Military hazing and suicidal ideation among active duty military personnel: Serial mediation effects of anger and depressive symptoms

The role of alexithymia in suicide ideation among Taiwanese army military personnel: A serial mediation model investigating the effects of perceived stress and depression

Maintaining the good mental health of Taiwanese military personnel is crucial, especially in light of incidents such as the Taiwan Strait crisis. Suicide is a leading cause of death among military personnel and alexithymia is a significant risk factor for suicidal ideation. However, the mechanisms linking alexithymia and suicidal ideation in this psychologically burdened population remain poorly understood. In total, 863 voluntary army military personnel from Taiwanese reserve brigades and combined-arms brigades were enroled between May 2020 and February 2021. Structured questionnaires about alexithymia, perceived stress, depression, suicidal ideation, and background characteristics were used. Mediation analyses were conducted to examine the serial mediation roles of perceived stress and depression in the relationship between alexithymia and suicidal ideation. Significant positive correlations were observed between alexithymia, perceived stress, depression, and suicidal ideation in bivariate analyses. Serial mediation analyses revealed that alexithymia significantly predicted higher levels of perceived stress, subsequently leading to depressive symptoms, which were associated with suicidal ideation. Depression served as a significant mediator between alexithymia and suicidal ideation. The strongest mediating effect (71.4%) was observed in the pathway from alexithymia through perceived stress and depression to suicidal ideation. Limitations included the utilization of cross-sectional data and a reliance on retrospective self-report measures. Perceived stress and depression were identified as serial mediators in the association between alexithymia and suicidal ideation. Clinically, it is crucial to prioritise interventions that target emotional regulation skills and assess the presence of alexithymia to effectively reduce suicidal ideation in military personnel.

Exposure to Bullying or Hazing During Deployment and Mental Health Outcomes Among US Army Soldiers

IMPORTANCE

Workplace bullying is associated with mental disorders and suicidality in civilians, but few studies have examined associations of bullying with these outcomes among military personnel.

OBJECTIVE

To evaluate associations of being bullied or hazed during deployment with major depressive disorder (MDD), intermittent explosive disorder, posttraumatic stress disorder (PTSD), suicidal ideation, and substance use disorder (SUD).

DESIGN, SETTING, AND PARTICIPANTS

This cohort study used data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) New Soldier Study (NSS; April 1, 2011, to November 30, 2012) and wave 1 of the STARRS Longitudinal Study (STARRS-LS1; September 1, 2016, to April 30, 2018). A computerized survey administered at 3 US Army installations (NSS) and a web/telephone survey (STARRS-LS1) were used to collect data. Data were analyzed from October 11, 2021, to October 28, 2022. The STARRS-LS1 recruited a probability sample of active-duty soldiers and veterans who had participated in Army STARRS baseline surveys while on active duty (weighted response rate, 35.6%). Respondents whose baseline was the NSS and who had deployed to a combat theater at least once were eligible for this study.

EXPOSURES

Being bullied or hazed during a combat deployment.

MAIN OUTCOMES AND MEASURES

The primary outcomes were MDD, intermittent explosive disorder, PTSD, and suicidal ideation in the 12 months before STARRS-LS1 and SUD in the 30 days before STARRS-LS1, assessed with items from the Composite International Diagnostic Interview Screening Scales, PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Columbia-Suicide Severity Rating Scale. Logistic regression was used to estimate associations of bullying or hazing exposure with the outcomes.

RESULTS

The 1463 participants were predominantly male (weighted percentage [SE], 90.4% [0.9%]) and had a mean (SE) age of 21.1 (0.1) years at baseline. At STARRS-LS1, 188 respondents (weighted percentage [SE], 12.2% [1.1%]) reported bullying or hazing during deployment. Weighted outcome prevalences were 18.7% (1.3%) for MDD, 5.2% (0.9%) for intermittent explosive disorder, 21.8% (1.5%) for PTSD, 14.2% (1.2%) for suicidal ideation, and 8.7% (1.0%) for SUD. In models that adjusted for baseline sociodemographic and clinical characteristics and other potential traumas, exposure to bullying or hazing was significantly associated with MDD (adjusted odds ratio [aOR], 2.92; 95% CI, 1.74-4.88), intermittent explosive disorder (aOR, 2.59; 95% CI, 1.20-5.59), PTSD (aOR, 1.86; 95% CI, 1.23-2.83), suicidal ideation (aOR, 1.91; 95% CI, 1.17-3.13), and SUD (aOR, 2.06; 95% CI, 1.15-3.70).

CONCLUSIONS AND RELEVANCE

In this cohort study of combat-deployed soldiers, reports of being bullied or hazed during deployment were associated with mental disorders and suicidal thoughts. Recognition of these associations may inform efforts to prevent and address mental health problems among service members.

Trauma type as a risk factor for insomnia in a military population

BACKGROUND

This study evaluated whether lifetime traumatic stress compared to deployment-related traumatic stress differentially affected the likelihood of insomnia in military personnel.

METHODS

Data were obtained from the Army Study to Assess Risk and Resilience in Servicemembers (unweighted N = 21,499; weighted N = 670,335; 18-61 years; 13.5% Female). DSM-5 criteria were applied to the Brief Insomnia Questionnaire to determine past month insomnia diagnostic status. A lifetime stress survey was used to assess traumatic stress encountered outside of the military, and a deployment-related stress survey assessed for various types of deployment-related traumatic stress.

RESULTS

Adjusting for sex and psychiatric disorders, lifetime traumatic stress increased the prevalence for insomnia among those who endorsed combat death of close friend or relative, 1.021 (95% CI, 1.02-1.02), followed by those who reported other experiences that put them at risk of death or serious injury, 1.013 (95% CI, 1.01-1.01), whereas deployment-related traumatic stress showed that the prevalence for insomnia was highest for those who reported being sexually assaulted or raped, 1.059 (95% CI, 1.04-1.08), followed by those who endorsed being hazed or bullied by one or more members of their unit 1.042 (95% CI, 1.04-1.05).

LIMITATIONS

The cross-sectional nature of the assessment limits causal inferences and there was no clinician determined diagnosis for insomnia.

CONCLUSION

Findings suggest that traumas over both one's lifetime and during deployment are associated with a higher prevalence for insomnia among Army soldiers. Results highlight the importance of considering both lifetime and deployment traumas into mental health assessment and treatment for active-duty soldiers.

The relationship between clinical recovery and personal recovery among people living with schizophrenia: A serial mediation model and the role of disability and quality of life

OBJECTIVE

We examine the relationship between two perspectives on recovery from schizophrenia: clinical recovery and personal recovery. Clinical recovery emphasizes an individual's psychiatric symptoms and functioning, whereas personal recovery emphasizes adaptation to one's illness that includes taking responsibility for one's recovery, establishing an identity apart from the illness, and finding meaning, purpose, and hope in life.

METHODS

Using serial mediation analysis, we examine the relationship between clinical and personal recovery in the context of two potential mediators, disability and quality of life. Study participants were 356 people with a diagnosis of schizophrenia and living with family in Changsha City of Hunan Province, China.

RESULTS

Although clinical recovery was modestly associated with personal recovery (r = 0.27, p < 0.001), subsequent serial mediation analysis showed that clinical recovery is not directly related to personal recovery when accounting for disability and quality of life. Clinical recovery was a significant predictor of disability, which predicted quality of life and personal recovery. Among the three mediation paths, quality of life accounted for most of the mediation effect (54%), followed by disability (24%), and disability and quality of life serially (22%). We discuss the implications of these findings for theory development, intervention, and future research.

Workplace victimization and alcohol misuse among junior military personnel: Mediating the role of anger

BACKGROUND

Workplace victimization is one of most serious problems for affecting alcohol misuse in junior military personnel (JMP) that has been largely overlooked in research attention. Studies on workplace victimization and alcohol misuse indicate anger as mediator. Workplace victimization may affect alcohol misuse (in)directly through the mediator.

METHODS

A sample of JMP (N = 815) completed an offline survey, consisting of the revised Conflict Tactics Scale-2, Composite International Diagnostic Interview Screening Scale, and the Alcohol Use Disorders Identification Test. Frequency, t-test and chi-square test, and mediation analyses were conducted to assess the effects of workplace victimization on alcohol misuse, mediated via anger.

RESULTS

Victims in the workplace showed higher level of anger and alcohol misuse. In mediation analyses, workplace victimization was related to higher levels of anger, which, in turn, were associated with greater alcohol misuse.

LIMITATIONS

Study limitations included the use of cross-sectional data with the use of retrospective self-report.

CONCLUSION

Workplace victimization in JMP is prevalent (17.7%), and alcohol misuse is associated with effects of workplace victimization and anger with full mediation path. Findings suggest that eliminating workplace victimization against JMP and intervention for anger should be focused upon, and implemented for online alcohol misuse prevention in the military context.

The suicide of Private Danny Chen: An interpersonal theory perspective

Despite considerable prevention and intervention efforts, military suicide rates have increased. Although most research on active-duty military suicide has focused on combat exposure, evidence shows that bullying, hazing, and race are understudied risk factors for military suicide. According to the interpersonal theory of suicide, thwarted belongingness, perceived burdensomeness, and acquired capability are necessary components for enacting a suicide death. In this theoretically-based interpersonal case analysis of the suicide death of Private Danny Chen, an American soldier of Chinese descent, we explore how bullying, hazing, and race may have intersected with other vulnerabilities to result in his death.

Childhood Trauma History and Negative Social Experiences in College

While there is literature documenting the association between childhood trauma and later sexual assault or interpersonal violence victimization, less is known about risk of less severe, but still negative, victimization experiences such as sexual harassment, hazing, and bullying in college. The goal of this study was to explore the association between self-reported childhood trauma (both personally experienced and witnessed) and negative social experiences in college-age adults (e.g., sexual harassment, hazing, and bullying), and the role that internalizing difficulties (i.e., depression and stress) plays in this association. A sample of 620 college-aged adults (ages 18-25) was recruited. Structural Equation Modeling (SEM) was used to investigate two models concerning direct and indirect childhood trauma experience. The models demonstrated significant positive relations between experiences of childhood trauma (both direct and indirect) and negative social experiences. Internalizing difficulties (i.e., depression and stress) mediated the relation between indirect childhood trauma and negative social experiences, but it did not significantly mediate the relation between direct childhood trauma and negative social experiences. These findings help to inform prevention efforts and have important implications for both school and community based mental health providers.

Workplace Hazing: Toward an Organizational Science of a Cryptic Group Practice

The purpose of this paper is to establish a foundation for studying and managing new employee hazing in workgroups. Available empirical evidence indicates 25–75% of American employees encounter workplace hazing, but very little empirical research exists on this phenomenon. Workers are changing jobs more frequently than ever, which increases the cumulative impact and importance of new employee experiences, including hazing, a complex group-based phenomenon. Because hazing is a relatively universal social practice without a strongly established literature in the organizational sciences, we draw from multiple disciplines in reviewing and modeling the practice. The current research offers three major contributions: (a) a relatively exhaustive review of relevant empirical and theoretical work on hazing, (b) an initial, testable model for understanding workplace hazing as a multi-level phenomenon, including individual and group-level antecedents and outcomes, and (c) an outline of the need and support for considering both the dysfunctional and functional consequences of hazing, given the variety of forms it takes and reactions it evokes. Finally, we present actionable guidance for researchers seeking to study workplace hazing and discuss the organizational implications of our work for practitioners.