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Attachment style and risk of suicide attempt among new soldiers in the U.S. Army

APA Citation:

Wang, J., Naifeh, J. A., Herberman Mash, H. B., Morganstein, J. C., Fullerton, C. S., Cozza, S. J., …Ursano, R. J. (2022). Attachment style and risk of suicide attempt among new soldiers in the U.S. Army. Psychiatry, 85(4), 387-398. https://doi.org/10.1080/00332747.2022.2062661

Abstract Created by REACH:

This study examined the link between attachment style and suicide risk among 38,507 Soldiers in Basic Combat Training. Soldiers self-reported on their attachment styles: secure (i.e., enjoying close relationships and trusting others), preoccupied (i.e., being concerned about rejection and trusting others), fearful (i.e., rejecting closeness to avoid vulnerability), and dismissing (i.e., rejecting closeness in favor of independence), as well as their lifetime history of suicidal ideation, suicide attempts, and mental disorders. Overall, Soldiers with a secure attachment style were at lower risk of suicidal ideation and attempts, whereas Soldiers with either a preoccupied or fearful attachment style were at greater risk.


Mental health

Branch of Service:


Military Affiliation:

Active Duty

Subject Affiliation:

Guard/Reserve member


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


Cross sectional study


Wang, Jing, Naifeh, James A., Herberman Mash, Holly B., Morganstein, Joshua C., Fullerton, Carol S., Cozza, Stephen J., Stein, Murray B., Ursano, Robert J.


Objective Among U.S. Army soldiers suicide attempts (SAs) are a significant public health concern, particularly early in service. We examined the association of attachment style with SA and suicide ideation (SI) among U.S. Army soldiers.Methods We analyzed survey data from new soldiers who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). The sample consists of 38,507 soldiers entering Basic Combat Training (BCT) between April 2011 and November 2012. Attachment style (secure, preoccupied, fearful, and dismissing) was assessed using items from the Relationship Questionnaire. Lifetime (pre-enlistment) SA and SI were assessed with a modified Columbia Suicide Severity Rating Scale. Logistic regression analyses examined associations of attachment style with lifetime SA, SI, and attempts among ideators, after adjusting for socio-demographic characteristics.Results The secure attachment style was associated with lower odds of SA (OR = 0.76, 95% CI = 0.63–0.92), whereas preoccupied (OR = 4.63, 95% CI = 3.83–5.61), fearful (OR = 4.08, 95% CI = 3.38–4.94), or dismissing (OR = 1.56, 95% CI = 1.24–1.96) attachment styles were associated with higher odds of SA. Similar results were found for SI. Importantly, both preoccupied (OR = 1.67, 95% CI = 1.37–2.04) and fearful (OR = 1.70, 95% CI = 1.38–2.08) attachment were associated with attempts among ideators.Conclusion These findings highlight the clinical importance of attachment style in predicting suicidal behavior and as possible targets for intervention. A critical next step is for prospective research to examine whether attachment style predicts future suicidal behavior.

Publication Type:

REACH Publication


attachment style, risk of suicide, new soldiers

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REACH Publication Type:

Research Summary

REACH Newsletter:

  July 2023

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