KILLING IN COMBAT MAY BE INDEPENDENTLY ASSOCIATED WITH SUICIDAL IDEATION
Article first published online: 13 APR 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 29, Issue 11, pages 918–923, November 2012
How to Cite
Maguen, S., Metzler, T. J., Bosch, J., Marmar, C. R., Knight, S. J. and Neylan, T. C. (2012), KILLING IN COMBAT MAY BE INDEPENDENTLY ASSOCIATED WITH SUICIDAL IDEATION. Depress. Anxiety, 29: 918–923. doi: 10.1002/da.21954
- Issue published online: 5 NOV 2012
- Article first published online: 13 APR 2012
- Manuscript Accepted: 17 MAR 2012
- Manuscript Revised: 13 MAR 2012
- Manuscript Received: 21 OCT 2011
- VA Health Services Research and Development Career Development. Grant Number: RCD 06–042
- stress disorders, posttraumatic;
The United States military has lost more troops to suicide than to combat for the second year in a row and better understanding combat-related risk factors for suicide is critical. We examined the association of killing and suicide among war veterans after accounting for PTSD, depression, and substance use disorders.
We utilized a cross-sectional, retrospective, nationally representative sample of Vietnam veterans from the National Vietnam Veterans Readjustment Study (NVVRS). In order to perform a more in depth analysis, we utilized a subsample of these data, the NVVRS Clinical Interview Sample (CIS), which is representative of 1.3 million veterans who were eligible for the clinical interview by virtue of living in proximity to an interview site, located within 28 standard metropolitan regions throughout the United States.
Veterans who had higher killing experiences had twice the odds of suicidal ideation, compared to those with lower or no killing experiences (OR = 1.99, 95% CI = 1.07–3.67), even after adjusting for demographic variables, PTSD, depression, substance use disorders, and adjusted combat exposure. PTSD (OR = 3.42, 95% CI = 1.09–10.73), depression (OR = 11.49, 95% CI = 2.12–62.38), and substance use disorders (OR = 3.98, 95% CI = 1.01–15.60) were each associated with higher odds of suicidal ideation. Endorsement of suicide attempts was most strongly associated with PTSD (OR = 5.52, 95% CI = 1.21–25.29).
Killing experiences are not routinely examined when assessing suicide risk. Our findings have important implications for conducting suicide risk assessments in veterans of war. Depression and Anxiety 00:1–6, 2012. © 2012 Wiley Periodicals, Inc.