A-18 Executive Dysfunction is Associated with Suicidal Ideation in Iraq/Afghanistan-era Combat-exposed Veterans

Abstract

Abstract Objective Suicidal ideation (SI) is highly prevalent in Veterans and reducing Veteran suicide is a national priority. The present study examined factors associated with SI in combat-exposed Veterans in order to inform suicide prevention efforts. Method Combat-exposed Iraq/Afghanistan-era Veterans (N = 77) completed questionnaires detailing demographic characteristics and combat-related experiences, as well as structured interviews assessing history of mild traumatic brain injury (mTBI), current posttraumatic stress disorder (PTSD), and suicidality in the past month. Veterans also underwent a comprehensive neuropsychological assessment. Analyses examined differences between endorsers versus non-endorsers of current SI, as well as predictors of SI, with a focus on cognitive variables. Results There were no SI group differences in demographic variables, levels of combat exposure, or rates of PTSD, or mTBI history. However, independent samples t-tests indicated that those who endorsed SI demonstrated worse executive functioning relative to those who denied SI (t(75) = 2.74, p = .008), whereas no group differences were observed on measures of attention/processing speed or memory. A logistic regression analysis predicting SI indicated that executive functioning remained a significant predictor of SI (B = .94, OR = 2.55, p = .047) even when adjusting for age, years of education, level of combat exposure, history of mTBI, and PTSD diagnosis. Conclusions Executive dysfunction may make it difficult for Veterans to inhibit maladaptive negative thoughts (particularly suicidal thoughts), regulate emotions, and problem solve in stressful situations, thus contributing to suicidality. Interventions addressing executive dysfunction in combat-exposed Veterans with SI may be a promising adjunct to current suicide prevention efforts.