Exposure to killing and death while deployed is connected to suicide risk

A new University of Utah study is the first to provide clear insight into contributors to suicide risk among military personnel and veterans who have deployed.

The study, published today in the journal Suicide and Life-Threatening Behavior, found that exposure to killing and death while deployed is connected to suicide risk. Previous studies that looked solely at the relationship between deployment and suicide risk without assessing for exposure to killing and death have shown inconsistent results.

"Many people assume that deployment equals exposure to specific forms of combat trauma, but the two are not equivalent," said Craig Bryan, psychology professor, director of the National Center for Veterans Studies at the U and lead author of the paper. "By looking specifically at exposure to death while deployed, it became clear that deployment itself does not increase risk for suicide because not all who are deployed are exposed to death and atrocity."

Part of the confusion from previous studies can be attributed to the variability in participant group sizes, where small differences in outcomes could appear very different. The U paper analyzed data from 22 studies, totaling 2.7 million participants from multiple eras and across nations, making it the most comprehensive evaluation to be conducted.

By reviewing these studies in aggregate, the researchers found much more consistency across data than the individual findings suggested.

Suicide rates have risen among military personnel during the past decade, and it is now the second-leading cause of death. The study found a 43 percent increased suicide risk when people were exposed to killing and atrocity compared to just 25 percent when looking at deployment in general.

"Next, we want to understand why exposure to killing and death leads to an increased suicide risk so we can develop better ways to support military personnel and veterans," Bryan said.

The research team's preliminary results suggest that seeing death and killing contributes to feelings of guilt, shame, regret and negative self-perceptions. Other research Bryan has conducted indicates that self-forgiveness protects against suicide attempts, and he plans to pursue this topic further so veterans and military personnel will have better support in dealing with trauma and transitioning to civilian life.

Why this study?

This study was very personal for Bryan, whose interest with the topic was solidified two years ago when former Army psychologist Peter Linnerooth

"His death had a profound effect on the military psychology community because we lost one of our own to this tragedy," Bryan said.

When he was deployed to Iraq in 2009 as an Air Force psychologist, Bryan was convinced the deployments contributed to suicide risk, but his research didn't confirm this theory.

Following the loss of Linnerooth, Bryan had a conversation with a fellow Army psychologist who told him that although he respected Bryan's research, he would never believe that Linnerooth's death wasn't connected to the things he saw while deployed to Iraq. That was when Linnerooth's life took a turn for the worse.

"That conversation haunted me for two years," Bryan said. "Then I realized that for more than a decade, researchers, including myself, have been asking the wrong question."

As he gathered all the studies he could find on the topic, the pattern began to emerge, and he realized that the mistake had been the assumption that deployment equaled exposure to killing and death.

"In many ways, this paper was driven by the motivation to provide greater clarity to Peter's family and friends, as well as to the military psychology community as a whole," Bryan said.