Suicide Attempts and Ideation Among Veterans/Service Members and Non-Veterans Over 5 Years Following Traumatic Brain Injury: A Combined NIDILRR and VA TBI Model Systems Study
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Objective: This study compared rates of suicide attempt (SA) and suicidal ideation (SI) during the first 5 years after traumatic brain injury (TBI) among veterans and service members (V/SMs) in the Veterans Affairs (VA) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Model Systems National Databases to each other and to non-veterans (non-Vs) in the NIDILRR database. Setting: Twenty-one NIDILRR and 5 VA TBI Model Systems (TBIMS) inpatient rehabilitation facilities in the United States. Participants: Participants with TBI were discharged from rehabilitation alive, had a known military status recorded (either non-V or history of military service), and successful 1-, 2-, and/or 5-year follow-up interviews completed between 2009 and 2021. The year 1 cohort included 8737 unique participants (8347 with SA data and 3987 with SI data); the year 2 (7628 participants) and year 5 (4837 participants) cohorts both had similar demographic characteristics to the year 1 cohort. Design: Longitudinal design with data collected across TBIMS centers at 1, 2, and 5 years post-injury. Main Outcomes and Measures: History of SA in past year and SI in past 2 weeks assessed by the Patient Health Questionnaire-9 (PHQ-9). Patient demographics, injury characteristics, and rehabilitation outcomes were also assessed. Results: Full sample rates of SA were 1.9%, 1.5%, and 1.6%, and rates of SI were 9.6%, 10.1%, and 8.7% (respectively at years 1, 2, and 5). There were significant differences among groups based on demographic, injury-related, mental/behavioral health, and functional outcome variables. Characteristics predicting SA/SI related to mental health history, substance use, younger age, lower functional independence, and greater levels of disability. Conclusions: Compared with participants with TBI in the NIDILRR system, higher rates of SI among V/SMs with TBI in the VA system appear associated with risk factors observed within this group, including mental/behavioral health characteristics and overall levels of disability.
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Comorbid depression and post-traumatic stress disorder are significant risk factors for suicide following TBI.
“Comorbid depression and post-traumatic stress disorder are significant risk factors for suicide following TBI [9-12].”
From An individualized approach to the treatment of affective disorders in the comorbidity of post-traumatic stress disorder and traumatic brain injury (2024) · cites this paper as [9]
The Introduction (page unavailable) identifies depression after TBI as a risk factor for suicidal thoughts and behaviors and describes PTSD as a mediator of the TBI–suicide association among veterans and service members. The Discussion (page unavailable) treats PTSD as a possible risk factor in that group, but does not establish that both conditions are statistically significant risk factors for suicide after TBI generally. (LLM, conf=0.85)
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Flagged first, then by citations
Research works printed but not linked: 3
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Cited by
Sorted by citations
Smashna, O. Y. (2024) · Psychiatry, Neurology and Medical Psychology · doi:10.26565/2312-5675-2024-25-02
- Authors
- Klyce, D. W., Perrin, P. B., Ketchum, J. M., Finn, J. A., Juengst, S. B., Gary, K. W., Fisher, L. B., Pasipanodya, E., Niemeier, J. P., Vargas, T. A., & Campbell, T. A.
- Affiliations
- University of Minnesota (US)
- ORCID
- Venue
- Journal of Head Trauma Rehabilitation
- Published
- 2023-09-29
- Volume
- 39
- Issue
- 3
- Pages
- 183-195
- ISSN
- 0885-9701 (ISSN-L)
- PMC
- PMC10978550
- OpenAlex
- W4387166742
- Cited by
- 9
- References
- 40
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Head Trauma Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- traumatic brain injury, suicide attempts, suicidal ideation, veterans, military personnel, inpatient rehabilitation, risk factors, mental health history, substance use, functional independence, disability, long-term outcomes
- MeSH terms
- Brain Injuries, Traumatic, Adult, Female, Humans, Male, Middle Aged, Military Personnel, Suicide, Attempted, United States, United States Department of Veterans Affairs, Veterans, Suicidal Ideation
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