Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine

Figures & data

Table 1 Profile of Veterans in Veterans’ Study Total Sample (N=1730)

Variables or mean	(N)	%	(95% C. I.)
Age (Mean = 59.6. SD = 12.8)
18–39	(177)	10.2	8.9–11.8
40–64	(574)	33.2	31.0–35.4
65 or older	(979)	56.6	54.2–58.9
Sex
Female	(85)	4.9	4.0–6.0
Male	(1645)	95.1	94.0–96.0
Race
Non-White	(75)	4.3	3.5–5.4
White	(1655)	95.7	94.6–96.0
Marital Status
Married	(1340)	77.5	75.4–79.4
Not Married	(390)	22.5	20.6–24.6
Deployed as Guard/Reserve
No	(1322)	76.4	74.4–78.4
Yes	(408)	23.6	21.6–25.6
Multiple Warzone Tours
No	(1041)	60.3	58.0–62.6
Yes	(686)	39.7	37.4–42.1
Warzone*
Vietnam	(972)	56.2	53.8–58.5
Persian Gulf	(275)	15.9	14.3–17.7
Iraq/Afghanistan/GWOT	(396)	22.9	21.0–24.9
Other Post-Vietnam Conflict	(245)	14.2	12.6–15.9
Service Branch*
Air Force	(288)	16.7	15.0–18.5
Army	(861)	49.8	47.4–52.1
Navy	(374)	21.6	19.7–23.6
Marines	(194)	11.2	9.8–12.8
VA Services Use*
Ever used VA	(1073)	62.0	59.7–64.3
Currently use VA	(864)	49.9	47.6–52.3
Suicide
Ever Thoughts	(196)	11.3	9.9–12.9
Ever Thought Seriously about Suicide	(209)	12.1	10.6–13.7
Ever Plan or Attempt Suicide	(98)	5.7	4.6–6.9
Suicide Thoughts in Past Month	(94)	5.5	4.4–6.6

Note: *Multiple responses allowed.

Abbreviation: GWOT, Global War on Terrorism.

Table 2 Bivariate Associations for Ever Suicide Attempt/Plan Among Community Veterans (N=1073)

Study Variables*	(N)	% Total	Ever Attempt/Plan		OR	p-value
			% No	% Yes
Mean PTSD Risk Score†	(1041)	100.0	3.6	4.0	1.23	0.034
% Age: 65+ vs < 65	(686)	64.0	95.9	4.1	0.54	0.027
% Female vs Male	(49)	4.6	93.9	6.1	1.19	0.771
% Iraq/Afghanistan Veteran vs not	(208)	19.4	91.4	8.6	2.06	0.015
% High Combat Exposure vs not High	(232)	21.6	91.8	8.2	1.94	0.024
% Child Neglect High vs not High	(184)	17.1	94.8	5.2	4.02	<0.001
% High Lifetime Trauma vs not High	(200)	18.7	94.8	5.2	3.05	<0.001
% Ever Major Depress. Disorder vs not	(233)	21.7	94.8	5.2	9.73	<0.001
% Ever PTSD vs no PTSD	(131)	12.2	94.8	5.2	6.38	<0.001
% Ever Marijuana 50+ Times vs not	(103)	9.6	87.4	12.6	3.11	0.001
% Low Psychological Resilience vs not	(265)	24.7	89.4	10.6	3.29	<0.001
% Rural vs Nonrural Residence	(496)	46.2	96.8	3.2	0.45	0.008
Total Column %	-	-	94.6	5.4	-	-

Notes: *For brevity, we only present the indicator variable results for crosstabulations shown in Table 2. †For genetic analyses, sample was reduced due to missing DNA and exclusion of 40 non-Caucasians.

Table 3 Multivariable Logistic Regression Predicting Ever Suicide Plan or Attempt Among Community Veterans with Genetic Data (N=1041) †

Variables*	OR	z Score	(95% C.I.)	p-value
PTSD genetic risk score	1.25	2.10	1.01–1.54	0.036
Age (in years)	0.99	−0.97	0.96–1.01	0.332
Female sex (vs male)	0.38	−1.29	0.09–1.65	0.195
Married (vs not married)	0.73	−0.90	0.37–1.45	0.368
High trauma exposure (vs low trauma)	1.49	1.20	0.78–2.83	0.228
High combat exposure (vs low combat)	1.27	0.70	0.64–2.52	0.487
History of child abuse/neglect (vs none)	2.34	2.60	1.23–4.43	0.009
Multiple tours/deployments (vs one)	0.63	−1.39	0.33–1.21	0.164
Ever major depression (vs no depression)	5.04	4.46	2.48–10.27	<0.001
Ever PTSD (vs no PTSD)	1.62	1.29	0.79–3.39	0.195
Low psychological resilience (vs not low)	1.41	1.05	0.74–2.69	0.292
Number times ever used marijuana††	1.56	2.33	1.07–2.27	0.020
Rural residence (vs non-rural)	0.49	−2.16	0.26–0.94	0.031

Notes: *Area under ROC curve = 0.844, Hosmer-Lemeshow χ² = 10.37, p = 0.240. †For genetic analyses, sample was reduced due to missing DNA and exclusion of 40 non-Caucasians. †† For MVA logistic regression marijuana use was coded as an ordinal variable coded as: never used, used occasionally, but less than 50 times, and used 50 or more times.

Table 4 Multivariable Logistic Regression Predicting Ever Suicidal Thoughts for Two Weeks or More Among Community Veterans with Genetic Data (N=1041) †

Variables*	OR	z Score	(95% C.I.)	p-value
PTSD genetic risk score	0.98	−0.30	0.84–1.14	0.761
Age (in years)	0.99	−1.46	0.97–1.00	0.145
Female sex (vs male)	1.67	1.11	0.68–4.09	0.267
Married (vs not married)	1.50	1.44	0.86–2.59	0.151
High trauma exposure (vs low trauma)	1.11	0.40	0.67–1.81	0.691
High combat exposure (vs low combat)	1.19	0.65	0.71–1.98	0.513
History of child abuse/neglect (vs none)	2.42	3.58	1.49–3.93	<0.001
Multiple tours/deployments (vs one)	0.87	−0.59	0.55–1.38	0.557
Ever major depression (vs no depression)	10.51	9.48	6.46–17.10	<0.001
Ever PTSD (vs no PTSD)	0.94	−0.21	0.54–1.63	0.835
Low psychological resilience (vs not low)	1.97	2.91	1.25–3.11	0.004
Number times ever used marijuana††	1.40	2.22	1.04–1.89	0.026
Rural residence (vs non-rural)	0.97	−0.15	0.63–1.50	0.883

Notes: *Area under ROC curve = 0.859, Hosmer-Lemeshow χ² = 4.95, p = 0.763. †For genetic analyses, sample was reduced due to missing DNA and exclusion of 40 non-Caucasians. ††For MVA logistic regression marijuana use was coded as an ordinal variable: never used, used occasionally, but less than 50 times, and used 50 or more times.