Comparing the interactions of risk factors by method of suicide among veterans: A moderated network analysis approach.

Abstract

Despite the well-established link between firearm access and suicide, less is known about other variables that may influence the risk for death by self-inflicted gunshot versus other methods of suicide. As individual factors have demonstrated limited predictive ability, scholars have called for studies that consider the multifaceted relations between myriad variables. One alternative to the typical cause-and-effect approach for investigating various forms of psychopathology is network analysis. However, few studies have applied this method to suicidal outcomes, particularly in the context of a veteran population. Data from 19,234 male veteran suicide decedents (89.1% White; M age = 57.16, SD = 18.64) acquired from the National Violent Death Reporting System were used to investigate characteristics of veteran suicide decedents who died by self-inflicted gunshot (gun; 66.4%) versus alternative methods (nongun, e.g., poisoning, hanging; 33.5%). Results of the overall moderated network model indicated that veterans in the gun group were more likely to have a physical health problem that contributed to the suicide than veterans in the nongun group. Additionally, results of the moderated network model revealed several pairs of associated circumstances whose relationships were significantly moderated by method of suicide, the three strongest of which included having a physical health problem that contributed to the suicide. Overall, results suggest that public health prevention and intervention efforts aimed at reducing the overall burden of physical health problems among male veterans may mitigate the risk of firearm suicides. This article was published Online First March 21, 2024. This research uses data from the National Violent Death Reporting System (NVDRS), a surveillance system designed by the Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control. The findings are based, in part, on the contributions of the funded states and territories that collected violent death data and the contributions of the states' partners, including personnel from law enforcement, vital records, medical examiners/coroners, and crime laboratories. The analyses, results, and conclusions presented here represent those of the authors and do not necessarily reflect those of the CDC. Amanda M.