title: Guilt is more strongly associated with suicidal ideation among military personnel with direct combat exposure.
abstract: BACKGROUND
  Suicide rates in the U.S. military have been rising rapidly in the past decade. Research suggests guilt is a significant predictor of suicidal ideation among military personnel, and may be especially pronounced among those who have been exposure to combat-related traumas. The current study explored the interactive effect of direct combat exposure and guilt on suicidal ideation in a clinical sample of military personnel.
  
  
  METHODS
  Ninety-seven active duty U.S. Air Force personnel receiving outpatient mental health treatment at two military clinics completed self-report symptom measures of guilt, depression, hopelessness, perceived burdensomeness, posttraumatic stress disorder, and suicidal ideation.
  
  
  RESULTS
  Generalized multiple regression analyses indicated a significant interaction of guilt and direct combat exposure (B=.124, SE=.053, p=.020), suggesting a stronger relationship of guilt with suicidal ideation among participants who had direct combat exposure as compared to those who had not. The interactions of direct combat exposure with depression (B=.004, SE=.040, p=.926), PTSD symptoms (B=.016, SE=.018, p=.382), perceived burdensomeness (B=.159, SE=.152, p=.300) and hopelessness (B=.069, SE=.036, p=.057) were nonsignificant.
  
  
  CONCLUSIONS
  Although guilt is associated with more severe suicidal ideation in general among military personnel, it is especially pronounced among those who have had direct combat exposure.
authors.affiliation: National Center for Veterans Studies, 260 S. Central Campus Dr., Room 205, Salt Lake City, UT 84112, 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; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D059020:Suicidal Ideation; D014857:Warfare; D055815:Young Adult