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Military service members and veterans (SMVs) are at risk for self-directed violence, including nonsuicidal self-injury (NSSI). While NSSI is an important construct worthy of independent study, it is understudied among SMVs and, when included in research, typically examined in the context of suicide risk. Consequently, lifetime prevalence rate estimates of NSSI among SMVs vary. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review and meta-analysis estimated the average lifetime NSSI prevalence among SMVs and explored demographic and methodological factors that may account for observed variability. Based on a search of Ovid MEDLINE, Embase, PsycINFO, and Web of Science, 47 samples from 42 articles across five countries met inclusion criteria. Results revealed an average NSSI lifetime prevalence rate of 15.76% among SMVs. Significantly higher prevalence rates were observed among clinical (28.14%) versus community (11.28%) samples and studies using interviews to assess NSSI (23.56%) versus self-report (13.44%) or chart review (7.84%). Lifetime prevalence increased as publication year increased and decreased as sample size increased. In contrast to prior literature, prevalence rates were comparable between active-duty SMVs, and studies collecting data anonymously versus those that did not. Lifetime prevalence was not moderated by age, gender, race, country, primary research focus, quality of NSSI operationalization, or whether NSSI methods were assessed. Findings suggest NSSI is a pervasive problem among military personnel, particularly within clinical settings, highlighting the need for systematic assessment of this important but understudied clinical phenomenon among SMVs. Further research is necessary to elucidate additional risk factors for NSSI among SMVs, including trauma exposure. [ABSTRACT FROM AUTHOR]

Using data from the 2016 Survey of Prison Inmates, this study used latent class analysis to examine patterns of mental health comorbidity within a large, nationally-representative sample of incarcerated adults (N = 24,848), including 7.6% with prior military service. Classes were compared on Veteran status, military service-related variables, and treatment-related variables. Results suggest four latent mental health patterns—"Low Psychopathology" (70% of the total sample), "Internalizing + Thought Disorder" (8%), "Internalizing" (14%), and "High Psychopathology" (8%). The High Psychopathology class had the highest rates of prior psychiatric/psychological treatment. Incarcerated Veterans were more likely to be in the Internalizing class, and rates of combat exposure, military service-related injury, and less-than-honorable military discharge were highest in Internalizing and High Psychopathology classes. Results attest to the importance of person-centered mental health care within correctional settings and suggest a "treatment track" or "step-based" approach may best address the needs of individuals in these settings. [ABSTRACT FROM AUTHOR]

Accumulating research suggests unique patterns of suicide risk, homelessness, and criminal-justice involvement in younger (age < 40) relative to older (aged 40+) cohorts of Veterans. However, potential explanations for these differences remain unclear. To address this gap, we analyzed data from a nationally representative sample of more than 4,000 US military Veterans to compare risk and protective correlations of prior suicidal behavior, homelessness, and justice-involvement in younger versus older Veterans. Results revealed that younger Veterans were significantly more likely than older Veterans to have a history of suicide attempt(s) (13.9% vs. 2.7%) and homelessness (22.5% vs. 8.7%). They also scored higher on measures of risk factors and lower on measures of protective factors. However, some factors - specifically, resilience, grit, impulsiveness, perceptions of the effect of the military on one's life and social support - were less strongly associated with a history of adverse events in younger versus older Veterans. Findings highlight the need for preventative homelessness and mental health services for younger Veterans that are tailored to the unique characteristics and needs of this age cohort. [ABSTRACT FROM AUTHOR]

Introduction: Growing evidence suggests emotion reactivity—sensitivity and intensity of emotional experience—may represent a diathesis for suicide risk. However, our understanding of its ability to differentiate risk for suicidal ideation (SI) from suicide attempt (SA) is limited. Method: This study compares Veterans with SI (n = 81) to Veterans with SA (n = 177) history on factors relevant to emotion reactivity to determine which variable(s) best differentiate groups. Variables examined are multimodal: (a) self‐report: childhood trauma, combat exposure; (b) clinician‐assessed: non‐suicidal self‐injury (NSSI), structured diagnostic interview of psychopathology; and (c) psychophysiological: affect‐modulated startle (AMS; proxy for amygdala reactivity and emotion reactivity) to unpleasant pictures was examined in a subset (n = 90). Results: SA history was independently predicted by NSSI history, MDD, PTSD, and SUD diagnosis. Childhood trauma and combat exposure did not differentiate groups. The composite risk index demonstrated good accuracy (AUC=0.71, sensitivity=0.90, specificity=0.49). Only AMS independently predicted SA history when added to the model and accuracy was improved (AUC=0.82, sensitivity=0.85, specificity=0.56). Conclusion: NSSI history, MDD, PTSD, and SUD diagnosis may be salient risk factors for this population. However, emotion reactivity is a more parsimonious predictor of SA history among Veterans suggesting it is an important treatment target among Veterans with SI. [ABSTRACT FROM AUTHOR]