Eric B Elbogen1, Kiera Molloy2, H Ryan Wagner3, Nathan A Kimbrel3, Jean C Beckham3, Lynn Van Male4, Jonathan Leinbach5, Daniel W Bradford5. 1. Durham VA Health Care System, Durham, NC, USA; VISN 6 Mental Illness Research, Education, and Clinical Center (MIRECC), Durham VA Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. Electronic address: eric.elbogen@duke.edu. 2. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. 3. Durham VA Health Care System, Durham, NC, USA; VISN 6 Mental Illness Research, Education, and Clinical Center (MIRECC), Durham VA Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. 4. Veterans Health Administration, Office of Mental Health and Suicide Prevention, Washington, DC, USA; Oregon Health & Sciences University, Department of Psychiatry, Portland, OR, USA. 5. Durham VA Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Abstract
BACKGROUND: This study investigates the empirical association between psychosocial protective factors and subsequent suicidal ideation in veterans. METHODS: We conducted a national longitudinal survey in which participants were randomly drawn from over one million U.S. military service members who served after September 11, 2001. Data were provided by a total of 1090 veterans representative of all 50 states and all military branches in two waves of data collection one year apart (79% retention rate). RESULTS: In chi-square analyses, psychosocial protective factors at wave 1 (employment, meeting basic needs, self-care, living stability, social support, spirituality, resilience, and self-determination) were significantly related to lower suicidal ideation at wave 2. In multivariable analyses controlling for covariates at wave 1 including suicidal ideation, the total number of protective factors endorsed at wave 1 significantly predicted reduced odds of suicidal ideation at wave 2. In multivariable analysis examining individual risk and protective factors, again controlling for covariates, results showed that money to cover basic needs and higher psychological resilience at wave 1 were associated with significantly lower odds of suicidal ideation at wave 2. LIMITATIONS: The study measured the link between psychosocial protective factors and suicidal ideation but not suicide attempts, which would be an important next step for this research. CONCLUSIONS: The results indicate that psychosocial rehabilitation and holistic approaches targeting financial well-being, homelessness, resilience, self-care, social support, spirituality, and work may offer a promising avenue in both veteran and non-veteran populations for treatment safety planning as well as suicide risk management and prevention. Published by Elsevier B.V.
BACKGROUND: This study investigates the empirical association between psychosocial protective factors and subsequent suicidal ideation in veterans. METHODS: We conducted a national longitudinal survey in which participants were randomly drawn from over one million U.S. military service members who served after September 11, 2001. Data were provided by a total of 1090 veterans representative of all 50 states and all military branches in two waves of data collection one year apart (79% retention rate). RESULTS: In chi-square analyses, psychosocial protective factors at wave 1 (employment, meeting basic needs, self-care, living stability, social support, spirituality, resilience, and self-determination) were significantly related to lower suicidal ideation at wave 2. In multivariable analyses controlling for covariates at wave 1 including suicidal ideation, the total number of protective factors endorsed at wave 1 significantly predicted reduced odds of suicidal ideation at wave 2. In multivariable analysis examining individual risk and protective factors, again controlling for covariates, results showed that money to cover basic needs and higher psychological resilience at wave 1 were associated with significantly lower odds of suicidal ideation at wave 2. LIMITATIONS: The study measured the link between psychosocial protective factors and suicidal ideation but not suicide attempts, which would be an important next step for this research. CONCLUSIONS: The results indicate that psychosocial rehabilitation and holistic approaches targeting financial well-being, homelessness, resilience, self-care, social support, spirituality, and work may offer a promising avenue in both veteran and non-veteran populations for treatment safety planning as well as suicide risk management and prevention. Published by Elsevier B.V.
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