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Das S, Kutela B, Menon N. Unlocking the Narrative: Using Text Mining to Reveal the Hidden Factors behind Suicide Related Traffic Crashes. Arch Suicide Res 2024; 28:877-891. [PMID: 37578055 DOI: 10.1080/13811118.2023.2247026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Suicide is the deliberate act of ending a person's own life due to multifarious reasons. In the U.S., suicide is the 10th major cause of death. Nearly 45,000 people died by suicide in 2016 across the nation. It is anticipated that not all traffic crashes can be considered as accidents. Traffic crash related injuries are occasionally considered a means of suicide, and some crashes occur due to the suicidal attempts. These attempts can be made by operators of motor vehicles, jumpers into the pathway of trains, and pedestrians deliberately jumping into the vehicle trajectory. There are a handful of studies that have focused on traffic crashes (both railroad and roadway) related to suicidal incidents. This study aimed to explore the insights associated with suicide related traffic crashes (SRTCs) by collecting traffic data for seven years (2010-2016) from Louisiana. At first, exploratory data analysis was performed to examine the five Ws (who, what, why, when, and where) associated with SRTCs. Later, this study applied text network analysis, which was not performed in any of the previous studies, to provide additional contexts of these crashes. The findings of this study can shed lights on an unexplored arena of transportation safety research.
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Blosnich JR, Haydinger A, Rhoades H, De Luca SM. Differences in Beliefs About Suicide by Occupation in a Representative Sample of Adults in the United States, General Social Survey 2002-2021. Arch Suicide Res 2024; 28:439-453. [PMID: 36916390 PMCID: PMC10500038 DOI: 10.1080/13811118.2023.2190363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Beliefs about suicide are important aspects of suicide prevention gatekeeper trainings. This study sought to determine if workers in finance- and legal/judicial-related industries have significantly different levels of suicide acceptability compared to the general US population. METHOD Cross-sectional data are from the 2002 to 2021 General Social Survey (GSS). Suicide acceptability was measured with four dichotomous items to which respondents indicated yes/no if they thought someone has the right to end their life in four negative life scenarios. Occupational categories were coded based on U.S. Census Bureau occupation and industry codes. Covariates for multiple logistic regression analyses included age, educational attainment, sex, race, ethnicity, survey year, and religiosity. RESULTS Among the 15,166 respondents, 651 people worked in finance-related occupations and 319 people worked in legal/judicial-related occupations. In adjusted models, people in finance-related occupations had greater odds of endorsing suicide as acceptable if one has an incurable disease (aOR = 1.25, 95%CI = 1.03-1.52) and marginally greater odds of endorsing suicide as acceptable if one dishonors their family (aOR = 1.31, 95%CI = 0.99-1.74) than the general adult population. People in legal/judicial-related occupations were more likely to endorse 3 of the 4 suicide acceptability items compared to the general adult population, however these differences were not statistically significant after accounting for demographic factors. CONCLUSION Workers in non-clinical industries that frequently see clients during negative life events are prime audiences for gatekeeper trainings but may have entrenched beliefs about suicide acceptability. Research is needed to determine how these beliefs may impact gatekeeper training.
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Affiliation(s)
- John R. Blosnich
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 Street, Los Angeles, CA, USA 90089
| | - Alexandra Haydinger
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 Street, Los Angeles, CA, USA 90089
| | - Harmony Rhoades
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 Street, Los Angeles, CA, USA 90089
| | - Susan M. De Luca
- The MetroHealth System, Population Health Research Institute, Center for Health Care Research and Policy, 2500 MetroHealth Drive, Cleveland, OH, USA 44109
- Case Western Reserve University, School of Medicine, 9501 Euclid Ave., Cleveland OH 44106
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Hogan WB, Daniels AH. Orthopaedic Surgeon Burnout and Suicide: Social Isolation as a Driver of Self-Harm. J Bone Joint Surg Am 2022; 104:e22. [PMID: 34648475 DOI: 10.2106/jbjs.21.00657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- William B Hogan
- Department of Orthopedics, Warren Alpert Medical School, Brown University, East Providence, Rhode Island
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Loscalzo Y, Giannini M, Gori A, Fabio AD. The Wellbeing of Italian Peacekeeper Military: Psychological Resources, Quality of Life and Internalizing Symptoms. Front Psychol 2018; 9:103. [PMID: 29487552 PMCID: PMC5816820 DOI: 10.3389/fpsyg.2018.00103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/22/2018] [Indexed: 11/30/2022] Open
Abstract
Working as a peacekeeper is associated with the exposure to acute and/or catastrophic events and chronic stressors. Hence, the meager literature about peacekeepers' wellbeing has mainly analyzed Post-Traumatic Stress Disorder (PTSD). This study aims to deep the analysis of the wellbeing of peacekeepers military. Based on the few studies on this population, we hypothesized that Italian peacekeeper military officers and enlisted men (n = 167; 103 males, 6 females, 58 missing) exhibit lower levels of internalizing symptoms (i.e., PTSD, depression, general anxiety, obsessions, and somatization) as compared to a control group (n = 60; 32 males, 28 females). Moreover, we hypothesized that peacekeepers have higher levels of psychological resources (i.e., self-efficacy, self-esteem, social support) and quality of life (i.e., higher life satisfaction and lower general stress). We compared the groups by means of MANOVAs on the subscales of the Psychological Treatment Inventory (PTI; Gori et al., 2015). We found that Italian peacekeepers have lower internalizing symptoms and higher levels of self-efficacy and self-esteem than the control group; however, no statistically significant differences were observed on perceived social support. Finally, peacekeepers have a higher quality of life: scores reflect higher life satisfaction and lower distress than the control group. This study is in line with previous literature supporting the claim that Italian peacekeeper military officers have sufficient psychological resources for coping with the stressful situations implied in peacekeeping missions. Future studies should deepen the analysis of the military's psychological characteristics by comparing war veterans and peacekeeper military.
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Affiliation(s)
- Yura Loscalzo
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Marco Giannini
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Alessio Gori
- Department of Human Sciences, LUMSA University, Rome, Italy
| | - Annamaria Di Fabio
- Psychology Section, Department of Education and Psychology, University of Florence, Florence, Italy
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Bullman T, Schneiderman A, Bossarte R. Suicide Risk by Unit Component among Veterans Who Served in Iraq or Afghanistan. Arch Suicide Res 2018; 22:1-10. [PMID: 28281890 PMCID: PMC5592133 DOI: 10.1080/13811118.2017.1304308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study assessed the risk of suicide by time since separation from the military for US veterans who served in Iraq or Afghanistan. Suicide risk was assessed by comparing the number of suicides among veterans, when stratified by active vs. reserve/National Guard status to the expected number based on rates of suicide in the US general population. Hazard rates were used to assess suicide risk since the time each veteran separated/deactivated from active duty service. Compared to the US general population, active duty veterans had a 56% increased risk of suicide and reserve/National Guard veterans had a 29% increased risk. Suicide risk decreased as time since separation/deactivation increased for both groups. The risk of suicide for both groups was greatest during the first year of follow-up.
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Correlates of suicidality in firefighter/EMS personnel. J Affect Disord 2017; 208:177-183. [PMID: 27788381 DOI: 10.1016/j.jad.2016.08.078] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/20/2016] [Accepted: 08/24/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Firefighter and Emergency Medical Services (EMS) personnel experience higher rates of lifetime suicidal ideation and attempts than the general population and other protective service professions. Several correlates of suicidality (alcohol use, depression, posttraumatic stress) have been identified in the literature as applicable to firefighter/EMS populations; however, few studies to date have examined the specific correlates of suicidality (lifetime suicidal ideation and/or attempts) in a firefighter/EMS sample. METHODS Participants (N=3036) from a large, urban fire department completed demographic and self-report measures of alcohol dependence, depression, posttraumatic stress disorder (PTSD) symptom severity, and lifetime suicidal ideation and attempts. Participants in this sample performed both firefighter and EMS duties, were predominately male (97%), White (61.6%), and 25-34 years old (32.1%). RESULTS Through hierarchical linear regressions, depression (β=.22, p<.05) and PTSD symptom severity (β=.21, p<.05) were significantly associated with lifetime suicidal ideation (R2 =17.5). Depression (β=.15, p<.001), and PTSD symptom severity (β=.07, p<.01) were significantly associated with lifetime suicide attempts (R2=5.1). LIMITATIONS Several limitations are addressed in the current study. The survey was a self-report pre-existing dataset and lifetime suicidal ideation and attempts were measured using sum scores. Additionally, the disproportionately large sample of males and large, urban setting, may not generalize to female firefighters and members of rural community fire departments. CONCLUSIONS The current study highlights the importance of targeting depression and PTSD symptom severity in efforts to reduce suicidality in firefighter/EMS personnel.
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Abstract
BACKGROUND Volunteering in international military missions has been scrutinized for its effects on mental health. Different kinds of exposures to traumatic events are associated with a variety of mental disorders, mainly heightened rates of post-traumatic stress disorder (PTSD) and alcohol abuse. AIMS Based on the literature we discuss risk and protective factors concerning the psychological well-being of soldiers attending to international military operations. METHODS A systematic literature search was carried out using relevant search terms to identify the articles for this review. RESULTS AND CONCLUSIONS The ability to recognize and treat acute stress reactions during deployments is important. Post-deployment psychosocial support and services have a role in lowering barriers to care, diminishing stigma and also in recognizing individuals who suffer from psychological distress or psychiatric symptoms, to connect them with appropriate care. Further investigation of gender differences and the role of stigmatization is warranted. Most of those participating in international military operations are repatriated without problems, but repeated exposure to combat situations and other stressors may affect mental health in various ways. Stigmatization is still a barrier to care.
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Affiliation(s)
- Noora M Kaikkonen
- a Noora M. Kaikkonen, Centre for Military Medicine, Finnish Defence Forces , Helsinki , Finland
| | - Tanja Laukkala
- b Tanja Laukkala, Field Medicine Services Unit, Centre for Military Medicine, Finnish Defence Forces , Helsinki , Finland
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O'Toole BI, Orreal-Scarborough T, Johnston D, Catts SV, Outram S. Suicidality in Australian Vietnam veterans and their partners. J Psychiatr Res 2015; 65:30-6. [PMID: 25914085 DOI: 10.1016/j.jpsychires.2015.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/30/2014] [Accepted: 02/06/2015] [Indexed: 11/30/2022]
Abstract
Lifetime suicidality was assessed in a cohort of 448 ageing Australian Vietnam veterans and 237 female partners during in-person structured psychiatric interviews that permitted direct comparison with age-sex matched Australian population statistics. Relative risks for suicidal ideation, planning and attempts were 7.9, 9.7 and 13.8 times higher for veterans compared with the Australian population and for partners were 6.2, 3.5 and 6.0 times higher. Odds ratios between psychiatric diagnoses and suicidality were computed using multivariate logistic regression, and suicidality severity scores were assigned from ideation, planning and attempt, and analysed using ordinal regression. PTSD, depression alcohol disorders, phobia and agoraphobia were prominent predictors of ideation, attempts and suicidal severity among veterans, while depression, PTSD, social phobia and panic disorder were prominent predictors among partners. For veterans and their partners, PTSD is a risk factor for suicidality even in the presence of other psychiatric disorders, and is stronger in Vietnam veterans than their partners.
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Affiliation(s)
- Brian I O'Toole
- University of Sydney Brain & Mind Research Institute, Sydney, Australia.
| | | | - Deborah Johnston
- University of Sydney Brain & Mind Research Institute, Sydney, Australia
| | - Stanley V Catts
- University of Sydney Brain & Mind Research Institute, Sydney, Australia; University of Queensland, Centre for Mental Health, Royal Brisbane and Women's Hospital, Brisbane, Australia.
| | - Sue Outram
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia.
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Patel BR. Caregivers of veterans with "invisible" injuries: what we know and implications for social work practice. SOCIAL WORK 2015; 60:9-17. [PMID: 25643571 DOI: 10.1093/sw/swu043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Today, as a result of the longest volunteer-fought conflict in U.S. history, there are many wounded coming home not only with posttraumatic stress disorder (PTSD), but also with traumatic brain injury (TBI), which together have been called the "signature" or "invisible" injuries of the Iraq and Afghanistan wars. Caregivers are an important part of their recovery, yet little is known about them, as previous research on caregivers mostly focused on geriatric populations. According to one estimate 275,000 to 1 million people are currently caring or have cared for loved ones who have returned from Iraq and Afghanistan. These caregivers are unique in that they are younger, some with children, and they are caring for a unique under-studied population for longer periods of time. This article summarizes literature on caregivers of veterans who suffer from PTSD, TBI, or both; provides a theoretical framework; and discusses implications for social workers in assisting caregivers and their families.
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Panagioti M, Gooding PA, Tarrier N. A prospective study of suicidal ideation in posttraumatic stress disorder: the role of perceptions of defeat and entrapment. J Clin Psychol 2014; 71:50-61. [PMID: 24913436 DOI: 10.1002/jclp.22103] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This study aimed to provide the first prospective test of the ability of defeat and entrapment to predict suicidal ideation in posttraumatic stress disorder (PTSD) after controlling for the effects of PTSD severity, comorbid depressive symptoms, and hopelessness on suicidal ideation. METHODS Participants were 52 individuals diagnosed with PTSD. Baseline and follow-up assessments were 13 to 15 months apart. Defeat and entrapment were conceptualized and analyzed as a unique construct (defeat/entrapment) in this study. Multiple regression analysis was applied to examine the predictive effects of defeat/entrapment on suicidal ideation. RESULTS Defeat/entrapment scores predicted changes in the levels of suicidal ideation at follow-up while controlling for baseline suicidal ideation, PTSD severity, comorbid depressive symptoms, and hopelessness. CONCLUSIONS These outcomes provide support to contemporary models of suicidality that suggest that defeat/entrapment is a strong predictor of suicidality in PTSD.
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11
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Kuo CY, Liao SC, Lin KH, Wu CL, Lee MB, Guo NW, Guo YL. Predictors for suicidal ideation after occupational injury. Psychiatry Res 2012; 198:430-5. [PMID: 22436350 DOI: 10.1016/j.psychres.2012.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 02/01/2012] [Accepted: 02/08/2012] [Indexed: 11/20/2022]
Abstract
Risk of suicide has been associated with trauma and negative life events in several studies. Our aim was to investigate the prevalence and risk factors of suicidal ideation, and the population attributable risk among workers after occupational injuries. We investigated workers who had been hospitalized for ≧3 days after occupational injuries between February 1 and August 31, 2009. A self-reported questionnaire including demographic data, injury condition, and the question of suicidal ideation was sent to 4498 workers at 3 months after their occupational injury. A total of 2001 workers (45.5%) completed the questionnaires and were included in final analysis. The prevalence of reporting suicidal ideation was 8.3%. After mutual adjustment, significant risk factors for suicidal ideation higher than "serious" in a self-rated severity scale (adjusted odds ratio, aOR=2.31; adjusted population attributable risk, aPAR=34.7%), total hospital stay for 8 days or longer (OR=1.98; aPAR=20.5%), intracranial injury (OR=2.30; aPAR=10.2%), and marriage status of being divorced/separated/widowed (OR=2.70; aPAR=10.0%). Three months after occupational injury, a significant proportion of workers suffered from suicidal ideation. Significant predictors of suicidal ideation after occupational injury included broken marriage, intracranial injury, injury severity, and total hospital stay. Identification of high risk subjects for early intervention is warranted.
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Affiliation(s)
- Chun-Ya Kuo
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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12
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Kaplan MS, McFarland BH, Huguet N, Valenstein M. Suicide risk and precipitating circumstances among young, middle-aged, and older male veterans. Am J Public Health 2012; 102 Suppl 1:S131-7. [PMID: 22390587 PMCID: PMC3496453 DOI: 10.2105/ajph.2011.300445] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2011] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the risk of suicide among veteran men relative to nonveteran men by age and to examine the prevalence of suicide circumstances among male veterans in different age groups (18-34, 35-44, 45-64, and ≥ 65 years). METHODS Data from the National Violent Death Reporting System (2003-2008) were used to calculate age-specific suicide rates for veterans (n = 8440) and nonveterans (n = 21,668) and to calculate the age-stratified mortality ratio for veterans. Multiple logistic regression was used to compare health status, stressful life events preceding suicide, and means of death among young, middle-aged, and older veterans. RESULTS Veterans were at higher risk for suicide compared with nonveterans in all age groups except the oldest. Mental health, substance abuse, and financial and relationship problems were more common in younger than in older veteran suicide decedents, whereas health problems were more prevalent in the older veterans. Most male veterans used firearms for suicide, and nearly all elderly veterans did so. CONCLUSIONS Our study highlighted heightened risk of suicide in male veterans compared with nonveterans. Within the veteran population, suicide might be influenced by different precipitating factors at various stages of life.
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Troxel WM, Germain A. Insecure attachment is an independent correlate of objective sleep disturbances in military veterans. Sleep Med 2011; 12:860-5. [PMID: 21925945 PMCID: PMC3367508 DOI: 10.1016/j.sleep.2011.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 06/27/2011] [Accepted: 07/14/2011] [Indexed: 12/28/2022]
Abstract
BACKGROUND Sleep disturbances and interpersonal problems are highly prevalent in military veterans with post-traumatic stress disorder (PTSD) and are associated with substantial comorbidities and increased healthcare costs. This study examines the association between interpersonal attachment styles and sleep in a high-risk cohort of military veterans with PTSD symptoms. METHODS Participants were 49 military veterans (85% male) enrolled in a treatment study of combat-related sleep disturbances. Data were collected at pre-treatment baseline. Attachment anxiety and avoidance, clinical characteristics, and subjective sleep quality were characterised via self-report. Polysomnographic sleep measures were averaged from two nights of in-laboratory sleep studies and included: visually scored duration and continuity, the percentage of stage 3+4 sleep and rapid eye movement (REM) sleep, and quantitative electroencephalographic (QEEG) measures of delta and beta power during NREM and REM sleep. Linear regressions evaluated the relationship between attachment styles and sleep with adjustment for demographics, and PTSD and depressive symptoms. RESULTS Greater attachment anxiety was associated with reduced percentage of stage 3+4 sleep, (β=-0.36, p<0.05) and increased relative beta power during NREM sleep (β=0.40, p<0.05). By contrast, greater attachment avoidance was positively associated with delta power during NREM and REM sleep (β=0.35 and 0.38, respectively, p<0.05). CONCLUSIONS These findings suggest specific effects of interpersonal styles on physiological sleep measures. Elucidating both the neurobiological and psychological correlates of PTSD-related sleep disturbances is critical for developing future targeted intervention efforts aimed at reducing the burden of PTSD.
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Affiliation(s)
- Wendy M Troxel
- University of Pittsburgh, Department of Psychiatry and Psychology, Pittsburgh, PA, USA.
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Treating Iraq and Afghanistan War Veterans With PTSD Who Are at High Risk for Suicide. COGNITIVE AND BEHAVIORAL PRACTICE 2011. [DOI: 10.1016/j.cbpra.2009.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Jakupcak M, Vannoy S, Imel Z, Cook JW, Fontana A, Rosenheck R, McFall M. Does PTSD moderate the relationship between social support and suicide risk in Iraq and Afghanistan War Veterans seeking mental health treatment? Depress Anxiety 2010; 27:1001-5. [PMID: 20721901 PMCID: PMC3038554 DOI: 10.1002/da.20722] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Revised: 05/27/2010] [Accepted: 05/29/2010] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study examined posttraumatic stress disorder (PTSD) as a potential moderating variable in the relationship between social support and elevated suicide risk in a sample of treatment-seeking Iraq and Afghanistan War Veterans. METHOD As part of routine care, self-reported marital status, satisfaction with social networks, PTSD, and recent suicidality were assessed in Veterans (N=431) referred for mental health services at a large Veteran Affairs Medical Center. Logistic regression analyses were conducted using this cross-sectional data sample to test predictions of diminished influence of social support on suicide risk in Veterans reporting PTSD. RESULTS Thirteen percent of Veterans were classified as being at elevated risk for suicide. Married Veterans were less likely to be at elevated suicide risk relative to unmarried Veterans and Veterans reporting greater satisfaction with their social networks were less likely to be at elevated risk relative to Veterans reporting lower satisfaction. Satisfaction with social networks was protective for suicide risk in PTSD and non-PTSD cases, but was significantly less protective for veterans reporting PTSD. CONCLUSIONS Veterans who are married and Veterans who report greater satisfaction with social networks are less likely to endorse suicidal thoughts or behaviors suggestive of elevated suicide risk. However, the presence of PTSD may diminish the protective influence of social networks among treatment-seeking Veterans.
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Affiliation(s)
- Matthew Jakupcak
- VISN 20 Northwest Mental Illness Research, Education, and Clinical Center, Seattle, Washington, USA.
| | - Steven Vannoy
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Zac Imel
- VISN 20 Northwest Mental Illness Research, Education, and Clinical Center, Seattle, Washington,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Jessica W. Cook
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Alan Fontana
- VISN 1 New England Mental Illness Research, Education, and Clinical Center, New England,Yale University School of Medicine, New Haven, Connecticut
| | - Robert Rosenheck
- VISN 1 New England Mental Illness Research, Education, and Clinical Center, New England,Yale University School of Medicine, New Haven, Connecticut
| | - Miles McFall
- VISN 20 Northwest Mental Illness Research, Education, and Clinical Center, Seattle, Washington,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
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Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE. The interpersonal theory of suicide. Psychol Rev 2010; 117:575-600. [PMID: 20438238 PMCID: PMC3130348 DOI: 10.1037/a0018697] [Citation(s) in RCA: 2734] [Impact Index Per Article: 195.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that the most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs-thwarted belongingness and perceived burdensomeness (and hopelessness about these states)-and further that the capability to engage in suicidal behavior is separate from the desire to engage in suicidal behavior. According to the theory, the capability for suicidal behavior emerges, via habituation and opponent processes, in response to repeated exposure to physically painful and/or fear-inducing experiences. In the current article, the theory's hypotheses are more precisely delineated than in previous presentations (Joiner, 2005), with the aim of inviting scientific inquiry and potential falsification of the theory's hypotheses.
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Affiliation(s)
- Kimberly A Van Orden
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA.
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Suicide risk factors in the professional military personnel in the Army of Serbia. VOJNOSANIT PREGL 2010; 67:303-12. [DOI: 10.2298/vsp1004303d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background/Aim. Recognition of suicide risk factors is important in taking adequate suicide preventive measures, Suicide Prevention Program for Professional Military Personnel (PMP) implemented in the Army of Serbia in 2003. The aim of our study was to establish suicide risk factors in PMP of the Army of Serbia. Methods. Analysis of suicide risk factors in PMP was carried out on the basis of data obtained by psychological suicide autopsy. The controls were demographically similar psychiatric outpatients with no history of suicidal behavior. A descriptive statistics method was used for risk factors analysis. The t-test was used for testing statistical hypotheses. Results. A total of 30 PMP, aged 22-49 years (30.53 ? 6.24 on average) committed suicide within the period 1998-2007. Distal suicide risk factors in PMP were considered to be not being married, psychiatric heredity, having no outpatient psychiatric treatment, gambling, regular physical practice (bodybuilding), less transfer to a different post, low motivation for military service (p < 0.001), not having children, parental loss in early childhood, alcohol abuse (p < 0.005), low salary (p < 0.01) uncompleted military school, debts in the family (p < 0.05). The commonest proximal suicide risk factors were: actual family problems (36.6%), actual mental problems (13.3%), burnout (13.3%), negative balance of accounts (13.3%), professional problems (6.7%), behavioral model while for 10.0% PMP suicide risk factors could not be established. Conclusion. According to the presence of multiple suicide risk factors, Suicide Prevention Program for PMP in the Army of Serbia is directed to the prevention of both proximal and distal suicide risk factors.
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Selby EA, Anestis MD, Bender TW, Ribeiro JD, Nock MK, Rudd MD, Bryan CJ, Lim IC, Baker MT, Gutierrez PM, Joiner TE. Overcoming the fear of lethal injury: evaluating suicidal behavior in the military through the lens of the Interpersonal-Psychological Theory of Suicide. Clin Psychol Rev 2009; 30:298-307. [PMID: 20051309 DOI: 10.1016/j.cpr.2009.12.004] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 12/02/2009] [Accepted: 12/03/2009] [Indexed: 12/25/2022]
Abstract
Suicide rates have been increasing in military personnel since the start of Operation Enduring Freedom and Operation Iraqi Freedom, and it is vital that efforts be made to advance suicide risk assessment techniques and treatment for members of the military who may be experiencing suicidal symptoms. One potential way to advance the understanding of suicide in the military is through the use of the Interpersonal-Psychological Theory of Suicide. This theory proposes that three necessary factors are needed to complete suicide: feelings that one does not belong with other people, feelings that one is a burden on others or society, and an acquired capability to overcome the fear and pain associated with suicide. This review analyzes the various ways that military service may influence suicidal behavior and integrates these findings into an overall framework with relevant practical implications. Findings suggest that although there are many important factors in military suicide, the acquired capability may be the most impacted by military experience because combat exposure and training may cause habituation to fear of painful experiences, including suicide. Future research directions, ways to enhance risk assessment, and treatment implications are also discussed.
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Affiliation(s)
- Edward A Selby
- Florida State University, Tallahassee, Florida 32306-1270, United States
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Kapur N, While D, Blatchley N, Bray I, Harrison K. Suicide after leaving the UK armed forces--a cohort study. PLoS Med 2009; 6:e26. [PMID: 19260757 PMCID: PMC2650723 DOI: 10.1371/journal.pmed.1000026] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 12/22/2008] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Few studies have examined suicide risk in individuals once they have left the military. We aimed to investigate the rate, timing, and risk factors for suicide in all those who had left the UK Armed Forces (1996-2005). METHODS AND FINDINGS We carried out a cohort study of ex-Armed Forces personnel by linking national databases of discharged personnel and suicide deaths (which included deaths receiving either a suicide or undetermined verdict). Comparisons were made with both general and serving populations. During the study period 233,803 individuals left the Armed Forces and 224 died by suicide. Although the overall rate of suicide was not greater than that in the general population, the risk of suicide in men aged 24 y and younger who had left the Armed Forces was approximately two to three times higher than the risk for the same age groups in the general and serving populations (age-specific rate ratios ranging from 170 to 290). The risk of suicide for men aged 30-49 y was lower than that in the general population. The risk was persistent but may have been at its highest in the first 2 y following discharge. The risk of suicide was greatest in males, those who had served in the Army, those with a short length of service, and those of lower rank. The rate of contact with specialist mental health was lowest in the age groups at greatest risk of suicide (14% for those aged under 20 y, 20% for those aged 20-24 y). CONCLUSIONS Young men who leave the UK Armed Forces were at increased risk of suicide. This may reflect preservice vulnerabilities rather than factors related to service experiences or discharge. Preventive strategies might include practical and psychological preparation for discharge and encouraging appropriate help-seeking behaviour once individuals have left the services.
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Affiliation(s)
- Navneet Kapur
- Centre for Suicide Prevention, University of Manchester, Manchester, United Kingdom.
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Abstract
To investigate the association between war zone stress exposure during international military operations and later suicidal ideation, a follow-up study of 1172 Norwegian male peacekeepers was conducted 7 years, on average, after redeployment. Suicidal ideation was reported in 6% of the veterans, while it was reported in 17% of the subsample of those who were prematurely repatriated. Suicidal ideation was significantly associated with service stress exposure level, even when background factors, repatriation status, negative life events, social support, alcohol consumption, and marital and occupational status were controlled for. Results indicate that the association between service stress exposure and suicidal ideation was mediated by posttraumatic stress symptoms and general mental health problems combined.
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Affiliation(s)
- Dietrich Doll
- Military Hospital of Berlin, Teaching Hospital of the Charité University, Berlin D-10115, Germany.
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