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Shelef L, Nir I, Tatsa-Laur L, Yavnai N, Gold N, Cohen G, Ben Yehuda A. Factors associated with self-harm behaviors during military service in the Israel Defense Forces, rates of such behaviors and their outcomes. MILITARY PSYCHOLOGY 2024; 36:158-167. [PMID: 38377251 PMCID: PMC10880502 DOI: 10.1080/08995605.2022.2151815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022]
Abstract
The military environment involves stressful situations that may trigger or aggravate suicidal behaviors, such as suicide attempts (SAs), which significantly increase the likelihood of future suicide. This cross-sectional study aims to assess risk factors for severe SAs and non-suicidal self-injury (NSSI) among Israel Defense Forces (IDF) soldiers. Data were retrieved from an IDF computerized self-harm surveillance database and were based on the criteria of the Columbia Suicide Severity Rating Scale (C-SSRS) and the Suicide Attempt Self-Injury Interview (SASII). The cohort included all 1,238 occurrences of self-harm behavior, during 2017-2021. Other investigated variables included adjustment difficulty (AD, as per IDF definition) and psychiatric diagnosis (PD) as reported by mental health officers (MHOs) during recruitment. Higher rates of adjustment difficulties were found among soldiers who had conducted NSSIs. Higher rates of previous psychiatric diagnoses were found among individuals with SAs, and their risk of dying by suicide during military service was twice as high (OR = 2.356; p < .001). If the latter also served in a combat unit, the risk was almost fourfold (OR = .3.860; p < .001). The current study demonstrates a clear difference between IDF soldiers who conduct NSSI vs. those conducting SA with regard to adjustment difficulty (as per IDF definition) and PD.
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Affiliation(s)
- Leah Shelef
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- The School of Social Work, Sapir Academic College, D.N. Hof Ashkelon, Israel
| | - Ishai Nir
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lucian Tatsa-Laur
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
| | - Nirit Yavnai
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Niv Gold
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
| | - Gadi Cohen
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
| | - Ariel Ben Yehuda
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
- Shalvata Mental Health Center, Clalit Health Services, Hod Hasharon, Israel
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Yahalom J, Yarns BC, Clair K, Cloitre M, Lang AJ, Hamilton AB. Patient experiences and reported effectiveness of a multimodal short-term pilot therapy group for veteran men with military sexual trauma. J Clin Psychol 2022; 78:2410-2426. [PMID: 35332551 DOI: 10.1002/jclp.23353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/31/2022] [Accepted: 03/10/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Despite recognition of its prevalence and impact, little is known about treatment for veteran men with a history of military sexual trauma (MST). While research suggests that such veterans may suffer from gender-based distress that poses unique treatment challenges, MST-focused treatment draws upon contemporary PTSD best practices that may overlook gender. The current initial pilot study evaluated a multimodal, time-limited men's MST group therapy that integrated exposure- and mindfulness-based, psychoeducational, and psychodynamic group interventions. METHOD This study examined pre- and posttreatment data from patients who completed group treatment (n = 24). Three-fourths of patients were 60 years or older, over 80% Black, Indigenous, People of Color. Assessment data were collected using the PTSD Checklist (PCL-5), an adaptation of the Recovery Assessment Scale, and open-ended written responses. Paired-samples t tests and effect sizes (Hedge's g) were calculated. Indictive thematic analysis was used for qualitative analysis. RESULTS Qualitative and quantitative data showed improvements in shame, self-forgiveness, and belonginess. There were significant reductions from pre- to posttreatment in total PCL-5 score (g = -0.69) and all 4 symptom clusters (g = -0.51--0.71), and significant improvements in 8 out of 10 recovery items (g = 0.44-2.46). CONCLUSIONS More research is needed to assess whether veteran men with a history of MST benefit from treatment that provides multimodal, multitheoretical interventions that address gender-based symptoms in addition to PTSD. The results of this study support future research in a randomized controlled study.
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Affiliation(s)
- Jonathan Yahalom
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Brandon C Yarns
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kimberly Clair
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Marylene Cloitre
- US Department of Veterans Affairs, National Center for PTSD Dissemination and Training Division, Palo Alto, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
| | - Ariel J Lang
- US Department of Veterans Affairs, Center of Excellence for Stress and Mental Health, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA
| | - Alison B Hamilton
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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3
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Gratz KL, Kiel EJ, Mann AJD, Tull MT. The prospective relation between borderline personality disorder symptoms and suicide risk: The mediating roles of emotion regulation difficulties and perceived burdensomeness. J Affect Disord 2022; 313:186-195. [PMID: 35772631 DOI: 10.1016/j.jad.2022.06.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/27/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Despite the strong link between borderline personality disorder (BPD) symptoms and suicide risk, little is known about the mechanisms underlying this association. Theory-driven research clarifying the pathways through which BPD symptoms increase suicide risk over time is needed and may highlight relevant treatment targets for decreasing suicide risk among individuals with heightened BPD symptoms. This study examined the prospective relations among BPD symptoms, emotion regulation (ER) difficulties, perceived burdensomeness, thwarted belongingness, and suicide risk across five assessments over a 7-month period. Consistent with the interpersonal theory of suicide, we hypothesized that greater BPD symptoms would predict greater suicide risk over time via greater ER difficulties and, subsequently, greater perceived burdensomeness. METHODS A U.S. nationwide sample of 500 adults (47 % women; mean age = 40.0 ± 11.64) completed a prospective online study, including an initial assessment and four follow-up assessments over the next seven months. RESULTS Results revealed a significant indirect relation between BPD symptoms and greater suicide risk over time through greater ER difficulties and later perceived burdensomeness. Results also provided evidence for transactional relations between BPD symptoms and ER difficulties and suicide risk over time. LIMITATIONS All constructs were assessed via self-report questionnaire data. Our measure of suicide risk focuses on only suicidal ideation, plans, and impulses, and not suicide attempts or preparatory behaviors. CONCLUSIONS Results highlight both ER- and interpersonal-related factors as key mechanisms underlying suicide risk among community adults with BPD symptoms.
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Affiliation(s)
- Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA.
| | | | - Adam J D Mann
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA
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Duan M, Wang L, Liu X, Su F, An L, Liu S. Abnormal brain activity in fronto-central regions in mental disorders with suicide: An EEG Study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:1035-1038. [PMID: 34891465 DOI: 10.1109/embc46164.2021.9629876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Suicide is a global health problem, and early and accurate identification of suicide attempt individuals has very important clinical significance. Thus the exploration of neurobiological mechanisms underlying suicidal behavior is crucial for systematically preventing suicide. However, the neurophysiological biomarkers for identifying affective disorders with suicidal attempt are remain unknown. Here, we recruited 28 patients with mental disorders from Tianjin Anding Hospital, and the subjects were divided into suicide attempt group (SA=14) and non suicide attempt group (NSA=14) according to whether they had attempted suicide. We also recruited 14 healthy subjects matched with age and sex ratio as healthy control group (HC=14). By recording the electroencephalogram(EEG) data of 60 electrodes in resting state for eight minutes (four minutes with open eyes and four minutes with close eyes), the absolute power of five frequency bands( delta(0.5-4Hz), theta(4-8Hz), alpha(8-13Hz), beta (13-30Hz), gamma(30-65Hz)) were analyzed to explore the changes of brain rhythm. And then the Modulation index (MI) was calculated to quantify the intensity of phase amplitude coupling (PAC) between different frequency bands in different brain regions, so as to observe the mechanism of neuronal synchronization in different frequency bands. We found that the absolute power of SA group was significantly higher than NSA group and HC group in delta (P<0.05), beta (P<0.05) and gamma (P<0.05) bands. The PAC strength between beta and gamma was calculated and it showed that the PAC strength of SA group was significantly weaker than NSA group in fronto-central regions, indicating that decreased synchronization between neurons could bring about brain function impairment. These findings suggest that the brain electrical activity in the fronto-central regions of the SA group may be damaged, which may lead to an increased suicidal risk in mental disoders. The EEG activity in delta, beta, gamma band and PAC in fronto-central regions may be used as a potential clinical biomarker for preventing suicide.
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Nonsuicidal Self-Injury on Instagram: Examining Hashtag Trends. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2021. [DOI: 10.1007/s10447-021-09451-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cunningham KC, Aunon FM, Patel TA, Mann AJ, DeBeer BB, Meyer EC, Morissette SB, Silvia PJ, Gratz KL, Calhoun PS, Beckham JC, Kimbrel NA. Nonsuicidal Self-Injury Disorder, Borderline Personality Disorder, and Lifetime History of Suicide Attempts among Male and Female Veterans with Mental Health Disorders. J Affect Disord 2021; 287:276-281. [PMID: 33799048 PMCID: PMC9004586 DOI: 10.1016/j.jad.2021.03.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Expanding on research that has identified nonsuicidal self-injury (NSSI) as a strong predictor of suicide risk, the present study examined NSSI disorder (NSSID) and borderline personality disorder (BPD) as unique contributors to lifetime suicide attempts. To our knowledge, the present study represents the first exploration of these associations among veterans. METHODS Participants included 124 male (74%) and female (26%) veterans diagnosed with at least one mental health disorder. Posttraumatic stress disorder (93%) and major depression (86%) were the most common mental health diagnoses. Large proportions of the sample met criteria for NSSID (48%) and BPD (40%). Suicide attempts were reported by 28% of the sample. Chi-square tests determined the bivariate associations among NSSID, BPD, history of suicide attempts, and other variables. Significant diagnostic (i.e., MDD, BPD, and NSSID) and demographic (i.e., age) characteristics were included as covariates in a logistic regression model examining the associations of BPD and NSSID with suicide attempts. RESULTS BPD, Χ2=11.1, p<0.001, and NSSID, Χ2=13.9, p<0.001, were uniquely associated with suicide attempts. When all significant predictors were included in the final model, only NSSID emerged as a significant contributor to suicide attempts, OR = 4.9, p < 0.001. LIMITATIONS Causality cannot be determined from cross-sectional analyses. CONCLUSION These findings highlight NSSID as a powerful and unique correlate of suicide attempts among veterans, beyond the associations of established diagnostic risk factors. Improving our understanding of the relationship between NSSID and suicide risk has the potential to inform suicide prevention efforts and improve clinical outcomes among veterans.
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Affiliation(s)
| | | | - Tapan A. Patel
- Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Adam J. Mann
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Bryann B. DeBeer
- VA Rocky Mountain Mental Illness, Research, Education, and Clinical Center, Aurora, CO,Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado
| | - Eric C. Meyer
- Department of Rehabilitation Science and Technology, University of Pittsburgh
| | - Sandra B. Morissette
- VISN 17 Center of Excellence for Research on Returning War Veterans at Central Texas Veterans Health Care System, Waco, TX, USA,Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Paul J. Silvia
- Department of Psychology, University of North Carolina at Greensboro, NC, USA
| | - Kim L. Gratz
- Department of Psychology, University of Toledo, OH, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Corresponding author at: Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Health Care System, 3022 Croasdaile Drive, Durham, NC, 27705. (N.A. Kimbrel)
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Patel TA, Mann AJD, Blakey SM, Aunon FM, Calhoun PS, Beckham JC, Kimbrel NA. Diagnostic Correlates of Nonsuicidal Self-Injury Disorder among Veterans with Psychiatric Disorders. Psychiatry Res 2021; 296:113672. [PMID: 33383275 PMCID: PMC7855413 DOI: 10.1016/j.psychres.2020.113672] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/20/2020] [Indexed: 11/30/2022]
Abstract
With its recent inclusion in the Diagnostic and Statistical Manual, nonsuicidal self-injury disorder (NSSID) has received limited research attention, especially in samples of military veterans. The present study sought to identify diagnostic predictors of NSSID within a veteran sample. Study participants included 124 veterans with at least one psychiatric diagnosis. Chi-square tests and t-tests evaluated bivariate associations between NSSID and twenty diagnostic correlates. Logistic regression models identified psychiatric disorders that were unique correlates of NSSID among veterans. Veterans with lifetime NSSID (n = 59) met criteria for a greater number of lifetime disorders than veterans with other psychiatric disorders. Bivariate associations were noted between NSSID and borderline personality disorder, depression, obsessive-compulsive disorder, generalized anxiety disorder, and cannabis use disorder. In the logistic regression model, only borderline personality disorder (AOR = 7.67) and obsessive-compulsive disorder (AOR = 3.23) continued to be associated with NSSID. The present study represents the first examination of the association between NSSID and psychiatric disorders among veterans. The findings shed light on psychiatric disorders associated with lifetime NSSID in veterans, with special consideration toward obsessive-compulsive disorder as a risk factor for NSSID.
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Affiliation(s)
- Tapan A. Patel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,Correspondence concerning this article should be sent to: Tapan A. Patel, M.S., Durham Veterans Affairs Health Care System, Mid-Atlantic MIRECC, 3022 Croasdaile Drive, Durham, NC 27705,
| | - Adam J. D. Mann
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Shannon M. Blakey
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Frances M. Aunon
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jean C. Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Lear MK, Penzenik ME, Forster JE, Starosta A, Brenner LA, Nazem S. Characteristics of nonsuicidal self-injury among veterans. J Clin Psychol 2020; 77:286-297. [PMID: 32662073 DOI: 10.1002/jclp.23027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/23/2020] [Accepted: 06/11/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The current study aimed to (a) assess basic nonsuicidal self-injury (NSSI) characteristics using a validated clinical interview among a sample of veterans not recruited for specific diagnostic or environmental criteria and (b) examine the relation between NSSI and medical severity of prior suicide attempts (SAs) among veterans. DESIGN We conducted secondary data analyses among a combined sample of veterans (N = 165) from two parent studies conducted at a large VA Medical Center that implemented identical recruitment protocols. No psychiatric criteria were utilized for inclusion or exclusion purposes. RESULTS Approximately 16% of participants reported NSSI history and almost 21% reported SA history. NSSI history was associated with probability of prior SA but not the medical severity of prior SA. CONCLUSIONS NSSI is a prevalent concern among veterans and is associated with probability of SA. It remains unclear whether prior NSSI is associated with more medically serious SA in this population.
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Affiliation(s)
- Mary K Lear
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, Oregon, USA
| | - Molly E Penzenik
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Aurora, Colorado, USA
| | - Jeri E Forster
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Aurora, Colorado, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Amy Starosta
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Lisa A Brenner
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Aurora, Colorado, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sarra Nazem
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Aurora, Colorado, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
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Bandel SL, Anestis MD. Non-suicidal self-injury among male service members: Descriptive information and a preliminary examination of external correlates. Psychiatry Res 2020; 285:112815. [PMID: 32036153 DOI: 10.1016/j.psychres.2020.112815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 10/25/2022]
Abstract
Previous literature has identified nonsuicidal self-injury (NSSI) as a common and noteworthy behavior, particularly given its association with psychopathology and suicide. However, the research on NSSI among males has resulted in mixed findings. Additionally, few studies have examined NSSI among service members and only one study to date has examined NSSI specifically among male service members. The present study examined descriptive statistics and clinical correlates of NSSI among male service members. Results indicated that the most common method of NSSI among this group was burning oneself with a cigarette, followed closely by cutting, and burning oneself with a lighter. NSSI engagement was associated with common correlates of NSSI such as increased emotion dysregulation, depression, impulsivity, and capability for suicide as well as decreased distress tolerance and a greatly likelihood to have experienced recent suicidal ideation. NSSI was also associated with grit, narcissism, and masculinity, some of which may be particularly important and valued in military culture. Overall, results suggest important similarities and differences among NSSI in service members relative to previously studied samples. Future research should continue to examine NSSI among male service members to ensure treatments are effectively targeting and addressing aspects of the behavior.
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