Cited by 281Suicide and Self-Harm StudiesOccupational Health and PerformancePosttraumatic Stress Disorder Research

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Predictors of Suicide and Accident Death in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS): Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

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Schoenbaum, Michael, Kessler, Ronald C., Gilman, Stephen E., Colpe, Lisa J., Heeringa, Steven G., Stein, Murray B., Ursano, Robert J., Cox, Kenneth L.·2014·JAMA Psychiatry

DOI 10.1001/jamapsychiatry.2013.4417PMC PMC4124912

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Abstract

IMPORTANCE: The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multicomponent study designed to generate actionable recommendations to reduce Army suicides and increase knowledge of risk and resilience factors for suicidality. OBJECTIVES: To present data on prevalence, trends, and basic sociodemographic and Army experience correlates of suicides and accident deaths among active duty Regular Army soldiers between January 1, 2004, and December 31, 2009, and thereby establish a foundation for future Army STARRS investigations. DESIGN, SETTING, AND PARTICIPANTS: Analysis of trends and predictors of suicide and accident deaths using Army and Department of Defense administrative data systems. Participants were all members of the US Regular Army serving at any time between 2004 and 2009. MAIN OUTCOMES AND MEASURES: Death by suicide or accident during active Army service. RESULTS: The suicide rate rose between 2004 and 2009 among never deployed and currently and previously deployed Regular Army soldiers. The accident death rate fell sharply among currently deployed soldiers, remained constant among the previously deployed, and trended upward among the never deployed. Increased suicide risk was associated with being a man (or a woman during deployment), white race/ethnicity, junior enlisted rank, recent demotion, and current or previous deployment. Sociodemographic and Army experience predictors were generally similar for suicides and accident deaths. Time trends in these predictors and in the Army's increased use of accession waivers (which relaxed some qualifications for new soldiers) do not explain the rise in Army suicides. CONCLUSIONS AND RELEVANCE: Predictors of Army suicides were largely similar to those reported elsewhere for civilians, although some predictors distinct to Army service emerged that deserve more in-depth analysis. The existence of a time trend in suicide risk among never-deployed soldiers argues indirectly against the view that exposure to combat-related trauma is the exclusive cause of the increase in Army suicides.

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Additional file 7 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557118
Additional file 5 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557112
Additional file 2 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557103
Additional file 3 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557106
Additional file 4 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J. E., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557109
Additional file 10 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J. E., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557127
Additional file 9 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557124
Additional file 1 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.25457819
Additional file 1 of The role of military service in preventing depression in China: evidence from a nationally representative longitudinal survey
Li, H., Zhang, N., Zhang, J., Xie, T., He, R., Jiang, Y., Mao, Y., & Zhu, B. (2024) · Figshare · doi:10.6084/m9.figshare.26650869
Additional file 6 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557115
Additional file 8 of Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Adams, R. S., Forster, J. E., Gradus, J. L., Hoffmire, C. A., Hostetter, T. A., Larson, M. J., Walsh, C. G., Brenner, L. A., Adams, R. S., & Walsh, C. G. (2024) · Figshare · doi:10.6084/m9.figshare.26557121
Trends in unintentional injury death among post-9/11 Army Veterans who do and do not use Veteran Health Administration services
Adams, R. S., Forster, J. E., Hoffmire, C. A., Gradus, J. L., Hostetter, T. A., Larson, M. J., Schneider, A. L., Smith, A. A., Walsh, C. G., & Brenner, L. A. (2026) · Injury Epidemiology · doi:10.1186/s40621-026-00666-5
Landscape of training for non-commissioned officers in difficult conversations with soldiers in their commands
Jaycox, L. H., Elinoff, D., Wagner, L., Ayer, L. A., Holliday, S. B., Hoch, E., & Ramchand, R. (2026) · Military Psychology · doi:10.1080/08995605.2026.2679827
Combat injury, pain, and suicidal ideation in U.S. army service members and veterans
Wild, M. G., Campbell‐Sills, L., Sun, X., Kessler, R. C., Wagner, J. R., Benedek, D. M., Ursano, R. J., Jain, S., & Stein, M. B. (2026) · Journal of Pain · doi:10.1016/j.jpain.2026.106390
Self-citation

Authors: Schoenbaum, M., Kessler, R. C., Gilman, S. E., Colpe, L. J., Heeringa, S. G., Stein, M. B., Ursano, R. J., & Cox, K. L.
Affiliations: National Institute of Mental Health (US)
Harvard University (US)
University of Michigan (US)
University of California San Diego (US)
Uniformed Services University of the Health Sciences (US)
Defense Center for Public Health - Aberdeen (US)
Corresponding author: Schoenbaum, Michael
ORCID: Schoenbaum, Michael
Kessler, Ronald C.
Gilman, Stephen E.
Colpe, Lisa J.
Heeringa, Steven G.
Stein, Murray B.
Ursano, Robert J.
Venue: JAMA Psychiatry
Publisher: American Medical Association (AMA)
Published: 2014-05-01
Volume: 71
Issue: 5
Pages: 493
ISSN: 2168-622X (ISSN-L)
DOI: 10.1001/jamapsychiatry.2013.4417
PMC: PMC4124912
OpenAlex: W2098848757
Cited by: 281
References: 21
Citations by year: 2026: 4 · 2025: 7 · 2024: 19 · 2023: 12 · 2022: 10 · 2021: 20 · 2020: 27 · 2019: 22 · 2018: 29 · 2017: 39 · 2016: 35 · 2015: 34 · 2014: 21
FWCI: 50.76
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders: U.S. Department of Health and Human Services (U01MH087981)
National Institutes of Health
National Institute of Mental Health (U01MH087981)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Performance
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords: military suicide, accident deaths, Army STARRS, suicide risk factors, resilience, active duty military personnel, deployment, sociodemographic predictors, suicide trends, demotion, combat exposure, suicide prevention
MeSH terms: Accidents, Occupational, Suicide Prevention, Adult, Cause of Death, Combat Disorders, Cross-Sectional Studies, Female, Forecasting, Humans, Male, Military Personnel, Risk Factors, Statistics as Topic, Stress Disorders, Post-Traumatic, Suicide, United States, Incidence, Risk Assessment, Iraq War, 2003-2011, Resilience, Psychological, Young Adult, Afghan Campaign 2001-

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Predictors of Suicide and Accident Death in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS): Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

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