Examining the link between prior suicidality and subsequent suicidal ideation among high-risk US military service members

Abstract

BackgroundResearch is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel.MethodsUS military service members referred to or seeking care for suicide risk (N = 624) completed self-report psychiatric domain measures and a clinician interview assessing prior suicidality severity at baseline. Three months later, participants completed a self-report measure of suicidal ideation severity. Three separate percentile bootstrap mediation models were used to examine psychiatric factors (i.e. alcohol abuse, anxiety sensitivity, hopelessness, insomnia, posttraumatic stress symptoms, suicidal ideation, and thwarted belongingness) as parallel mediators of the relationship between prior suicidality severity (specifically, suicidal ideation, suicide attempt, and overall suicidality – i.e. ideation/attempt severity combined) at baseline and suicidal ideation severity at follow-up.ResultsHopelessness, specifically, and the total effect of all mediators, each significantly accounted for the relationship between prior suicidality severity and subsequent ideation severity across models. In the models with attempt severity and overall suicidality severity as predictors, thwarted belongingness was also a significant mediator.ConclusionsHopelessness, thwarted belongingness, and overall severity of psychiatric indices may explain the relationship between prior suicidality severity and future suicidal ideation severity among service members at elevated suicide risk. Research is needed to replicate these findings and examine other possible mediators.

Military Suicide Research Consortium common data elements: Bifactor analysis and longitudinal predictive ability of suicidal ideation and suicide attempts within a clinical sample.

“…The present findings suggest that the shared variance assessed via the CDEs results in increased identification of service members at high risk for future suicide attempts in both combat-exposed and non-combat-exposed service members. The present findings also expand the results of Hom, Duffy et al (2019) by demonstrating that the CDEs not only account for shared variance between historical suicidal symptoms and future suicidal ideation, but the shared variance captured across their scale-specific constructs actually results in significantly more accurate identification of service members at increased risk for future suicide attempts. Additionally, although the effect sizes observed in the present study are small to medium, they are consistent with the top established risk factors for future suicidal ideation and suicide attempts identified within the larger literature (Franklin et al, 2017).…”

“…Another study by Hom, Duffy et al (2019) utilized a subset of the present sample to identify potential mediators of the association between severity of past suicidality (as measured by the SHBQ) and severity of suicidal ideation at three-month follow-up (as measured via the Adult Suicidal Ideation Questionnaire; ASIQ). They found that hopelessness and the total effect of CDE-derived mediators (anxiety sensitivity, alcohol use, depressive symptoms, insomnia, thwarted belongingness, suicidal ideation, and PTSD symptoms) significantly explained the relationship between severity of historical suicidality (SHBQ total scores) and severity of suicidal ideation (i.e., ASIQ total scores) at follow-up.…”

Suicide‐related interpersonal needs of young Iranian people: A preliminary validation of thwarted belongingness and perceived burdensomeness constructs

“…Additionally, TB may trigger other risk factors, including PB and hopelessness, over time (Roeder & Cole, 2019). Also, Hom et al (2019) demonstrated prior suicidality to be linked to subsequent ideation, where TB played a mediating role. Thus, it may be argued that a thwarted need for belonging might be more implicated in a diminished desire to live, instead of an active desire to die (Harrison, Stritzke, Fay, Ellison, & Hudaib, 2014).…”