title: Mental Disorders, Comorbidity, and Pre-enlistment 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: We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre-enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6-8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention-deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre-enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts.
authors.affiliation: Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Nock
authors.affiliation: Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Heeringa
authors.affiliation: Department of Psychiatry and Department of Family and Preventive Medicine, VA San Diego Healthcare System, University of California San Diego, La Jolla, California, USA.
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
authors.affiliation: Department of Family and Preventive Medicine, VA San Diego Healthcare System, University of California San Diego, La Jolla, California, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Family and Preventive Medicine and Department of Neurosciences, VA San Diego Healthcare System, University of California San Diego, La Jolla, California, USA.
authors.forename: Rema
authors.initials: R
authors.lastname: Raman
authors.affiliation: Department of Family and Preventive Medicine, VA San Diego Healthcare System, University of California San Diego, La Jolla, California, USA.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Wai Tat
authors.initials: WT
authors.lastname: Chiu
authors.affiliation: National Institute of Mental Health, Bethesda, Maryland, USA.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Colpe
authors.affiliation: Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Fullerton
authors.affiliation: Department of Social and Behavioral Sciences and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilman
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Irving
authors.initials: I
authors.lastname: Hwang
authors.affiliation: Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Naifeh
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Rosellini
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.affiliation: National Institute of Mental Health, Bethesda, Maryland, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Schoenbaum
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Zaslavsky
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler