Publication year
2011
Citation Title
Factors associated with suicidal ideation in OEF/OIF veterans.
Journal Name
Journal of Affective Disorders
Journal Volume
130
Issue Number
2-Jan
Page Numbers
231-238
DOI
10.1016/j.jad.2010.10.021
Summary
Mental health screenings of OEF/OIF Veterans were reviewed to examine factors associated with suicidal ideation. History of suicide attempts and documented mental health diagnoses (psychotic disorder, depressive disorder, or posttraumatic stress disorder [PTSD]) were associated with suicidal ideation.
Key Findings
Prior suicide attempts and being female were associated with higher rates of suicidal ideation.
Having a mental health diagnosis (psychosis, depression, or PTSD) was associated with suicidal ideation; depression was associated with the most elevated risk for suicidal ideation.
Having co-morbid depression and PTSD increased the risk of current suicidal ideation even more than having either diagnosis alone.
Social support was protective against suicidal ideation.
Implications for Program Leaders
Host welcome back events for recently returned Veterans and their families in order to strengthen social support
Offer on-going gatherings for Service members and Veterans to increase social ties among Service members
Provide families with information related to suicide, including symptoms of suicidal ideation, and resources for those struggling with thoughts of suicide
Implications for Policy Makers
Recommend routine and periodic screenings of recently returned Service members to examine for suicidal ideation and behavior
Continue to support outreach activities, prevention efforts, and interventions aimed at decreasing suicide-related behavior among Service members
Encourage training for service providers working with returning Service members regarding how to recognize the sign and symptoms of suicidal ideation and behaviors
Methods
All returning OEF/OIF Veterans registering with the Houston Veterans Affairs Medical Center were assessed for PTSD, substance use, depression, and overall functioning.
Deployment risk and resiliency factors were rated by psychologists, social workers, and psychiatrists.
The records of Veterans initially screened between May 2004 and March 2008 were identified; clinical raters reviewed the records for suicidal ideation, suicide attempts, and mental health diagnoses.
Veterans were separated into two groups: those with and without suicidal ideation.
Participants
Study participants included 1,716 Veterans (89% male).
Fifty percent of participants were White, 27% were Black, and 18% were Latino.
No information on military branch was presented.
Limitations
The standardize interview was developed for clinical purposes and not designed for research which could impact the accuracy of results.
The data were retrospective and may be biased.
These findings were specific to Houston-based OIF/OEF Veterans and may not generalize to other populations.
Avenues for Future Research
Investigate the efficacy of interventions designed to bolster social support among Service members as a protection against suicidal behavior
Utilize a validated measure of suicidal behavior to increase validity of the study
Replicate this study with Service members from other hospitals/clinics, including those in other geographic parts of the country
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
The purpose of this project was to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans. Methods: A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview. Results: Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder (PTSD). Deployment concerns related to training (protective), the deployment environment, family concerns, deployment concerns, post-deployment support (protective), and post-deployment stressors were also associated with current suicidal ideation. Logistic regression analysis revealed the major risk factors were having a prior suicide attempt, female gender, and a depressive disorder diagnosis; while more perceived current social support was a protective factor. Logistic regression analysis also revealed having comorbid PTSD and depression carried a higher odds ratio for risk than did having either PTSD or depression alone; and that the PTSD avoidance symptom-cluster was associated with more risk than either the re-experiencing or hyper-arousal symptom clusters for current suicidal ideation. As a cross-sectional retrospective medical chart review, limitations include limited generalizability and causal relationships cannot be evaluated. Further investigation of these risk factors is warranted to aid in suicide risk assessment and in the development of targeted interventions to mitigate the identified risk factors and bolster the identified protective factor.
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