Risk and protective factors that distinguish United States veterans with a history of suicidal ideation and suicide attempt

Abstract

Many risk and protective factors for suicidal thoughts and behaviors among United States veterans are known. However, factors differentiating veterans who endorse suicidal ideation to veterans who engage in suicide attempts are understudied. The current study examined factors that distinguished these two groups using the Military Health and Well-Being Project, an online dataset of 1495 veterans that oversampled for female and Black veterans. Veterans (N = 620; 39 % female; 15 % Black) were grouped by those who endorsed a history of suicidal thoughts (n = 548) or suicide attempts (n = 72). Independent samples t-tests were conducted to examine differences in individual risk and protective factors. A binary logistic regression was conducted to examine which factors uniquely distinguished between veterans with past ideation and veterans with past attempts. Compared to veterans with past ideation, those with past attempts had higher scores on moral injury (d = −0.80; p < .001), substance use (d = −0.72; p < .001), and loneliness (d = −0.62; p < .001) and lower scores on meaning and purpose in life (d = 0.89; p < .001) and social support (d = 0.61; p < .001). When collectively examined, female gender (OR = 2.37), endorsing lower meaning and purpose in life (OR = 0.55) and endorsing greater substance use (OR = 1.81) were unique predictors of attempting suicide. Findings suggest the importance of assessing and targeting meaning and purpose in life and substance use in veterans endorsing suicidal ideation to potentially prevent the transition to attempting suicide.