title: Differentiating Army suicide attempters from psychologically treated and untreated soldiers: a demographic, psychological and stress-reaction characterization.
abstract: BACKGROUND
  Suicide is the leading cause of death in most armies during peace-time. The recent dramatic rise in suicides in the US Army further focuses attention on the causes of suicidal behavior in the military.
  
  
  METHODS
  This study investigated demographic characteristics, psychological profile and stress-related risk factors associated with suicide attempts in Israelis aged 18-21 years, who served in the Army in 2009. Soldiers who attempted suicide (N=60) were compared to soldiers treated by a mental health professional, but reported no suicidal behavior (N=58), and to controls (N=50).
  
  
  RESULTS
  Suicide attempters had lower socioeconomic status and less cognitive ability compared with treated soldiers and untreated control soldiers. Only 25% of the suicide attempters had received mental healthcare prior to the attempt. The majority of the attempts were non-lethal (86.2%), and only 5.2% used firearms. Attempters had more previous suicide attempts (37.9%) and deliberate selfharm incidents (19.3%), compared to almost no such behaviors in the other two groups. Following the suicide attempt, 77% were diagnosed with moderate to severe mental disorders, 44.8% personality disorders and 8.6% mood disorders. Attempters reported higher levels of general stress compared to their peers in the other two groups. Being away from home and obeying authority were especially more stressful in attempters.
  
  
  CONCLUSIONS
  Young soldiers are less prone to seek mental health assistance, despite suffering from higher levels of stress. Screening is required to detect soldiers at risk for suicidal behavior and preventive intervention will require active outreach.
authors.affiliation: Geha Mental Health Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. assafyacobi@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Yacobi
authors.forename: E
authors.initials: E
authors.lastname: Fruchter
authors.forename: J J
authors.initials: JJ
authors.lastname: Mann
authors.forename: L
authors.initials: L
authors.lastname: Shelef
mesh_terms: D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D019964:Mood Disorders / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010554:Personality Disorders / Q000453:epidemiology; D012307:Risk Factors; D016728:Self-Injurious Behavior; D013315:Stress, Psychological; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Adolescents; Attempt; Israel; Military; Soldiers; Suicide