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Meaning in life moderates the association between morally injurious experiences and suicide ideation among U.S. combat veterans: Results from the National Health and Resilience in Veterans Study.

ABSTRACT: OBJECTIVE:Effectively responding to suicide risk among veterans involves further developing understanding of reactions to combat experiences, including life-threatening events, traumatic losses, and morally injurious experiences. An important determinant of whether stressors lead to poor mental health outcomes is the perception of meaning. The current study aimed to determine whether global meaning (i.e., general beliefs, goals, and sense of purpose in life) moderates the relationship between morally injurious experiences and suicide ideation among combat veterans. METHOD:This analysis examined 564 participants in the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. military veterans, who reported a history of deployment to a combat zone. Multivariable logistic regressions examined interactions between morally injurious experiences and global meaning as predictors of the likelihood of current suicide ideation. RESULTS:There were significant interactions between global meaning and 2 morally injurious experience subtypes-transgressions by others and betrayal experiences. Higher global meaning was associated with significantly lower likelihood of experiencing suicide ideation at higher levels of transgression by others and betrayal experiences. CONCLUSIONS:Veterans who report higher levels of morally injurious experiences involving transgressions by others and betrayal experiences in the presence of higher levels of global meaning are significantly less likely to experience suicide ideation. Continued research is needed to determine whether interventions aimed at cultivating global meaning may help mitigate suicide risk in combat veterans with high exposure to certain potentially morally injurious experiences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

SUBMITTER: Corona CD

PROVIDER: S-EPMC6722007 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Meaning in life moderates the association between morally injurious experiences and suicide ideation among U.S. combat veterans: Results from the National Health and Resilience in Veterans Study.

Corona Christopher D CD Van Orden Kimberly A KA Wisco Blair E BE Pietrzak Robert H RH

Psychological trauma : theory, research, practice and policy 20190530 6

<h4>Objective</h4>Effectively responding to suicide risk among veterans involves further developing understanding of reactions to combat experiences, including life-threatening events, traumatic losses, and morally injurious experiences. An important determinant of whether stressors lead to poor mental health outcomes is the perception of meaning. The current study aimed to determine whether global meaning (i.e., general beliefs, goals, and sense of purpose in life) moderates the relationship be ...[more]

PMID: 31144841

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Project description:BACKGROUND:Data on the prevalence of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background are scarce. There are hints that this population is at risk. The aim of the study is to investigate the epidemiology of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background in Germany while taking gender-specific differences into consideration. METHODS:A representative study with N = 10,638 students (mean age 14.91 years, SD = .73).) in the state of Lower Saxony in Germany was conducted. In the 2014-2015 school year, 672 classes were selected by randomly sampling different school types. The participation rate was 84.1%, excluding any classes for which the director refused to provide consent. A total of 49.8% were female adolescents, and 23.3% of the participants had a migration background. Target variables were assessed with items from the Ottawa Self-Injury Inventory, the Self-Harm Behavior Questionnaire and the Self-Harm Inventory, partly adapted. RESULTS:Of all students, 7.6% had a lifetime history of suicide attempts, and 36.6% answered with a rating of at least "rarely" when asked to rate the lifetime prevalence of suicidal ideation. The 12-month prevalence of direct self-injurious behavior was 17.8%. Adolescents with a migration background showed a significantly higher prevalence of all three constructs (p = .006; p < .001; p = .006). Male students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (4.7% vs. 3.1%) than native males (p = .009). Female students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (15.9% vs. 10.4%) and suicidal ideation ("often" 12.1% vs. 8.9%) than native female students (p < .001; p = .008). CONCLUSION:Our assessment indicates an elevated risk for suicidal behaviors in adolescents with a migration background. From research on adults, it is known that the dominant motives for suicidal behavior in migrants are associated with their migration history/situation. As suggested by Cramer and Kapusta's (Front Psychol 8:1756, 2017) theoretical model, the Social-Ecological Framework of Theory, Assessment, and Prevention, there is a need for culturally sensitive preventions that take into account the specific reasons for suicide attempts in migrants.

Project description:Recent work inspired by graph theory has begun to conceptualize mental disorders as networks of interacting symptoms. Posttraumatic stress disorder (PTSD) symptom networks have been investigated in clinical samples meeting full diagnostic criteria, including military veterans, natural disaster survivors, civilian survivors of war, and child sexual abuse survivors. Despite reliable associations across reported networks, more work is needed to compare central symptoms across trauma types. Additionally, individuals without a diagnosis who still experience symptoms, also referred to as subthreshold cases, have not been explored with network analysis in veterans. A sample of 1,050 Iraq/Afghanistan-era U.S. military veterans (851 males, mean age = 36.3, SD = 9.53) meeting current full-criteria PTSD (n = 912) and subthreshold PTSD (n = 138) were assessed with the Structured Clinical Interview for DSM-IV Disorders (SCID). Combat Exposure Scale (CES) scores were used to group the sample meeting full-criteria into high (n = 639) and low (n = 273) combat exposure subgroups. Networks were estimated using regularized partial correlation models in the R-package qgraph, and robustness tests were performed with bootnet. Frequently co-occurring symptom pairs (strong network connections) emerged between two avoidance symptoms, hypervigilance and startle response, loss of interest and detachment, as well as, detachment and restricted affect. These associations replicate findings reported across PTSD trauma types. A symptom network analysis of PTSD in a veteran population found significantly greater overall connectivity in the full-criteria PTSD group as compared to the subthreshold PTSD group. Additionally, novel findings indicate that the association between intrusive thoughts and irritability is a feature of the symptom network of veterans with high levels of combat exposure. Mean node predictability is high for PTSD symptom networks, averaging 51.5% shared variance. With the tools described here and by others, researchers can help refine diagnostic criteria for PTSD, develop more accurate measures for assessing PTSD, and eventually inform therapies that target symptoms with strong network connections to interrupt interconnected symptom complexes and promote functional recovery.

Dataset Information

Meaning in life moderates the association between morally injurious experiences and suicide ideation among U.S. combat veterans: Results from the National Health and Resilience in Veterans Study.

Publications

Meaning in life moderates the association between morally injurious experiences and suicide ideation among U.S. combat veterans: Results from the National Health and Resilience in Veterans Study.

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