Detecting Potential Underreporting of Suicide Ideation Among U.S. Military Personnel

Abstract

Using a military sample comprised largely of National Guard personnel, zero-inflation negative binomial regression was applied to estimate the effects of indirect, nonface valid indicators of suicide ideation [Thwarted Belongingness (TB), Perceived Burdensomeness (PB), and Hopelessness], in predicting suicide ideation. Data from a sample of 497 military personnel (82.1% male; m = 27.24; range = 18-59) were analyzed. TB and the interaction of TB with Hopelessness were significant predictors in the logistic regression, and in the negative binomial regression, the main effects of TB and hopelessness, and the interactions of TB with hopelessness and PB with hopelessness were significant. The findings further indicated that approximately 10% of those not reporting ideation would be predicted to be ideators. Clinically, these results indicate that, in samples reluctant to report ideation, the assessment of suicide risk may improve through the use of relevant measures that do not explicitly reference suicide thoughts.

Military Deployments and Suicide: A Critical Examination

“…It will be necessary for future research to move beyond the current approach to data collection, which largely relies on the collection of self-report data at the time the data are needed. Not only are such self-reports limited for a variety of methodological reasons (e.g., recall problems, mental-health disorders, subjectivity of the scale; Sternke, 2011), but self-reported suicide-related behaviors and thoughts are believed to be underreported (Anestis, Mohn, Dorminey, & Green, 2017). Additionally, researchers are often unable to validate these data, so the data may not be reliable (e.g., Garvey Wilson, Hoge, McGurk, Thomas, & Castro, 2010; Polusny et al, 2011; Wessely et al, 2003).…”

Factors contributing to honor‐endorsing men's suicide capability: Firearm ownership, practical capability, and exposure to painful and provocative events

“…Relatedly, this area of work would also benefit from distinguishing honor-based masculinity from masculinity norms found in other potentially related subcultures, such as the military and warrior culture (Anestis et al, 2019;Bryan & Morrow, 2011;Lancaster et al, 2018). Not only are honor-endorsing individuals more supportive of military action (Barnes et al, 2014;Barnes, Brown, & Osterman, 2012;Saucier, Webster, et al, 2018), but individuals from U.S. honor cultures may be overrepresented in the U.S. military (Brown, 2016;Council on Foreign Relations, 2020;Watkins & Sherk, 2008).…”

Using categorical data analyses in suicide research: Considering clinical utility and practicality

“…Zero‐inflated Poisson or negative binomial regression is used when there a large number of zeros in one's data (e.g., many people report zero suicide attempts or a score of zero on self‐reported suicide ideation). Zero‐inflated models have been implemented with greater frequency in suicide research, especially to identify underreporting of suicide ideation (e.g., Anestis, Mohn, Dorminey, & Green, 2019; Ansell et al, 2015; Cukrowicz, Jahn, Graham, Poindexter, & Williams, 2013). Hu, Pavlicova, and Nunes (2011) provide a superb and non‐technical review of zero‐inflated count regression models for those interested.…”