Asking a servicemember about self-worth or emotional pain may be a better way of predicting suicide than inquiring whether they intend to kill themselves, researchers report.
Research has shown that more than half of troops who die by suicide denied in their last medical appointment that they were contemplating the act. Scientists are concerned that they fail to admit suicidal thoughts out of worry it would harm their military career.
But a Defense Department-funded study published online this week in the Journal of Affective Disorders discusses how several questions used on military members identified those at risk for suicide attempts, and yet don't use the word "suicide."
"Those statements of 'I'm horrible, worthless,' actually predict future suicide attempts better than asking them, 'Do you want to kill yourself?' " said Craig Bryan, a psychologist and lead author on the study.
Research questions focused on how a servicemember sees himself or herself, and their place in the world, concentrating on areas scientists labeled "unlovability" — feeling worthless or defective — and "unbearability," being unable to tolerate distress.
The questions were asked of 175 soldiers at Fort Carson, Colo., who had been hospitalized for mental health problems and 152 airmen who were behavioral health outpatients in military clinics in the southern and western United States.
Troops were asked to rate how certain statements pertained to them.
Examples include "nothing can help solve my problems"; "I can't imagine anyone being able to withstand this pain"; "I can never be forgiven for the mistakes I have made"; and "I am completely unworthy of love."
Examining the medical records of those airmen who participated and tracking the soldiers over a period of two years, scientists found that high scores on questions identified those soldiers who later attempted suicide and those airmen who had attempted it in the past.
The 18-question assessment tool that was used included questions about suicide. But Bryan said that when answers to those suicide questions were excluded from the analysis, the remaining responses were highly predictive of suicide attempts.
"So maybe we can detect or pick up somebody who otherwise might be reluctant to discuss suicidal thoughts. That's the hope," he said.