Publication year
2013
Citation Title
Guilt is more strongly associated with suicidal ideation among military personnel with direct combat exposure.
Journal Name
Journal of Affective Disorders
Journal Volume
148
Issue Number
1
Page Numbers
37-41
DOI
10.1016/j.jad.2012.11.044
Summary
Active Duty Air Force personnel who were seeking outpatient mental health treatment participated in a study examining the interactive effect of direct combat exposure and guilt on suicidal ideation. There was a stronger relationship between guilt and suicidal ideation for those who endorsed direct combat exposure compared to those who did not.
Key Findings
Guilt was positively associated with suicidal ideation; more guilt corresponded to higher levels of suicidal ideation.
This association was especially pronounced for Airmen who had direct combat exposure.
Depression, posttraumatic stress disorder (PTSD) symptoms, and perceived burdensomeness did not show a differential relationship with suicidal ideation according to direct combat exposure.
Hopelessness showed a stronger, but non-significant, relationship with suicidal ideation among Veterans who have been involved in direct combat compared to those without combat exposure.
Implications for Program Leaders
Offer classes for family members on how to be supportive to Service members facing mental health concerns after deployment
Conduct installation-wide awareness campaigns regarding depression and suicidal ideation, encouraging Service members and families to be aware of these mental health concerns and to seek professional help when indicated
Continue to provide reintegration programs to all Service members returning from deployment
Implications for Policy Makers
Recommend incorporating specific screening of guilt among Service members after deployment
Support efforts aimed at reducing stigma regarding help seeking for mental health issues among Service members
Continue to support services that work with Service members coping with mental health issues, including crisis hotlines, peer support programs, and mental health services
Methods
Active Duty Air Force personnel receiving outpatient mental health treatment at two military clinics in the Southern and Western U.S.
Participants were recruited via clinic staff.
Participants completed an anonymous packet of questionnaires in the clinic waiting room that included measures of suicidal ideation, self-injurious behavior and thoughts, hopelessness and pessimism, depression, PTSD, perceived burden on others, and guilt.
Participants
Ninety-seven Active Duty Air Force personnel participated.
The majority of participants were male (59%), White (68%), and had an average age of 34.13 years (SD = 8.69 years).
Military rank included: 42% non-commissioned officer (E5-E6), 24% junior enlisted (24%), and 20% officers (O1-O6).
Limitations
The sample size was small which may have limited the ability to detect some of the relationships.
The sample was all Active Duty Air Force personnel who were seeking mental health treatment; therefore, findings may not generalize to other branches or to those Service members not seeking mental health treatment.
This study did not assess for exposure to different kinds of combat; these exposures could be differentially related to guilt and suicide risk.
Avenues for Future Research
Collect data from clinical and non-clinical settings to increase generalizability
Use structured clinical interviews (rather than solely self-report measures) to strengthen these conclusions
Replicate the study with Service members from other military branches
Focus
Air Force
Target Population
Population Focus
Military Branch
Military Component
Abstract
Background: Suicide rates in the U.S. military have been rising rapidly in the past decade. Research suggests guilt is a significant predictor of suicidal ideation among military personnel, and may be especially pronounced among those who have been exposure to combat-related traumas. The current study explored the interactive effect of direct combat exposure and guilt on suicidal ideation in a clinical sample of military personnel. Methods: Ninety-seven active duty U.S. Air Force personnel receiving outpatient mental health treatment at two military clinics completed self-report symptom measures of guilt, depression, hopelessness, perceived burdensomeness, posttraumatic stress disorder, and suicidal ideation. Results: Generalized multiple regression analyses indicated a significant interaction of guilt and direct combat exposure (B=.124, SE=.053, p=.020), suggesting a stronger relationship of guilt with suicidal ideation among participants who had direct combat exposure as compared to those who had not. The interactions of direct combat exposure with depression (B=.004, SE=.040, p=.926), PTSD symptoms (B=.016, SE=.018, p=.382), perceived burdensomeness (B=.159, SE=.152, p=.300) and hopelessness (B=.069, SE=.036, p=.057) were nonsignificant. Conclusions: Although guilt is associated with more severe suicidal ideation in general among military personnel, it is especially pronounced among those who have had direct combat exposure.
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