Documented family violence and risk of suicide attempt among U.S. Army soldiers

Abstract

Suicide attempt (SA) rates in the U.S. Army increased substantially during the wars in Afghanistan and Iraq. This study examined associations of family violence (FV) history with SA risk among soldiers. Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records of active duty, Regular Army, enlisted soldiers with medically documented SAs from 2004 to 2009 (n = 9650) and a sample of control person-months (n = 153,528). Logistic regression analyses examined associations of FV with SA, adjusting for socio-demographics, service-related characteristics, and prior mental health diagnosis. Odds of SA were higher in soldiers with a FV history and increased as the number of FV events increased. Soldiers experiencing past-month FV were almost five times as likely to attempt suicide as those with no FV history. Odds of SA were elevated for both perpetrators and those who were exclusively victims. Male perpetrators had higher odds of SA than male victims, whereas female perpetrators and female victims did not differ in SA risk. A discrete-time hazard function indicated that SA risk was highest in the initial months following the first FV event. FV is an important consideration in understanding risk of SA among soldiers.

Keywords: Domestic violence; Interpersonal violence; Military; Partner abuse; Spouse abuse; Suicide, attempted.

Figure 1.. Monthly risk of suicide attempt by time since first family violence event among enlisted soldiers with a history of family violence

¹The sample of enlisted soldiers in the first two years after their first family violence event (n=448 cases, 2,556 control person-months) is a subset of the total sample (n=193,617 person-months) from the Army STARRS Historical Administrative Data Study (HADS) that includes all Regular Army soldiers (i.e., excluding those in the U.S. Army National Guard and Army Reserve) with a suicide attempt in their administrative records during the years 2004–2009, plus a 1:200 stratified probability sample of all other active duty Regular Army person-months in the population exclusive of soldiers with a suicide attempt or other non-fatal suicidal event (e.g., suicidal ideation) and person-months associated with death (i.e., suicides, combat deaths, homicides, and deaths due to other injuries or illnesses). All records in the 1:200 sample were assigned a weight of 200 to adjust for the under-sampling of months not associated with suicide attempt. ²Monthly risk based on hazard rates and linear spline models.