title: Comparing U.S. Army suicide cases to a control sample: initial data and methodological lessons.
abstract: Identification of risk and protective factors for suicide is a priority for the United States military, especially in light of the recent steady increase in military suicide rates. The Department of Defense Suicide Event Report contains comprehensive data on suicides for active duty military personnel, but no analogous control data is available to permit identification of factors that differentially determine suicide risk. This proof-of-concept study was conducted to determine the feasibility of collecting such control data. The study employed a prospective case-control design in which control cases were randomly selected from a large Army installation at a rate of four control participants for every qualifying Army suicide. Although 111 Army suicides were confirmed during the study period, just 27 control soldiers completed the study. Despite the small control sample, preliminary analyses comparing suicide cases to controls identified several factors more frequently reported for suicide cases, including recent failed intimate relationships, outpatient mental health history, mood disorder diagnosis, substance abuse history, and prior self-injury. No deployment-related risk factors were found. These data are consistent with existing literature and form a foundation for larger control studies. Methodological lessons learned regarding study design and recruitment are discussed to inform future studies.
authors.affiliation: National Center for Telehealth and Technology, 9933C West Hayes Street, Madigan Annex, Joint Base Lewis-McChord, WA 98431.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Alexander
authors.affiliation: National Center for Telehealth and Technology, 9933C West Hayes Street, Madigan Annex, Joint Base Lewis-McChord, WA 98431.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Reger
authors.affiliation: National Center for Telehealth and Technology, 9933C West Hayes Street, Madigan Annex, Joint Base Lewis-McChord, WA 98431.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Smolenski
authors.affiliation: National Center for Telehealth and Technology, 9933C West Hayes Street, Madigan Annex, Joint Base Lewis-McChord, WA 98431.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Fullerton
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D008889:Military Personnel / Q000706:statistics & numerical data*; D019964:Mood Disorders / Q000453:epidemiology; D010865:Pilot Projects; D011446:Prospective Studies; D016728:Self-Injurious Behavior / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult