Firearms Matter: The Moderating Role of Firearm Storage in the Association Between Current Suicidal Ideation and Likelihood of Future Suicide Attempts Among United States Military Personnel

The relationship between firearm ownership and suicide is well documented. This study hypothesized that how soldiers store their firearms would moderate the relationship between suicidal ideation and the self-reported likelihood of engaging in a future suicide attempt, and that this relationship would be explained by fearlessness about death. There were 432 military personnel (91.3% men, 74.2% White, M_age = 27.60) who endorsed current ownership of a private firearm and who were recruited from a military base in the southeastern United States (94.5% National Guard). Firearm storage moderated the relationship between suicidal ideation and the self-reported likelihood of engaging in a future suicide attempt, but this relationship was not explained by fearlessness about death. Individuals who reported keeping their firearms loaded and stored in an unsecure location exhibited higher mean levels of fearlessness about death. Findings highlight the need for research examining contributors to suicide risk in the context of firearm storage, and provide support for suicide prevention efforts involving restricting means.     

The Performance of the AUDIT-C and the Examination of Risks Associated With Postdeployment Alcohol Misuse in Air Force Medical Service Personnel

This study assessed the performance of the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) in diagnosing a postdeployment alcohol disorder in a cohort of Air Force Medical Services personnel (N = 13,353). The prevalence of alcohol disorders in this population of previously deployed military healthcare personnel was 1.26% based on medical record data. Assessing the AUDIT-C as a screening tool, the following characteristics were found: sensitivity was 23.81%, specificity was 91.48%, positive predictive value was 3.44%, and negative predictive value was 98.95%. The positive and negative likelihood ratios were 2.80 and 0.83, respectively. Classification accuracy of the AUDIT-C was improved by accounting for officer status and female gender. The area under the receiver operating characteristic curve was 0.69 for the multivariable model, indicating poor to fair classification accuracy. However, this model was significantly improved over the univariate model. Thus, taking rank and gender into account when conducting screening may improve the utility of the AUDIT-C.     

Associations Between Time Since Event and Posttraumatic Growth Among Military Veterans

Despite efforts to understand the antecedents, correlates, and consequences of posttraumatic growth (PTG), the role of time since a traumatic event (time since event) vis-à-vis PTG is not well understood. Part of a larger project exploring experiences following emotionally distressing events among military veterans (N = 197) using Amazon’s Mechanical Turk (Mturk), in the current study, we sought to clarify associations between the time since event and PTG. We used cluster-analytic techniques and analyses of variance to (a) determine the number of clusters, and (b) assess differences in core constructs of PTG and participant characteristics across clusters. Results revealed 4 significantly different groups (i.e., clusters) characterized by differential associations between PTG and time since event. These groups also differed significantly in challenge to core beliefs, level of PTSD symptoms, intrusive and deliberate rumination, and age. The immediate moderate-growth group (Cluster 1) experienced moderate levels of PTG over shorter periods of time, severe PTSD symptoms, and was significantly younger. The low-growth group (Cluster 2) was characterized by minimal PTG, regardless of time, the least challenge to core beliefs, and low amounts of intrusive and deliberate rumination. The long-term small-growth group (Cluster 3) was primarily characterized by small amounts of PTG over longer periods of time. The high-growth group (Cluster 4) was characterized by high PTG, regardless of time, greater challenge to core beliefs, the highest amount of deliberate rumination, and the highest number of PTSD symptoms. Findings underscore heterogeneity within military veterans’ experiences of PTG over time.     

A Systematic Review of the Biopsychosocial–Spiritual Health of Active Duty Women

Women make up approximately 15% of today’s active duty (AD) military. Not only are more women volunteering for military service now than ever before in America’s history, but due to recent policy changes, they are also allowed to apply for more jobs. Therefore, since the number of women in the military is continuing to rise and there are more job opportunities for women in the military, it is important to understand the unique health effects they experience that differ from civilian women and AD males. Although there is current literature on the biological, psychological, social, and spiritual health of veteran women, few researchers have explored the biopsychosocial–spiritual effects of military service on AD women. Thus, the purpose of this systematic review was to explore the existing research on the biopsychosocial–spiritual health factors associated with military service in AD women. The results of this study indicated that there is more data on the biological health compared to the psychological and social health of AD women. There is even less research demonstrating the interconnectedness among biological, psychological, social, and spiritual health with AD women. Future research recommendations and policy implications are provided.     

The Performance of the PHQ-2 and the Examination of Risks Associated With Postdeployment Depression in Air Force Medical Service Personnel

This study assessed the performance of the 2-item Patient Health Questionnaire (PHQ-2) in identifying postdeployment depressive disorders in a cohort of Air Force Medical Services personnel (N = 18,398). The prevalence of depressive disorders in the cohort was 9.00% based on medical record data. The area under the receiver operating characteristic curve was 0.56, indicating very poor classification accuracy. Sensitivity was 15.53%, specificity was 95.57%, positive predictive value was 25.75%, and negative predictive value was 91.97%. The positive and negative likelihood ratios were 3.51 and 0.88, respectively. Several risk factors associated with postdeployment depressive disorders were identified that could potentially improve screening in this population.     

Coping profiles characterize individual flourishing,languishing, and depression

Abstract

According to the broaden-and-build theory of positive emotions, negative emotions narrow one's thought–action repertoire. In contrast, positive emotions have a broadening effect, expanding cognitive capacity, increasing potential coping strategies that come to mind, and enhancing decision-making, reaction, and adaptation to adversity. Fredrickson and Losada determined that a positivity ratio – the ratio of experienced positive to negative emotions – at or above 2.9 promotes human flourishing. A ratio below 2.9 is indicative of languishing individuals, whereas a ratio below 1.0 is a marker of depression. This study examined whether adaptive and maladaptive coping profiles differentiated those who flourish, languish, or are depressed in two convenience samples – military spouses (n =367) and public school teachers (n=267). Results were consistent with the theoretical predictions, as coping profiles of the groups differed significantly, with flourishing individuals favoring adaptive coping strategies more than those who were languishing or depressed. Conversely, depressed individuals reported greater use of maladaptive coping strategies than those who were languishing or flourishing. These results provide further empirical support for the mathematical model of Fredrickson and Losada, as the set of positivity criteria were predictive of coping profiles in two samples where successful coping and adaptation are important.     

Main and interactive effects of social support in predicting mental health symptoms in men and women following military stressor exposure

Abstract

Evidence across a multitude of contexts indicates that social support is associated with reduced risk for mental health symptoms. More information is needed on the effectiveness of different sources of support, as well as sex differences in support. Associations between social support from two sources – the military unit and friends and family – and mental health symptoms were examined in a study of 1571 Marine recruits assessed at the beginning and end of a highly stressful 13-week training program. Military social support buffered the stressor exposure–posttraumatic stress symptomatology (PTSS) relationship, whereas the relationship between stressor exposure and PTSS was highest when civilian social support was high. Further inspection of the interactions revealed that military support was most important at high levels of stressor exposure. Sex differences in the relationship between social support and symptoms were found, such that support from military peers was associated with lower levels of PTSS for men, whereas civilian support was associated with lower PTSS for women. While civilian social support was associated with lower levels of depression symptom severity in both women and men, the relationship was stronger for women. Reviewed implications focus on the importance of considering the recipient, source, and context of social support.     

Combating the Suicide Epidemic: The Effects of Leisure Engagement on the Incidence of Depression and Poor Life Satisfaction in Soldiers

This cross-sectional study examined the relationship of leisure engagement to levels of depression and life satisfaction in U.S. Army Soldiers. The relationship between overall time engaging in leisure, as well as categories of physically active and sedentary leisure, on the incidence of depression and poor life satisfaction were examined. Results from self-report survey of 230 soldiers revealed higher amounts of time spent engaged in leisure correlated with reported lower levels of depression and higher life satisfaction. The categories physically active and sedentary leisure did not demonstrate a distinct relationship to levels of depression, but both positively related to life satisfaction.     

The military chaplain: a study in ambiguity

This article looks at the ambiguities in the role of the military chaplain from three points of view. The first considers the nature of the constituency within which the chaplain ministers, paying particular attention to the degree – or otherwise – of secularisation and the reasons for this. The second examines the role of the chaplain in relation to the two institutions which he or she serves (i.e. church and state) and the tensions that emerge as a result. These are articulated in terms of ‘an angle of eschatological tension’. The third is concerned with ‘the roles within the role’ – that is the variety of tasks that make up the role of chaplaincy and the degree to which these are compatible with each other. The significance of theology in the resolution of the ensuing issues is set against diminishing societal resources in terms of religious literacy.     

Together or Apart

Psychotherapists often mistake their theories for realities that they are not and thus may operate with an overly confident sense of "knowing" what is true about a particular couple relationship. Many schools of therapy tend to "pathologize" the dynamics of couple interaction and practitioners need to guard against being too inducted into any one world view. Facility with the theories and techniques of many different couples counseling strategies (psychodynamic, behavioral, structural and strategic approaches) can increase flexibility and the "working base" of therapists. Ultimately, however, the personhood of therapists, their awareness of their own biases (about levels of connection, emotional expressivity, feminism, or power relationships) and their ability to adopt a neutral, therapeutic stance are the essential ingredients for meaningful and curative couples counseling.