Meaning in life, emotional distress, suicidal ideation, and life functioning in an active duty military sample

Do measures of social support and social distress share general factors associated with suicidal ideation and attempts?

INTRODUCTION

Aspects of social relationships have variably been associated with suicidal ideation (SI) and suicide attempts (SAs). This study assessed whether social support and social distress measures have general factors versus measure-specific factors that are associated with suicide risk.

METHODS

Adults (N = 455, 60.0% female), admitted to psychiatric inpatient units following a recent suicide attempt or active SI, completed assessments of social support (emotional support, instrumental support, friendship, perceived support from significant others, friends, family) and social distress (loneliness, perceived rejection, perceived burdensomeness, thwarted belongingness). Bifactor modeling examined general and specific factors of social support and distress in relation to SI (week prior to hospitalization, via the Beck Scale for SI) and SAs (past 30 days, via the Columbia Suicide Severity Rating Scale).

RESULTS

SI was significantly associated with the general social support (B = -1.51), the general social distress (B = 1.67), and the specific perceived burdensomeness (B = 1.57) factors. SAs were significantly associated with the specific Perceived Rejection (OR = 1.05) and Thwarted Belongingness (OR = 0.91) factors.

CONCLUSION

General social support and social distress were associated with SI but not recent SAs. Specific social distress factors were also related to SI and SAs controlling for general social distress, suggesting areas for future interventions.

The Protective Role of Curiosity Behaviors in Coping with Existential Vacuum

An existential vacuum is experienced as a kind of crisis that one can cope with using his/her strengths. The related literature suggests that the important determinants of coping with existential emptiness include positive emotional and personality resources, and among these-Curiosity Behaviors. The purpose of this study is to describe the role of curiosity as an important factor in relation to emotional resources in individuals experiencing an existential vacuum. A survey was conducted using online tools (n = 484). The hypotheses about the direct and indirect relationships between Curiosity Behaviors and existential vacuum were tested using multiple regression analyses and mediations. The study involved a sample of adult participants representing the general population. The participants completed five questionnaires, the first one focusing on Curiosity Behaviors, such as seeking out novel and challenging experiences and engagement in activities that capture one's attention (The Curiosity and Exploration Inventory), and the other tools being the Multidimensional Existential Meaning Scale, the Emotional Regulation Questionnaire, the Flourishing Scale, and the Depression Anxiety Stress Scale. The results indicate that Curiosity Behaviors characteristically negatively predict existential vacuum. In addition, other variables, such as Flourishing, seem to be useful in explaining the relationships between these factors. Flourishing along with Curiosity increases a sense of Meaning in Life. Our results present evidence showing the importance of Curiosity Behaviors in coping with the existential vacuum.

What predicts personal growth following a deployment? An examination of National Guard soldiers through the lens of posttraumatic growth

National Guard soldiers experience unique reintegration challenges. In addition to managing the consequences of combat-related trauma, they also navigate multiple transitions between military and civilian life. Despite these obstacles, many soldiers report positive outcomes and personal growth due to deployment, a phenomenon most commonly referred to in the literature as posttraumatic growth (PTG). The current study explored PTG in National Guard soldiers using a multidimensional longitudinal approach, with the goal of validating reports of PTG in soldiers. Data were collected from National Guard soldiers at pre-deployment, reintegration, one year post-deployment and two years post-deployment. Informed by PTG theory, three PTG constructs were measured (perceived ability to handle stress, social support seeking, and purpose in life) at each of the four time points, with increases in these constructs indicating growth. Potential predictors of growth in these PTG constructs were also explored. Results from a repeated measure latent profile analysis indicated that PTG did occur in certain soldiers, and that higher optimism and less severe PTSD symptoms predict this growth. These findings emphasize the importance of making efforts to facilitate PTG in soldiers.

A longitudinal network analysis of suicide risk factors among service members and veterans sampled for suicidal ideation or attempt

BACKGROUND

Suicidal thoughts and behaviors are elevated among active-duty service members (ADSM) and veterans compared to the general population. Hence, it is a priority to examine maintenance factors underlying suicidal ideation among ADSM and veterans to develop effective, targeted interventions. In particular, interpersonal risk factors, hopelessness, and overarousal have been robustly connected to suicidal ideation and intent.

METHODS

To identify the suicidal ideation risk factors that are most relevant, we employed network analysis to examine between-subjects (cross-sectional), contemporaneous (within seconds), and temporal (across four hours) group-level networks of suicidal ideation and related risk factors in a sample of ADSM and veterans (participant n = 92, observations n = 10 650). Participants completed ecological momentary assessment (EMA) surveys four times a day for 30 days, where they answered questions related to suicidal ideation, interpersonal risk factors, hopelessness, and overarousal.

RESULTS

The between-subjects and contemporaneous networks identified agitation, not feeling close to others, and ineffectiveness as the most central symptoms. The temporal network revealed that feeling ineffective was most likely to influence other symptoms in the network over time.

CONCLUSION

Our findings suggest that ineffectiveness, low belongingness, and agitation are important drivers of moment-to-moment and longitudinal relations between risk factors for suicidal ideation in ADSM and veterans. Targeting these symptoms may disrupt suicidal ideation.

Purpose in life protects against the development of suicidal thoughts and behaviors in U.S. veterans without a history of suicidality: A 10-year, nationally representative, longitudinal study

OBJECTIVES

To determine the incidence of suicidal ideation and suicide attempts (STBs) in veterans without an endorsed history of STBs and identify baseline predictors of these outcomes over a 10-year period.

METHODS

Population-based prospective cohort study of 2307 US military veterans using five waves of the 2011-2021 National Health and Resilience in Veterans Study. Baseline data were collected in 2011, with follow-up assessments conducted 2-(2013), 4-(2015), 7-(2018), and 10-years (2021) later.

RESULTS

In total, 10.1 % (N = 203) of veterans endorsed incident suicidal ideation (SI) over the 10-year period and 3.0 % (N = 55) endorsed an incident suicide attempt (SA). Multivariable regression analyses revealed the following baseline predictors of incident SI: lower annual household income, current posttraumatic stress disorder, current alcohol use disorder (AUD), disability with activities of daily living (i.e., ADLs) or instrumental activities of daily living (i.e., IADLs), lower perceived social support, lower community integration, and lower purpose in life. Current AUD, greater cumulative trauma burden, and lower purpose in life at baseline were predictive of incident SA. Relative importance analyses revealed that lower purpose in life was the strongest predictor of both incident SI and SA.

CONCLUSIONS

Psychosocial determinants of health, such as purpose in life, may be more reliable predictors of incident suicidal thoughts and behaviors than traditional risk factors (e.g., psychiatric distress; history of SA) in those without a history of STBs. Evidence-based interventions that facilitate purpose in life and feelings of connectedness and belonging should be examined as possible treatments for STBs.

Life meaning and mental health in post-9/11 veterans: the mediating role of perceived stress

BACKGROUND AND OBJECTIVES

Post-9/11 veterans frequently experience diminished mental health following military service. Life meaning is related to better mental health in veterans, yet its mechanism of action is unknown. A meaning-making model suggests that life meaning can reduce perceived stress, thus enhancing mental health. The present study tested this meaning-making model by predicting multiple dimensions of mental health (i.e., symptoms of posttraumatic stress disorder, anxiety, insomnia, and depression, and mental health quality of life) from life meaning as mediated by perceived stress.

DESIGN AND METHODS

The present study was a secondary analysis of a 12-month observational study of 367 post-9/11 veterans. Participants completed demographic and health surveys at baseline, 6-month, and 12-month follow-ups. A multivariate mediation model was created predicting changes in dimensions of mental health from 6 months to 12 months.

RESULTS

Higher life meaning at baseline predicted changes in all dimensions of mental health between 6 and 12 months, an effect mediated by changes in perceived stress between baseline and 6 months.

CONCLUSIONS

Across dimensions of mental health, the meaning-making model was supported. Understanding post-9/11 veteran mental health from this theoretical perspective may help better tailor healthcare efforts and enhance veteran health overall.

Effect of Academic Self-Efficacy on Test Anxiety of Higher Vocational College Students: The Chain Mediating Effect

Objective

This study aimed to investigate the impact of academic self-efficacy on test anxiety among higher vocational students, as well as the role of sense of life meaning, fear of failure, and gender difference in mediating this relationship.

Methods

A total of 2231 higher vocational students from Shandong Province were surveyed by means of Academic Self-efficacy Questionnaire, Meaning in Life Questionnaire, and Test Anxiety Scale.

Results

There were significant negative correlations among academic self-efficacy, sense of life meaning, and test anxiety. Fear of failure was positively correlated with test anxiety. Sense of life meaning and fear of failure played a mediating role in the relationship between academic self-efficacy and test anxiety. The chain mediating effect was significant only in the female group, not in the male group. In contrast, academic self-efficacy indirectly predicted test anxiety by the independent mediating effect of sense of life meaning or fear of failure in the male group.

Conclusion

Academic self-efficacy may influence test anxiety through the independent mediating effect of sense of life meaning, fear of failure, and the chain mediating effect, and there is a gender difference in these effects.

Meaning in Life and Coping With Everyday Stressors

Meaning in life (MIL) has been proposed to improve coping and resilience. Yet MIL's association with coping has primarily been investigated in the context of extreme stressors and trauma, often using varied measures of MIL. Is MIL associated with varied coping strategies, coping self-efficacy, and distress in relation to commonly experienced, everyday challenges? Using diverse methodological designs, five studies (total N = 1,646) investigated the association between MIL and coping strategies/appraisals pertaining to varied challenging, stressful events. Across recalled (Studies 1 and 2), anticipated (Study 3), and experienced stressors (Studies 3-5), MIL was consistently associated with positive reinterpretation, proactive planning, coping self-efficacy, and stress. MIL was inconsistently related to threat/emotion-coping.

Instability of emotional relationships and suicide among youth: a qualitative study

BACKGROUND

Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults.

METHOD

This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis.

RESULTS

The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide.

CONCLUSION

The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support.

Meaning in Life Moderates Relations between Personality and Temperament and Nonsuicidal Self-Injury in Hospitalized Adolescents

Previous research indicates that sensation seeking, emotion dysregulation, and impulsivity are predictive of non-suicidal self-injury (NSSI). A body of research supports that meaning in life predicts improved mental health and well-being, including fewer suicidal thoughts and attempts, yet no research has examined the moderating effects of meaning in life on the relations between personality and temperament and NSSI. Given the growing incidence rates of NSSI among adolescents and the potential lifelong consequences of NSSI, it is imperative to better understand the factors that reduce the rates at which adolescents in a clinical sample engage in NSSI. The present study investigates if the protective factors of meaning in life moderate the relation between personality and temperament variables and NSSI among 126 adolescents (71% female, Mage = 16.1, SD = 1.1, range 13-18, 80% White) residing in an inpatient psychiatric hospital who endorsed NSSI in the last 12 months. Results from hurdle modeling indicate that two subtypes of meaning in life, presence of meaning in life and search for meaning of life, may serve as robust protective factors against engagement in NSSI among a clinical sample of adolescents. Additionally, results suggest that search for meaning, but not presence of meaning in life, variables moderate the relations between personality and temperament and NSSI. Results provide evidence that meaning in life is an understudied variable of importance in understanding how to prevent or treat NSSI. It also underscores the need to develop, refine, and test meaning-making interventions.

Group-based Compassion-focused Therapy on Experiential Avoidance, Meaning-in-life, and Sense of Coherence in Female Survivors of Intimate Partner Violence with PTSD: A Randomized Controlled Trial

The current study was carried out to investigate the effects of compassion-focused therapy (CFT) on experiential avoidance, meaning-in-life, and sense of coherence (SoC) in women suffering from post-traumatic stress disorder (PTSD) due to the intimate partner violence (IPV).42 women suffering from PTSD due to the IPV exposure were randomized to the two groups of experimental and control (21 per group). All participants completed the questionnaires of experiential avoidance, meaning-in-life, and SoC as pre-test measures. The experimental group received eight sessions of CFT, while the controls did not receive any treatment. After that, all subjects responded to the questionnaires of experiential avoidance, meaning-in-life, and SoC as the post-test measures. Data were analyzed using one-way repeated measures MANOVA.Subjects of the experimental group indicated a greater reduction in post-test scores of experiential avoidance, and a significant rise in the level of meaning-in-life and its subscales including the presence of meaning-in-life and search for meaning-in-life when compared to the controls. Nevertheless, there was no change in the level of SoC as a function of CFT.Applying CFT can result in reducing experiential avoidance and raising the meaning of life in women with PTSD due to IPV exposure. CFT is highly recommended to strengthen the well-being of patients with PTSD and reduce the PTSD symptoms.

Is Gratitude Associated With Suicidal Ideation in Veterans With Mental Illness and Student Veterans With PTSD Symptoms?

ABSTRACT

The present study is aimed to identify the effect of gratitude as an adaptive regulating mechanism from suicidal ideation (SI) for veterans with mental illness (study 1) and student veterans with posttraumatic stress disorder (PTSD) symptoms (study 2) in the United States. Descriptive statistics and regression analyses were used to examine sociodemographic characteristics and relationships between gratitude and SI. Our study 1 consisted of 156 veterans with mental illness. The mean age for study 1 was 37.85. Our study 2 consisted of 232 student veterans with PTSD symptoms. The mean age for study 2 was 28.43. Higher gratitude scores in study 1 and study 2 were significantly associated with lower SI scores after adjusting for demographics and depression. This study partially supports the association between gratitude and SI in veterans with mental illness. Based on the results from this study, gratitude interventions may be effective in reducing SI when working with veterans with mental illness.

Using suicide notes to understand suicide among cancer patients: A mixed-method study

BACKGROUND

Cancer patients are at risk of suicide. However, no studies have used suicide notes to investigate their expressed reasons for suicide. The objectives of this study were to compare the characteristics between note leavers and non-leavers among cancer suicide cases and to understand the patterns in expressed reasons for suicide using suicide notes.

METHOD

Suicide cases (2012-2017) were identified from the Hong Kong Coroner's Court reports, which provide detailed information as well as the content of suicide notes. Bivariate tests and multiple logistic regression were performed to compare the characteristics of note leavers and non-leavers among suicide cases with cancer. Thematic analysis was performed on suicide notes to extract themes of expressed reasons for suicides by cancer status and age group.

RESULTS

Among cancer suicide cases and compared to non-leavers, note leavers were younger, more likely to be male, use non-violent suicide methods, have better housing conditions, and live alone. Suffering from physical disease was a major theme identified among cancer note leavers across all age groups. Young and middle-aged non-cancer note leavers had various themes identified. Physical illness was the major theme for elderly non-cancer note leavers.

CONCLUSIONS

Cancer note leavers had unique characteristics and suffering from physical illness was the major expressed reason identified in the suicide notes. Healthcare professionals should pay attention to the mental as well as the physical needs of patients. Improving quality of life and regaining control of life are vital for suicide prevention among cancer patients.

The relationship of perceived social support to feelings of hopelessness under COVID-19 pandemic: The effects of epidemic risk and meaning in life

Lockdown orders were issued on January 23, 2020 in Wuhan, China, for the purpose of preventing and controlling COVID-19, which led to severe psychological problems for residents. The present study aimed to investigate the recovery model of hopelessness through interpersonal pathways during the COVID-19 epidemic. An online survey was conducted in 34 provinces (those in autonomous regions and municipalities) of China. This survey investigated residents' hopelessness and the impact of three factors on it, including their perceived social support, meaning in life, and epidemic risk levels. Results showed that both perceived social support and meaning in life negatively predicted hopelessness, while meaning in life played a partial mediating role between perceived social support and hopelessness. Further, epidemic risk level played a moderating role between perceived social support and meaning in life, indicating a “marginal zone effect.” Specifically, when comparing other province, perceived social support showed a stronger positive relationship with meaning in life among residents living in other regions of Hubei province. In sum, this study extends the recovery model of hopelessness through interpersonal pathways, and has important implications for public health emergency management.

Post-9/11 military veterans' adjustment to civilian life over time following separation from service

OBJECTIVES

US military veterans face many challenges in transitioning to civilian life; little information is available regarding veterans' reintegration experiences over time. The current study characterized veterans' postdeployment stressful life events and concurrent psychosocial wellbeing over one year and determined how stressors and wellbeing differ by demographic factors.

METHODS

Recent Post-911 veterans (n = 402) were assessed approximately every three months for 1 year. Participants were 60% men, primarily White (78%), and 12% Latinx; the average age was 36 years.

RESULTS

The frequency of stressful events decreased over time but was higher for men and minority-race veterans (independent of time since separation). Veterans reported high mean levels of posttraumatic stress disorder, anxiety, and insomnia symptoms, which improved slightly over time. Minority-race and Latinx veterans had higher symptom levels and slower rates of symptom reduction.

CONCLUSION

Veterans remain distressed in their overall transition to civilian life. Interventions to promote resilience and help veterans manage readjustment to civilian life appear urgently needed.

The Mediating Role of Meaning in Life in the Effects of Calling on Posttraumatic Stress Symptoms and Growth: A Longitudinal Study of Navy Soldiers Deployed to the Gulf of Aden

This study examined the mediating role of meaning in life in the effect of calling on posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) among navy soldiers of the Republic of Korea deployed to the Gulf of Aden, Somalia. Participants responded to the questionnaire survey three times (pre-deployment, deployment, and post-deployment) at 4-month intervals. From the first, second, and third surveys, data were collected for 223, 195, and 103 respondents, respectively. Results showed that calling had a negative effect on PTSD, fully mediated by meaning in life, whereas calling had a positive effect on PTG, partially mediated by meaning in life. Our findings suggest that calling acts as a positive psychological resource for maintaining the meaning in life throughout stressful events experienced during deployment, thereby reducing posttraumatic stress symptoms and promoting post-deployment psychological growth. Finally, theoretical and practical implications and the need for follow-up studies are discussed.

Spiritual Well-Being and Purpose in Life Among Conscripts: A Case Study in Iran

BACKGROUND

Spiritual Well-Being (SWB) is an important aspect of health. Since soldiers, as members of community, are faced with numerous spiritual, psychological, and physical problems, belief in spirituality can play an important role in explaining their purpose in life (PIL). Therefore, this study aimed to evaluate SWB, PIL, and the relationship between these two concepts in conscripts. In this cross-sectional study, 301 soldiers were selected by available sampling method from one of the military barracks in Iran 2019. Data were collected using the demographic, SWB, and PIL questionnaires. The results showed that SWB of the soldiers were at the high level (100.6 ± 12.30) and their PIL were at the moderate level (112.92 ± 13.70). Furthermore, a direct and intermediate relationship was observed between the soldiers' SWB and PIL (P <0.001, r = 0.50). Based on the findings, increased SWB enhanced PIL in soldiers and vice versa. To increase generalizability of the data, studies over a larger statistical population are recommended in different cultures. Findings of this study can also identify the interventional strategies to increase the soldiers' purpose in life.

Testing the Effectiveness of a Salutogenic Model for Reducing Suicidal Tendencies in a Population of Elderly and Young Adults

Suicide is a leading cause of mortality worldwide, with the elderly having the highest suicide rates. This study tests the effectiveness of a salutogenic model in normative elderly people compared with young adults in protecting against risk behaviors and suicidal tendencies, based on two variables: locus of control and meaning in life (mediating variable between locus of control and suicidal tendency). Participants were 191 people aged 65 to 100 years and 200 young adults aged 18 to 28 years old. Participants completed questionnaires on locus of control and purpose in life and were assessed for suicidal tendencies. Findings reveal a negative effect of age on locus of control, purpose in life, and a negative correlation between purpose in life and internal locus of control and suicidal tendency. Purpose in life mediates between internal locus of control and suicidal tendency in both populations. The salutogenic model has significant implications and can be used to reduce suicidal tendencies.

Associations Between the NIH Toolbox Adult Social Relationship Scales and Suicidal Ideation

Various measures of social support have been associated with suicidal ideation (SI). However, a brief, consistent, multidimensional approach to social support assessment has not been established. We assessed the NIH Toolbox Adult Social Relationship (ASR) scales and their associations with the Beck Scale for Suicidal Ideation (BSI). Five ASR scales (emotional support, instrumental support, friendship, loneliness, perceived rejection) were used to predict BSI scores among psychiatric inpatients at baseline (N = 79) and at 3-months follow-up (N = 63). Mean BSI scores were 22.2 (SD 8.6) at baseline and 5.7 (SD 6.7) at follow-up. The ASR scales had high internal consistency (Cronbach's α = 0.93-0.96). Emotional support was associated with SI at baseline and 3-month follow-up. Instrumental support, loneliness and perceived rejection were associated with SI at baseline. Friendship was not associated with SI at either time-point. The ASR scales appear promising in differentiating aspects of social support most relevant to SI.

Meaning in Life Drives Reductions in Suicide Risk Among Acutely Suicidal Soldiers Receiving a Crisis Response Plan

Objective: The purpose was to examine temporal associations among meaning in life and suicide risk across suicide-focused interventions.

Methods: A secondary analysis was conducted using data from a randomized clinical trial testing the efficacy of a standard crisis response plan (S-CRP) and a CRP enhanced with a discussion about the patient's reasons for living (E-CRP) as compared to treatment as usual (TAU). A total of 97 active duty U.S. Army personnel presenting to military emergency departments and outpatient behavioral health clinics with active suicide ideation or a lifetime history of suicide attempts were enrolled between January 2013 and February 2016. Meaning in life and suicide risk were assessed at baseline and 1, 3, and 6 month follow-ups.

Results: The association of meaning in life with time-lagged suicide risk significantly differed across treatment groups (p = .024). In TAU, meaning in life was not significantly associated with later reductions in suicide risk. In S-CRP, a stronger desire to establish meaning in life was significantly associated with later reductions in suicide risk (p < .001). In E-CRP, a stronger sense of purpose and meaning in life was significantly associated with later reductions in suicide risk (p < .001).

Discussion: Faster reductions in suicide risk observed among patients who receive a CRP are attributable in part by the effects of strengthened meaning in life. Different facets of meaning in life contribute to reduced suicide risk in unique ways across treatments with varying components.

Clinical Trials Registration: Data used in this secondary analysis came from ClinicalTrials.gov identifier NCT02042131.

Meaning in life following deployment sexual trauma: Prediction of posttraumatic stress symptoms, depressive symptoms, and suicidal ideation

Deployment sexual trauma (DST; i.e., sexual harassment or assault during deployment in the military) is associated with physical and mental health consequences, including posttraumatic stress disorder (PTSD), depression, and suicidal ideation (SI). Less attention has been placed on factors that may offer protection from deleterious mental health outcomes following DST. Global meaning in life (i.e., purpose, beliefs, goals, and subjective feelings) has been shown to be a protective factor against PTSD, depression, and SI following combat trauma; however, the extent to which meaning in life may affect outcomes following DST has not been investigated. Cross-sectional associations and Hayes mediation models were examined using baseline interview data from the Survey of Experiences of Returning Veterans sample (SERV; 850 recently returned veterans, 352 women). DST was associated with post-deployment posttraumatic stress symptoms (PTSS), depressive symptoms, and SI severity, and with decreased sense of meaning in life. Further, meaning in life was a significant mediator between DST and each of the three outcomes, even after controlling for demographic variables and combat experiences. The mediation models did not differ by gender. Findings suggest meaning in life may be an important clinical factor, both for the identification of risk and as a point of intervention.

Exploring cross-lagged associations between spiritual struggles and risk for suicidal behavior in a community sample of military veterans

BACKGROUND

There is consensus that struggles with religious faith and/or spirituality likely contribute to risk for suicidal behavior in military populations. However, a lack of longitudinal information has limited the ability to clarify the temporal associations between these variables.

METHODS

This study examined cross-lagged associations between key types of spiritual struggles (divine, morality, ultimate meaning, interpersonal relations, and doubting) and indices of risk for suicidal behavior (suicidal ideation and probability of future attempt) in a community sample of veterans who completed assessments spaced apart by six months.

RESULTS

Greater severity of all forms of spiritual struggles was generally concurrently associated with indices of suicidal behavior at both time points. Of the possible models for predicting suicide risk, structural equation modeling analyses revealed that a cross-lagged option with spiritual struggles predicting risk provided the best-fitting solution for veterans' responses on study measures. In addition to PTSD and MDD symptomatology, issues with ultimate meaning at Time 1 were uniquely predictive of veterans' perceived likelihood of making a suicide attempt beyond the second assessment, after accounting for autoregressive effects and other variables in this model.

LIMITATIONS

This sample was recruited from a single geographic region with disproportionate ties to Christian religious traditions. In addition, reliance on self-report instrumentation potentially limited the accuracy of gauging suicide risk in some cases.

CONCLUSIONS

Findings highlight the prognostic value of spiritually integrated models for assessing suicide risk in military veterans that account for mental health conditions along with possible expressions of suffering in the spiritual domain.

Curiosity improves coping efficacy and reduces suicidal ideation severity among military veterans at risk for suicide

Curiosity, the tendency to engage in novel and challenging opportunities, may be an important source of resilience for those at risk for suicide. We hypothesized that curiosity would have a buffering effect against risk conferred by multiple sources of distress, whereby curiosity would be associated with reduced suicidal ideation and increased coping efficacy. As part of a larger intervention trial designed to improve coping skills and reduce suicidal ideation, 117 military veterans with suicidal ideation completed measures of curiosity and distress (perceived stress, depression, anxiety, and sleep disturbances) at baseline, and completed measures of suicidal ideation and coping efficacy (to stop negative thoughts, to enlist support from friends and family) at baseline and 3-, 6-, and 12-week follow up. Growth curve models showed that curiosity moderated the association between distress and suicidal ideation at baseline and that curiosity moderated the association between distress and increased coping efficacy to stop negative thoughts over time. Findings suggest that curiosity may buffer against the effect of heightened levels of distress on suicidal ideation and help facilitate stronger gains in coping efficacy over time. Additional work should further examine the role of curiosity as a protective factor for veterans with suicidal ideation.

College student suicidal ideation: Perceived burdensomeness, thwarted belongingness, and meaning made of stress

The interpersonal theory of suicide (ITS) posits that suicidal ideation is interpersonal in nature. More specifically, in the ITS, perceived burdensomeness and thwarted belongingness are dynamic cognitive-affective interpersonal states that engender suicidal ideation. However, intrapersonal (i.e., within the self) existential protective factors for suicidal ideation, such as the ability to make meaning from stressful life events, remain relatively unexplored. The authors examined the degree to which interpersonal and intrapersonal variables contribute to the variance of suicidal ideation in college students (n = 165). Results indicated that students' meaning made of stress was negatively and uniquely associated with suicidal ideation after controlling for ITS interpersonal contributions.

Military Veterans' Experiences with Suicidal Ideation: Implications for Intervention and Prevention

We sought to understand Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans' experiences with suicidal ideation. Semi-structured interviews with 34 OEF/OIF veterans addressed circumstances leading up to disclosure of suicidal ideation during brief clinical assessments. We used an iterative, inductive and deductive thematic analysis approach. Results revealed three pervasive, persistent domains that reinforce the uniqueness of veteran suicidal thoughts: military culture, difficult deployment experiences, and postdeployment adjustment challenges. Within postdeployment, we identified four themes that serve as intervention targets: adjusting to civilian culture, changes to sense of self, feeling overwhelmed by stressors, and lacking life purpose or meaning.

Life meaning is associated with suicidal ideation among depressed veterans

Suicide is a major public health concern among U.S. veterans. Even when asked directly, veterans who die by suicide have been found to deny suicidal thoughts. Psychological assessment needs to go beyond the current risk factors and evaluate underlying factors that may increase suicide risk. In the present study, diagnostic interviews and self-report questionnaires were used to measure life meaning and suicidal ideation in a sample of 110 depressed veterans. Life meaning was significantly associated with suicidal ideation, even after accounting for depression and suicide history. Life meaning may be an important, previously ignored indicator of suicide risk.