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Child abuse exposure common among military personnel, increases suicide risk

Individuals exposed to child abuse may be more likely to enter the military and exposure may increase their risk for suicide-related outcomes, according to recent findings.

“Recent evidence indicates a high prevalence of child abuse exposure in modern U.S. veterans, which may explain in part their higher likelihood of suicide relative to civilians. However, the relationship between child abuse exposure and suicide-related outcomes in military personnel relative to civilians is unknown,” Tracie O. Afifi, PhD, of the University of Manitoba, Winnipeg, Canada, and colleagues wrote. “Furthermore, the associations among deployment-related trauma, child abuse exposure and suicide-related outcomes in military personnel have not been examined.”

To assess child abuse exposure with suicidal ideation, suicide plans and attempts in military personnel, researchers analyzed data from the 2013 Canadian Forces Mental Health Survey (CFMHS) (n = 8,161) for the Canadian Armed Forces and the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH) (n = 23,395) for the Canadian general population. The final study cohort included 24,142 respondents aged 18 to 60 years.

Child abuse exposure of any kind was higher among the Regular Forces (47.7%) and Afghanistan mission-deployed Reserve Forces (49.4%), compared with the general population (33.1%).

All types of child abuse exposures were associated with increased risk for suicidal ideation, suicide plans and suicide attempts among the general population (P < .05) and Canadian Armed Forces (P < .05). Many of these associations were weaker among military personnel compared with civilians.

Researchers observed additive effects due to child abuse exposure and deployment-related trauma significantly increasing risk for past-year suicidal ideation and suicide plans, compared with exposure to deployment-related trauma only.

Analysis of interaction effects indicated deployment-related trauma was associated with past-year suicidal ideation (aOR = 1.4; 95% CI, 1-1.8; P < .05) and suicide plans (aOR = 1.7; 95% CI, 1.1-2.7; P < .05). However, only suicide plan associations remained significant when adjusting for child abuse exposure (aOR = 1.7; 95% CI, 1.1-2.6; P < .05).

Child abuse exposure was associated with past-year suicidal ideation (aOR = 2.2; 95% CI, 1.6-2.9; P < .05) and suicide plans (aOR = 2.7; 95% CI, 1.7-4.3; P < .05) and remained significant when adjusting for deployment-related trauma.

Researchers found no interaction effects between child abuse exposure and deployment-related trauma.

“Afifi et al corroborate results from a recent U.S. study showing higher prevalence of childhood abuse among persons with a history of military service compared with persons who did not serve in the military. More importantly, Afifi and colleagues show how childhood abuse was differentially associated with suicidal risk among military and nonmilitary samples, and they explore childhood abuse in the context of deployment-related traumatic experiences among military personnel,” John R. Blosnich, PhD, MPH, of the VA Pittsburgh Healthcare System, U.S. Department of Veterans Affairs, and Robert M. Bossarte, PhD, of the Office of Public Health, U.S. Department of Veterans Affairs, Washington, DC, wrote in an accompanying editorial. “These important findings have repercussions, from epidemiology through intervention and implementation efforts, for how scientists, health care professionals, and systems tackle the issue of understanding health outcomes, including suicide risk, among individuals who have served in the military.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.