High rates of suicide among military personnel and veterans may be related to traumatic experiences

High rates of suicide among military service members and veterans may be related to traumatic experiences they had before enlisting, making them more vulnerable to suicidal behavior when coping with combat and multiple deployments, according to the findings of several recent studies presented at the American Psychological Association's 122nd Annual Convention.

Experiencing child abuse, being sexually victimized by someone not in the service and exhibiting suicidal behavior before enlisting are significant risk factors for service members and veterans who attempt or commit suicide, according to experts with the National Center for Veterans Studies (NCVS) at the University of Utah. Suicide is the second-leading cause of death among U.S. military personnel. In 2012, there were 319 suicides among active duty service members and 203 among reserve service members, compared to 237 combat-related deaths of active duty service members in Afghanistan, according to the Department of Defense.

Soldiers who reported abuse as children were three to eight times more likely than those who were not abused to report suicidal behavior, which could include thoughts about, planning or attempting suicide, said retired Army Col. James Griffith, PhD. He and other researchers examined Army survey data gathered in 2010 from 12,567 Army National Guard soldiers in 180 company-sized units. Army National Guard and Army Reserve personnel supplement active duty personnel and, at times, comprised 30 to 40 percent of the ground forces in the Iraq and Afghanistan wars. The study found that 16 percent of the respondents reported harsh punishment during childhood and 8 percent reported physical abuse, findings that are similar to those of studies of active duty Army soldiers. Studies of civilians have also shown childhood abuse to be a significant risk factor for suicide, Griffith said.

"Experiencing abuse early in life in the home may lead to a tendency to perceive and experience stressful events as catastrophic and insurmountable," said Griffith. "A child experiencing abuse has little opportunity to effectively cope when stressed, being in a powerless position with no recourse. This may lead to less ability to handle future stressful circumstances."

Sexual trauma of any type, whether or not the perpetrator is in the military, increases the risk for suicidal behavior among military personnel, according to other research presented. To determine if there was any difference in suicide risk from military sexual trauma compared to civilian sexual trauma, researchers surveyed 426 service members and veterans from all branches in the armed services enrolled in college classes. More than 25 percent of women and 4 percent of men reported sexual trauma while in the military, which is similar to the prevalence of sexual victimization among the general U.S. and college student populations.

Sexual victimization both within and outside of the military was associated with significantly higher rates of suicidal thoughts and behaviors, but there were no differences between groups that had suffered either civilian or military sexual victimization, according to the presentation. However, there were differences in how men and women coped with sexual victimization.

"Previous research has found that male survivors of military sexual trauma are less likely to seek mental health care than female survivors," said Craig J. Bryan, PsyD, an Iraq veteran and NCVS executive director. "Men may see it as a threat to their masculinity and be especially prone to shame, which is a strong predictor of suicide attempts in military personnel."

Service members and veterans who attempted suicide before joining the military were six times more likely to attempt suicide after joining the military than those who had never attempted suicide, said Bobbie N. Ray-Sannerud, PsyD, who previously served as an Air Force psychologist. Among service members and veterans who attempted suicide, approximately 50 percent had thought about committing suicide and 25 percent had attempted suicide before joining the military. For these findings, researchers examined data collected from 371 college student veterans via an anonymous online survey and from 151 military personnel receiving outpatient mental health treatment. The study participants came from all branches of military service.

"No previous studies report when many military personnel and veterans first experience suicidal behavior, despite the fact that these vulnerabilities may have a relatively stronger relationship with military and veteran suicide than other commonly investigated risk factors, such as psychiatric symptoms and life stressors," said Ray-Sannerud. "Information about how suicide risk first emerges in military personnel and which military personnel are most vulnerable after they join the service is important for screening and treatment."