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Edwards ER, Coolidge B, Ruiz D, Epshteyn G, Krauss A, Gorman D, Connelly B, Redden C, El-Meouchy P, Geraci J. Situational stress and suicide attempt behavior in Army soldiers and veterans: Insights from the Army Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study. Suicide Life Threat Behav 2023; 53:642-654. [PMID: 37306332 DOI: 10.1111/sltb.12970] [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] [Received: 01/24/2023] [Revised: 04/07/2023] [Accepted: 05/07/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Prevention of suicide-related behaviors is considered a top clinical priority within the Departments of Veterans Affairs and Defense. Despite previous literature attesting to the likely importance of situational stress as a key correlate of acute changes in suicide risk, longitudinal research into associations between situational stress and suicide-related outcomes among military personnel has been relatively limited. METHODS The current study examined associations between situational stress, recent suicide attempt, and future suicide attempt using data from 14,508 Army soldiers and recently discharged veterans enrolled in the Army Study to Assess Risk and Resilience in Servicemembers-Longitudinal Studies (STARRS-LS). RESULTS Recent situational stress was more common among recently discharged veterans (vs. soldiers), those with a recent suicide attempt (vs. those without), and those with a subsequent suicide attempt (vs. those without). Job loss was more closely associated with suicide attempts among soldiers, whereas financial crisis, police contact, and death, illness, or injury of close others were more closely associated with suicide attempts among recently discharged veterans. CONCLUSION Findings further highlight situational stress as a salient risk factor for suicide-related outcomes among military personnel, particularly among recently discharged veterans. Implications for screening and treatment of at-risk military personnel are discussed.
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Affiliation(s)
- Emily R Edwards
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Brettland Coolidge
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Danny Ruiz
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
| | - Gabriella Epshteyn
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Alison Krauss
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System, Waco, Texas, USA
| | - Daniel Gorman
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
| | - Brigid Connelly
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
- Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Clare Redden
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
- Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Paul El-Meouchy
- Department of Psychology, Fielding Graduate University, Santa Barbara, California, USA
| | - Joseph Geraci
- VISN 2 Mental Illness, Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Bronx, New York, USA
- Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
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