The Link between Deployment-Related Injuries and Suicidal Thinking in the Army National Guard: Examining the Role of Perceived Burdensomeness and Hopelessness.

OBJECTIVE: In 2020, Army National Guard members demonstrated greater risk of suicide than their military and civilian counterparts. Though literature on deployment-related experiences and suicidal ideation (SI) is mixed, investigations of specific deployment-related experiences (e.g., injuries) may further elucidate the relationship between deployment and suicide risk. Deployment-related injuries, including pain severity and functional impairment, have been linked to increased risk of SI, and correlates like perceived burdensomeness (PB) and hopelessness. The current study sought to examine the cross-sectional relationship between deployment-related injuries, including pain severity and functional impairment, and severity of SI through PB and hopelessness. METHOD: Immediately post-deployment, Army National Guard members (N = 2,261) completed validated self-report measures on past-week SI, PB, hopelessness, and single items regarding injury sustained during deployment and associated functional impairment and pain severity. RESULTS: Indirect effect analyses revealed that experience of deployment-related injury was related to SI through PB and hopelessness (R2 = .1993), functional impairment was related to SI through PB, and pain severity was related to SI through PB. Contrary to hypotheses, hopelessness was not associated with SI when PB was simultaneously considered. CONCLUSIONS: Army National Guard members who develop a sense of PB related to their injury and functional impairment of that injury may be at increased risk for suicidal ideation. Military suicide-prevention efforts may be potentiated through targeting distorted cognitions such as PB and hopelessness, especially in service members who have been injured.

Postdeployment Treatment Gap: Symptoms and Treatment Utilization Among Returning National Guard Soldiers.

This study evaluated rates of psychiatric symptoms and mental health treatment utilization among National Guard service members during the post-deployment period. National Guard service members (n=311) completed surveys assessing demographics, beliefs about mental health treatment, emotion regulation strategies, and psychiatric symptoms. Mental health treatment utilization was assessed at 6-month follow-up. Post-deployment, 41.2% of the sample had psychiatric symptoms above the clinical cut-off for at least one symptom measure. This proportion increased at follow-up (53.5%). Alcohol use disorder (AUD) symptoms showed the largest increase (d=0.66), although symptoms of depression and posttraumatic stress disorder (PTSD) also showed small magnitude increases. Among those with elevated symptoms post-deployment (n=128), only 27.8% received mental health treatment at follow-up. Severity of depression, anxiety, and PTSD were higher among those who utilized treatment. The post-deployment period is a vulnerable one. Continued efforts to understand and address barriers to treatment for this population are warranted.

Firearm Ownership and Capability for Suicide in Post-Deployment National Guard Service Members.

OBJECTIVE: National Guard service members demonstrate increased suicide risk relative to the civilian population. One potential mechanism for this increased risk may be familiarity with and access to firearms following deployment. This study examined the association between firearm ownership, reasons for ownership, and firearm familiarity with a widely studied suicide risk factor-capability for suicide-among National Guard service members. METHOD: Data were drawn from a cross-sectional survey of National Guard service members conducted immediately post-deployment in 2010. Service members (n = 2,292) completed measures of firearm ownership, firearm familiarity, and capability for suicide. RESULTS: Firearm ownership and increased firearm familiarity were associated with capability for suicide (d = 0.47 and r = .25, for firearm ownership and familiarity, respectively). When examined separately based on reason for ownership, owning a firearm for self-protection (d = 0.33) or owning a military weapon (d = 0.27) remained significantly associated with capability for suicide. In contrast, owning a firearm for hobby purposes did not (d = -0.07). CONCLUSION: Our findings support theories emphasizing practical aspects of suicide (e.g., three-step theory) and suggest that owning firearms, in particular for self-protection, along with familiarity using firearms may be associated with greater capability for suicide.

Are belongingness and hope essential features of academic enhancement groups? A psychosociocultural perspective.

Despite evidence of the effectiveness of postsecondary academic enhancement interventions, presently there is a paucity of research examining the effective processes of such programs. Informed by the psychosociocultural model, this study tested the relationship between the growth in hope and belongingness, as well as academic achievement for undergraduates on academic probation participating in academic enhancement groups. Longitudinal ratings of hope and belongingness from 167 undergraduates enrolled in 22 academic enhancement groups were modeled as predictors of changes in their grade-point average (GPA). Results indicated that the growth in students' hope and belongingness were significantly associated with changes in their GPA. Additionally, gender significantly moderated the relationship between hope and academic achievement, such that women who had small or large increases in their hope during the intervention and men who had large increases in hope during the intervention had significant and large improvements in their GPAs; men who had small increases in hope during the intervention had significant but small improvements in their GPAs. Our findings suggest the importance of group processes of belongingness and hope for academic enhancement groups. (PsycINFO Database Record

The importance of problem-focused treatments: A meta-analysis of anxiety treatments.

One explanation for differences in treatment effectiveness for targeted symptoms is that more-effective treatments are more focused on patients' problems than are less-effective treatments. This conjecture was examined meta-analytically. Comparisons of two treatments of adults with anxiety disorders were included. Effect sizes for targeted symptoms, nontargeted symptoms, and global outcomes (e.g., quality of life and well-being) as well as the relative focus on patients' problems and researcher allegiance were coded. Metaregressions were conducted to predict effect sizes from (a) variables related to the focus on patients' problems and (b) researcher allegiance. For symptom measures, the relative focus on patients' problems predicted the relative effectiveness of the treatments, with the expectations created by explanation appearing more predictive than specific therapeutic actions focused on patients' problems, although conclusions about relative importance were difficult to determine given collinearity of predictors. Researcher allegiance also predicted the effects of the comparisons. For global outcomes, both the focus on patients' problems and researcher allegiance seemed to have smaller roles. A focus on patients' problems appears to be important for the reductions of symptoms. Clinical trials comparing treatments need to balance the focus on patients' problems and reduce researcher allegiance. (PsycINFO Database Record

The enduring effects of psychodynamic treatments vis-à-vis alternative treatments: A multilevel longitudinal meta-analysis.

Although evidence suggests that the benefits of psychodynamic treatments are sustained over time, presently it is unclear whether these sustained benefits are superior to non-psychodynamic treatments. Additionally, the extant literature comparing the sustained benefits of psychodynamic treatments compared to alternative treatments is limited with methodological shortcomings. The purpose of the current study was to conduct a rigorous test of the growth of the benefits of psychodynamic treatments relative to alternative treatments across distinct domains of change (i.e., all outcome measures, targeted outcome measures, non-targeted outcome measures, and personality outcome measures). To do so, the study employed strict inclusion criteria to identify randomized clinical trials that directly compared at least one bona fide psychodynamic treatment and one bona fide non-psychodynamic treatment. Hierarchical linear modeling (Raudenbush, Bryk, Cheong, Congdon, & du Toit, 2011) was used to longitudinally model the impact of psychodynamic treatments compared to non-psychodynamic treatments at post-treatment and to compare the growth (i.e., slope) of effects beyond treatment completion. Findings from the present meta-analysis indicated that psychodynamic treatments and non-psychodynamic treatments were equally efficacious at post-treatment and at follow-up for combined outcomes (k=20), targeted outcomes (k=19), non-targeted outcomes (k=17), and personality outcomes (k=6). Clinical implications, directions for future research, and limitations are discussed.