https://aub.ie/MilitaryREACH-Dempsey2024

Dempsey, C. L., Ao, J., Georg, M. W., Aliaga, P. A., Brent, D. A., Benedek, D. M., …Ursano, R. J. (2024). Suicide without warning: Results from the Army Study to Assess Risk and Resilience in Servicemembers (STARRS). Journal of Mood & Anxiety Disorders, 7, Article 100064. https://doi.org/10.1016/j.xjmad.2024.100064

Using a psychological autopsy method, this study examined risk factors for death by suicide for Soldiers who, according to their supervisor, did not have a mental health diagnosis or suicidal ideation. Data were drawn from medical records and the Soldiers Health Outcomes Study component of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) project. Supervisors and next of kin of Soldiers who died by suicide between 2011 and 2013 (n = 40) reported on the Soldiers’ mental health (e.g., anxiety, depressive symptoms), recent stress (e.g., spouse leaving), social network, personality traits, stress management behaviors, and help-seeking tendencies. These data were compared to supervisor and next-of-kin reports on living Soldiers who had similar demographic and military characteristics (n = 99). Overall, Soldiers who died by suicide were more likely to have a mental health diagnosis in their medical record, have experienced a recent stressful event, and to have had a smaller social network than their living counterparts.

https://doi.org/10.1016/j.xjmad.2024.100064

Mental health

Army

Active Duty

Active duty service member
Military Leadership
Parent of a service member or veteran

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

Cross-Sectional Study
Secondary Analysis

Dempsey, Catherine L., Ao, Jingning, Georg, Matthew W., Aliaga, Pablo A., Brent, David A., Benedek, David M., Zuromski, Kelly L., Nock, Matthew K., Heeringa, Steven G., Kessler, Ronald C., Stein, Murray B., Ursano, Robert J.

Objectives The rate of suicide increased in members of the United States Army since 2011 after the Iraq and Afghanistan wars and continues to be a major concern. In order to reverse this disturbing trend, it is vital to understand the risk and protective factors for suicide death in servicemembers. Methods Data were obtained from a case-control psychological autopsy study, which compared U.S. Army suicide decedent cases (n = 135) to a probability sample of living controls (n = 255) who are also service members weighted to be representative of the Army. Interviews were conducted with next-of-kin (NOK) and supervisor (SUP) informants. Multivariable logistic regressions models were constructed using predictors significant after controlling for multiple comparisons. Results The most parsimonious multivariable model controlling for deployment status, as reported by SUP were: spouse or partner leaving him or her in the past month (OR= 28.5 [95% CI =1.8, 442.7] χ²= 5.72, p =.0168); a smaller social network (OR =.2 [95% CI =.1, 0.9] χ²= 3.97, p =.0462), being less likely to seek help from a mental health counselor (OR =.3 [95% CI =.1, 0.8] χ²= 5.35, p =.0207) and less likely to be cautious (OR=.2 [95% CI =.01,.8] χ²=5.42, p =.0199). The AUC =.88 [95%CI = 0.82, 0.94) for this regression model suggests strong prediction. Conclusions Our findings suggest that recent relationship problems, especially in soldiers who are less likely to seek out support from others, may be warning signs for detection and prevention of imminent risk of suicide and according to supervisor informant surveys, had neither evidence of a mental health disorder, nor disclosed suicidal ideation or self-harm. Implications for suicide prevention are discussed.

Article
REACH Publication

suicide, STARRS, resilience

https://www.jmoodanxdisorders.org/article/S2950-0044(24)00018-X/fulltext

Research Summary

  June 2024