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Non-suicidal self-injury prevalence, course, and association with suicidal thoughts and behaviors in two large, representative samples of US Army soldiers

Published online by Cambridge University Press:  22 August 2018

Brianna J. Turner ,
Evan M. Kleiman  and
Matthew K. Nock
Brianna J. Turner*
Affiliation:
Department of Psychology, University of Victoria, Victoria, BC, Canada
Evan M. Kleiman
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Matthew K. Nock
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
*
Author for correspondence: Brianna J. Turner, E-mail: briannat@uvic.ca
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Abstract

Background

Non-suicidal self-injury (NSSI) prospectively predicts suicidal thoughts and behaviors in civilian populations. Despite high rates of suicide among US military members, little is known about the prevalence and course of NSSI, or how NSSI relates to suicidal thoughts and behaviors, in military personnel.

Methods

We conducted secondary analyses of two representative surveys of active-duty soldiers (N = 21 449) and newly enlisted soldiers (N = 38 507) from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

Results

The lifetime prevalence of NSSI is 6.3% (1.2% 12-month prevalence) in active-duty soldiers and 7.9% (1.3% 12-month prevalence) in new soldiers. Demographic risk factors for lifetime NSSI include female sex, younger age, non-Hispanic white ethnicity, never having married, and lower educational attainment. The association of NSSI with temporally primary internalizing and externalizing disorders varies by service history (new v. active-duty soldiers) and gender (men v. women). In both active-duty and new soldiers, NSSI is associated with increased odds of subsequent onset of suicidal ideation [adjusted odds ratio (OR) = 1.66–1.81] and suicide attempts (adjusted OR = 2.02–2.43), although not with the transition from ideation to attempt (adjusted OR = 0.92–1.36). Soldiers with a history of NSSI are more likely to have made multiple suicide attempts, compared with soldiers without NSSI.

Conclusions

NSSI is prevalent among US Army soldiers and is associated with significantly increased odds of later suicidal thoughts and behaviors, even after NSSI has resolved. Suicide risk assessments in military populations should screen for history of NSSI.

Keywords

Militaryprevalenceriskself-harmsoldiersuicide
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 9 , July 2019 , pp. 1470 - 1480
Copyright
Copyright © Cambridge University Press 2018 

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