Abstract:
BACKGROUND:Civilian suicide rates vary by occupation in ways related to occupational stress exposure. Comparable military research finds suicide rates elevated in combat arms occupations. However, no research has evaluated variation in this pattern by deployment history, the indicator of occupation stress widely considered responsible for the recent rise in the military suicide rate. METHOD:The joint associations of Army occupation and deployment history in predicting suicides were analysed in an administrative dataset for the 729 337 male enlisted Regular Army soldiers in the US Army between 2004 and 2009. RESULTS:There were 496 suicides over the study period (22.4/100 000 person-years). Only two occupational categories, both in combat arms, had significantly elevated suicide rates: infantrymen (37.2/100 000 person-years) and combat engineers (38.2/100 000 person-years). However, the suicide rates in these two categories were significantly lower when currently deployed (30.6/100 000 person-years) than never deployed or previously deployed (41.2-39.1/100 000 person-years), whereas the suicide rate of other soldiers was significantly higher when currently deployed and previously deployed (20.2-22.4/100 000 person-years) than never deployed (14.5/100 000 person-years), resulting in the adjusted suicide rate of infantrymen and combat engineers being most elevated when never deployed [odds ratio (OR) 2.9, 95% confidence interval (CI) 2.1-4.1], less so when previously deployed (OR 1.6, 95% CI 1.1-2.1), and not at all when currently deployed (OR 1.2, 95% CI 0.8-1.8). Adjustment for a differential 'healthy warrior effect' cannot explain this variation in the relative suicide rates of never-deployed infantrymen and combat engineers by deployment status. CONCLUSIONS:Efforts are needed to elucidate the causal mechanisms underlying this interaction to guide preventive interventions for soldiers at high suicide risk.
journal_name
Psychol Medjournal_title
Psychological medicineauthors
Kessler RC,Stein MB,Bliese PD,Bromet EJ,Chiu WT,Cox KL,Colpe LJ,Fullerton CS,Gilman SE,Gruber MJ,Heeringa SG,Lewandowski-Romps L,Millikan-Bell A,Naifeh JA,Nock MK,Petukhova MV,Rosellini AJ,Sampson NA,Schoenbaum M,Zadoi
10.1017/S0033291715001294subject
Has Abstractpub_date
2015-11-01 00:00:00pages
3293-304issue
15eissn
0033-2917issn
1469-8978pii
S0033291715001294journal_volume
45pub_type
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