Evidence map›Paper›PMID 26190760›Full record

ArticlePsychological medicine2015

Occupational differences in US Army suicide rates.

R C Kessler, M B Stein, P D Bliese, E J Bromet, W T Chiu, K L Cox, L J Colpe, C S Fullerton, S E Gilman, M J Gruber and 11 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychological medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 54 citations in OpenAlex.

  1. Article
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  7. Military occupation as a moderator between combat exposure and posttraumatic stress disorder symptoms in US Army personnel.Military psychology : the official journal of the Division of Military Psychology, American Psychological Association · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 8 institutions in 1 country.

R C KesslerDepartment of Health Care Policy,Harvard Medical School,Boston,MA,USA.
M B SteinDepartments of Psychiatry and Family and Preventive Medicine,University of California San Diego,La Jolla,CA,USA.
P D BlieseDarla Moore School of Business,University of South Carolina,Columbia,SC,USA.
E J BrometDepartment of Psychiatry,Stony Brook University School of Medicine,Stony Brook,NY,USA.
W T ChiuDepartment of Health Care Policy,Harvard Medical School,Boston,MA,USA.
K L CoxUS Army Public Health Command,Aberdeen Proving Ground,MD,USA.
L J ColpeDivision of Services and Intervention Research,National Institute of Mental Health,Bethesda,MD,USA.
C S FullertonCenter for the Study of Traumatic Stress,Department of Psychiatry,Uniformed Services University School of Medicine,Bethesda,MD,USA.
S E GilmanDepartments of Social and Behavioral Sciences, and Epidemiology,Harvard School of Public Health,Boston,MA,USA.
M J GruberDepartment of Health Care Policy,Harvard Medical School,Boston,MA,USA.
S G HeeringaInstitute for Social Research,University of Michigan,Ann Arbor,MI,USA.
L Lewandowski-RompsInstitute for Social Research,University of Michigan,Ann Arbor,MI,USA.
A Millikan-BellUS Army Public Health Command,Aberdeen Proving Ground,MD,USA.
J A NaifehCenter for the Study of Traumatic Stress,Department of Psychiatry,Uniformed Services University School of Medicine,Bethesda,MD,USA.
M K NockDepartment of Psychology,Harvard University,Cambridge,MA,USA.
M V PetukhovaDepartment of Health Care Policy,Harvard Medical School,Boston,MA,USA.
A J RoselliniDepartment of Health Care Policy,Harvard Medical School,Boston,MA,USA.
N A SampsonDepartment of Health Care Policy,Harvard Medical School,Boston,MA,USA.
M SchoenbaumOffice of Science Policy,Planning and Communications,National Institute of Mental Health,Bethesda,MD,USA.
A M ZaslavskyDepartment of Health Care Policy,Harvard Medical School,Boston,MA,USA.
R J UrsanoCenter for the Study of Traumatic Stress,Department of Psychiatry,Uniformed Services University School of Medicine,Bethesda,MD,USA.
Harvard University · USUniformed Services University of the Health Sciences · USNational Institute of Mental Health · USUnited States Army Medical Command · USUniversity of Michigan–Ann Arbor · USStony Brook University · USUniversity of California, San Diego · USUniversity of South Carolina · US

Funding

Modifiable Risk and Protective Factors for Suicidal Behaviors in the US ArmyU01MH087981 · NIMH · HENRY M. JACKSON FDN FOR THE ADV MIL/MED · PI STEIN, MURRAY B., URSANO, ROBERT J. · 2009 to 2013
$65.0M
NIMH NIH HHS U01 MH087981NIMH NIH HHS U01MH 087981
6 · The paper itself

Abstract

backgroundCivilian suicide rates vary by occupation in ways related to occupational stress exposure. Comparable military research finds suicide rates elevated in combat arms occupations. However, no research has evaluated variation in this pattern by deployment history, the indicator of occupation stress widely considered responsible for the recent rise in the military suicide rate.

methodThe joint associations of Army occupation and deployment history in predicting suicides were analysed in an administrative dataset for the 729 337 male enlisted Regular Army soldiers in the US Army between 2004 and 2009.

resultsThere were 496 suicides over the study period (22.4/100 000 person-years). Only two occupational categories, both in combat arms, had significantly elevated suicide rates: infantrymen (37.2/100 000 person-years) and combat engineers (38.2/100 000 person-years). However, the suicide rates in these two categories were significantly lower when currently deployed (30.6/100 000 person-years) than never deployed or previously deployed (41.2-39.1/100 000 person-years), whereas the suicide rate of other soldiers was significantly higher when currently deployed and previously deployed (20.2-22.4/100 000 person-years) than never deployed (14.5/100 000 person-years), resulting in the adjusted suicide rate of infantrymen and combat engineers being most elevated when never deployed [odds ratio (OR) 2.9, 95% confidence interval (CI) 2.1-4.1], less so when previously deployed (OR 1.6, 95% CI 1.1-2.1), and not at all when currently deployed (OR 1.2, 95% CI 0.8-1.8). Adjustment for a differential 'healthy warrior effect' cannot explain this variation in the relative suicide rates of never-deployed infantrymen and combat engineers by deployment status.

conclusionsEfforts are needed to elucidate the causal mechanisms underlying this interaction to guide preventive interventions for soldiers at high suicide risk.

Indexed as

AdultHumansMaleMiddle AgedMilitary PersonnelOccupationsResilience, PsychologicalSuicideUnited StatesUnited States Department of DefenseYoung AdultArmyArmy STARRSdeploymentresiliency factorssuicide

Identifiers

PMID26190760
PMCPMC4860903
OpenAlexW2116415874

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.