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Examining the link between prior suicidality and subsequent suicidal ideation among high-risk US military service members

Published online by Cambridge University Press:  25 October 2018

Melanie A. Hom ,
Mary E. Duffy ,
Megan L. Rogers ,
Jetta E. Hanson ,
Peter M. Gutierrez  and
Thomas E. Joiner
Melanie A. Hom*
Affiliation:
Department of Psychology, Florida State University, Tallahassee, FL, USA
Mary E. Duffy
Affiliation:
Department of Psychology, Florida State University, Tallahassee, FL, USA
Megan L. Rogers
Affiliation:
Department of Psychology, Florida State University, Tallahassee, FL, USA
Jetta E. Hanson
Affiliation:
Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, CO, USA
Peter M. Gutierrez
Affiliation:
Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, CO, USA Denver Veterans Affairs Medical Center, Aurora, CO, USA Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
Thomas E. Joiner
Affiliation:
Department of Psychology, Florida State University, Tallahassee, FL, USA
*
Author for correspondence: Melanie A. Hom, E-mail: [email protected]
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Abstract

Background

Research is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel.

Methods

US military service members referred to or seeking care for suicide risk (N = 624) completed self-report psychiatric domain measures and a clinician interview assessing prior suicidality severity at baseline. Three months later, participants completed a self-report measure of suicidal ideation severity. Three separate percentile bootstrap mediation models were used to examine psychiatric factors (i.e. alcohol abuse, anxiety sensitivity, hopelessness, insomnia, posttraumatic stress symptoms, suicidal ideation, and thwarted belongingness) as parallel mediators of the relationship between prior suicidality severity (specifically, suicidal ideation, suicide attempt, and overall suicidality – i.e. ideation/attempt severity combined) at baseline and suicidal ideation severity at follow-up.

Results

Hopelessness, specifically, and the total effect of all mediators, each significantly accounted for the relationship between prior suicidality severity and subsequent ideation severity across models. In the models with attempt severity and overall suicidality severity as predictors, thwarted belongingness was also a significant mediator.

Conclusions

Hopelessness, thwarted belongingness, and overall severity of psychiatric indices may explain the relationship between prior suicidality severity and future suicidal ideation severity among service members at elevated suicide risk. Research is needed to replicate these findings and examine other possible mediators.

Keywords

Hopelessnessmilitaryservice memberssuicidethwarted belongingness
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 13 , October 2019 , pp. 2237 - 2246
Copyright
Copyright © Cambridge University Press 2018 

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