title: Predicting Suicide Risk in Trauma Exposed Veterans: The Role of Health Promoting Behaviors.
abstract: BACKGROUND
  Returning veterans of the wars in Iraq and Afghanistan experience high rates of post-traumatic stress disorder (PTSD) and suicidal behavior. Suicidal ideation is among the strongest risk factors for completed suicide. Some research suggests an association between PTSD and suicidal ideation, and that health-promoting behaviors-behaviors that sustain or increase well-being-play a role in this association. The current study examined whether health-promoting behaviors moderate the association between PTSD severity and suicidal ideation.
  
  
  METHODS
  Veterans of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF; N = 108) completed measures of PTSD symptoms, trauma exposure, suicidal ideation, and health-promoting behaviors.
  
  
  RESULTS
  Moderated regression was used to test the hypothesis. Results indicated that health promoting behaviors, β = -.06, p = .001, and PTSD symptoms, β = .36, p < .001, were significantly related to suicidal ideation. Consistent with our main hypothesis, the health promoting behaviors x PTSD interaction term was significantly associated with suicidal ideation, β = -.09, p = .001. The overall model accounted for 13% of the variance in suicidal ideation. Among individuals with high PTSD symptom severity, those who engaged in more health promoting behaviors reported less suicidal ideation than those who engaged in fewer health promoting behaviors.
  
  
  CONCLUSIONS
  Health-promoting behaviors could be important for reducing suicidal ideation among veterans with high levels of PTSD symptoms. It is recommended that future research examine health promotion interventions as a means of reducing suicidal ideation.
authors.affiliation: Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, United States of America.|Texas A&M Health Science Center, Temple, Texas, United States of America.
authors.forename: Bryann B
authors.initials: BB
authors.lastname: DeBeer
authors.affiliation: Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, United States of America.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Kittel
authors.affiliation: Texas A&M Health Science Center, Temple, Texas, United States of America.|Central Texas Veterans Health Care System, Temple, Texas, United States of America.
authors.forename: Andrew
authors.initials: A
authors.lastname: Cook
authors.affiliation: Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, United States of America.|Texas A&M Health Science Center, Temple, Texas, United States of America.
authors.forename: Dena
authors.initials: D
authors.lastname: Davidson
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America.|VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, United States of America.|Duke University School of Medicine, Durham, North Carolina, United States of America.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Kimbrel
authors.affiliation: Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, United States of America.|Texas A&M Health Science Center, Temple, Texas, United States of America.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Meyer
authors.affiliation: Texas A&M Health Science Center, Temple, Texas, United States of America.|Warriors Research Institute, Baylor, Scott & White Healthcare System, Waco, Texas, United States of America.
authors.forename: Suzy B
authors.initials: SB
authors.lastname: Gulliver
authors.affiliation: Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, United States of America.|Texas A&M Health Science Center, Temple, Texas, United States of America.
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Morissette
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000473:pathology; D059020:Suicidal Ideation; D014728:Veterans