Suicide Ideation and Social Support Trajectories in National Guard and Reserve Servicemembers

Abstract

Objective: Since 2004 increased rates of suicide have been noted in the US Armed Forces. We examined the association of social support (SS) trajectories and suicide ideation (SI) over a four-year period in Reserve Component (RC) servicemembers (National Guard and Reserve). We also examined baseline mental health measures, as predictors of the identified trajectories. Methods: Structured interviews were conducted with a nationally representative sample of 1,582 RC servicemembers at baseline and three follow-up waves. Latent growth mixture modeling identified SS trajectories and the association with follow-up SI. Multinomial logistic regression analyses were used to predict SS trajectories using baseline measures of demographics and mental health. Results: We identified four trajectories of SS and their associated prevalence of follow-up SI: low (n = 60, 3.8%; SI = 30.5%), medium (n = 229, 14.5%; SI = 14.1%), high-low (n = 66, 4.2%; SI = 13.6%), and high-high (n = 1,227, 77.5%; SI = 4.2%). There were significant differences in follow-up SI prevalence between each pair of SS trajectories except between the medium-SS and high-low-SS trajectories. Baseline SI, post-traumatic stress disorder (PTSD), depression, binge drinking, and mental health diagnosis were associated with increased likelihood of being on a low-SS or medium-SS trajectory. Baseline PTSD discriminated being on the high-high-SS and high-low-SS trajectories. Conclusion: Results support four trajectories of social support and that individuals with low or decreasing SS are likely to have greater follow-up SI. Baseline mental health assessments can identify these risk trajectories.

Figure 1.. The Four Trajectories of Social Support across the Four Annual Waves

Note. Baseline interviews were conducted between January and July of 2010 and three follow-up annual waves from 2011–2013. Responses of social support items were rated on a scale from 1 (“strongly disagree”) to 5 (“strongly agree”)

Figure 2.. Prevalence of Follow-up Suicide Ideation (Overall, New-onset, Recurrent) across Social Support Trajectories

Note. Different letters in the superscript were significantly different at alpha of .05. See Supplemental Table 2 for details of comparisons between any two social support trajectories.