Military sexual trauma linked with later suicide attempts, death by suicide or overdose
Incidence of any suicide attempt was 12 percentage points higher for men who experienced military sexual trauma than men who did not; for women, incidence of any suicide attempt increased by 6 percentage points among those who had experienced military sexual trauma, an analysis of more than five million veterans ages 50 years and older found.
Experiencing military sexual trauma is associated with late-life suicide attempts and death by suicide or overdose, according to results of a longitudinal cohort study.
Researchers assessed data from 5,059,526 patients ages 50 years or older (6.1% women) treated at Veterans Affairs (VA) medical centers from 2012 and 2013, with follow-up through December 2020. Of the included veterans, 15.7% of women and 1.3% of men had a positive military sexual trauma screening result. Median follow-up time until death, nonfatal suicide attempt, or the end of the study was 7.3 years. On average, individuals who experienced military sexual trauma were younger than those who did not (63.3 years vs. 68.8 years for men, 57.0 years vs. 61.0 years for women). Findings were published by Annals of Internal Medicine on April 29.
By age 90 years, the adjusted cumulative incidence of any suicide attempt was higher for those with military sexual trauma (men, 18.67%; women, 8.66%) than for those without (men, 6.25%; women, 2.92%). In addition, there were adjusted risk differences for any late-life suicide attempt (12.41% in men and 5.74% in women), nonfatal suicide attempt (11.92% and 5.58%) and fatal suicide attempt (0.27% and 0.15%, respectively). The risk difference for any drug overdose was 1.05% among men and 0.48% among women. Military sexual trauma was a risk factor for any suicide attempt regardless of post-traumatic stress disorder (PTSD) diagnosis, but having a PTSD diagnosis and military sexual trauma exposure was associated with increased risk for suicidal behavior compared with PTSD alone.
The findings may be less generalizable to veterans who did not receive care in the VA, the authors cautioned, adding that they did not have access to data on type of sexual trauma experienced or veterans' rank, type of service, or destination.
“These findings advance our understanding of the lasting effect of sexual trauma on suicide risk and mortality and suggest that monitoring and treatment of [military sexual trauma]-related conditions are vital over the long term,” the authors wrote.
The researchers also called for a strengthening of systemic structures and policies to hold perpetrators accountable while protecting the safety and privacy of survivors within the military.