Traumatic stress and suicide risk: The role of rural origin.

Abstract

Posttraumatic stress disorder (PTSD) has been associated with increased risk for suicide. This study addressed 1 factor that could influence the relationship between PTSD and risk of suicide: rural origin. Suicide rates are elevated in rural compared to nonrural areas. Reluctance to seek mental health care and other factors thought to contribute to high suicide rates in rural locations also may be associated with increased risk of suicide for individuals from rural compared to nonrural areas who are experiencing posttraumatic stress symptoms (PSS). However, little research has examined this relationship with an emphasis on location of origin. We hypothesized that rural origin would moderate the relationship between PSS and suicide risk (as measured by the Suicidal Behaviors Questionnaire-Revised), such that growing up in a rural area would result in an amplification of this relationship. Analyses revealed a significant interaction between PSS and rural origin in the prediction of suicide risk. However, the relationship between PSS and suicide risk was weaker for individuals from rural areas than nonrural areas. The results of this study suggest that posttraumatic stress symptoms are less likely to be associated with suicidality among individuals who were raised in a rural versus nonrural area.

A Systematic Review of Factors Impacting Suicide Risk Among Rural Adults in the United States

“…The vast majority (n = 25) of included studies were cross‐sectional designs, 3,20–43 followed by noncomparative qualitative study designs 44–48 (n = 5), 3 cohort studies (n = 2 retrospective cohort 49,50 ; n = 1 nonconcurrent cohort 51 ), and 1 case‐control 52 study (see Table 2).…”

Alaska Native quality of life: culture, rurality and the sacred

“…Even AN Elder research has found that moving to an urban environment and the lack of traditional resources such as plants, food, running water, fresh air and space to be on the land and practice cultural activities (for example, hunting, fishing, gathering) is deleterious to AN quality of life and successful ageing (Lewis, 2010). Further, while suicide risk is often a salient associative risk and concern for rural residents, research (Thorne et al, 2017) suggests that PTSD symptomology that leads to taking one's life is more likely to be associated with being raised in an urban environment as opposed to a rural environment. While the complexities of urban and rural life are not easily summed as either-or, good versus bad, protective versus harmful, it is important to both acknowledge the disparities that exists for those in rural environments (for example, lack of resources, healthcare inequity) and to recognise the innate and generative quality of life that is embedded in rurality.…”

Personalized implementation of video telehealth for rural veterans (PIVOT-R)

“…Among rural Veterans, MH care is a critical concern, as one in five post-deployment Veterans met criteria for an MH diagnosis; (6) and 33% of Veterans Health Administration (VHA) enrollees live in rural areas (5). Veterans in rural areas report poorer MH, have more severe MH diagnoses, and are more likely to die by suicide than urban veterans (7,8). The suicide rate among veterans is 1.5 times higher compared to non-veterans, with the highest concentrations in western and rural states (9,10).…”