The association of military sexual harassment/assault with suicidal ideation, plans, attempts, and mortality among service members and veterans: A meta-analysis and research study
- Livingston, W. (2022). The association of military sexual harassment/assault with suicidal ideation, plans, attempts, and mortality among service members and veterans: A meta-analysis and research study [Ph.D., Utah State University]. https://digitalcommons.usu.edu/etd/8493
- Rates of death by suicide and sexual harassment/assault that occurs during military service (MSH/A) are higher among service members/veterans than rates of suicide and sexual violence among civilians. Suicide risk includes thoughts and attempts, and research examining the strength of the relationship between suicide risk and sexual violence across past studies that examined this association are limited to civilians. Moreover, current theories hypothesizing which factors are related to suicide risk do not adequately predict suicide among service members and veterans, and do not account for factors such as MSH/A. This two-study dissertation first calculated the magnitude of the relationship between suicide risk and MSH/A among service members/veterans across studies and tested for factors that may increase this association (gender, marital status, service member versus veteran status, and military branch). Second, a novel theory, The Three-Step Theory of Suicide, was tested to identify whether it explains suicide risk among men service members and veterans. This theory indicates that a risk factor for suicide is psychological pain, which was operationalized as exposure to MSH/A in the current study. Findings indicate MSH/A and suicidal thoughts and attempts are related. Moreover, the relationship of these factors is stronger among women, married, service members, and those in the Air Force relative to men, those who are not married, veterans, and all other branches, respectively. When testing The Three-Step Theory of Suicide, higher hopelessness and lower connectedness were associated with increased suicide ideation, whereas MSH/A and other factors were not associated with suicide ideation and attempts. A secondary analysis allowed for increased statistical power by combining military and/or premilitary sexual harassment/assault, which represented exposure to psychological pain. This analysis indicated that the combination of exposure to psychological pain and higher hopelessness were associated with suicide ideation. Service members/veterans with histories of MSH/A should be considered at higher risk of suicide, and those who identify as women, married, a service member, or in the Air Force may be at greatest risk. To reduce suicide risk in men, interventions that reduce feelings of hopelessness may be particularly helpful.
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