Evidence map›Paper›PMID 37650289›Full record

ArticlePsychological medicine2024

Prospective association of attachment style with suicide attempts among US Army soldiers.

James A Naifeh, Robert J Ursano, Murray B Stein, Jing Wang, Holly B Herberman Mash, Pablo A Aliaga, Carol S Fullerton, Hieu M Dinh, Tzu-Cheg Kao, Nancy A Sampson and 1 more

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

Article in Psychological medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.3field-weighted citation impact, top 20% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
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

11 authors at 4 institutions in 1 country.

James A NaifehCenter for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.ORCID 0000-0001-7248-3054
Robert J UrsanoCenter for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.ORCID 0000-0002-1861-9173
Murray B SteinDepartment of Psychiatry and School of Public Health, University of California San Diego, La Jolla, CA, USA.
Jing WangCenter for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Holly B Herberman MashCenter for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.ORCID 0000-0001-5562-6009
Pablo A AliagaCenter for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Carol S FullertonCenter for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Hieu M DinhCenter for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Tzu-Cheg KaoDepartment of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Nancy A SampsonDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Henry M. Jackson Foundation · USUniformed Services University of the Health Sciences · USHarvard University · USUniversity of California San Diego · 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 MH087981
6 · The paper itself

Abstract

backgroundInsecure attachment styles are associated with retrospectively reported suicide attempts (SAs). It is not known if attachment styles are prospectively associated with medically documented SAs.

methodsA representative sample of US Army soldiers entering service (

resultsIn total, 253 respondents attempted suicide. Endorsed attachment styles included secure (46.8%), preoccupied (9.1%), fearful (15.7%), and dismissing (19.2%). Examined separately, insecure attachment styles were associated with increased odds of SA: preoccupied [OR 2.5 (95% CI 1.7-3.4)], fearful [OR 1.6 (95% CI 1.1-2.3)], dismissing [OR 1.8 (95% CI 1.3-2.6)]. Examining attachment styles simultaneously along with other covariates, preoccupied [OR 1.9 (95% CI 1.4-2.7)] and dismissing [OR 1.7 (95% CI 1.2-2.4)] remained significant. The dismissing attachment and MH-Dx interaction was significant. In stratified analyses, dismissing attachment was associated with SA only among soldiers without MH-Dx. Other interactions were non-significant. Soldiers endorsing any insecure attachment style had elevated SA risk across the first 48 months in service, particularly during the first 12 months.

conclusionsInsecure attachment styles, particularly preoccupied and dismissing, are associated with increased future SA risk among soldiers. Elevated risk is most substantial during first year of service but persists through the first 48 months. Dismissing attachment may indicate risk specifically among soldiers not identified by the mental healthcare system.

Indexed as

Military PersonnelSuicide, AttemptedFearHumansObject AttachmentRetrospective StudiesRisk Factorsattachment stylemilitarysuicidesuicide attempt

Identifiers

PMID37650289
PMCPMC10902194
OpenAlexW4386305495

What OpenQuestion holds

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Registered trials

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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.