Child abuse exposure, suicidal ideation in Canadian military, general population

Military personnel in Canada were more likely to have had exposure to child abuse than individuals in the general population and that exposure was associated with an increased risk of suicidal behavior that had a stronger effect on the general population than military personnel, according to an article published online by JAMA Psychiatry.Suicide is an important public health problem among both military and civilian populations. The ability to accurately anticipate who will think about, plan, and attempt suicide is a difficult task.

Tracie O. Afifi, Ph.D., of the University of Manitoba, Canada, and coauthors examined the association between child abuse exposure and suicidal behavior (ideation, planning and attempts) among representative groups of military personnel and the general population. The authors analyzed data from 24,142 respondents (ages 18 to 60) in two nationally representative data sets.

The study reports that child abuse exposure was higher in the regular forces (47.7 percent) and reserve forces (49.4 percent) compared with the Canadian general population (33.1 percent).

Child abuse exposures were associated with increased odds of suicidal ideation, suicidal plans and suicide attempts in the general population and in the Canadian Armed Forces, although many of the associations were weaker in military personnel compared with civilians, the study results indicate.

Deployment-related trauma was associated with past-year suicidal ideation and plans but by comparison, child abuse exposure was more strongly and consistently associated with suicide-related behaviors.

The authors cannot determine why almost half of all military personnel in Canada have a history of child abuse exposure.

"But escaping from child abuse exposure at home or otherwise improving life circumstances with career and education opportunities available through the military may be the cause," they explain.

The authors also note their study precludes making causal influences about child abuse exposure and suicide-related behavior.

"The higher prevalence and the broad negative effects of child abuse exposure make this finding an important public health concern in the military, as in civilians. ... Therefore, prevention efforts targeting child abuse exposure or mediators in the relationship between child abuse exposure and suicide-related outcomes may help reduce suicide-related outcomes," the study concludes.

"There are several steps that scientists, health care professionals and systems can take to better serve the individuals who have bravely served their countries, including an honest reckoning with the growing evidence base showing a disproportionately high burden of childhood abuse among military personnel, a genuine and continuous effort to diminish the stigma of disclosing childhood abuse, and allocation of resources for epidemiologic efforts and treatment modalities to address issues of childhood abuse among military personnel," write John R. Blosnich, Ph.D., M.P.H., and Robert M. Bossarte, Ph.D., of the U.S. Department of Veterans Affairs.