Suicide attempts in U.S. Army combat arms, special forces and combat medics

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Suicide attempts in U.S. Army combat arms, special forces and combat medics

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Title: Suicide attempts in U.S. Army combat arms, special forces and combat medics
Author: Ursano, Robert J.; Kessler, Ronald C.; Naifeh, James A.; Mash, Holly Herberman; Fullerton, Carol S.; Ng, Tsz Hin Hinz; Aliaga, Pablo A.; Wynn, Gary H.; Dinh, Hieu M.; McCarroll, James E.; Sampson, Nancy A.; Kao, Tzu-Cheg; Schoenbaum, Michael; Heeringa, Steven G.; Stein, Murray B.; Wagner, James; Cox, Kenneth; Benedek, David M.; Campbell-Sills, Laura; Gebler, Nancy; Gifford, Robert K.; Jain, Sonia; Lewandowski-Romps, Lisa; Hurwitz, Paul E.; Nock, Matthew K.; Santiago, Patcho; Zaslavsky, Alan M.

Note: Order does not necessarily reflect citation order of authors.

Citation: Ursano, R. J., R. C. Kessler, J. A. Naifeh, H. H. Mash, C. S. Fullerton, T. H. H. Ng, P. A. Aliaga, et al. 2017. “Suicide attempts in U.S. Army combat arms, special forces and combat medics.” BMC Psychiatry 17 (1): 194. doi:10.1186/s12888-017-1350-y.
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Abstract: Background: The 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. Methods: Using 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. Results: In 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. Conclusions: Military occupation can inform the understanding suicide attempt risk among soldiers. Electronic supplementary material The online version of this article (doi:10.1186/s12888-017-1350-y) contains supplementary material, which is available to authorized users.
Published Version: doi:10.1186/s12888-017-1350-y
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