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J Abnorm Psychol. 2018 Oct;127(7):650-658. doi: 10.1037/abn0000379.

Patterns and predictors of persistence of suicide ideation: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

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Department of Psychology, Harvard University.
Department of Neurosurgery, Medical College of Wisconsin.
Denver Veterans Affairs Medical Center, Rocky Mountain Mental Illness Research, Education, and Clinical Center.
Department of Psychology, Florida State University.
Department of Health Care Policy, Harvard Medical School.
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences.
Departments of Psychiatry and Family and Preventive Medicine, University of California, San Diego.


Persistent suicide ideation (SI) is known to be a risk factor for subsequent suicidal behaviors. Reducing SI persistence among people with a history of SI consequently might be a useful target for preventive intervention; however, basic information is lacking about patterns and predictors of SI persistence. We report preliminary retrospective data on annual SI persistence in a representative sample of 3,501 U.S. Army soldiers with lifetime SI from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Reports about age-of-onset and number of years with SI were used to estimate two definitions of persistence: persistence beyond year-of-onset and proportional annual persistence (i.e., percentage of years with SI since year-of-onset). Results revealed that for 47.8% of respondents with lifetime SI, their SI did not persist beyond the year-of-onset. For the 52.2% whose SI did persist beyond the year-of-onset, the median (interquartile range) proportional annual persistence was 33% (17-67%). Significant predictors of increased persistence were different for respondents with preenlistment SI onset (prior histories of attention-deficit/hyperactivity disorder [ADHD], bipolar disorder, and panic disorder) and postenlistment SI onset (male, combat support military occupation specialty, prior histories of ADHD, panic disorder, and posttraumatic stress disorder). These predictors of persistence are different from the predictors of SI onset, suggesting that secondary preventive interventions to reduce SI persistence may need to focus on different factors than primary preventive interventions to reduce SI onset. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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