Study Discusses Suicide Risk Factors for OIF Veterans
BACKGROUND:
Suicide rates among OEF/OIF military personnel and Veterans are a growing public health concern, with the DoD and VA conducting several initiatives to decrease rising rates. Suicide risk is increased for OEF/OIF Veterans diagnosed with mental health disorders, including PTSD, depressive disorders, and alcohol problems. There are several other variables that increase suicide risk among Veterans, including a family history of suicide attempts, pre-deployment mental health diagnoses, and a history of prior suicide attempt. A number of studies also have found an association between combat exposure and subsequent suicidal ideation. This study examined combat and mental health as risk factors for suicidal ideation among OIF Veterans. Investigators identified 2,854 OIF soldiers who presented for routine post-deployment screening at a large Army medical facility from 11/05 to 6/06. Data from the screening was used to assess: demographics and psychiatric history (i.e., previous suicide attempts, psychiatric diagnosis); combat exposure (i.e., being injured, witnessing death, killing in combat); and symptoms of PTSD, depression, alcohol use disorder, as well as suicidal ideation. Analyses examined whether the association between killing and suicidal thinking – and killing and desire for self-harm was mediated by PTSD and/or depression.
FINDINGS:
- Overall, 2.8% of the OIF Veterans reported suicidal thinking, the desire for self-harm, or both.
- Post-deployment depression symptoms were associated with suicidal thoughts, while post-deployment PTSD symptoms were associated with current desire for self-harm.
- Post-deployment depression and PTSD symptoms mediated the association between killing in combat and suicidal thinking, while post-deployment PTSD symptoms mediated the association between killing in combat and the desire for self-harm.
IMPLICATIONS:
- These results provide preliminary evidence that suicidal thinking and the desire for self-harm are associated with different mental health predictors, and that the impact of killing on suicidal ideation may be important to consider in the evaluation and care of our newly returning Veterans.
LIMITATIONS:
- This was a retrospective study that focused on Veterans of only one branch of service.
- Outcome measures were based on self-report measures used for mental health screening, rather than diagnostic instruments; also, these measures were obtained as part of a non-anonymous, routine deployment screening, in which a variety of biases may have motivated soldiers to under- or over-report their symptoms.
AUTHOR/FUNDING INFORMATION:
This study was funded through Dr. Maguen’s HSR&D Career Development Award; she is part of HSR&D’s Program to Improve Care for Veterans with Complex Comorbid Conditions in San Francisco.
Maguen S, Luxton D, Skopp N, et al. Killing in Combat, Mental Health Symptoms, and Suicidal Ideation in Iraq War Veterans. Journal of Anxiety Disorders January 22, 2011;e-pub ahead of print.
