Abstract
BackgroundThe U.S. Army suicide attempt rate increased sharply during the wars in Iraq and Afghanistan. Risk may vary according to occupation, which significantly influences the stressors that soldiers experience.MethodsUsing administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records for all active duty Regular Army enlisted soldiers who had a medically documented suicide attempt from 2004 through 2009 (n = 9650) and an equal-probability sample of control person-months (n = 153,528). Logistic regression analyses examined the association of combat occupation (combat arms [CA], special forces [SF], combat medic [CM]) with suicide attempt, adjusting for socio-demographics, service-related characteristics, and prior mental health diagnosis.ResultsIn adjusted models, the odds of attempting suicide were higher in CA (OR = 1.2 [95% CI: 1.1–1.2]) and CM (OR = 1.4 [95% CI: 1.3–1.5]), but lower in SF (OR = 0.3 [95% CI: 0.2–0.5]) compared to all other occupations. CA and CM had higher odds of suicide attempt than other occupations if never deployed (ORs = 1.1–1.5) or previously deployed (ORs = 1.2–1.3), but not when currently deployed. Occupation was associated with suicide attempt in the first ten years of service, but not beyond. In the first year of service, primarily a time of training, CM had higher odds of suicide attempt than both CA (OR = 1.4 [95% CI: 1.2–1.6]) and other occupations (OR = 1.5 [95% CI: 1.3–1.7]). Discrete-time hazard functions revealed that these occupations had distinct patterns of monthly risk during the first year of service.ConclusionsMilitary occupation can inform the understanding suicide attempt risk among soldiers.
Highlights
The U.S Army suicide attempt rate increased sharply during the wars in Iraq and Afghanistan
Pairwise analyses indicated that Combat medics (CM) were significantly more likely to attempt suicide than combat arms (CA) (OR = 1.2 [95% confidence intervals (CI): 1.1–1.3]), and this remained unchanged when comparing CM to CA among males only (OR = 1.2 [95% CI: 1.1– 1.3]), which is important given that female soldiers were not permitted to have a CA or Special forces (SF) occupation at this time
Our findings suggest that occupation may assist in identifying the sub-populations and timing of elevated risk for suicide attempt in the U.S Army, but the individual risk associated with occupation remains modest
Summary
The U.S Army suicide attempt rate increased sharply during the wars in Iraq and Afghanistan. Suicidal behavior among U.S Army soldiers increased substantially during the wars in Iraq and Afghanistan, [1, 2] with the rates of suicide death more than doubling from 2001 (9/100,000) through 2009 (22/100,000) and surpassing the adjusted civilian rate in 2008 [3]. Deployment experiences vary substantially depending on a soldier’s military occupation. A metaanalysis found that suicidal outcomes were more strongly associated with particular combat experiences (e.g., killing, exposure to death) than with deployment in general, [12] suggesting that occupations characterized by direct combat exposure may have a higher suicide risk than other occupations [13, 14].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
