{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:56:01Z","timestamp":1794243361668,"version":"4.9.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>People with disability are at heightened risk for suicide ideation, planning, and attempt, with risk growing as the number of disabling limitations increases. Military veterans have higher rates of suicide deaths and disability relative to nonveterans.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate whether veteran status is associated with greater risk for suicide in those with disability.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This survey study used cross-sectional self-reported data from US adults who participated in the 2015-2020 National Survey on Drug Use and Health. Data were weighted to represent the population. Data analysis was conducted from July to August 2022.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Suicide ideation, planning, and attempt served as primary outcomes. Disability status (present or absent) and number of disabling limitations (1, 2, or \u22653) served as factors. Veteran status was determined based on self-report (veteran or nonveteran). Multivariable logistic regression examined suicide ideation, planning, and attempt as a function of veteran status and disability variables.<\/jats:p><\/jats:sec>Results<\/jats:title>Participants included 231\u202f099 US veterans and nonveterans, representing 236\u202f551\u202f727 US adults, of whom 20.03% (weighted n\u2009=\u200947\u202f397\u202f876) reported a disabling limitation, 8.92% were veterans (weighted n\u2009=\u200921\u202f111\u202f727; 16.0% aged 35-49 years; 91.0% men; 6.7% Hispanic; 10.9% non-Hispanic Black; and 78.4% non-Hispanic White) and 91.08% were nonveterans (weighted n\u2009=\u2009215\u202f440\u202f000; 25.4% aged 35-49 years; 44.0% male; 16.5% Hispanic; 11.7% non-Hispanic Black; and 63.3% non-Hispanic White). Overall, 4.39% reported suicide ideation, planning, or attempt (weighted n\u2009=\u200910\u202f401\u202f065). Among those with no disability, veteran status was associated with higher risk of suicide planning (adjusted odds ratio [AOR], 1.71; 95% CI, 1.17-2.49). Among those with 1 or 2 disabling limitations, being a veteran was associated with a lower risk of suicide planning (AOR, 0.57; 95% CI, 0.34-0.95) and history of attempt (AOR, 0.46; 95% CI, 0.24-0.88).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study of how suicide risk differs as a function of disability and veteran status, risk for death by suicide was lower among veterans with disability relative to nonveterans with disability. Veteran status may mitigate risk for suicide given increased receipt of more disability-related care through the Department of Veterans Affairs. Further research would extend this line of inquiry by examining the cause and type of disability as well as perceptions of disability on self-worth. It is possible that physical wounds of war are protective because of the meaning and value of service to one\u2019s country.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.37679","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T15:31:00Z","timestamp":1697211060000},"page":"e2337679","source":"Crossref","is-referenced-by-count":6,"title":["Suicide Ideation, Plans, and Attempts Among Military Veterans vs Nonveterans With Disability"],"prefix":"10.1001","volume":"6","author":[{"given":"Rebecca K.","family":"Blais","sequence":"first","affiliation":[{"name":"Arizona State University, Tempe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of North Florida, Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne V.","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Marlow","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Management and Policy, University of Florida, Gainesville"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"issue":"8","key":"zoi231099r1","doi-asserted-by":"publisher","first-page":"306","DOI":"10.15585\/mmwr.mm7108a5","article-title":"Changes in suicide rates\u2014United States, 2019 and 2020.","volume":"71","author":"Ehlman","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"6","key":"zoi231099r4","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1016\/j.amepre.2021.05.035","article-title":"Association between disability and suicide-related outcomes among US adults.","volume":"61","author":"Marlow","year":"2021","journal-title":"Am J Prev Med"},{"key":"zoi231099r5","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.jad.2017.10.043","article-title":"Functional disability and suicidal behavior in middle-aged and older adults: a systematic critical review.","volume":"227","author":"Lutz","year":"2018","journal-title":"J Affect Disord"},{"issue":"5","key":"zoi231099r6","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/MLR.0000000000000336","article-title":"Long-term disability associated with war-related experience among Vietnam veterans: retrospective cohort study.","volume":"53","author":"Clarke","year":"2015","journal-title":"Med Care"},{"key":"zoi231099r9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S0033291721000301","article-title":"Longitudinal courses of suicidal ideation in U.S. military veterans: a 7-year population-based, prospective cohort study.","author":"Herzog","year":"2021","journal-title":"Psychol Med"},{"issue":"6","key":"zoi231099r10","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1177\/0004867417718945","article-title":"Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity.","volume":"52","author":"Kerr","year":"2018","journal-title":"Aust N Z J Psychiatry"},{"issue":"4","key":"zoi231099r11","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1001\/jamapsychiatry.2022.5144","article-title":"Association of frailty with risk of suicide attempt in a national cohort of US veterans aged 65 years or older.","volume":"80","author":"Kuffel","year":"2023","journal-title":"JAMA Psychiatry"},{"key":"zoi231099r12","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.genhosppsych.2021.08.007","article-title":"Differentiating U.S. military veterans who think about suicide from those who attempt suicide: a population-based study.","volume":"72","author":"Nichter","year":"2021","journal-title":"Gen Hosp Psychiatry"},{"issue":"6","key":"zoi231099r13","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1111\/sltb.2018.48.issue-6","article-title":"Risk factors for suicidal behavior depend on age for veterans in the Pacific Islands.","volume":"48","author":"Pitts","year":"2018","journal-title":"Suicide Life Threat Behav"},{"issue":"8","key":"zoi231099r14","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1016\/j.apmr.2006.04.021","article-title":"Suicidal ideation in multiple sclerosis.","volume":"87","author":"Turner","year":"2006","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"zoi231099r15","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1037\/ort0000590","article-title":"Suicidal ideation in Iraq and Afghanistan veterans with mental health conditions at risk for homelessness.","volume":"92","author":"Keller","year":"2022","journal-title":"Am J Orthopsychiatry"},{"issue":"12","key":"zoi231099r16","doi-asserted-by":"publisher","first-page":"2193","DOI":"10.2105\/AJPH.2007.115477","article-title":"Suicide mortality among individuals receiving treatment for depression in the Veterans Affairs health system: associations with patient and treatment setting characteristics.","volume":"97","author":"Zivin","year":"2007","journal-title":"Am J Public Health"},{"issue":"Suppl 4","key":"zoi231099r17","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s11606-014-3028-1","article-title":"Correlates of suicide among veterans treated in primary care: case-control study of a nationally representative sample.","volume":"29","author":"Dobscha","year":"2014","journal-title":"J Gen Intern Med"},{"issue":"1","key":"zoi231099r23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/sltb.2014.44.issue-1","article-title":"Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research.","volume":"44","author":"Klonsky","year":"2014","journal-title":"Suicide Life Threat Behav"},{"issue":"2","key":"zoi231099r24","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1521\/ijct.2015.8.2.114","article-title":"The Three-Step Theory (3ST): a new theory of suicide rooted in the \u201cideation-to-action\u201d framework.","volume":"8","author":"Klonsky","year":"2015","journal-title":"Int J Behav Med"},{"issue":"1","key":"zoi231099r25","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1111\/cpsp.12134","article-title":"Moving toward an ideation-to-action framework in suicide research: a commentary on May and Klonsky (2015).","volume":"23","author":"Burke","year":"2016","journal-title":"Clin Psychol (New York)"},{"issue":"6","key":"zoi231099r26","doi-asserted-by":"publisher","first-page":"S136","DOI":"10.1016\/j.outlook.2022.08.007","article-title":"Home therapies to improve disability, activity, and quality of life in military personnel with subacute low back pain: Secondary outcome analysis of a randomized controlled trial.","volume":"70","author":"Talbot","year":"2022","journal-title":"Nurs Outlook"},{"key":"zoi231099r28","doi-asserted-by":"publisher","first-page":"64","DOI":"10.11606\/s1518-8787.2022056003893","article-title":"Barriers to the access of people with disabilities to health services: a scoping review.","volume":"56","author":"Clemente","year":"2022","journal-title":"Rev Saude Publica"},{"issue":"6","key":"zoi231099r29","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1377\/hlthaff.2015.1672","article-title":"Suicide prevention: an emerging priority for health care.","volume":"35","author":"Hogan","year":"2016","journal-title":"Health Aff (Millwood)"},{"key":"zoi231099r30","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1093\/milmed\/usz223","article-title":"Predicting and planning for musculoskeletal service-connected disabilities in VA using disability for active duty OEF\/OIF military service members.","volume":"185","author":"Gundlapalli","year":"2020","journal-title":"Mil Med"},{"issue":"11","key":"zoi231099r31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0277909","article-title":"Acute influence of an adaptive sporting event on quality of life in veterans with disabilities.","volume":"17","author":"Sidiropoulos","year":"2022","journal-title":"PLoS One"},{"issue":"1","key":"zoi231099r32","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1097\/PXR.0000000000000054","article-title":"Prosthesis satisfaction and quality of life in US service members with combat-related major lower-limb amputation.","volume":"46","author":"Eskridge","year":"2022","journal-title":"Prosthet Orthot Int"},{"issue":"4","key":"zoi231099r34","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1080\/21635781.2021.2013350","article-title":"Service-connected disabilities and suicide attempts in veterans: the moderating role of mental health care utilization.","volume":"10","author":"Kuhlman","year":"2022","journal-title":"Mil Behav Health"},{"key":"zoi231099r35","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.avsg.2021.07.023","article-title":"Acceptance of illness, quality of life and nutritional status of patients after lower limb amputation due to diabetes mellitus.","volume":"79","author":"Juzwiszyn","year":"2022","journal-title":"Ann Vasc Surg"},{"key":"zoi231099r37","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1037\/mil0000119","article-title":"The importance of distinguishing between sources and types of stigma: implications for stigma research in military service members.","volume":"28","author":"Blais","year":"2016","journal-title":"Mil Psychol"},{"key":"zoi231099r38","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.738609","article-title":"Development and initial validation of an acute readiness monitoring scale in military personnel.","volume":"12","author":"Keegan","year":"2021","journal-title":"Front Psychol"},{"issue":"4","key":"zoi231099r40","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1037\/a0025513","article-title":"Sexuality among wounded veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND): implications for rehabilitation psychologists.","volume":"56","author":"Cameron","year":"2011","journal-title":"Rehabil Psychol"},{"key":"zoi231099r41","doi-asserted-by":"publisher","DOI":"10.1177\/15248380221109790","article-title":"The association of military sexual harassment\/assault with suicide ideation, plans, attempts, and mortality among US service members\/veterans: a meta-analysis.","author":"Livingston","year":"2023","journal-title":"Trauma Violence Abuse"},{"issue":"6","key":"zoi231099r42","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1111\/sltb.v52.6","article-title":"Suicide plan prevalence, recurrence, and longitudinal association with nonfatal suicide attempt.","volume":"52","author":"Linthicum","year":"2022","journal-title":"Suicide Life Threat Behav"},{"issue":"9","key":"zoi231099r43","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0162688","article-title":"The stigma of suicide survivorship and related consequences\u2014a systematic review.","volume":"11","author":"Hanschmidt","year":"2016","journal-title":"PLoS One"},{"issue":"5","key":"zoi231099r44","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1002\/jts.v33.5","article-title":"The impact of common psychiatric and behavioral comorbidities on functional disability across time and individuals in post-9\/11 veterans.","volume":"33","author":"Fortenbaugh","year":"2020","journal-title":"J Trauma Stress"},{"key":"zoi231099r45","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.jpsychires.2022.07.014","article-title":"Association between functional disability type and suicide-related outcomes among U.S. adults with disabilities in the National Survey on Drug Use and Health, 2015-2019.","volume":"153","author":"Marlow","year":"2022","journal-title":"J Psychiatr Res"},{"key":"zoi231099r33","volume-title":"Annual Report on People with Disabilities in America","author":"Houtenville","year":"2019"},{"key":"zoi231099r36","volume-title":"Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery","author":"Tanielian","year":"2008"},{"key":"zoi231099r39","volume-title":"Why People Die by Suicide","author":"Joiner","year":"2005"},{"key":"zoi231099r2","unstructured":"Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2020 National Survey on Drug Use and Health. October 2021. Accessed January 25, 2023. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt35325\/NSDUHFFRPDFWHTMLFiles2020\/2020NSDUHFFR1PDFW102121.pdf"},{"key":"zoi231099r3","unstructured":"Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS), cost of injury reports: year 2020 data. Updated February 9, 2023. Accessed February 16, 2023. https:\/\/wisqars.cdc.gov:8443\/costT\/cost_Part1_Intro.jsp"},{"key":"zoi231099r7","unstructured":"Holder? KA. The disability of veterans. Accessed February 23, 2023. https:\/\/www.census.gov\/content\/dam\/Census\/library\/working-papers\/2016\/demo\/Holder-2016-01.pdf"},{"key":"zoi231099r8","unstructured":"U.S. Department of Veteran Affairs. National veteran prevention annual report. September 2022. Accessed February 2, 2023. https:\/\/www.mentalhealth.va.gov\/docs\/data-sheets\/2022\/2022-National-Veteran-Suicide-Prevention-Annual-Report-FINAL-508.pdf"},{"key":"zoi231099r18","unstructured":"RTI International. 2015 National Survey on Drug Use and Health methodological resource book, field interviewer manual. Accessed January 30, 2023. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/NSDUH-MethodSummDefsHTML-2015\/NSDUH-MethodSummDefsHTML-2015\/NSDUH-MethodSummDefs-2015.htm"},{"key":"zoi231099r19","unstructured":"RTI International. 2016 National Survey on Drug Use and Health methodological resource book, field interviewer manual. Accessed February 1, 2023. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/NSDUHmrbFIManual2016.pdf"},{"key":"zoi231099r20","unstructured":"RTI International. 2017 National Survey on Drug Use and Health methodological resource book, field interviewer manual. Accessed February 1, 2023. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/NSDUHmrbFIManual2017.pdf"},{"key":"zoi231099r21","unstructured":"RTI International. 2018 National Survey on Drug Use and Health methodological resource book, field interviewer manual. Accessed January 29, 2023. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/cbhsq-reports\/NSDUHmrbFIManual2018.pdf"},{"key":"zoi231099r22","unstructured":"US Department of Agriculture, Economic Research Service. Rural-urban continuum codes. Updated December 10, 2020. Accessed February 23, 2023. https:\/\/www.ers.usda.gov\/data-products\/rural-urban-continuum-codes\/"},{"key":"zoi231099r27","unstructured":"Department of Veterans Affairs. Suicide prevention. Updated January 18, 2023. Accessed August 18, 2023. https:\/\/www.mentalhealth.va.gov\/suicide_prevention\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2810648\/blais_2023_oi_231099_1696521074.24181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T15:31:06Z","timestamp":1697211066000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2810648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,13]]},"references-count":45,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.37679","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,13]]}}}