation and poor quality relationships are likely to be important risk factors for suicidal thoughts and behaviours and are frequent triggers for a suicide attempt. This review highlights intimate partner relationships as a significant component in a suicide risk assessment, regardless of the clinical setting. Consequently, clinicians should be aware that individuals reporting relationship problems are likely to be at increased risk of suicidal thoughts and behaviours.
    Full-text · Article · Nov 2015
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