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.

DISCLAIMER STATEMENT

The opinions and assertions expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Uniformed Services University, the Department of Defense or the Henry M. Jackson Foundation for the Advancement of Military Medicine.

DISCLOSURE STATEMENT

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

SUPPLEMENTARY MATERIAL

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Additional information

Notes on contributors

Jing Wang

Jing Wang is a research assistant professor in the Department of Psychiatry at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and a scientist at the Center for the Study of Traumatic Stress. Her research has primarily focused on risk and protective factors for military mental health problems. Her primary research interests also include application of latent variable modeling in mental health research.

Robert J. Ursano

Robert J. Ursano is a Professor of Psychiatry and Neuroscience at the Uniformed Services University (USU). He is founding Director of the Center for the Study of Traumatic Stress and served as the Chairman of the Department of Psychiatry at USU for 25 years. He completed twenty years of service in the USAF medical corps and retired as Colonel.

Robert K. Gifford

Robert K. Gifford was the Executive Officer at the Center for the Study of Traumatic Stress (CSTS). He completed 20+ years of service in the US Army and retired as Colonel.

Hieu Dinh

Hieu Dinh is a Center Program Manager at the Center for the Study of Traumatic Stress (CSTS). She graduated from the Catholic University of America with a Bachelor’s of Science in Biochemistry and a minor in Psychology.

Alysse Weinberg

Alysse Weinberg is a Research Assistant at the Center for the Study of Traumatic Stress (CSTS). She graduated from Lehigh University with a B.A. in Psychology and Health, Medicine, and Society.

Gregory H. Cohen

Gregory H. Cohen is a Statistical Analyst at Boston University School of Public Health and has significant experience in epidemiological research.

Laura Sampson

Laura Sampson is Postdoctoral Research Fellow at the Harvard T.H. Chan School of Public Health. Sampson holds a doctoral degree in epidemiology from Boston University School of Public Health.

Sandro Galea

Sandro Galea, a physician, epidemiologist, and author, is dean and Robert A. Knox Professor at Boston University School of Public Health. He holds a medical degree from the University of Toronto, graduate degrees from Harvard University and Columbia University, and an honorary doctorate from the University of Glasgow.

Carol S. Fullerton

Carol S. Fullerton is Research Professor, Department of Psychiatry, Uniformed Services University, and Scientific Director of the Center for the Study of Traumatic Stress. She is widely published in the areas of post-traumatic stress disorder and the behavioral and psychological effects of disasters, war, terrorism, family violence, child neglect, bereavement, and suicide.