Suicide Risk: Relationship to Combat Exposure

Jay Morse& Heidi Radunovich, PhD

Suicide remains an important topic for clinicians serving the active duty military due to the high rates of suicide among active duty members, National Guard and Reserve members and military veterans. Research led by Dr. Craig Bryan, Executive Director of the University of Utah National Center for Veteran Studies, provides a rigorous look at suicide risk and its relationship to combat exposure.

Military Personnel shooting gun
[Flickr, 090817-A-8124P-084 by North Carolina National Guard, CC BY-ND 2.0] Retrieved on September 17, 2015
Combat exposure and suicide risk in two samples of military personnel

The objective of the study by Bryan, Hernandez, Allison, and Clemans (2013) [1] was to identify the relationship between exposure to combat and suicide risk. Structural equation modeling was used to analyze two samples of military personnel: active duty military who were participating in a routine neurocognitive screening, and deployed military personnel participating in a routine evaluation or treatment for traumatic brain injury (TBI).

In this study:

(1) Combat exposure was directly related to PTSD (and to fearlessness of death) but did not show a direct or indirect effect on suicide risk.

(2) Symptoms of PTSD were shown to be strongly associated with depression, which in turn was directly related to suicide risk in the non-clinical sample (those who were participating in the routine screening), and indirectly related to suicide risk in the clinical sample (those who had TBI) where,

(3) Depression was directly related to a low sense of belonging or perceived burdensomeness, which in turn was related to suicide risk in the clinical sample (those who had TBI).

What does this mean to clinicians?

Suicide risk may not be as closely related to combat exposure as previously thought. Other factors should be considered when evaluating suicide risk, including symptoms of PTSD and symptoms of depression (particularly a lack of a sense of belonging and a feeling of being burdensome).

For more information on the National Center for Veterans Studies projects, link to the University of Utah’s National Center for Veterans Studies.


[1] Bryan, C. J., Hernandez, A. M., Allison, S., & Clemans, T. (2013). Combat exposure and suicide risk in two samples of military personnel. Journal of Clinical Psychology, 69(1), 64-77. doi:10.1002/JCLP.21932

This post was written by Jay Morse & Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on Twitter, YouTube, and on LinkedIn.

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