ADHD and nonsuicidal self-injury in male veterans with and without PTSD

Abstract

The objective of the present research was to examine the association between ADHD symptoms and nonsuicidal self-injury (NSSI) in male Iraq/Afghanistan-era veterans with and without PTSD. Approximately 25% of veterans screened positive for clinically-significant levels of ADHD. Male veterans with PTSD were significantly more likely to report ADHD symptoms than male veterans without PTSD. In addition, as expected, ADHD was strongly associated with NSSI, even after accounting for the effects of demographic variables, PTSD, depression, and alcohol use disorder. Future work aimed at replicating and extending these findings in longitudinal studies of veterans is needed.

Characteristics of nonsuicidal self‐injury among veterans

“…0%;Bloshnich et al, 2015;Bryan & Bryan, 2014;. Prevalence observed in this study fits within the range found in prior studies that have utilized NSSI assessment tools explicitly evaluating SDV intent among clinical and community samples of veterans (6%-25%; Chu et al, 2018;Holliday et al, 2018;Kimbrel et al, 2015Kimbrel et al, , 2016Kimbrel et al, , 2017Kimbrel, Meyer, et al, 2018). By contrast, it is notably lower than rates observed in studies that have examined NSSI using the Habit Questionnaire (Resnick & Weaver, 1994), which…”

“…As one example, research on treatment‐seeking attitudes among active duty service members suggests distinct barriers to disclosing mental health concerns that do not exist for veterans, such as future‐oriented concerns about one's military career (Hom, Stanley, Schneider, & Joiner, 2017). Relatedly, nine of the fourteen studies assessed NSSI in specialized veteran populations, including veterans specifically enrolled in college courses (Blosnich et al, 2015; Bryan & Bryan, 2014; Bryan et al, 2015) or veterans oversampled for PTSD diagnosis (Calhoun et al, 2017; Cunningham et al, 2019; Kimbrel et al, 2015, 2016, 2017) or history of military sexual trauma (MST; Holliday et al, 2018), potentially limiting generalizability to veterans outside these unique diagnostic or environmental circumstances.…”

“…Risk of bias due to varying assessment methodology in the literature may also contribute to the omission of data important to understanding NSSI characteristics in this population. Six studies among veterans used a single, dichotomous question to assess the presence or absence of NSSI history (Baer et al, 2018; Bryan et al, 2015; Chu et al, 2018; Kimbrel et al, 2015, 2017; Kimbrel, Meyer, et al, 2018). Not only does this method provide limited information on the typological characteristics that may differentially affect suicide risk (e.g., method, frequency, versatility; Turner, Layden, Butler, & Chapman, 2013), but it may also affect prevalence estimates.…”

“…Among veterans, lifetime prevalence of NSSI is estimated to range from 4.7% to 62.0% (Baer et al, 2018;Blosnich, Kopacz, McCarten, & Bossarte, 2015;Bryan & Bryan, 2014;Bryan, Rudd, Wertenberger, Young-McCaughon, & Peterson, 2015;Bryan, Bryan, May, & Klonsky, 2015;Chu et al, 2018;Holliday, Smith, & Monteith, 2018;Kimbrel, DeBeer, Meyer, Gulliver, & Morissette, 2016;Kimbrel et al, 2015Kimbrel et al, , 2017Kimbrel, Meyer, DeBeer, Gulliver, & Morrissette, 2018;Kimbrel, Thomas, et al, 2018) with past 2-week prevalence as high as 59% among a treatment-seeking sample (Cunningham et al, 2019). History of NSSI among veterans is cross-sectionally associated with concurrent suicidal ideation (Bryan & Bryan, 2014;Chu et al, 2018;Cunningham et al, 2019;Holliday et al, 2018;Kimbrel et al, 2014Kimbrel et al, , 2015 and history of SAs (Kimbrel et al, 2016;Kimbrel, Meyer, et al, 2018;Kimbrel, Thomas, et al, 2018) beyond demographic and psychopathological correlates.…”

Non-suicidal self-injury prevalence, course, and association with suicidal thoughts and behaviors in two large, representative samples of US Army soldiers

“…Non-suicidal self-injury (NSSI), defined as the deliberate, self-inflicted damage of any body tissue without suicidal intent and for purposes not socially or culturally sanctioned (International Society for the Study of Self-Injury, 2018), is a strong prospective predictor of suicide attempts (SA) in civilian populations (Asarnow et al ., 2011; Wilkinson et al ., 2011; Hamza et al ., 2012; Ribeiro et al ., 2016). Yet, to our knowledge, only a handful of published studies have investigated the prevalence and characteristics of NSSI in military samples (Klonsky et al ., 2003; Bryan and Bryan, 2014; Kimbrel et al ., 2014; Shelef et al ., 2014; Bryan et al ., 2015 a , 2015 b ; Kimbrel et al ., 2015, 2016, 2017; Calhoun et al ., 2017; Baer et al ., 2018). Like civilian samples, NSSI in military samples is more prevalent in women (Bryan and Bryan, 2014; cf.…”