Study identifies specific stressors that increase the odds of suicide in active duty soldiers

Suicide rates among US Army service members rose to record levels in the 2000s. In response, the US Army worked with scientists to launch the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) (ICPSR 35197) in 2011. The largest research study of mental health risk and resilience ever conducted among Army personnel, Army STARRS was designed to comprehensively investigate risk factors and protective factors for suicide, suicide-related behavior, and other mental/behavioral health issues. The study collected historical and present-day administrative data, as well as survey data from more than 100,000 active-duty soldiers. They also collected neurocognitive test data, as well as blood and genetic biomarker samples. In 2018, the first of four planned waves of STARRS-LS was fielded–longitudinal follow-up studies of more than 72,000 soldiers who participated in Army STARRS. ICPSR currently provides, via restricted data use agreements, the public-use datasets from three Army STARRS surveys: the All Army Study, the New Soldier Study, and the Pre/Post Deployment Study, as well as from the first two waves of the STARRS-LS.

In a paper published online first last week in the journal, Psychiatric Research & Clinical Practice, authors Dempsey et al. (STARRS co-PIs) noted that the suicide mortality rate for active duty soldiers increased almost 10 percent from 2015 to 2020. They describe in their paper how they used data from a psychological autopsy component of Army STARRS “to identify the extent to which the presence of recent stressful events, lifetime traumatic stressors, and history of lifetime mental health disorders” are risk factors for suicide among active duty US Army soldiers, as reported by next of kin and supervisors. They looked at data from 135 US Army soldiers who died by suicide while on active duty between 2011 and 2013, and for each of the soldiers, the researchers interviewed their next-of-kin and/or first-line Army supervisor. (Next-of-kin and Army supervisor data are not available from ICPSR.) Dempsey et al. also used data drawn from a large, representative sample of living soldiers who participated in the All Army Study to form two control groups. One was a group of propensity score-matched soldiers, and the other was made up of soldiers who had considered suicide in the past year. Using multivariate logistic regression analyses, Dempsey et al. created a risk score for suicide. Their study is the first to identify specific precursor stressors, namely relationship problems, military punishment, and perceived failure or humiliation, that increase the odds of suicide death by contributing most to the transition from suicide ideation to action. Soldiers who experienced these stressors in the month prior to death had significantly higher odds of suicide. These findings remained even after controlling for lifetime stressful events and mental health disorders. According to the authors, this identified set of stressors provides “an actionable target for suicide prevention and intervention for clinicians, family members, and supervisors.”