title: Interaction of combat exposure and unit cohesion in predicting suicide-related ideation among post-deployment soldiers.
abstract: Suicide is one of the leading causes of death among U.S. Army soldiers. Suicide-related ideation, which is associated with suicide attempts and suicide, can cause considerable distress. In a sample of 1,663 recently redeployed soldiers, we used factor analysis and structural equation modeling to test the associations between combat exposure, unit cohesion, and their interaction in predicting suicide-related ideation. We found that combat exposure was a significant risk factor for suicide-related ideation, while unit cohesion was a significant protective factor. The significant interaction between the two factors indicated that soldiers who experienced greater combat exposure but also had higher levels of unit cohesion had relatively lower levels of suicide-related ideation. In addition, those who had higher levels of combat exposure and lower unit cohesion were most at risk for suicide-related ideation. Our findings indicate the importance of unit cohesion in protecting soldiers from suicide-related ideation and suggest a higher risk group of soldiers who should be targeted for interventions.
authors.affiliation: Behavioral and Social Health Outcomes Program in the Epidemiology and Disease Surveillance Portfolio, US Army Institute of Public Health, Edgewood Arsenal of Aberdeen Proving Ground, MD 21010, USA. mary.moser.mitchell@us.army.mil
authors.forename: Mary M
authors.initials: MM
authors.lastname: Mitchell
authors.forename: Michael Shayne
authors.initials: MS
authors.lastname: Gallaway
authors.forename: Amy M
authors.initials: AM
authors.lastname: Millikan
authors.forename: Michael
authors.initials: M
authors.lastname: Bell
mesh_terms: D003130:Combat Disorders / Q000175:diagnosis* / Q000523:psychology; D005163:Factor Analysis, Statistical; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D014481:United States