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. 2024;15(1):2312756.
doi: 10.1080/20008066.2024.2312756. Epub 2024 Apr 3.

Male sex and hazardous alcohol use following military sexual assault increase suicide risk among US service members and veterans

Rebecca K Blais  1   2 , Bingyu Xu  1 , Hallie Tannahill  2   3 , Patrick Dulin  4
Affiliations

Male sex and hazardous alcohol use following military sexual assault increase suicide risk among US service members and veterans

Rebecca K Blais et al. Eur J Psychotraumatol. 2024.

Abstract
in English, Spanish

Background: Higher alcohol use and military sexual assault (MSA) are associated with increased risk of death by suicide. Risk for death by suicide is rapidly increasing among females, who report higher rates of MSA, yet actual death by suicide and alcohol use are higher among males. It is not well understood whether higher alcohol use confers greater suicide risk in male or female service members and veterans who have experienced MSA.Objective: To determine whether the association between alcohol misuse and suicide risk was moderated by biological sex in a sample of male and female service members (N = 400, 50% female) who reported MSA.Method: Participants completed surveys of alcohol use and suicide risk as well as a demographic inventory. Linear regression with an interaction term was used to determine if suicide risk differed by sex and alcohol use severity after accounting for discharge status, sexual orientation, and age.Results: Average scores on the suicide risk measure were consistent with an inpatient psychiatric sample and scores on the AUDIT-C were indicative of a probable positive screen for alcohol misuse. Suicide risk was most pronounced among males who reported higher levels of hazardous alcohol use. A sensitivity analysis examining suicide risk by sex and screening results for alcohol misuse (positive/negative) showed that men with a probable positive screen had higher suicide risk.Discussion: The current study provides novel findings on suicide risk among survivors of military sexual violence by including both male and female survivors. Interventions to decrease suicide risk following MSA may consider alcohol reduction strategies, and optimizing these interventions in males. Engaging military culture at both the US Departments of Defense and Veterans Affairs to encourage more healthy alcohol consumption may mitigate this public health concern. Future research may consider how country of origin relates to these associations.

Antecedentes: Un mayor consumo de alcohol y la agresión sexual en el ámbito militar (MSA, según sus siglas en inglés) se asocian con un mayor riesgo de muerte por suicidio. El riesgo de muerte por suicidio está aumentando rápidamente entre las mujeres, que informan de mayores tasas de MSA, sin embargo, la muerte real por suicidio y el consumo de alcohol son mayores entre los hombres. No se comprende bien si un mayor uso de alcohol confiere un mayor riesgo de suicidio en miembros y veteranos del ejército, ya sean hombres o mujeres, que han experimentado MSA.

Objetivo: Determinar si la asociación entre el abuso de alcohol y el riesgo de suicidio estaba condicionado por el sexo biológico en una muestra de miembros del ejército masculinos y femeninos (N = 400, 50% mujeres) que informaron sobre el MSA.

Método: Los participantes completaron encuestas sobre el consumo de alcohol y el riesgo de suicidio, así como un inventario demográfico. Se utilizó un modelo de regresión lineal con una interacción para determinar si el riesgo de suicidio difería según el sexo y la gravedad del consumo de alcohol, después de tener en cuenta el estado de baja, la orientación sexual y la edad.

Resultados: Las puntuaciones promedio en la medida de riesgo de suicidio fueron consistentes con una muestra psiquiátrica de pacientes hospitalizados, y las puntuaciones en el AUDIT-C indicaron una probable detección positiva de abuso de alcohol. El riesgo de suicidio fue más elevado entre los varones que declararon niveles más altos de consumo peligroso de alcohol. Un análisis de sensibilidad que examinó el riesgo de suicidio por sexo y los resultados de la detección de abuso de alcohol (positivo/negativo) mostró que los hombres con un cribado probablemente positivo tenían un mayor riesgo de suicidio.

Discusión: El presente estudio ofrece hallazgos novedosos sobre el riesgo de suicidio entre los sobrevivientes de agresión sexual en el ámbito militar al incluir tanto a sobrevivientes masculinos como femeninos. Las intervenciones para reducir el riesgo de suicidio después de una MSA podrían contemplar estrategias de reducción del consumo de alcohol y optimizar estas intervenciones en los hombres. La participación en la cultura militar en los Departamentos de Defensa y Asuntos de Veteranos de los Estados Unidos para promover un consumo más saludable de alcohol podría mitigar esta preocupación de salud pública. Investigaciones futuras podrían considerar cómo el país de origen se relaciona con estas asociaciones.

Keywords: Suicide; Suicidio; abuso de alcohol; agresión sexual en el ámbito militar; alcohol use; diferencias de sexo; military; sex; veterans.

Plain language summary

Average scores for the suicide risk measure and alcohol use were high among a sample of male and female survivors of military sexual assault.Suicide risk was most pronounced among males who reported higher levels of hazardous alcohol use.A sensitivity analysis examining suicide risk by sex and screening results for alcohol misuse (positive/negative) showed that men with a probable positive screen had higher suicide risk.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Probe of moderation model of alcohol use and sex on suicide risk.
Figure 2.
Figure 2.
Suicide risk stratified by sex and hazardous drinking, with 95% confidence interval error bars.
See this image and copyright information in PMC

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