Killing in war linked with suicidal thoughts among Vietnam veterans, study finds

The experience of killing in war was strongly associated with thoughts of suicide, in a study of Vietnam-era veterans led by researchers at the San Francisco VA Medical Center (SFVAMC) and the University of California, San Francisco (UCSF).

The scientists found that with more involving killing were twice as likely to have reported as veterans who had fewer or no experiences.

To evaluate the experience of killing, the authors created four variables – killing enemy combatants, killing prisoners, killing civilians in general and killing or injuring women, children or the elderly. For each veteran, they combined those variables into a single composite measure. The higher the composite score, the greater the likelihood that a veteran had thought about suicide.

The relationship between killing and suicidal thoughts held even after the scientists adjusted for variables including post-traumatic stress disorder (PTSD), depression, substance use disorders and exposure to combat.

The study, which was published electronically on April 13 in the journal Depression and Anxiety, was based on an analysis of data from the National Vietnam Veterans Readjustment Survey, a comprehensive study of a nationally representative sample of Vietnam-era veterans.

The authors cited other research indicating that veterans are at elevated risk of suicide compared to people with no military service. They noted that by 2009, the suicide rate in the U.S. Army had risen to 21.8 per 100,000 soldiers, a rate exceeding that of the general population.

"The VA has a lot of very good programs, including programs targeting suicide prevention. Our goal is to make those programs even stronger," said lead author Shira Maguen, a clinical psychologist at SFVAMC and an assistant clinical professor of psychiatry at UCSF. "We want clinicians and suicide prevention coordinators to be aware that in analyzing a veteran's risk of suicide, killing in combat is an additional factor that they may or may not be aware of."

Notably, the scientists found that the only variable with a significant link to actual suicide attempts among the veterans was PTSD – a finding that replicated earlier studies, according to Maguen. Thus, she said, the link between killing and suicide attempts was not as significant as the link between killing and suicidal thoughts.

Maguen noted that, currently, the mental health impact of killing is not formally evaluated as part of VA or Department of Defense mental health treatments, nor typically taken into consideration when assessing a veteran's risk of .

"We know from our previous research how hard it is to talk about killing," Maguen cautioned. "It's important that we as care providers have these conversations with veterans in a supportive, therapeutic environment so that they will feel comfortable talking about their experiences."

The overall goal, she said, "is to look back and understand some lessons of the past that we can apply to the present. Talking with people who have had suicidal thoughts can potentially give us insights into why suicides occur, and hopefully help us prevent them."

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Brains transform remote threats into anxiety

Nov 21, 2014

Modern life can feel defined by low-level anxiety swirling through society. Continual reports about terrorism and war. A struggle to stay on top of family finances and hold onto jobs. An onslaught of news ...

Mental disorders due to permanent stress

Nov 21, 2014

Activated through permanent stress, immune cells will have a damaging effect on and cause changes to the brain. This may result in mental disorders. The effects of permanent stress on the immune system are studied by the ...

Could there be a bright side to depression?

Nov 21, 2014

(Medical Xpress)—A group of researchers studying the roots of depression has developed a test that leads them closer to the idea that depression may actually be an adaptation meant to help people cope with ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.