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Small SSN and insecure attachment styles are associated with SAs. The current study examines the extent to which these factors may relate to SA risk during the first 2\u2009years of military service, a period of elevated risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A representative sample of US Army soldiers entering service (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921,772) was surveyed and followed via administrative records for their first 24\u2009months of service. Insecure attachment styles (preoccupied and dismissing) and SSN size were assessed at baseline. Administrative records identified SAs over the 2\u2010year period of assessment. Discrete\u2010time survival analysis examined associations of SSN and attachment style with future SA during service, adjusting for socio\u2010demographics and service\u2010related characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During this period, 154 soldiers attempted suicide. Examined in a multivariable model, small SSN and insecure attachment styles were associated with increased SA risk. This persisted after accounting for previous mental health diagnosis: Small SSN (OR\u2009=\u20091.8 [95% CI\u2009=\u20091.3\u20132.4]); preoccupied (OR\u2009=\u20091.7 [95% CI\u2009=\u20091.1\u20132.8]) and dismissing (OR\u2009=\u20091.6 [95% CI\u2009=\u20091.0\u20132.4]) attachment. Soldiers with a small SSN consistently had higher SA risk across time in service, whereas among soldiers with a large SSN, SA risk decreased between the first and second years. Two\u2010way interactions between attachment styles and SSN were non\u2010significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings underscore the importance of understanding the impact of SSN size and attachment style on SA risk among soldiers as they enter military service, as a means to identify risk and potential interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cpp.70207","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:49:09Z","timestamp":1767775749000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Social Network Size and Attachment Style With Future Suicide Attempt Among US Army Soldiers"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2620-9780","authenticated-orcid":false,"given":"Rachel","family":"Shor","sequence":"first","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5562-6009","authenticated-orcid":false,"given":"Holly\u00a0B.","family":"Herberman\u00a0Mash","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1030-6380","authenticated-orcid":false,"given":"Emily\u00a0R.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Veterans Integrated Service Network 2, Mental Illness Research, Education and Clinical Center  Bronx New York USA"},{"name":"Department of Psychiatry Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7248-3054","authenticated-orcid":false,"given":"James\u00a0A.","family":"Naifeh","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo\u00a0A.","family":"Aliaga","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol\u00a0S.","family":"Fullerton","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu\u2010Cheg","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Biostatistics Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4831-2305","authenticated-orcid":false,"given":"Ronald\u00a0C.","family":"Kessler","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9564-2871","authenticated-orcid":false,"given":"Murray\u00a0B.","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and School of Public Health University of California San Diego  La Jolla California USA"},{"name":"VA San Diego Healthcare System  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1861-9173","authenticated-orcid":false,"given":"Robert\u00a0J.","family":"Ursano","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127\u2010024\u201002722\u20101"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2021.01.017"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.61.2.226"},{"key":"e_1_2_13_5_1","first-page":"25","volume-title":"Attachment Theory and Close Relationships","author":"Bartholomew K.","year":"1998"},{"key":"e_1_2_13_6_1","unstructured":"Centers for Disease Control and Prevention.2013. \u201cThe International Classification of Diseases Ninth Revision Clinical Modification (ICD\u20109\u2010CM).\u201dhttps:\/\/www.cdc.gov\/nchs\/icd\/icd9cm.htm."},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000123"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.34172\/jrhs.2024.144"},{"key":"e_1_2_13_9_1","unstructured":"Department of Defense.2024. \u201cAnnual Report on Suicide in the Military: Calendar Year 2023.\u201dhttps:\/\/www.dspo.mil\/Portals\/113\/2024\/documents\/annual_report\/ARSM_CY23_final_508c.pdf."},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300574"},{"key":"e_1_2_13_11_1","article-title":"Relationship Scales Questionnaire","author":"Griffin D. 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