Suicide Typologies in the United States Air Force: A Hierarchical Cluster Analysis.

OBJECTIVE: This study describes characteristics of United States Air Force (USAF) suicide decedents and determines subgroups. METHOD: Retrospective review of demographic, psychiatric, event-related, and psychosocial variables for USAF suicide decedents in the Suicide Event Surveillance System database was conducted between February 1999 and July 2009 (N = 376). Hierarchical cluster analysis was used to determine initial clusters and cluster centroids. RESULTS: Analyses identified three clusters. Cluster 1 (n = 149) individuals were mostly single or divorced, E-1-E-6 rank, living alone, and less likely to have psychiatric disorder diagnoses or engage with most helping resources. Cluster 2 (n = 126) decedents were mostly married, living with a partner, higher ranking, and least likely to communicate suicide intent. Cluster 3 (n = 101) individuals were mostly E-4-E-6 rank, with the highest rates of most psychiatric diagnoses, previous suicide-related events, engagement with multiple helping resources, communication of intent, and psychosocial precipitants. Clusters differed significantly in marital status, rank, psychiatric diagnoses, precipitants, service utilization, previous suicide-related events, risk factors, communication of intent, location and method of death, and residential status. CONCLUSIONS: This study identifies empirically based suicide typologies within a military decedent sample. While further research and replications of findings are needed, these typologies have clinical and policy implications for military suicide prevention.

Marital status, life stressor precipitants, and communications of distress and suicide intent in a sample of United States Air Force suicide decedents.

Life stressor precipitants and communications of distress and suicide intent were examined among a sample of United States Air Force (USAF) married versus unmarried suicide decedents. A total of 100 death investigations conducted by the Office of Special Investigations on active duty USAF suicides occurring between 1996 and 2006 were retrospectively reviewed. Married decedents were twice as likely 1) to have documented interpersonal conflict 24 hours prior to suicide and 2) to have communicated suicide intent to peers or professionals. Themes of distress communication for all decedents were intrapersonal (perceived stress, depression, psychological pain) and interpersonal (thwarted belongingness, rejection, loneliness). Suicide prevention programs and policies are encouraged to adapt efforts to the unique needs of married and unmarried individuals.

Central, peripheral and resistance arterial reactivity: fluctuates during the phases of the menstrual cycle.

The purpose of this study was to document the temporal changes in vascular reactivity occurring simultaneously in central, peripheral and microvascular resistance arteries in the same cohort of women during the normal menstrual cycle. Twenty-three (n = 23) women (mean age (+/-SD) = 19 +/- 1 y) were tested during four phases of a normal menstrual cycle. Delineation of the four phases occurred as follows: (1) the early follicular phase; (2) the late follicular (LF) phase; (3) the early luteal (EL) phase; and (4) the late luteal phase. Non-invasive measurement of central hemodynamics and peripheral artery pulse wave velocity (PWV) were performed using applanation tonometry. Measurement of peripheral endothelial function was determined by flow-mediated dilation (FMD) testing in the brachial artery and venous occlusion plethysmography in the forearm and calf resistance arteries. Additionally, plasma NOx and 17beta-estradiol (E) concentrations were measured. Both central (aortic) and peripheral blood pressure (BP) were lowest (P < 0.05) during the LF phase and BP reduction was sustained (P < 0.05) into the EL phase. The timing and amplitude of the reflected pressure wave were attenuated only during the LF phase (P < 0.05). No temporal changes were observed in either central (carotid-femoral) or peripheral PWV (femoral-dorsalis pedis, carotid-radial). Peak forearm and calf blood flow during reactive hyperemia were greatest in LF. Brachial FMD was greatest during the LF phase (P < 0.05). Plasma E and NOx concentrations were highest during the LF phase (P < 0.05). Young premenopausal women experienced an overwhelming pattern of reduced BP and increased systemic vascular reactivity during the LF phase prior to ovulation.