Suicide Risk Among Wounded U.S. Service Members

The association between suicide and combat injuries sustained during the wars in Iraq and Afghanistan was examined. A retrospective population‐based cohort design was conducted using official military records to identify combat injuries (October 7, 2001, to December 31, 2007). Those who were injured during combat had higher crude suicide rates than those who deployed and were not injured (incidence rate ratio [IRR] = 1.50; confidence interval [CI] = 1.06, 2.12), or never deployed (IRR = 1.46; CI = 1.04, 2.06). After adjusting for demographics, these findings were no longer statistically significant. Although our data did not support an elevated suicide risk among wounded service members, additional research is needed to examine the impact of injury severity.     

Suicide Exposure in the Population: Perceptions of Impact and Closeness

Recent studies of people exposed to suicide point to a continuum of effects moderated by a perception of closeness to the deceased. We investigated the importance of perception of impact of the death on mental health outcomes of those exposed to suicide. Female sex, younger age, and multiple exposures to suicide were associated with greater risk for poorer outcomes. Suicide exposed with high impact was more likely to have depression, anxiety, posttraumatic stress disorder, prolonged grief, and suicide ideation. Findings can help focus postvention resources for suicide‐exposed individuals.     

Adolescent Suicidal Trajectories through Young Adulthood: Prospective Assessment of Religiosity and Psychosocial Factors among a Population‐Based Sample in the United States

The main objective was to identify distinct patterns of suicidal behaviors over the life course from adolescence to young adulthood and to determine influences of religiosity and other contextual factors on subgroup membership. Semiparametric growth mixture models were used to identify distinct clusters of suicide ideation and suicide attempt trajectories, and generalized estimating equations were used to assess individual and contextual characteristics predicting suicidal behaviors in adolescence and in young adulthood. Distinct trajectories of suicide ideation and suicide attempt were identified for the total sample and for the gender groups. Results showed marked gender differences in the trajectory of suicide ideation and attempt patterns. Religiosity effects on suicidality were prominent in adolescence but not in young adulthood. Analysis showed that an important window of opportunity for preventing the escalation of suicidality exists during the early adolescent period, an opportunity that should be emphasized in interventions on adolescence suicide prevention.     

Encountering the Body at the Site of the Suicide: A Population‐Based Survey in Sweden

Encountering the body of a child who died by suicide at the site of death is believed to be especially harmful for bereaved parents. We investigated the association between encountering the body at the site of the suicide and psychological distress in 666 suicide‐bereaved parents. Parents who had encountered their child's body at the site of the suicide (n = 147) did not have a higher risk of nightmares (relative risk [RR] 0.95, 95% confidence interval [CI] 0.67–1.35), intrusive memories (RR 0.97, 95% CI 0.84–1.13), avoidance of thoughts (RR 0.97, 95% CI 0.74–1.27), avoidance of places or things (RR 0.91, 95% CI 0.66–1.25), anxiety (RR 0.93, 95% CI 0.64–1.33), or depression (RR 0.94, 95% CI 0.63–1.42) compared with parents who had not encountered the body (n = 512). Our results suggest that losing a child by suicide is sufficiently disastrous by itself to elicit posttraumatic responses or psychiatric morbidity whether or not the parent has encountered the deceased child at the site of death.     

The impact of stress on marital quality: A stress-vulnerability theory

This article outlines a stress-vulnerability theory for describing how stress impacts marital quality. Implications for therapy are also discussed based on the stress-vulnerability theory.Appreciation is expressed to Joan Jurich, PhD for her helpful comments during the development of this theory.     

Adolescents Exposed to Suicidal Behavior of Others: Prevalence of Self‐Harm and Associated Psychological,Lifestyle, and Life Event Factors

Exposure to suicidal behavior of others was examined among 3,881 Irish adolescents in the Child and Adolescent Self‐harm in Europe (CASE) study. One third of the sample had been exposed to suicidal behavior, and exposed adolescents were eight times more likely to also report own self‐harm. Exposed adolescents shared many risk factors with those reporting own self‐harm. Those reporting both exposure and own self‐harm presented the most maladaptive profile on psychological, life event, and lifestyle domains, but neither anxiety nor depression distinguished this group. Exposed adolescents are burdened by a wide range of risk factors and in need of support.     

Predictors of Suicidal Ideation in a Gender‐Stratified Sample of OEF/OIF Veterans

There is a growing concern about suicide among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We examined the role of postdeployment mental health in associations between deployment stressors and postdeployment suicidal ideation (SI) in a national sample of 2,321 female and male OEF/OIF veterans. Data were obtained via survey, and path analysis was used. For women and men, mental health symptoms largely accounted for associations between deployment stressors and SI; however, they only partly accounted for the sexual harassment and SI association among women. These findings enhance the understanding of the mental health profile of OEF/OIF veterans.     

Motivations for Self‐Injury,Affect, and Impulsivity: A Comparison of Individuals with Current Self‐Injury to Individuals with a History of Self‐Injury

Individuals who report nonsuicidal self‐injury (NSSI) are characterized by the tendency to act rashly while experiencing distress (negative urgency), the tendency to act without thinking, and endorsement of both social and affect regulation motives for the behavior. However, very little research has identified characteristics that distinguish current self‐injurers from those with a history of the behavior. The purpose of this study was to compare individuals with current self‐injury to a history of self‐injury on impulsivity‐related personality traits, motives for self‐injury, and distress. Among a sample of 429 undergraduates, 120 reported self‐injury. Among these 120 individuals, 33 endorsed self‐injury within the past month, with a mean frequency of 4.77 acts of NSSI. Within the self‐injury group, current self‐injurers reported higher endorsement of affect regulation motives for NSSI, and higher levels of current negative affect than individuals with a history of self‐injury. There were no differences between current and former self‐injurers on measures of impulsivity, endorsement of social motives for NSSI, or positive affect. We propose that individuals who use NSSI to regulate negative affect may be more likely to repeatedly engage in this behavior over time.