Associations of lifetime traumatic brain injury characteristics with prospective suicide attempt among deployed U.S. Army soldiers.
Campbell-Sills, L., Stein, M., Liu, H., Agtapap, S., Heeinga, S., Nock, M., Ursano, R. & Kessler, R.
To estimate associations of lifetime traumatic brain injury (TBI) characteristics with prospective suicide attempt among U.S. Army soldiers.
The Army STARRS Pre/Post Deployment Study surveyed 3 Brigade Combat Teams that deployed to Afghanistan in 2012. Lifetime TBI and past-month post-concussive/post-TBI symptoms were evaluated at pre-deployment baseline. Recency and number of TBIs were quantified, and TBI severity was classified based on reports of alteration/loss of consciousness and memory lapse. Suicide attempt data came from administrative records and surveys administered after return from deployment. Logistic regression models estimated associations of TBI characteristics with prospective suicide attempt among baseline respondents who deployed (n=7677), adjusting for other risk factors including lifetime mental disorder.
103 soldiers made a suicide attempt over a median follow-up period of 30 months [weighted prevalence=1.31% (0.14%)]. In the final model estimating joint associations of TBI severity/recency and past-month post-concussive/post-TBI symptoms, only post-concussive/post-TBI symptoms were associated with higher risk of suicide attempt [per standard score increase: AOR=1.31, 95% CI=1.05-1.63, p=.012].
Among the lifetime TBI characteristics evaluated at pre-deployment baseline, only past-month post-concussive/post-TBI symptoms were prospectively associated with increased risk of suicide attempt following deployment. Detection of post-concussive/post-TBI symptoms could facilitate targeting of Army suicide prevention programs.