Attempted suicide among adolescents in military families: The mediating role of adverse childhood experiences
Clements-Nolle, K., Lensch, T., Yang, Y., Martin, H., Peek, J., & Yang, W. (2020). Attempted suicide among adolescents in military families: The mediating role of adverse childhood experiences. Journal of Interpersonal Violence. Advance online publication. https://doi.org/10.1177/0886260519900976
Abstract Created by REACH:
Previous research has shown that adolescents in military families are at greater risk of attempted suicide. However, it is not clear whether this increased risk is related to factors unique to the military context (e.g., parental deployment) or other factors that have been linked to suicide risk in civilian populations, such as adverse childhood experiences. Adverse childhood experiences are traumatic childhood events, like experiencing physical or sexual abuse, or witnessing domestic violence, that often have a long-term impact. This study explored the links between military family membership, exposure to adverse childhood experiences, and risk of attempted suicide in a sample of 5,030 high school students (4.5% were from military families). The results suggest that exposure to adverse childhood experiences explain the increased risk for adolescents attempted suicide in military families.
Branch of Service:
Child of a service member or veteran
Adolescence (13 - 17 yrs)
Clements-Nolle, Kristen, Lensch, Taylor, Yang, Yueran, Martin, Heather, Peek, Julia, Yang, Wei
Research has shown that adolescents in military families have higher rates of suicidal behaviors compared to their nonmilitary peers. This is typically attributed to military-specific stressors, but exposure to adverse childhood experiences (ACEs) may also play a role. Our primary research objective was to determine whether cumulative exposure to ACEs mediates the relationship between military family involvement and attempted suicide. A two-stage cluster random sampling design was used to randomly sample 5,336 students from 98 high schools. Students were asked whether a parent or other adult in their home was serving on active duty in the military and attempted suicide in the past 12 months was assessed. Six measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3–6 ACEs. Weighted logistic regression and multinomial regression were used to assess differences in ACEs and attempted suicide, controlling for sex, age, race/ethnicity, rurality, and qualification for free/reduced lunch. To investigate potential mediation effects of ACEs on the relationship between military family and attempted suicide, we conducted path analyses controlling for demographics. Compared to their peers, students in military families had higher exposure to ACEs (1 ACE: adjusted odds ratio [AOR] = 1.49, 95% confidence interval [CI] = [0.88, 2.53], 2 ACEs: AOR = 2.07, 95% CI = [1.23, 3.48], and 3–6 ACEs: AOR = 2.57, 95% CI = [1.54, 4.27]) and twice the odds of attempting suicide in the past 12 months (AOR = 2.16, 95% CI = [1.30, 3.61]). Mediation analyses showed that cumulative exposure to ACEs completely mediated the relationship between military family involvement and attempted suicide. The study results highlight the need for trauma-informed approaches to mental health promotion with military families.
University of Nevada, KCN
University of Nevada, TL
University of Nevada, YY
University of Nevada, HM
Nevada Division of Public and Behavioral Health, JP
University of Nevada, WY
domestic violence, child abuse, mental health and violence, children exposed to domestic violence, family issues and mediators
REACH Publication Type:
This research was partially supported by a grant from the Centers for Disease Control and Prevention (CDC-PS13-1308) and supplemental funding from the Nevada State Division of Public and Behavioral Health.
Advanced Online Publication:
Advanced Online Copy