The relationship between combat exposure and suicide risk in U.S. military veterans: Exploring the role of posttraumatic stress symptoms and religious coping.

BACKGROUND: Rising suicide rates in the U.S. veteran population are a growing concern. Combat exposure has been identified as a potential predictor of suicide risk, but factors that may mediate the relation between combat exposure and suicide risk, and the role of potential coping mechanisms remain largely understudied. To address this gap, this study examined the association between lifetime combat exposure and current suicide risk; whether this association is mediated by posttraumatic stress disorder (PTSD) symptoms; and whether direct and/or indirect associations with combat exposure are moderated by organizational, non-organizational, and intrinsic religiosity. METHODS: Data were analyzed from the National Health and Resilience in Veterans Study (2019-2020; n = 3843). Ordinary least squares and conditional process analyses were conducted to evaluate the conditional direct and indirect predictors of suicide risk. RESULTS: PTSD symptoms significantly mediated the association between combat exposure and suicide risk. Intrinsic religiosity showed significant moderation and reduced the coefficient of PTSD symptoms predicting suicide risk but increased the coefficient of combat exposure predicting PTSD symptoms. LIMITATIONS: In this cross-sectional, observational study, no conclusions can be made regarding causality. CONCLUSIONS: Results of this study suggest a multifaceted relationship between combat exposure, PTSD, religiosity/spirituality, and suicide risk in U.S. veterans, and underscore the importance of PTSD and religious coping as part of ongoing suicide prevention efforts in this population.

Enduring Effects of Early Life Traumas on Adult Suicidal Ideation.

Exposure to traumas early in life has been found to have a range of negative health effects later in adulthood, including a higher risk for suicidal behavior. Using data from the Waves I (1994/95) and IV (2008) of the National Longitudinal Study of Adolescent to Adult Health (N = 14,385; 49.35% female; Mage in Wave IV = 29), this study examines the effects of exposure to three different types of early life traumas-emotional abuse, physical abuse, and sexual abuse before the age of 18-on adult suicidal ideation. Guided by the stress process model incorporated with a life-course perspective, potential mediating roles of psychological distress, subjective powerlessness, and perceived social rejection were also investigated. A series of regression and Karlson-Holm-Breen (KHB) mediation analyses were performed using Stata 14 to assess the total, direct, and indirect effects. All three early life trauma measures were found to be significantly and independently associated with a higher risk of suicidal ideation in adulthood. A substantive portion (between 30 and 50%) of the effects was mediated by psychological distress (i.e., depression and anxiety), subjective powerlessness, and perceived social rejection. The general policy implications of this study include evaluating suicidal individuals for prior childhood abuse experiences and assessing abuse survivors for suicidality.

The Utility of Social Learning Theory in Explaining Cigarette Use in a Military Setting.

Background: A large body of empirical studies has shown that cigarette use has detrimental consequences. Along with its adverse health effects, it is also associated with negative outcomes for social institutions, including the military. Objectives: Utilizing a Social Learning Theory (SLT) framework, this study attempts to explore the associations among cigarette use and elements of social learning in a military setting, including differential association, differential reinforcement, and definitions favorable to smoking. Methods: We draw upon unique data from the Cadet Smoking Survey (CSS) conducted in 2015 at the Turkish Military Academy (n = 378), and utilize binary logistic regression as the analytic strategy. Results: The findings reveal that the smoking habits of fathers and peers, as well as cadets' own definitions that make smoking justifiable, were strong positive predictors of Turkish cadets being cigarette smokers. The links between smoking and parental reaction or peer reinforcement, however, were not robust. Conclusion/Importance: The results of this study partially support the assumptions in SLT and suggest that military units might serve as venues for facilitating learning regarding cigarette use. The implications, limitations, and directions for future research are discussed below.