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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Suicide attempts in U.S. Army combat arms, special forces and combat medics

Authors: Robert J. Ursano, Ronald C. Kessler, James A. Naifeh, Holly Herberman Mash, Carol S. Fullerton, Tsz Hin Hinz Ng, Pablo A. Aliaga, Gary H. Wynn, Hieu M. Dinh, James E. McCarroll, Nancy A. Sampson, Tzu-Cheg Kao, Michael Schoenbaum, Steven G. Heeringa, Murray B. Stein, on behalf of the Army STARRS collaborators

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

The U.S. Army suicide attempt rate increased sharply during the wars in Iraq and Afghanistan. Risk may vary according to occupation, which significantly influences the stressors that soldiers experience.

Methods

Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records for all active duty Regular Army enlisted soldiers who had a medically documented suicide attempt from 2004 through 2009 (n = 9650) and an equal-probability sample of control person-months (n = 153,528). Logistic regression analyses examined the association of combat occupation (combat arms [CA], special forces [SF], combat medic [CM]) with suicide attempt, adjusting for socio-demographics, service-related characteristics, and prior mental health diagnosis.

Results

In adjusted models, the odds of attempting suicide were higher in CA (OR = 1.2 [95% CI: 1.1–1.2]) and CM (OR = 1.4 [95% CI: 1.3–1.5]), but lower in SF (OR = 0.3 [95% CI: 0.2–0.5]) compared to all other occupations. CA and CM had higher odds of suicide attempt than other occupations if never deployed (ORs = 1.1–1.5) or previously deployed (ORs = 1.2–1.3), but not when currently deployed. Occupation was associated with suicide attempt in the first ten years of service, but not beyond. In the first year of service, primarily a time of training, CM had higher odds of suicide attempt than both CA (OR = 1.4 [95% CI: 1.2–1.6]) and other occupations (OR = 1.5 [95% CI: 1.3–1.7]). Discrete-time hazard functions revealed that these occupations had distinct patterns of monthly risk during the first year of service.

Conclusions

Military occupation can inform the understanding suicide attempt risk among soldiers.
Appendix
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Metadata
Title
Suicide attempts in U.S. Army combat arms, special forces and combat medics
Authors
Robert J. Ursano
Ronald C. Kessler
James A. Naifeh
Holly Herberman Mash
Carol S. Fullerton
Tsz Hin Hinz Ng
Pablo A. Aliaga
Gary H. Wynn
Hieu M. Dinh
James E. McCarroll
Nancy A. Sampson
Tzu-Cheg Kao
Michael Schoenbaum
Steven G. Heeringa
Murray B. Stein
on behalf of the Army STARRS collaborators
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1350-y

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