Sex Differences in US Army Suicide Attempts During the Wars in Iraq and Afghanistan

Naifeh, James A.; Mash, Holly B. Herberman; Stein, Murray B.; Vance, Mary C.; Aliaga, Pablo A.; Fullerton, Carol S.; Dinh, Hieu M.; Wynn, Gary H.; Kao, Tzu‐Cheg; Sampson, Nancy A.; Kessler, Ronald C.; Ursano, Robert J.

doi:10.1097/mlr.0000000000001425

Cited by 6 publications

(3 citation statements)

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“…Contrary to research indicating overall population-level higher SA risk among female soldiers [ 15 , 31 ], women with depression were not more likely to attempt suicide within 30 days. Given that depression is more common in women in both civilian [ 32 ] and military [ 33 , 34 ] populations, further examination of psychiatric disorders associated with SA among Army women with various medically-documented diagnoses may clarify this relationship.…”

Section: Discussioncontrasting

confidence: 96%

Predictors of suicide attempt within 30 days of first medically documented major depression diagnosis in U.S. army soldiers with no prior suicidal ideation

et al. 2023

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Background Understanding mental health predictors of imminent suicide attempt (SA; within 30 days) among soldiers with depression and no prior suicide ideation (SI) can inform prevention and treatment. The current study aimed to identify sociodemographic and service-related characteristics and mental disorder predictors associated with imminent SA among U.S. Army soldiers following first documented major depression diagnosis (MDD) with no history of SI. Methods In this case-control study using Army Study to Assess Risk and Resilience in Servicemembers (STARRS) administrative data, we identified 101,046 active-duty Regular Army enlisted soldiers (2010–2016) with medically-documented MDD and no prior SI (MDD/No-SI). We examined risk factors for SA within 30 days of first MDD/No-SI using logistic regression analyses, including socio-demographic/service-related characteristics and psychiatric diagnoses. Results The 101,046 soldiers with documented MDD/No-SI were primarily male (78.0%), < 29 years old (63.9%), White (58.1%), high school-educated (74.5%), currently married (62.0%) and < 21 when first entering the Army (56.9%). Among soldiers with MDD/No-SI, 2,600 (2.6%) subsequently attempted suicide, 16.2% (n = 421) within 30 days (rate: 416.6/100,000). Our final multivariable model identified: Soldiers with less than high school education (χ23 = 11.21, OR = 1.5[95%CI = 1.2–1.9]); combat medics (χ22 = 8.95, OR = 1.5[95%CI = 1.1–2.2]); bipolar disorder (OR = 3.1[95%CI = 1.5–6.3]), traumatic stress (i.e., acute reaction to stress/not PTSD; OR = 2.6[95%CI = 1.4–4.8]), and “other” diagnosis (e.g., unspecified mental disorder: OR = 5.5[95%CI = 3.8-8.0]) diagnosed same day as MDD; and those with alcohol use disorder (OR = 1.4[95%CI = 1.0-1.8]) and somatoform/dissociative disorders (OR = 1.7[95%CI = 1.0-2.8]) diagnosed before MDD were more likely to attempt suicide within 30 days. Currently married soldiers (χ22 = 6.68, OR = 0.7[95%CI = 0.6–0.9]), those in service 10 + years (χ23 = 10.06, OR = 0.4[95%CI = 0.2–0.7]), and a sleep disorder diagnosed same day as MDD (OR = 0.3[95%CI = 0.1–0.9]) were less likely. Conclusions SA risk within 30 days following first MDD is more likely among soldiers with less education, combat medics, and bipolar disorder, traumatic stress, and “other” disorder the same day as MDD, and alcohol use disorder and somatoform/dissociative disorders before MDD. These factors identify imminent SA risk and can be indicators for early intervention.

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Section: Discussioncontrasting

confidence: 96%

Predictors of suicide attempt within 30 days of first medically documented major depression diagnosis in U.S. army soldiers with no prior suicidal ideation

et al. 2023

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“…En consecuencia, la ansiedad hace referencia al estado de agitación ante la anticipación de una amenaza, es decir, de una situación peligrosa, lo que conlleva a una respuesta emocional que engloba, tanto el nivel cognitivo, como el emocional, el fisiológico, y/o el motor (Soriano et al, 2020). En esta dirección, la presencia de bajos niveles podría mostrar un mayor optimismo (Naifeh et al, 2021) y un menor riesgo para desarrollar el síndrome de burnout (Ram et al, 2021), lo que favorece su bienestar personal (Martínez-Cuazitl et al, 2022;McBride et al, 2022).…”

Section: Discussionunclassified

“…Por ello, es necesario que emerja bienestar por parte de los trabajadores de las diferentes escalas del Ejército para alcanzar mejores resultados de productividad y de reducción de rotación de personal, mitigando los niveles de estrés, pudiendo liderar a través de un adecuado nivel de IE (García, 2019). En otra dirección, la resiliencia es considerada un constructo fundamental en el Ejército contemporáneo, ya que dicho constructo permitirá hacer frente a los diversos escenarios de estrés (Naifeh et al, 2021), saliendo de los mismos de manera favorecida, mostrando el ser un mayor compromiso institucional al ayudarle a alcanzar los objetivos organizacionales previamente establecidos (Arslan, 2021). Los síntomas disociativos se asocian a un peor funcionamiento cognitivo en los dominios de la memoria, atención y funcionamiento ejecutivo entre los individuos con TEPT (McKinnon et al, 2016), incluidos los veteranos (Howard et al, 2021).…”

Section: Introductionunclassified

Beneficios de la intervención ante el Trastorno de Estrés Postraumático en soldados. Una revisión sistemática

Soriano-Sánchez

2022

Rev. estudios psicol.

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Antecedentes: Actualmente, el Ejército, constituido por el de Tierra, Aire y Mar, demanda de un trabajo constante al servicio de la nación, siendo el primer deber del militar la disposición permanente de la defensa nacional. En consecuencia, sus integrantes han de hacer frente a diversas situaciones estresantes durante su trayectoria profesional. Objetivo: Identificar mediante una revisión sistemática la influencia que ejercen los programas de intervención sobre el Trastorno de Estrés Postraumático (TEPT) en personal militar profesional. Materiales y métodos: Revisión sistemática en cinco bases de datos multidisciplinarias mediante dos fórmulas de búsqueda en inglés y español, siguiendo las recomendaciones de Cochrane, las fases de la guía PRISMA. La selección de los estudios se realizó mediante dos lecturas, garantizando exhaustividad y reproducibilidad. Resultados: Se incluyeron dos estudios con un total de N = 263 participantes. Los resultados muestran una relación existente entre la participación en Zona de Operaciones (ZO) y TEPT en el personal militar profesional. Conclusión: El TEPT afecta negativamente la salud física y psicológica del soldado. En consecuencia, es relevante intervenir mediante programas para reducir el TEPT. Finalmente, se resalta la importancia que posee la IE, la resiliencia y el apoyo, tanto familiar como social, para paliar los efectos del TEPT.

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Moral injury associated with increased odds of past-year mental health disorders: a Canadian Armed Forces examination

Easterbrook

Plouffe

Houle

et al. 2023

European Journal of Psychotraumatology

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Sex Differences in US Army Suicide Attempts During the Wars in Iraq and Afghanistan

Abstract: Supplemental Digital Content is available in the text.

Cited by 6 publications

References 49 publications

Predictors of suicide attempt within 30 days of first medically documented major depression diagnosis in U.S. army soldiers with no prior suicidal ideation

Predictors of suicide attempt within 30 days of first medically documented major depression diagnosis in U.S. army soldiers with no prior suicidal ideation

Beneficios de la intervención ante el Trastorno de Estrés Postraumático en soldados. Una revisión sistemática

Moral injury associated with increased odds of past-year mental health disorders: a Canadian Armed Forces examination

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