Improving Military Readiness and Reducing Suicide Risk: The Role Between Positive TBI Screens, Severe Insomnia, and Suicidal Outcomes

Abstract

This study examined how insomnia severity and a positive traumatic brain injury (TBI) screen relate to suicidal outcomes across military branches. Data were compiled from 1,635 participants across seven studies. A series of analyses were conducted by military branch to identify which significantly differed on the variables of interest. A series of multiple regression analyses were conducted to explore whether insomnia severity and a positive TBI screen predicted suicidal outcomes and whether the effect varied as a function of military branch. Insomnia severity and a positive TBI screen each had independent relationships with the suicide risk outcomes. The relationship between insomnia and suicide risk varied by military branch. However, a positive TBI screen had a significant effect on suicidal behavior and thoughts and the effect was similar across the four groups. Efforts to identify and intervene on insomnia and TBI sequelae may improve quality of care for service members at risk of suicide. Insomnia and post-TBI symptoms are important targets of intervention as they are often less stigmatized and can be easily assessed by brief self-report measures.