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Love is not all you need: Understanding the association between relationship status and relationship dysfunction with self-directed violence in veterans

APA Citation:

Weber, D. M., Halverson, T. F., Daruwala, S. E., Pugh, M. J., Calhoun, P. S., Beckham, J. C., & Kimbrel, N. A. (2023). Love is not all you need: Understanding the association between relationship status and relationship dysfunction with self-directed violence in veterans. Archives of Suicide Research. Advance online publication. https://doi.org/10.1080/13811118.2023.2237097

Abstract Created by REACH:

This study examined whether relationship status and relationship dysfunction were related to Veterans’ self-directed violence (i.e., self-injury, suicidality). 1,049 Veterans selfreported their relationship status (i.e., living together or divorced/separated), relationship dysfunction over the past month, history of self-directed violence (i.e., prior non-suicidal self-injury or suicide attempt), future risk for self-directed violence (i.e., suicidal ideation and likelihood of a future suicide attempt), mental health diagnoses (e.g., depression), and demographics (e.g., age, race). Veterans were compared based on multiple combinations of relationship status and dysfunction. Overall, highly dysfunctional relationships were related to both a history of and future risk for self-directed violence. Being divorced or separated was related to future risk for self-directed violence.



Branch of Service:

Multiple branches

Military Affiliation:


Subject Affiliation:



Adulthood (18 yrs & older)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)


Quantitative Study


Weber, Danielle M., Halverson, Tate F., Daruwala, Samantha E., Pugh, Mary Jo, Calhoun, Patrick S., Beckham, Jean C., Kimbrel, Nathan A.


Introduction Research indicates that being married is associated with reduced risk of suicide and self-directed violence (SDV) relative to being divorced. Simultaneously, difficulties within relationships predict poorer health outcomes. However, research on relationship status rarely examines relationship functioning, obfuscating the joint contribution of these variables for SDV risk.Method Veterans (N = 1,049) completed a survey that included assessment of relationship status, relationship functioning, and SDV history. Logistic regression models tested how (a) relationship status, (b) relationship dysfunction, and (c) being divorced compared to being in a low- or high-dysfunction relationship were associated with SDV, controlling for several intrapersonal risk factors.Results Veterans in a relationship did not differ in SDV history compared to divorced/separated veterans. However, more dysfunction within relationships was associated with greater odds of a history of SDV and suicidal cognitions. Finally, SDV histories were more likely among veterans endorsing high-dysfunction relationships compared with (a) low-dysfunction relationships and (b) divorced veterans.Conclusion It may be insufficient to only consider relationship status when evaluating interpersonal risk factors for SDV. A single item assessing relationship dysfunction was associated with enacted SDV and suicidal cognitions over and above intrapersonal risk factors. Integrating such single-item measures into clinical practice could improve identification and subsequent tailored intervention for veterans at greater risk for SDV.

Publisher/Sponsoring Organization:

Taylor & Francis

Publication Type:

REACH Publication


self-directed violence, relationship functioning, dysfunction

View Research Summary:

REACH Publication Type:

Research Summary


This research was supported by VA Grant No. 1I01HX001682 awarded to Drs. Kimbrel and Pugh. Dr. Halverson was supported by a VA Office of Academic Affiliations Advanced Fellowship in Mental Illness Research and Treatment. Dr. Beckham was funded by a Senior Research Career Scientist award from VA Clinical Sciences Research and Development (No. IK6BX00377). Dr. Pugh was funded by a Research Career Scientist Award from VA Health Services Research and Development (No. IK6HX002608).

REACH Newsletter:

  January 2024

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