Life stressors, emotional distress, and trauma-related thoughts occurring in the 24 h preceding active duty U.S. soldiers' suicide attempts.

External life events and internal experiences (i.e., emotional distress and trauma-related thoughts) occurring in the 24 h preceding suicide attempts were examined in a sample of active duty U.S. soldiers. Seventy-two Soldiers (66 male, 6 female; 65.3% Caucasian, 9.7% African-American, 2.8% Asian, 2.8% Pacific Islander, 4.2% Native American, and 9.7% "other"; age M = 27.34, SD = 6.50) were interviewed using the suicide attempt self injury interview to assess the occurrence of external events and internal experiences on the day of their suicide attempts, and to determine their associations with several dimensions of suicide risk: suicidal intent, lethality, and deliberation about attempting. Multiple external stressors and internal states were experienced by soldiers in the 24 h preceding their suicide attempts, with emotional distress being the most common. Trauma-related thoughts were much less frequently reported in the 24 h preceding suicide attempts. Emotional experiences were directly associated with suicidal intent, and explained the relationship between external events and suicidal intent. Lethality was unrelated to any external events, emotional experiences, or trauma-related thoughts. Greater emotional distress and trauma-related thoughts were associated with shorter deliberation about whether or not to attempt suicide. Soldiers experience multiple sources of distress in the period immediately preceding their suicide attempts. Soldiers who experience more negative emotional experiences have a stronger desire for suicide and spend less time deliberating before an attempt.