title: Prevalence and correlates of suicidal behavior among new soldiers in the U.S. Army: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).
abstract: BACKGROUND
  The prevalence of suicide among U.S. Army soldiers has risen dramatically in recent years. Prior studies suggest that most soldiers with suicidal behaviors (i.e., ideation, plans, and attempts) had first onsets prior to enlistment. However, those data are based on retrospective self-reports of soldiers later in their Army careers. Unbiased examination of this issue requires investigation of suicidality among new soldiers.
  
  
  METHODS
  The New Soldier Study (NSS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) used fully structured self-administered measures to estimate preenlistment histories of suicide ideation, plans, and attempts among new soldiers reporting for Basic Combat Training in 2011-2012. Survival models examined sociodemographic correlates of each suicidal outcome.
  
  
  RESULTS
  Lifetime prevalence estimates of preenlistment suicide ideation, plans, and attempts were 14.1, 2.3, and 1.9%, respectively. Most reported onsets of suicide plans and attempts (73.3-81.5%) occurred within the first year after onset of ideation. Odds of these lifetime suicidal behaviors among new soldiers were positively, but weakly associated with being female, unmarried, religion other than Protestant or Catholic, and a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic.
  
  
  CONCLUSIONS
  Lifetime prevalence estimates of suicidal behaviors among new soldiers are consistent with retrospective reports of preenlistment prevalence obtained from soldiers later in their Army careers. Given that prior suicidal behaviors are among the strongest predictors of later suicides, consideration should be given to developing methods of obtaining valid reports of preenlistment suicidality from new soldiers to facilitate targeting of preventive interventions.
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.forename: Steven G
authors.initials: SG
authors.lastname: Heeringa
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
authors.forename: Sonia
authors.initials: S
authors.lastname: Jain
authors.forename: Rema
authors.initials: R
authors.lastname: Raman
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Sun
authors.forename: Wai Tat
authors.initials: WT
authors.lastname: Chiu
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Colpe
authors.forename: Carol S
authors.initials: CS
authors.lastname: Fullerton
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilman
authors.forename: Irving
authors.initials: I
authors.lastname: Hwang
authors.forename: James A
authors.initials: JA
authors.lastname: Naifeh
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Nock
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Rosellini
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.forename: Michael
authors.initials: M
authors.lastname: Schoenbaum
authors.forename: Alan M
authors.initials: AM
authors.lastname: Zaslavsky
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D055500:Resilience, Psychological; D018570:Risk Assessment; D057566:Self Report; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
keywords: military personnel; prevalence; suicide; suicide attempt; suicide ideation