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How well can U.S. military veterans’ suicidal ideation be predicted from static and change-based indicators of their psychosocial well-being as they adapt to civilian life?

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Abstract

Background

Identifying predictors of suicidal ideation (SI) is important to inform suicide prevention efforts, particularly among high-risk populations like military veterans. Although many studies have examined the contribution of psychopathology to veterans’ SI, fewer studies have examined whether experiencing good psychosocial well-being with regard to multiple aspects of life can protect veterans from SI or evaluated whether SI risk prediction can be enhanced by considering change in life circumstances along with static factors.

Methods

The study drew from a longitudinal population-based sample of 7141 U.S. veterans assessed throughout the first three years after leaving military service. Machine learning methods (cross-validated random forests) were applied to examine the predictive utility of static and change-based well-being indicators to veterans’ SI, as compared to psychopathology predictors.

Results

Although psychopathology models performed better, the full set of well-being predictors demonstrated acceptable discrimination in predicting new-onset SI and accounted for approximately two-thirds of cases of SI in the top strata (quintile) of predicted risk. Greater engagement in health promoting behavior and social well-being were most important in predicting reduced SI risk, with several change-based predictors of SI identified but stronger associations observed for static as compared to change-based indicator sets as a whole.

Conclusions

Findings support the value of considering veterans’ broader well-being in identifying individuals at risk for suicidal ideation and suggest the possibility that well-being promotion efforts may be useful in reducing suicide risk. Findings also highlight the need for additional attention to change-based predictors to better understand their potential value in identifying individuals at risk for SI.

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Data availability

These data are owned by VA. VA supports efforts to provide limited, restricted access to research data under written agreements that are consistent with commitments made to protecting subjects’ privacy and confidentiality and subject to resource availability. Contact the corresponding author for further information.

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Acknowledgements

This research was funded by a grant from Veterans Health Administration Health Services Research and Development Service (PI: Vogt), and drew from data collected as part of a previously funded project managed by the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF); and collaboratively sponsored by the Bob Woodruff Foundation, Health Net Federal Services, The Heinz Endowments, HJF, Lockheed Martin Corporation, May and Stanley Smith Charitable Trust, National Endowment for the Humanities, Northrop Grumman, Philip and Marge Odeen, Prudential, Robert R. McCormick Foundation, Rumsfeld Foundation, Schultz Family Foundation, Walmart Foundation, Wounded Warrior Project, Inc., and the Veterans Health Administration Health Services Research and Development Service (PI: Vogt). The views expressed are those of the authors and do not necessarily represent the views or policy of the Department of Veterans Affairs or the United States Government.

Author information

Authors and Affiliations

  1. Women’s Health Sciences Division, National Center for Posttraumatic Stress Disorder (PTSD), VA Boston Healthcare System, 150 S. Huntington Ave, Boston, MA, 02130, USA

    Dawne Vogt, Shelby Borowski & Amy E. Street

  2. Department of Psychiatry, Boston University Chobanian and Avedesian School of Medicine, Boston, MA, USA

    Dawne Vogt, Shelby Borowski & Amy E. Street

  3. Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA

    Anthony J. Rosellini

  4. US Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service, Washington, D.C., USA

    Robert W. O’Brien & Naomi Tomoyasu

  5. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Anthony J. Rosellini

Authors
  1. Dawne Vogt
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  2. Anthony J. Rosellini
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  3. Shelby Borowski
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  4. Amy E. Street
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  5. Robert W. O’Brien
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  6. Naomi Tomoyasu
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Contributions

DV: conceptualization, methodology, investigation, resources, writing—review & editing, supervision, project administration, funding acquisition. AJR: conceptualization, methodology, software, validation, formal analysis, resources, data curation, writing—review & editing, visualization; SB: conceptualization, methodology, formal analysis, resources, data curation, writing—original draft, visualization, project administration; AES: conceptualization, methodology, writing—review & editing; RWO: conceptualization, writing—review & editing; NT: conceptualization, writing—review & editing.

Corresponding author

Correspondence to Dawne Vogt.

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The authors have no conflicts of interest to disclose.

Ethical approval

This study was approved by the local Institutional Review Board.

Patient consent

All participants provided informed consent to participate.

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Vogt, D., Rosellini, A.J., Borowski, S. et al. How well can U.S. military veterans’ suicidal ideation be predicted from static and change-based indicators of their psychosocial well-being as they adapt to civilian life?. Soc Psychiatry Psychiatr Epidemiol 59, 261–271 (2024). https://doi.org/10.1007/s00127-023-02511-2

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  • DOI: https://doi.org/10.1007/s00127-023-02511-2

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