Social Support and Social Stress Among Suicidal Inpatients at Military Treatment Facilities: A Multidimensional Investigation.

ABSTRACT: The associations between social support and stress with internalizing symptoms (depressive symptoms and hopelessness) and hazardous drinking were tested in an inpatient sample of suicidal military personnel. Baseline data from a randomized clinical trial were analyzed. Different sources of support and stressors in the social context of military personnel were differentially linked to internalizing symptoms and hazardous drinking. In the full sample ( n = 192), family and nonfamily support were both inversely associated with internalizing symptoms but not hazardous drinking. Family stress was positively associated with internalizing symptoms. In a subsample of service members who had a history of deployment ( n = 98), postdeployment social support was protective against internalizing symptoms, whereas deployment harassment was associated with increased odds of hazardous drinking. Results underscore the need for assessment of various dimensions of social support and stress to guide case formulation and optimize strategies to support patients' mental well-being and adaptive coping.

Perceived changes in social interactions following military psychiatric hospitalization for a suicidal crisis.

Introduction Changes in social interactions following psychiatric hospitalization, a period characterized by heightened suicide risk, are important to understand. OBJECTIVE: We qualitatively explored perceived changes in social interactions one month after inpatient psychiatric discharge following a suicidal crisis. METHODS: A total of 113 United States Service members, recruited in the context of a psychotherapy randomized controlled trial, described the extent to which social interactions with family members, peers, and military commanders had changed. RESULTS: Most participants (82.3%) reported at least some change in social interactions, conveying six common themes. Showing more care and checking in more were frequently reported for family (24.8%, 20.4%), commanders (23.0%, 16.8%), and by peers (12.4%, 10.6%). Showing more concern was most frequently reported for family (13.3%) followed by peers (6.2%) and commanders (6.2%). Participants reported showing more caution from peers (14.2%), commanders (13.3%) and family (6.2%). Acting more distant was reported from commanders (7.1%), peers (7.1%), and family (5.3%). Showing negative reaction(s) was reported from commanders (8.0%), family (3.5%) and rarely for peers (0.9%). CONCLUSION: Inpatient providers are encouraged to prepare patients for potential changes in social interactions following psychiatric discharge and how to best respond to these changes.

Understanding the clinical characteristics of lesbian, gay, and bisexual military service members and adult beneficiaries within an inpatient psychiatric sample.

BACKGROUND: Limited knowledge exists regarding targets for suicide-focused care among high-risk United States (U.S.) civilian and military sexual minorities. PURPOSE: This study aimed to understand the demographic and clinical characteristics of a suicidal sexual minority sample, psychiatrically hospitalized in military treatment facilities, to advance future targeted care for this vulnerable subgroup. METHODS: Secondary analysis of baseline data from a multisite psychotherapy randomized controlled trial was performed comparing those who self-identified as lesbian, gay, or bisexual (LGB; n = 39) to heterosexual participants (n = 170). RESULTS: LGB participants were more likely than heterosexual participants to be younger, female, never married, and enlisted rank. LGB participants reported significantly lower family support, higher perceived burdensomeness, lower acquired capability for suicide, and were twice as likely to report that they could not control their suicidal thoughts. LGB and heterosexual participants reported similar levels of other suicide risk indicators and similar lifetime suicidal ideation and attempt histories. CONCLUSIONS: Compared to heterosexual participants, LGB participants reported increased risk indicators for suicide yet similar lifetime suicidal ideation and attempt histories. Suicide prevention programs should address the unique needs of this vulnerable subgroup. Interventions targeting family support, perceived burdensomeness, and controllability of suicidal thoughts may be promising.