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. 2017 May 25;17(1):194.
doi: 10.1186/s12888-017-1350-y.

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

Robert J Ursano  1 , Ronald C Kessler  2 , James A Naifeh  3 , Holly Herberman Mash  3 , Carol S Fullerton  3 , Tsz Hin Hinz Ng  3 , Pablo A Aliaga  3 , Gary H Wynn  3 , Hieu M Dinh  3 , James E McCarroll  3 , Nancy A Sampson  2 , Tzu-Cheg Kao  4 , Michael Schoenbaum  5 , Steven G Heeringa  6 , Murray B Stein  7   8 ; Army STARRS collaborators
Collaborators, Affiliations

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

Robert J Ursano et al. BMC Psychiatry. .

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.

Keywords: Military; Occupation; Suicide attempt.

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Figures

Fig. 1
Fig. 1
Monthly risk of suicide attempt by military occupation and among Regular Army enlisted soldiers in their first year of service1,2 1The sample of enlisted soldiers in their first year of service (combat arms, n=6,853; combat medic, n=1,450; other, n=17,483) is a subset of the total sample of enlisted soldiers (n=163,173 person-months) from the Army STARRS Historical Administrative Data Study (HADS). Control person-months were assigned a weight of 200 to adjust for under-sampling. 2 Monthly risk based on hazard rates and linear spline models
See this image and copyright information in PMC

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