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Study Suggests Pre-Military Trauma Associated with Post-Recruit Training Suicide Attempts among Marines


BACKGROUND:
In 2011, a report from the U.S. Marine suicide prevention program indicated that more Marines attempted suicide that year than ever before — more than double the number that attempted suicide in 2002 (172 vs. 82). More recently, the New York Times reported that the rate of troops dying from suicide is greater than the number of troops dying in battle. This study examines pre- and post-Marine recruit training risk factors for suicide attempts among current and former Marines in the 10 years following training. It also describes characteristics of the sub-sample of current and former Marines who died by suicide during this time. Data for this study were collected at three time points: between March and August 1997, Marine recruits (n=1,847) completed a self-report survey at the start of recruit training; following training (13 weeks), participants (n=1,624) completed another self-report questionnaire; and 10 years after the start of recruit training, participants (n=680) were re-contacted via mail survey, irrespective of military status. In addition to assessing the numbers of suicide attempts and completed suicides (using National Death Index searches) among study participants, investigators also examined: recruit training stress (e.g., performance-related stress); childhood trauma (e.g., emotional and physical abuse, sexual abuse); modified life stressors (e.g., accidents, disasters, combat, physical assault); sexual experiences (e.g., harassment, assault); as well as symptoms of PTSD, depression, anxiety, and alcohol use.

FINDINGS:

  • Stressful and traumatic life events (e.g., childhood physical, sexual and emotional abuse, sexual harassment during recruit training) and suicide attempts made before recruit training had strong associations with suicide attempts after recruit training.
  • Those who experienced at least one life stressor prior to joining the Marines had 3.9 times the odds of suicide attempt compared to those who did not report any life stressors prior to joining.
  • Half of the Marines in this study who died by suicide (per death certificate) in the 10 years following recruit training (n=3) reported at least one significant life stressor prior to joining the Marines.
  • Marines who experienced military sexual harassment during recruit training had 2.8 times the odds of suicide attempt in the 10 years following training compared with those who did not report this experience.
  • Marines with PTSD symptoms consistent with a diagnosis had about double the odds of suicide attempts compared with those without PTSD symptoms.

LIMITATIONS:

  • Data were obtained via self-report and death record searches, and do not include diagnoses made by clinicians. Associations with risk factors were based on only six completed suicides and 28 attempts.
  • As a result of the recruitment site, the cohort was over 50% female and may not be completely representative of active duty Marines, of whom fewer than 10% are female.
  • Suicidal behavior is notoriously under-reported, and it is likely that some participants did not report suicide attempts in the current study.

AUTHOR/FUNDING INFORMATION:
This study was partly funded by HSR&D (IIR 04-420). All authors, except Dr. Miller, were part of the National Center for PTSD, VA Boston Healthcare System at the time of this work.


PubMed Logo Gradus J, Shipherd J, Suvak M, Giasson H, and Miller M. Suicide Attempts and Suicide among Marines: A Decade of Follow-up. Suicide and Life-Threatening Behavior October 19, 2012;e-pub ahead of print.

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HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.