Suicide and War: The Mediating Effects of Negative Mood, Posttraumatic Stress Disorder Symptoms, and Social Support among Army National Guard Soldiers

The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard soldiers (N = 4,546). Results from structural equation modeling suggested that war experiences may precipitate a sequence of psychological consequences leading to suicidality. However, suicidality may be an enduring behavioral health condition. War experiences showed no direct effects on postdeployment suicidality, rather its effect was indirect through PTSD symptoms and negative mood. War experiences were, however, predictive of PTSD symptoms, as would be expected. PSTD symptoms showed no direct effect on postdeployment suicidality, but showed indirect effects through negative mood. Results also suggested that suicidality is relatively persistent, at least during deployment and postdeployment. The percentage of those at risk for suicide was low both during and after deployment, with little association between suicidality and time since returning from deployment. Additionally, few soldiers were initially nonsuicidal and then reported such symptoms at postdeployment. Implications of relationships of both negative mood and combat trauma to suicidality are discussed, as well as possible mediating effects of both personal dispositions and social support on relationships of war experiences to PTSD, negative mood, and suicidality.     

Soldier Background and Postinvestigative Events Associated With Timing of Suicide Following Deployment of U.S. Army National Guard Soldiers

The present study examined the timing of suicide and its associated soldier background and postinvestigative events among deployed Army National Guard (ARNG) soldiers from calendar years 2007 through 2014. Suicide deaths were nearly equally distributed between soldiers who had been deployed and those who had not. Among those deployed, however, suicides occurred mostly 1 year or more after having returned from deployment. Soldier background and postsuicide investigative events were associated with the timing of suicide. Having more years of military service, more previous deployments, and being married were associated with in-theater suicides. Soldiers younger in age (17–24 years), single, nonprior service, and lower in rank, in addition to having parent-family conflicts, full-time employment problems, and military transition problems were associated with suicides that had occurred 1–120 days and 120–365 days since return from deployment. Soldiers aged (24–29 years), married, and higher in rank, along with more reported problems including past behavioral health conditions, postdeployment behavior health referrals, criminal behaviors, and military performance were associated with suicides that had occurred 1 year or more after return. Findings likely represent time periods of suicide vulnerability for identifiable groups of soldiers, based on soldier background and events surrounding the suicide. Practical and theoretical implications of the findings are discussed.     

Shyness and emotion‐processing skills in preschoolers: a 6‐month longitudinal study

The present study utilized a short‐term longitudinal research design to examine the hypothesis that shyness in preschoolers is differentially related to different aspects of emotion processing. Using teacher reports of shyness and performance measures of emotion processing, including (1) facial emotion recognition, (2) non‐facial emotion recognition, and (3) emotional perspective‐taking, we examined 337 Head Start attendees twice at a 24‐week interval. Results revealed significant concurrent and longitudinal relationships between shyness and facial emotion recognition, and either minimal or non‐existent relationships between shyness and the other aspects of emotion processing. Correlational analyses of concurrent assessments revealed that shyness predicted poorer facial emotion recognition scores for negative emotions (sad, angry, and afraid), but not a positive emotion (happy). Analyses of change over time, on the other hand, revealed that shyness predicted change in facial emotion recognition scores for all four measured emotions. Facial emotion recognition scores did not predict changes in shyness. Results are discussed with respect to expanding the scope of research on shyness and emotion processing to include time‐dependent studies that allow for the specification of developmental processes. Copyright © 2007 John Wiley & Sons, Ltd.     

Suicide Attempts and Suicide among Marines: A Decade of Follow‐up

Suicidal behavior among military personnel is of paramount public health importance because of the increased risk of death from suicide in this population. Pre‐ and post‐Marine recruit training risk factors for suicide attempts among current and former Marines were examined in 10 years following recruit training. The characteristics of the subsample of current and former Marines who died by suicide during this time are also described. Stressful and traumatic life events (e.g., childhood physical, sexual, and emotional abuse, sexual harassment during recruit training) and pre‐recruit training suicide attempts emerged as having strong associations with post‐recruit training attempts. Half of those who died by suicide in the 10 years following recruit training endorsed at least one significant life stressor prior to joining the Marines. This study highlights the importance of screening for stressful and potentially traumatic experiences occurring both before and during military service as part of a comprehensive suicide risk assessment in military samples.     

Precipitating Circumstances of Suicide among Active Duty U.S. Army Personnel Versus U.S. Civilians, 2005–2010

To help understand suicide among soldiers, we compared suicide events between active duty U.S. Army versus civilian decedents to identify differences and inform military prevention efforts. We linked 141 Army suicide records from 2005 to 2010 to National Violent Death Reporting System (NVDRS) data. We described the decedents’ military background and compared their precipitators of death captured in NVDRS to those of demographically matched civilian suicide decedents. Both groups commonly had mental health and intimate partner precipitating circumstances, but soldier decedents less commonly disclosed suicide intent.     

Awareness,Attitudes, and Use of Crisis Hotlines among Youth At‐Risk for Suicide

Crisis hotlines have been central to suicide prevention efforts; however, utilization among youth remains low. A sample of at‐risk youth was surveyed about their awareness, utilization, and attitudes toward local and national crisis hotlines. Youth reported low rates of awareness and utilization, yet expressed a strong interest in phone hotlines (41% vs. 59% for new media categories combined). Youth reported stigma, but that help‐seeking could be positively influenced by peers and adults in their support system. Implications include making crisis services available across several mediums and the importance of engaging trusted others in youth suicide awareness campaigns and prevention efforts.     

Motivation and dropout in female handballers: a 21‐month prospective study

The purpose of this study was to test a motivational model of sport dropout that integrates the four‐stage causal sequence proposed by the Hierarchical Model of Vallerand ( 1997 ) and elements from achievement goal theory (Nicholls, 1989 ). The model posits that a task involving motivational climate facilitates, while an ego‐involving climate undermines, perceptions of competence, autonomy, and relatedness. In turn, feeling incompetent, non‐autonomous, and unrelated to others undermines self‐determined motivation toward handball which leads to the intention of dropping out of the game. Finally, such intentions are implemented later. Three hundred and thirty‐five female handballers completed a motivation questionnaire and were followed for 21 months. Results from structural equation modelling analyses provided basic support for the model. The findings are discussed in the light of their theoretical and applied implications. Copyright © 2002 John Wiley & Sons, Ltd.     

Suicide Ideation in Adolescents Following Inpatient Hospitalization: Examination of Intensity and Lability Over 6 Months

Understanding suicide ideation (SI) in adolescents, especially during the high‐risk time following hospitalization for a suicidal event, is a crucial component of improving risk assessment. Most studies rely on single assessments of SI, despite the potential for SI to vary considerably over time. This study examined how indices of SI intensity (mean values) and lability (mean squared successive difference values) over a 6‐month period predict suicide attempts (SAs) and self‐harm, as well as how they relate to psychosocial risk factors and affective functioning, in a sample of 103 adolescents hospitalized for a SA or significant SI. Across the sample, SI intensity, but not lability, was associated with SAs and nonsuicidal self‐injury at 6‐month follow‐up. SI intensity performed similarly to single time point SI assessments, and its relations were not moderated by SI lability. SI intensity was also associated with borderline personality disorder criteria and a history of sexual abuse. In contrast, SI lability was associated with greater negative affect intensity and lability. These findings suggest that intensity of SI may confer more risk posthospitalization, and provide support for using these statistical methods to capture two distinct parameters of SI.     

Prevalence of Suicide Risk Factors and Suicide‐Related Outcomes in the National Mental Health Study,Colombia

A community survey in 4,426 adults was undertaken as part of the World Mental Health Survey Initiative reporting the prevalence and risk factors for suicide‐related outcomes in Colombia. Lifetime prevalence estimates of suicide ideation, plans, attempts, and risk factors for suicide‐related outcomes were assessed. Retrospective reports of disorders age‐of‐onset were used to study associations between primary mental disorders and first onset of suicide‐related outcomes. Risks of plans and attempts were highest with ideation early age‐of‐onset and within the first year. The highest risk for ideation and attempt among ideators occurred in the 18–29 age group. After first employment (defined as the first paid job accepted by the respondent) and presence of mental disorders constituted risk factors. Impulse‐control disorders were strongest diagnostic predictors.     

Mental Disorders,Comorbidity, and Pre‐enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre‐enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6–8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention‐deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre‐enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts.     

Attentional Predictors of 5‐month‐olds' Performance on a Looking A‐not‐B Task

In the first year of life, the ability to search for hidden objects is an indicator of object permanence and, when multiple locations are involved, executive function (i.e. inhibition, cognitive flexibility and working memory). The current study was designed to examine attentional predictors of search in 5‐month‐old infants (as measured by the looking A‐not‐B task), and whether levels of maternal education moderated the effect of the predictors. Specifically, in a separate task, the infants were shown a unique puppet, and we measured the percentage of time attending to the puppet, as well as the length of the longest look (i.e., peak fixation) directed towards the puppet. Across the entire sample (N = 390), the percentage of time attending to the puppet was positively related to performance on the visual A‐not‐B task. However, for infants whose mothers had not completed college, having a shorter peak looking time (after controlling for percentage of time) was also a predictor of visual A‐not‐B performance. The role of attention, peak fixation and maternal education in visual search is discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

Meaning Made of Stress among Veterans Transitioning to College: Examining Unique Associations with Suicide Risk and Life‐Threatening Behavior

Meaning made of stress has been shown to be a unique predictor of mental and physical health. In this study, we examined the unique associations between two facets of meaning made of stress (comprehensibility and footing in the world) and suicide risk and life‐threatening behavior among military veterans who have transitioned to college were examined, controlling for demographic factors, religiousness, combat‐related physical injury, combat exposure, depressive symptoms, and posttraumatic stress symptoms. Findings suggest that comprehensibility (having “made sense” of a stressor) is uniquely associated with lower suicide risk and a lower likelihood of driving under the influence of drugs or alcohol and engaging in self‐mutilating behaviors.     

The Effect of Training on Multicultural Counseling Competencies: An Exploratory Study Over a Ten‐Year Period

The impact of integrated multicultural internship training on multicultural counseling competencies was evaluated. Multicultural Counseling Awareness Scale (MCAS:B; J. G. Ponterotto, C. M. Sanchez, & D. M. Magids, 1991) scores were obtained at the beginning and end of internship. Knowledge/Skills scores significantly increased at the end of training. Implications for training, measurement, and research with multicultural counseling competencies are discussed. El impacto de integrar las competencias de consejería multicultural en el entrenamiento de internados de psicología, fué evaluado. Los resultados de internos en la Escala de Consciencia de Consejería Multicultural (MCAS:B; J. G. Ponterotto, C. M. Sanchez, & D. M. Magids, 1991) fueron obtenidos al principio y al final del entrenamiento. Al fin del entrenamiento los resultados de las technica/conocimientos aumentaron significamente. Consideraciones para el entrenamiento, la medición e investigación de las competencias de consejería multicultural son discutidas.     

A Preliminary Validation Study of Two Ultra‐Brief Measures of Suicide Risk: The Suicide and Perceived Burdensomeness Visual Analog Scales

The advent of rapid‐acting suicide‐focused interventions and longitudinal research designs employing high‐frequency, repeated measurement of suicide risk has resulted in a need to quantify suicide risk during very brief windows of time (e.g., minutes, hours, days). This has rapidly outpaced traditional methods for assessing suicide risk, which often focus on measuring indicators of suicide risk during much broader intervals of time (e.g., weeks to months). Valid and practical methods for rapidly assessing suicide risk during small time intervals are therefore needed. This study reports a preliminary examination of the Suicide Visual Analog Scale (S‐VAS) and the Perceived Burdensomeness Visual Analog Scale (PB‐VAS) in a clinical sample of suicidal adults. Results support the convergent validity, predictive validity, responsiveness, and clinical utility of both scales, suggesting the S‐VAS and PB‐VAS are valid methods for rapidly quantifying two dimensions of suicide risk.     

Development of navigational working memory: Evidence from 6‐ to 10‐year‐old children

The ability to learn complex environments may require the contribution of different types of working memory. Therefore, we investigated the development of different types of working memory (navigational, reaching, and verbal) in 129 typically developing children. We aimed to determine whether navigational working memory develops at the same rate as other types of working memory and whether the gender differences reported in adults are already present during development. We found that navigational working memory is less developed than both verbal and reaching working memory and that gender predicts performance only for navigational working memory. Our results are in line with reports that children made significantly more errors in far space than adults, showing that near space representation develops before far space representation.     

The effects of adults' affective expression and direction of visual gaze on 12‐month‐olds' visual preferences for an object following a 5‐minute, 1‐day,or 1‐month delay

Between 12‐ and 14 months of age infants begin to use another's direction of gaze and affective expression in learning about various objects and events. What is not well understood is how long infants' behaviour towards a previously unfamiliar object continues to be influenced following their participation in circumstances of social referencing. In this experiment, we examined infants' sensitivity to an adult's direction of gaze and their visual preference for one of two objects following a 5‐min, 1‐day, or 1‐month delay. Ninety‐six 12‐month‐olds participated. For half of the infants during habituation (i.e., familiarization), the adults' direction of gaze was directed towards an unfamiliar object (look condition). For the remaining half of the infants during habituation, the adults' direction of gaze was directed away from the unfamiliar object (look‐away condition). All infants were habituated to two events. One event consisted of an adult looking towards (look condition) or away from (look‐away condition) an object while facially and vocally conveying a positive affective expression. The second event consisted of the same adult looking towards or away from a different object while conveying a disgusted affective expression. Following the habituation phase and a 5‐min, 1‐day, or 1‐month delay, infants' visual preference was assessed. During the visual preference phase, infants saw the two objects side by side where the adult conveying the affective expression was not visible. Results of the visual preference phase indicate that infants in the look condition showed a significant preference for object previously paired with the positive affect following a 5‐min and 1‐day delay. No significant visual preference was found in the look condition following a 1‐month delay. No significant preferences were found at any retention interval in the look‐away condition. Results are discussed in terms of early learning, social referencing, and early memory.