{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:09:38Z","timestamp":1785150578314,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T00:00:00Z","timestamp":1672185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","award":["I50HX001240"],"award-info":[{"award-number":["I50HX001240"]}],"id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Suicide &amp;amp; Life Threat Behav"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Examinations of risk factors for suicide attempt in United States service members at high risk of mental health diagnoses, such as those with combat injuries, are essential to guiding prevention and intervention efforts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of 8727 combat\u2010injured patients matched to deployed, non\u2010injured patients utilizing Department of Defense and Veterans Affairs administrative records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Combat injury was positively associated with suicide attempt in the univariate model (HR\u00a0=\u00a01.75, 95% CI 1.5\u20132.1), but lost significance after adjustment for mental health diagnoses. Utilizing Latent Transition Analysis in the combat\u2010injured group, we identified five mental\/behavioral health profiles: (1) <jats:italic>Few mental health diagnoses<\/jats:italic>, (2) <jats:italic>PTSD and depressive disorders<\/jats:italic>, (3) <jats:italic>Adjustment disorder<\/jats:italic>, (4) <jats:italic>Multiple mental health comorbidities<\/jats:italic>, and (5) <jats:italic>Multiple mental health comorbidities with alcohol use disorder (AUD)<\/jats:italic>. <jats:italic>Multiple mental health comorbidities with AUD<\/jats:italic> had the highest suicide attempt rate throughout the study and more than four times that of <jats:italic>Multiple mental health comorbidities<\/jats:italic> in the first study year (23.4 vs. 5.1 per 1000 person years, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Findings indicate that (1) combat injury's impact on suicide attempt is attenuated by mental health and (2) AUD with multiple mental health comorbidities confers heightened suicide attempt risk in combat\u2010injured service members.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sltb.12938","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T13:12:59Z","timestamp":1672233179000},"page":"227-240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Suicide attempts and mental health diagnoses in combat\u2010injured service members: A retrospective cohort study"],"prefix":"10.1111","volume":"53","author":[{"given":"Lauren E.","family":"Walker","sequence":"first","affiliation":[{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.  Bethesda Maryland USA"},{"name":"Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Poltavskiy","sequence":"additional","affiliation":[{"name":"David Grant USAF Medical Center, Travis AFB  Fairfield California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Howard","sequence":"additional","affiliation":[{"name":"University of Texas San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jud C.","family":"Janak","sequence":"additional","affiliation":[{"name":"Bexar Data  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Watrous","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Leidos Inc.  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Alcover","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren B. P.","family":"Pettey","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva","family":"Ambardar","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Eastern Virginia Medical School  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Meyer","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adi V.","family":"Gundlapalli","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6653-875X","authenticated-orcid":false,"given":"Ian J.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Military Cardiovascular Outcomes Research (MiCOR)  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.PROCS.2020.03.059"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15139"},{"key":"e_1_2_10_4_1","volume-title":"Survival analysis using SAS: A practical guide","author":"Allison P. D.","year":"2010"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-197403000-00001"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/TRA0001018"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/APPI.AJP.2016.15070854"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2013.10.006"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12163"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470567333"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1207\/S15327906MBR2701_8"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.35946\/ARCR.V40.1.02"},{"key":"e_1_2_10_13_1","unstructured":"Defense Manpower and Data Center. (n.d.).Joint Department of Veterans Affairs (VA) and Department of Defense (DoD) Suicide Data Repository \u2013 National Death Index (NDI) Extract. Available fromhttps:\/\/www.dspo.mil\/About\u2010Suicide\/Suicide\u2010Data\u2010Repository\/"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/2670170"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.301957"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.03.014"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.5664\/JCSM.9276"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.5664\/JCSM.9530"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.9.1023"},{"key":"e_1_2_10_20_1","unstructured":"Joint Trauma System. (n.d.).Registries. Retrieved fromhttps:\/\/jts.amedd.army.mil\/index.cfm\/data\/registries"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(19)30213\u20105"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.2.276"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/ARCHINTERNMED.2007.109"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.36065"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.65164"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/DA.22736"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2020.31357"},{"key":"e_1_2_10_28_1","unstructured":"Military Health System. (n.d.).Surveillance Case Definitions. Retrieved fromhttps:\/\/health.mil\/Military\u2010Health\u2010Topics\/Combat\u2010Support\/Armed\u2010Forces\u2010Health\u2010Surveillance\u2010Branch\/Epidemiology\u2010and\u2010Analysis\/Surveillance\u2010Case\u2010Definitions"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1037\/\/0022\u2010006X.67.6.989"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717001179"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1037\/ADB0000348"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000117"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/AJE\/KWX117"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usy296"},{"key":"e_1_2_10_35_1","unstructured":"Psychological Health Center of Excellence. (2021).DoDSER Calendar Year 2019 Annual Report. Retrieved fromhttps:\/\/health.mil\/Military\u2010Health\u2010Topics\/Centers\u2010of\u2010Excellence\/Psychological\u2010Health\u2010Center\u2010of\u2010Excellence\/Department\u2010of\u2010Defense\u2010Suicide\u2010Event\u2010Report"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.17l11790"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2017.12.008"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12282"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691618785366"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.SAPHARM.2016.11.011"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(16)30304\u20102"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201006195\u20101"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.DRUGALCDEP.2018.09.011"},{"key":"e_1_2_10_44_1","unstructured":"Suitt T. H.(2021).High Suicide Rates among United States Service Members and Veterans of the Post\u20109\/11 Wars. Retrieved fromhttps:\/\/watson.brown.edu\/costsofwar\/files\/cow\/imce\/papers\/2021\/Suitt_Suicides_CostsofWar_June212021.pdf"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz038"},{"key":"e_1_2_10_46_1","volume-title":"VA\/DOD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder","author":"The Management of Posttraumatic Stress Disorder Work Group","year":"2017"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691618812680"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAPSYCHIATRY.2015.0987"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.0600"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1080\/21635781.2015.1093981"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2088"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1126\/SCIADV.AAX4043"}],"container-title":["Suicide and Life-Threatening Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sltb.12938","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/sltb.12938","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sltb.12938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T22:27:13Z","timestamp":1692656833000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sltb.12938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,28]]},"references-count":51,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1111\/sltb.12938"],"URL":"https:\/\/doi.org\/10.1111\/sltb.12938","archive":["Portico"],"relation":{},"ISSN":["0363-0234","1943-278X"],"issn-type":[{"value":"0363-0234","type":"print"},{"value":"1943-278X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,28]]},"assertion":[{"value":"2022-04-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}