Risk Factors Explaining Military Deaths From Suicide, 2008–2017: A Latent Class Analysis

• DOI: http://doi.org/10.1177/0095327X211046976
• Published date: 01 January 2023
• Date: 01 January 2023
• Subject Matter: Articles

Article

1134644AFSXXX10.1177/0095327X20917183Armed Forces & SocietyLevy

research-article2022

Risk Factors Explaining

Military Deaths From

Suicide, 2008–2017:

A Latent Class Analysis

Scott D. Landes

1

, Janet M. Wilmoth

1

,

Andrew S. London

1

, and Ann T. Landes

2

Abstract

Military suicide prevention efforts would benef‌it from population-based research

documenting patterns in risk factors among service members who die from suicide.

We use latent class analysis to analyze patterns in identif‌ied risk factors among the

population of 2660 active-duty military service members that the Department of

Defense Suicide Event Report (DoDSER) system indicates died by suicide between

2008 and 2017. The largest of f‌ive empirically derived latent classes was primarily

characterized by the dissolution of an intimate relationship in the past year. Rela-

tionship dissolution was common in the other four latent classes, but those classes

were also characterized by job, administrative, or legal problems, or mental health

factors. Distinct demographic and military-status differences were apparent across the

latent classes. Results point to the need to increase awareness among mental health

service providers and others that suicide among military service members often in-

volves a constellation of potentially interrelated risk factors.

Keywords

suicide, military, relationships, job problems, mental health

1

Department of Sociology and Aging Studies Institute, Maxwell School of Citizenship and Public Affairs,

Syracuse University, Syracuse, NY, USA

2

Syracuse VA Medical Center, Syracuse, NY, USA

Corresponding Author:

Scott D. Landes, Department of Sociology and Aging Studies Institute, Maxwell School of Citizenship and

Public Affairs, Syracuse University, 314 Lyman Hall, Syracuse, NY 13244-1100, USA.

Email: sdlandes@maxwell.syr.edu

https://doi.org/10.1177/0095327X20917183

Armed Forces & Society

2023, Vol. 49(1) 115 –137

© The Author(s) 2021

Article reuse guidelines:

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DOI: 10.1177/0095327X211046976

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116 Armed Forces & Society 49(1)

Background

Although the military generally selects young, healthy individuals, the suicide rate

among active-duty military service members has recently increased and is now

equivalent to the suicide rate in the general population (Pruitt et al., 2019). Most

research documenting this trend has focused on the Army, the largest branch of the US

military. The suicide rate among active-duty Army personnel was below that of the

general population and stable until 2004; but exceeded the suicide rate in the general

population by 2008 (Black et al., 2011;Bryan et al., 2012;Bush et al., 2013;Kuehn,

2009;Logan et al., 2012;Nock et al., 2013). Over time, the suicide rate in the Army has

consistently been higher than that in the Air Force, Marines, and Navy (Pruitt et al.,

2018;Ramchand et al., 2011).

In the general population, the predominant risk factors for suicide include: mental

health, alcohol, and substance abuse problems; interpersonal/family relationship issues;

legal concerns; f‌inancial diff‌iculties; and physical health challenges (Ertl et al., 2019;

Nock et al., 2008,2013;Stone et al., 2018). In part, suicide risk factors in the active-

duty military population are similar (Black et al., 2011;Bush et al., 2013;

Ghahramanlou-Holloway et al., 2017;Hyman et al., 2012;Logan et al., 2012;Maguen

et al., 2015;Nock et al., 2013). Additionally, service members face a distinct set of

service-connected risk factors since military service entails exposure to a set of oc-

cupational hazards (e.g., frequent deployments, exposure to military training exercises,

and/or combat) that can lead to the disruption of relationships and the development of

physical and mental health problems (Ardelt et al., 2010;Black et al., 2011;Bryan et al.,

2012;Wilmoth et al., 2019). Other military-related risk factors include: military

administrative issues, such as demotion, separation, and discharge (Ghahramanlou-

Holloway et al., 2017); job problems related to a chosen or assigned military occu-

pational specialty (Logan et al., 2012); and service-connected problems with sleep

(Hyman et al., 2012). Reports from the Department of Defense Suicide Event Report

(DoDSER) system between 2008 and 2017 conf‌irm these f‌indings (Psychological

Health Center of Excellence, 2019;Pruitt et al., 2019). In each year, the most frequently

identif‌ied risk factor was a failed intimate relationship, which was documented in

almost half of all suicides among active-duty service members. Other prominent risk

factors identif‌ied in each year include mental health concerns, job-related problems,

military administrative issues, and civilian legal challenges.

In response to these empirical f‌indings, suicide prevention materials published by

the Defense Suicide Prevention Off‌ice (DSPO, 2019), an agency within the Department

of Defense (DoD), identify three domains of potential suicide risk factors for service

members: failed relationships; administrative or legal problems; and mental health

concerns. Dissemination of this information is an extremely important response to the

high and increasing rate of suicide among active-duty service members. Raising

awareness of suicide risk factors may help improve risk recognition, increase effective

intervention, and reduce suicides among military personnel. However, identif‌ication of

these three domains of potential suicide risk may not suff‌iciently account for the

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