Nature and determinants of suicidal ideation among U.S. veterans: Results from the national health and resilience in veterans study

• Published in: Journal of affective disorders Vol. 197; pp. 66 - 73
• Main Authors: Smith, Noelle B, Mota, Natalie, Tsai, Jack, Monteith, Lindsey, Harpaz-Rotem, Ilan, Southwick, Steven M, Pietrzak, Robert H
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2016
• Subjects: Adult; Cohort Studies; Female; Humans; Longitudinal time points; Male; Nationally representative veteran sample; Prevalence; Prospective Studies; Protective and risk factors; Protective Factors; Psychiatry; Resilience, Psychological; Social Support; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Suicidal Ideation; United States; Veterans - psychology; Veterans - statistics & numerical data; Young Adult; Nationally representative veteran sample; Protective and risk factors; Suicidal ideation; Longitudinal time points
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2016.02.069

Abstract Background Suicidal thoughts and behaviors among U.S. military veterans are a major public health concern. To date, however, scarce data are available regarding the nature and correlates of suicidal ideation (SI) among U.S. veterans. This study evaluated the prevalence and correlates of suicidal ideation in a contemporary, nationally representative, 2-year prospective cohort study. Method Data were analysed from a total of 2157 U.S. veterans who participated in the National Health and Resilience Veterans Study (NHRVS; Wave 1 conducted in 2011; Wave 2 in 2013). Veterans completed measures assessing SI, sociodemographic characteristics, and potential risk and protective correlates. Results The majority of veterans (86.3%) denied SI at either time point, 5.0% had SI onset (no SI at Wave 1, SI at Wave 2), 4.9% chronic SI (SI at Waves 1 and 2), and 3.8% had remitted SI (SI at Wave 1, no SI Wave 2). Greater Wave 1 psychiatric distress was associated with increased likelihood of chronic SI (relative risk ratio [RRR]=3.72), remitted SI (RRR=3.38), SI onset (RRR=1.48); greater Wave 1 physical health difficulties were additionally associated with chronic SI (RRR=1.64) and SI onset (RRR=1.47); and Wave 1 substance abuse history was associated with chronic SI (RRR 1.57). Greater protective psychosocial characteristics (e.g., resilience, gratitude) at Wave 1 were negatively related to SI onset (RRR=0.57); and greater social connectedness at Wave 1, specifically perceived social support and secure attachment style, was negatively associated with SI onset (RRR=0.75) and remitted SI (RRR=0.44), respectively. Limitations Suicidal ideation was assessed using a past two-week timeframe, and the limited duration of follow-up precludes conclusions regarding more dynamic changes in SI over time. Conclusions These results indicate that a significant minority (13.7%) of U.S. veterans has chronic, onset, or remitted SI. Prevention and treatment efforts designed to mitigate psychiatric and physical health difficulties, and bolster social connectedness and protective psychosocial characteristics may help mitigate risk for SI.