title: Shame, pride, and suicidal ideation in a military clinical sample.
abstract: BACKGROUND
  Suicide risk among U.S. military personnel has been increasing over the past decade. Fluid vulnerability theory (FVT; Rudd, 2006) posits that acute suicidal episodes increase in severity when trait-based (e.g., shame) and state-based (e.g., hopelessness) risk factors interact, especially among individuals who have been previously suicidal. In contrast, trait-based protective factors (e.g., pride) should buffer the deleterious effects of risk factors.
  
  
  METHODS
  77 active duty military personnel (95% Air Force; 58.4% male, 39.0% female; 67.5% Caucasian, 19.5% African-American, 1.3% Native American, 1.3% Native Hawaiian/Pacific Islander, 1.3% Asian, and 5.2% other) engaged in outpatient mental health treatment completed self-report surveys of shame, hopelessness, pride, and suicidal ideation. Multiple generalized regression was utilized to test the associations and interactive effects of shame, hopelessness, and worst-point past suicidal ideation on severity of current suicidal ideation.
  
  
  RESULTS
  Shame significantly interacted with hopelessness (B=-0.013, SE=0.004, p<0.001) and worst-point suicidal ideation (B=0.027, SE=0.010, p=0.010), augmenting each variable's effect on severity of current suicidal ideation. A significant three-way interaction among shame, worst-point suicidal ideation, and pride was also observed (B=-0.010, SE=0.0043, p=0.021), indicating that pride buffered the interactive effects of shame with worst-point suicidal ideation.
  
  
  CONCLUSIONS
  Small sample size, cross-sectional design, and primarily Air Force sample.
  
  
  CONCLUSIONS
  Among military outpatients with histories of severe suicidal episodes, pride buffers the effects of hopelessness on current suicidal ideation. Results are consistent with FVT.
authors.affiliation: National Center for Veterans Studies, United States. craig.bryan@utah.edu
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Bryan
authors.forename: Bobbie
authors.initials: B
authors.lastname: Ray-Sannerud
authors.forename: Chad E
authors.initials: CE
authors.lastname: Morrow
authors.forename: Neysa
authors.initials: N
authors.lastname: Etienne
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D010551:Personality; D012307:Risk Factors; D012752:Shame; D059020:Suicidal Ideation; D055815:Young Adult