| Description |
Suicide is one of the most devastating issues facing the military. Research has yielded inconsistent associations of risk factors with suicidal ideation (SI), behaviors, and suicide attempts. Atheoretical, cross-sectional designs, lack of specificity of suicide nomenclature across studies, and a failure to distinguish within- and between-person differences contribute to inconsistencies and decrease clinical ability to predict and prevent military suicide. This study compares longitudinal relationships of risk and suicide outcomes in military personnel within a Fluid Vulnerability Theory (FVT) framework. Existing data from 152 soldiers reporting SI with intent to die during the past week and/or a suicide attempt within the past month as part of the Brief Cognitive Behavioral Therapy clinical trial were used. SI, preparatory behaviors, suicide attempts, depression, thwarted belongingness, perceived burdensomeness, and hopelessness were collected at baseline and 3, 6, 12, 18, and 24-months postbaseline. Within-person differences explained more variance in SI and preparatory behaviors while between-person differences explained more variance in suicide attempts over time. There were significant between-person changes in suicide outcomes over time. However, none of the four within- or between-person risk factors were significantly associated with all suicide outcomes. Previously identified risk factors have distinct associations with suicide outcomes iv over time. In line with FVT, within-person changes, as opposed to standardized cutoff scores, may provide more useful information as to the onset of acute risk. Consistent with FVT, history of suicide attempts is more strongly associated with future attempts than ideation or preparatory behaviors. |
