Citation

Gilman SE, Bromet EJ, Cox KL, Colpe LJ, Fullerton CS, Gruber MJ, Heeringa SG, Lewandowski-Romps L, Millikan-Bell AM, Naifeh JA, Nock MK, Petukhova MV, Sampson NA, Schoenbaum M, Stein MB, Ursano RJ, Wessely S, Zaslavsky AM, Kessler RC. Psychol. Med. 2014; 44(12): 2579-2592.

Affiliation

Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.

Copyright

(Copyright © 2014, Cambridge University Press)

DOI

10.1017/S003329171400018X

PMID

25055175

Abstract

BACKGROUND: The US Army suicide rate has increased sharply in recent years. Identifying significant predictors of Army suicides in Army and Department of Defense (DoD) administrative records might help focus prevention efforts and guide intervention content. Previous studies of administrative data, although documenting significant predictors, were based on limited samples and models. A career history perspective is used here to develop more textured models.

METHOD: The analysis was carried out as part of the Historical Administrative Data Study (HADS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). De-identified data were combined across numerous Army and DoD administrative data systems for all Regular Army soldiers on active duty in 2004-2009. Multivariate associations of sociodemographics and Army career variables with suicide were examined in subgroups defined by time in service, rank and deployment history.

RESULTS: Several novel results were found that could have intervention implications. The most notable of these were significantly elevated suicide rates (69.6-80.0 suicides per 100 000 person-years compared with 18.5 suicides per 100 000 person-years in the total Army) among enlisted soldiers deployed either during their first year of service or with less than expected (based on time in service) junior enlisted rank; a substantially greater rise in suicide among women than men during deployment; and a protective effect of marriage against suicide only during deployment.

CONCLUSIONS: A career history approach produces several actionable insights missed in less textured analyses of administrative data predictors. Expansion of analyses to a richer set of predictors might help refine understanding of intervention implications.

Language: en