The association between aggression and suicidal behaviors in veterans at risk for suicide

Abstract

Suicide is a leading cause of death among United States veterans. Although aggression is common among veterans and represents a strong predictor of suicidal behaviors in civilians, it is seldom studied among veterans. The scant existing research on aggression and suicide in veterans is limited by its restricted examination of the full range of suicidal behavior, oversimplification of suicide attempt history (no attempt vs. attempt), and its focus on physical aggression rather than examining both physical and verbal aggression as unique correlates of suicide. The current study addresses these gaps in a sample of veterans at high-risk for suicide. Participants (N = 207) were recruited as part of a larger clinical trial examining a suicide intervention; the current study uses the baseline data. Veterans completed a self-report measure of physical and verbal aggression and a clinician-administered interview of suicidal behaviors. Logistic regression models indicated that aggression was unrelated to the presence of suicide attempts or behaviors in this high-risk sample. However, count models suggested that physical and verbal aggression were related to a greater number of suicide attempts, and physical aggression was related to a greater number of suicidal behaviors. The current findings align with civilian research suggesting aggression is a risk factor for frequent suicide attempts. Further research is needed to better understand this association, particularly in determining whether aggression plays a causal role in suicide behaviors in veterans.