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Psychosocial functioning deficits impact and are impacted by suicidal ideation in post-9/11 women veterans

APA Citation:

Lawrence, K. A., Vogt, D., Dugan, A. J., Nigam, S., Slade, E., & Smith, B. N. (2022). Psychosocial functioning deficits impacts and are impacted by suicidal ideation in post-9/11 women veterans. Journal of Affective Disorders Reports, 9, Article 100361. https://doi.org/10.1016/j.jadr.2022.100361

Abstract Created by REACH:

Using a sample of 183 women Veterans who had separated from the military, this study examined the bidirectional associations between changes in psychosocial functioning (i.e., work, intimate relationship, and parental functioning) and changes in suicidal ideation (i.e., thoughts about killing oneself) across 2 time points (i.e., 5 and 7 years after their separation from the military). Overall, there was evidence of bidirectional associations such that changes in elements of psychosocial functioning explained changes in suicidal ideation, and, at the same time, changes in suicidal ideation were implicated in altered psychosocial functioning.


Mental health

Branch of Service:

Marine Corps
Air Force
Multiple branches

Military Affiliation:


Subject Affiliation:



Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)


Secondary Analysis
Cross sectional study
Longitudinal Study
Quantitative Study


Lawrence, Karen A., Vogt, Dawne, Dugan, Adam J., Nigam, Shawn, Slade, Emily, Smith, Brian N.


Women veterans in the United States (U.S.) are known to be at greater risk for suicide than non-veteran women (Hoffmire et al., 2021). Suicidal ideation (SI) is an established early predictor of suicide (Klonsky et al., 2016). Yet, to our knowledge, associations between psychosocial functioning and SI, over time, have not been examined in women veterans. Broadly, psychosocial functioning has been defined with respect to a micro-level context consisting of daily functioning such as in work and family roles as well as a macro-level context comprising the pursuit of life goals and values (Ro and Clark, 2009). The present study is focused on the micro-level context and uses a measure designed to assess micro-level psychosocial functioning in the context of trauma-related psychopathology (Bovin et al., 2018). Aspects of psychosocial functioning have been identified as gender-specific risk factors associated with suicide attempt and death. For example, among post-9/11 service members, female gender was associated with a cluster of risk factors for suicide attempt and death that included presence of a psychiatric diagnosis and prior self-directed violence with an additional risk factor for suicide death being a recent failed intimate relationship (Skopp et al., 2016). In contrast, male gender was associated with a cluster of suicide attempt and death risk factors that were of a more externalizing and antisocial nature (Skopp et al., 2016). Yet, whether psychosocial functioning such as intimate relationship functioning also affects SI in women veterans is unknown. Given that SI is upstream of suicidal behavior in the ideation-to-action framework (Klonsky et al., 2016), understanding associations between psychosocial functioning and SI has implications for prevention of suicidal behavior. Although intimate relationship functioning was identified as a suicide risk factor among women service members, this and other psychosocial functioning domains may warrant attention after military service completion. Reintegrating post-9/11 women veterans are known to be more likely to report negative relationship and family experiences including divorce, relative to veteran men and non-veteran women (Adler-Baeder et al., 2006; Beder et al., 2011; U.S. Department of Veterans Affairs, 2014). Additionally, women veterans are more likely than veteran men to report being unemployed (Vogt et al., 2017). Therefore, psychosocial functioning, such as work and family functioning, are important factors to consider with respect to women veterans’ mental health and within the context of their readjustment to civilian life after military service completion. The present study extends prior research which showed that PTSD and depression symptom severity are bi-directionally related to psychosocial functioning in women veterans (Lawrence et al., 2021). Our objective in this study was to test the hypothesis that a bi-directional association would exist between SI and work, relationship, and parental domains of psychosocial functioning in women veterans, such that worsening functioning would exacerbate subsequent SI, and changes in SI would also impact subsequent psychosocial functioning.

Publisher/Sponsoring Organization:


Publication Type:

REACH Publication

Author Affiliation:

College of Social Work, University of Kentucky, KAL
Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, DV
Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, BNS
Department of Psychiatry, Boston University School of Medicine, DV
Department of Psychiatry, Boston University School of Medicine, BNS
Department of Biostatistics, College of Public Health, University of Kentucky, AJD
Department of Biostatistics, College of Public Health, University of Kentucky, SN
Department of Biostatistics, College of Public Health, University of Kentucky, ES


suicidal ideation, women veterans, psychosocial functioning

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REACH Publication Type:

Research Summary

REACH Newsletter:

  November 2022

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