Suicides in the U.S. Military

Abstract

This paper builds a case for examining suicide in the U.S. military relative to broad societal context, specifically, the unique experiences of birth cohorts relating to processes described by Durkheim’s theory of suicide. In more recent birth cohorts, suicide rates have increased among teenagers and young adults. In addition, suicide rates of age intervals at a given time period have been reliably predicted by the size of the birth cohort and the percentage of nonmarital births—supposed indicators of Durkheim’s diminished social integration and behavioral regulation. Consequences of these trends are likely more evident in the U.S. military due to having proportionally more individuals known to be at risk for suicide, that is, young males who are from nontraditional households. The all-volunteer force compared to draft force has fewer applicants to select, and proportionally more of applicants are accepted for military service. Consequently, more recruits having varied conditions now than before, perhaps including greater vulnerability to suicide, serve in the U.S. military. These points are further elaborated with supporting evidence, concluding with a call for new directions in suicide research, practice, and policy.

Keywords

military suicides birth cohort social integration all-volunteer force

Increased Suicides in the U.S. Military

A current major health policy concern of the U.S. military is the steadily rising suicide rate (U.S. Army Office of the Chief of Public Affairs, 2010, 2012). Historically, the U.S. military has had a lower suicide rate than the civilian population, and the suicide rate among U.S. military personnel has typically decreased during wartime (Cassimatis & Rothberg, 1997; Rothberg, Holloway, & Ursano, 1987). After 2000, however, the suicide rate among military personnel increased from 10.3 suicides per 100,000 service members in 2001 to 15.8 suicides per 100,000 in 2008 (Ramchand et al., 2014). This 50% increase across all the armed services was largely due to the doubling of the suicide rate in the U.S. Army, which is the focus of this paper.

The U.S. Army represents the largest number of U.S. military personnel, consisting of the active component Army numbering about 500,000 and the reserve component numbering about 550,000, comprising the U.S. Army Reserve (approximately 200,000) and the Army National Guard (ARNG; approximately 350,000). Figure 1 displays the annual suicide rates for the active component Army and the ARNG gathered by the U.S. Army Public Health Command (2015). Soon after 2007, the suicide rate for the active component Army surpassed the civilian age-matched rate. A few years later, the suicide rate for the ARNG did the same. Suicide rates for both components have subsequently continued to rise, with the active component showing a more steady increase and the ARNG showing a more varied increase. Comparison of the Army rates to civilian rates is problematic for recent years. Civilian rates, obtained from the Centers for Disease Control, usually lag 2 to 3 years behind the current year.

Figure 1.

Crude suicide rates for the active component army and the Army National Guard (ARNG), 2002–2014, and for the available civilian age matched population. Civilian rates adjust for the age composition of the army, that is, younger aged population. No reliable suicide rates are available for the ARNG prior to CY2007. Suicide rate source: Army Institute of Public Health (April, 2015) and Army National Guard briefing (May, 2015). A graph of crude suicide rates for all US military services is available as an online supplement, available at http://afs.sagepub.com/supplemental.

Recent trends in suicides in the U.S. military suggest increased individual vulnerability to suicide largely associated with recent birth cohorts. This influence of birth cohort is supported by several lines of evidence including (a) demographic shifts in the U.S. Army over time, (b) increased rates of pre-enlistment behavioral problems and psychological health conditions, and (c) changes in recruitment patterns subsequent to the switch from the draft to the all-volunteer force (AVF).

Demographic Shifts

Birth cohort vulnerability is likely more evident in the U.S. military population due to proportionally more personnel who are at greatest risk for suicide: young, White, and male. Young age, male gender, and White racial identity have been identified in both civilian and military research studies as some of the primary risk factors for suicide (for civilians, Karch, Logan, & Patel, 2011; Kessler, Berglund, Borges, Nock, & Wang, 2005; and for military personnel, Black, Gallaway, & Bell, 2011; Griffith, 2012a; LeardMann et al., 2013; Millikan, Spiess, Mitchell, Watts, & Porter, 2011; Nock, Deming, et al., 2014; Schoenbaum et al., 2014). Both the active component Army and the ARNG have proportionally more young males than the general population. With respect to gender and age, in fiscal year 2012, the ARNG population was about 85% male, and 40% were 18–24 years of age (Griffith, 2013). With respect to race, the U.S. Army has larger proportion of Black and White personnel than the U.S. general population (for Blacks 21% vs. 17% and for Whites, 61% vs. 58%, respectively). Over time, the U.S. Army has seen an increase in the proportion of White soldiers and a decrease in the proportion of racial minority soldiers. From 1995 to 2009, for instance, the percentage of Black enlisted soldiers has decreased from 27.0% to 19.7% in the active component Army and from 15.6% to 13.0% in the ARNG. Conversely, the percentage of White enlisted soldiers has increased from 61.8% to 62.7% (the former statistics are reported in the publication by the Headquarters, Department of the Army, 2006). These changes in demographics have particular relevance when considering that O’Brien and Stockard (2002) found increased suicide risk across birth cohorts was greater for young White men than others. In other words, the subpopulation for whom generational vulnerability has increased the most is the very same subpopulation that has proportionally increased the most within the U.S. Army.

Preenlistment Behavioral Problems

Another factor related to increased suicide risk among recent birth cohorts, in particular, the Army, is that recruits increasingly come from unique family structures and childhood experiences associated with vulnerability. Recruits disproportionally come from single-family households and households of adverse childhood experiences, both of which are associated with suicide risk (Griffith, 2014; O’Brien & Stockard, 2002; Stockard & O’Brien, 2002). Recent studies also suggest that those who now volunteer for military service are distinctly different from nonvolunteers of the same age. Using data from the National Longitudinal Study of Adolescent Health, Spence, Henderson, and Elder (2013) observed that youth living in a single-parent household had increased odds of military enlistment independent of socioeconomic status, characteristics of parent–child relationships, or feelings of social isolation. Based on their findings, Spence et al. concluded that military service for many youth today provided independence and sense of belonging. In a similar vein, Blosnich, Dichter, Cerulli, Batten, and Bossarte (2014) suggested that enlistment may serve as an escape from adversity for some young adults, particularly consequences from early negative childhood events. Based on population-based samples of noninstitutionalized U.S. adults during 2010, they found that veterans had greater likelihood of early (i.e., before 18 years old) negative life experiences than did nonveterans, with the greatest differences being observed for those veterans who served in the AVF rather than in the draft force. Men with a history of military service from the all-volunteer era had more than twice the prevalence of adverse childhood experiences than men from the draft era, specifically in the areas of family mental illness, parental separation or divorce, drug and alcohol abuse, domestic violence, and emotional and/or sexual abuse.

The increased number of medical and moral waivers given to recruits in recent years further suggests greater vulnerability of military personnel. Armor and Gilroy (2010) reported that beginning in 2005 there was a slight increase in Category IV recruits and an even larger increase in Category IIIB recruits in the Army, which are likely explained by recruitment challenges during the Iraq War. 1 On the one hand, increased waivers might represent more disqualified applicants due to raising standards, who are then allowed exceptions or waivers to enter military service. Most researchers, on the other hand, have seen increased waivers as indicating more applicants having entered military service due to lowering standards (M. S. Gallaway, personal communication, July 7, 2015). This was particularly the case during 2004–2006 when applicants with misdemeanors, behavioral health conditions, weight, and so on were allowed to join to increase the size of the U.S. Army (Lipscomb, 2015).

Gallaway et al. (2013) examined Army soldiers who had been granted enlistment waivers from 2003 to 2008 and reported that most waivers were either medical or misconduct waivers. The percentage of soldiers who were granted medical and conduct waivers increased significantly from 2003 (12%) to 2008 (20%), with the largest increase occurring in the percentage of moral conduct waivers. Similar trends were observed in the ARNG (ARNG, 2015). During this same time period, suicide rates for both components of the Army increased. Although recent research suggests that accession waivers are not a direct correlate of suicide at the individual level (Schoenbaum et al., 2014), the rise in waivers for preenlistment misconduct nonetheless reflects a cohort of soldiers who have conditions, which would normally disqualify them, but who were allowed to enter military service due to the need for more recruits.

The risk factors described above likely make recent generations of soldiers more vulnerable to behavioral health problems, in general, and suicide, in particular, compared to previous generations. For a certain subgroup of soldiers, this risk predates enlistment and is carried forward into military service. Recent epidemiological studies conducted by the Army STARRS research consortium, for example, estimates that 14% of soldiers have a preenlistment history of suicide ideation, 2% have a history of preenlistment suicide plans, and 2% made at least one suicide attempt before joining the military (Nock, Stein, et al., 2014; Ursano et al., 2015). The observed rate of preenlistment suicide ideation among new U.S. Army recruits was higher than that reported among age-matched civilians, but the rate of preenlistment suicide ideation among older U.S. Army personnel was no different than age-matched civilians. This pattern suggests that more recent recruit cohorts were coming into the service with higher rates of suicide ideation than earlier cohorts. This increased vulnerability could interact adversely with the stressors of military service, thereby contributing to increased suicide rates overall (R. C. Kessler, personal communication, October 24, 2014).

Nock, Stein, et al. (2014) also reported increased vulnerability of U.S. Army soldiers based on the findings that approximately one third of the suicide attempts that occurred during military service were associated with psychiatric conditions during preenlistment onset. Similarly, cluster analyses of the 2007–2010 ARNG suicides suggested increased suicide vulnerability among recent recruits. In these analyses, Griffith (2012c) identified two clusters of ARNG suicides: (1) “first termers” who tended to be young, male, White, single, of junior ranking, nonprior service, had fewer years of service, were of part-time status or mobilization day assets, were in training, and had no history of deployments and (2) “careerists” who tended to be older, male, White, were married, of senior ranking, prior service, have deployment histories, were less likely to be of part-time status or mobilization day assets, and in training. First termers comprised about two thirds of all suicides and showed increased vulnerability over time. That is, the percentage of suicides in the first termers increased from 57% in 2007 to 74% in 2010. This increase coincided with a dramatic increase in the ARNG suicide overall from 2009 to 2010 onward, when such increases in similar demographic clusters were not observed in the ARNG population. Results, as a whole, suggested that first termers, or younger soldiers, had become more at risk for suicide over time.

Changes in Recruitment Subsequent to the AVF

Increased vulnerability of soldiers in recent years might also be explained in part by a considerable change in the pool of applicants who are eligible for military service since the implementation of the AVF. It is instructional to consider who enters military service and how during the era of the AVF as compared to the draft military that existed as recently as the Vietnam War. The recent conflicts in Iraq and Afghanistan represented the first protracted wars since Vietnam, and by extension, the first protracted wars of the AVF. When comparing the time periods of the Vietnam War (Chambers, 1987) and time periods of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF; Sackett & Mavor, 2006; U.S. Department of Veterans Affairs, 2011), the AVF is marked by considerably fewer applicants to choose from: about 429,000 applicants over a 2-year period for OEF/OIF as compared to an average of about 4,500,000 applicants per 2-year period for Vietnam (see Table 1). Of the applicants in the AVF, proportionally more (56%) were accepted for military service than during Vietnam (8%). Conversely, proportionally more applicants were rejected during Vietnam (57%) than during OEF/OIF (16%). When considered in light of the trends discussed previously, these data suggest that the military is likely recruiting a more vulnerable cohort of soldiers as compared to earlier generations. This speculation deserves further consideration in military suicide research studies, but research to date has largely overlooked how vulnerability for suicide can be influenced by birth cohort.

Table 1.

Comparison of U.S. Military Applicants, Recruits, Failures to Recruit, and Waivers Between the All-Volunteer Force (2003–2005) and Draft Force (1964–1975).

	Accessions to all active forces, May 1, 2003, to April 30, 2005 (Sackett & Mavor, 2006, p. 15)	Accessions to all active forces, 1964 and 1975
Applicants	429,116 (Of 4.3 million 18-year-olds) for 2-year period	27,000,000; 1964–1975 (4,500,000 for a 2-year period [est.])
Total accessed	239,940 (55.9% of applicants)	2,215,000 (8.2% of applicants) over the 11-year period (U.S. Department of Veterans Affairs, 2011)
Failure to qualify applicants	70,034 (16.3%)	½ Of the 27 million (about 57%)—due to jobs, education, physical and mental deficiencies, and criminal records (Morris, 2006). Nearly 500,000 (1.9%) were disqualified for criminal records (Chambers, 1987)
Percentage of failures waived	26,613 (38%) of 70,034	Not available

Social Disintegration and Birth Cohort Suicide Vulnerability

One of the earliest theories of suicide was Durkheim’s (1897/1951) who posited and described the influence of broad social influences related to suicide in Europe during the late 19th century. Noting differences in suicide rates between Protestants and Catholics, Durkheim proposed that suicide is associated with two forces connecting the individual and social group: behavioral regulation and social integration. Behavioral regulation pertained to norms and customs of society that prescribed acceptable behaviors, especially interpersonal behaviors. Norms and customs gave social or group oversight of individual behaviors and provided moral guidance and constraint on individual desires. Internalization of group practices determined the extent to which the individual became attached and committed to the group. This latter process described the concept of integration (see Wray, Colen, & Pescosolido, 2011). Well-integrated or cohesive groups provided predictable, stable, and enduring social ties which, when under stressful life circumstances, offered support and relief to the individual, thereby reducing his or her vulnerability to suicide. Extremes in both of these forces yielded suicides having different motivations: low levels of both regulation and integration resulted in “egoistic” (marginalized from group) and “anomic” (devoid of meaningfulness) suicides, while high levels of each produced “altruistic” (sacrifice for the group) and “fatalistic” (hopelessness) suicides. In sum, Durkheim conceptualized suicide as the consequence of broad social factors such as religious, political, and family institutions, all of which impact the degree to which the individual feels socially integrated and behaviorally regulated.

Although Durkheim’s theory has served as the foundation for understanding the full range of suicidal behavior, few researchers have used Durkheim’s model to guide studies focused on suicides in the U.S. military. It is our position that this theory has not been sufficiently utilized to guide suicide research in the military and that the consideration of social integration and behavioral regulation could provide new insights and directions for scientific inquiry specific to military suicide. Several lines of research that suggest diminished social integration and behavioral regulation among recent birth cohorts have given rise to a range of behavioral health conditions, including suicide risk, among younger generations of U.S. military personnel.

Characteristics of birth cohorts can impact social integration and behavioral regulation as the individual matures throughout the life span, with variations in cohort characteristics conferring greater suicide vulnerability for some birth cohorts and lower suicide vulnerability for other birth cohorts. Evidence in support of this proposition is provided by O’Brien and Stockard (2002) who examined the distribution of suicide rates across age-groups for the birth cohorts from 1930, 1965, and 2000. Over time, they observed that the age distributions of suicide rates shifted such that in the 2000 cohort there were relatively more suicides committed by younger age-groups (late teens to mid-20s) than in the 1930 or 1965 cohort (see Figure 2). During this same time, the proportion of children born to two-parent households declined, whereas the proportion of children born into poverty increased (see Figure 3).

Figure 2.

Suicide rates for age-specific intervals for three “snapshot” distributions of ages (J. Stockard, personal communication, March 26, 2015).

Figure 3.

Percentages of U.S. children living in poverty and children not in two-parent households, 1967–2009. Source. U.S. Department of Commerce, Table 20, Poverty status of related children (2015b) and Table 1, Living arrangements of children (July 3, 2015a).

O’Brien and Stockard (2002) also found that birth cohort size and births to unwed or unmarried others predicted variations in age-interval suicide rates for given time periods. They speculated that these findings demonstrated less social integration among more recent birth cohorts and reasoned that larger birth cohorts and nonmarital births resulted in fewer financial resources available and/or fewer adult providers within a household than in previous birth cohorts. Larger sized birth cohorts having more children born per parent overloaded institutions that typically offered support to and control for children. More childbirths per parent leads to more children per classroom, which results in relatively less attention and supervision for each individual child, thereby leading to less behavioral control and internalization of social norms. In addition, single parents have less time to supervise and monitor children to reduce problem behaviors. Consequently, members of larger birth cohorts and cohorts with fewer adults in the home are more likely to be influenced by peer relations, thereby creating a “youth culture” that is “relatively insulated from the influence of older generations” (Holinger, Offer, Barter, & Bell, 1994). Children who receive less attention and supervision from adult community members potentially form less stable and integrative relationships over the long term.

Stockard and O’Brien (2002) drew on other research to elaborate on the pronounced risk conveyed by age, gender, and race across birth cohorts. For example, young adults might be less able to cope with adversities (i.e., having fewer coping skills, fewer developed social supports) than older adults (Diekstra, 1995; Stockard & OBrien, 2002). With respect to gender, variation in age-specific suicide rates is explained for males more so than for females (O’Brien & Stockard, 2002; Stockard & O’Brien, 2002). Concerning race, research suggests that Whites may be more vulnerable to adversities than non-Whites due to the extended support network that exists among racial minority groups relative to White Americans (Gibbs, 1997; Hetherington & Parke, 1975; Kubrin & Wadsworth, 2009; Taylor, Chatters, Tucker, & Lewis, 1990). Thus, Whites might experience more negative consequences to stressful circumstances than would racial minorities, perhaps because Whites have experienced relatively less adverse life circumstances such as discrimination, unemployment, poverty, urban living, and so on (McIntosh & Santos, 1981). Others have further posited that greater participation in religious activities among racial minorities serves as an additional inhibition against self-harm (Kubrin & Wadsworth, 2009). These demographic risk factors have particular relevance to military suicides, as they are among the most robust risk factors for suicide among U.S. military personnel (Nock, Deming, et al., 2014).

Civilian research suggests that the relation of these demographic risk factors to suicide have shifted over time. Using data from 1935 to 2010, for instance, Phillips (2014) performed age-period–cohort analyses to examine cohort characteristics associated with suicides in the United States. She found that suicide rates began to rise with the baby boomer generation (born 1946–1961), with subsequent cohorts exhibiting increasingly higher rates of suicide. Again, this pattern was more pronounced for men than for women. For males born in 1930–1934, the suicide rate was estimated at 17.4 suicides per 100,000, for males born in 1955–1959, the rate was estimated at 28 suicides per 100,000, and for males born in 1985–1989, the rate was an estimated at 37.8 suicides per 100,000. In short, vulnerability for suicide has steadily increased over time, especially for men. Taking into account concurrent increases in birth cohort size, proportion of children born to single-parent families, and children born in poverty, Phillips interpreted her results as evidence for weakened social integration and regulation among more recent cohorts.

Generational Trends Related to Decreased Social Integration

Other studies hint at greater vulnerability to behavioral health and related conditions among more recent generations. Twenge, Gentile, DeWall, Lacefield, and Schurtz (2010) performed a meta-analysis of studies that had gathered data on young adults’ Minnesota Multiphasic Personality Inventory (MMPI) scores. The study included 117 samples (n = 63,706) of college students between 1938 and 2007 and 14 samples (n = 13,870) of high school students between 1951 and 2002. Significant increases in psychopathology were found over time among college students and high school students, with the most recent generations scoring about 1 standard deviation (SD) higher on the psychopathic deviant, paranoia, hypomania, and depression scales. Birth cohort effects were large and significant even after controlling for social desirability, indicating changes were not associated with motivated responding. Consistent with the notion of diminished social integration among recent birth cohorts, Twenge et al. concluded that the observed changes over time likely pertained to shifts in values away from community, meaning in life, and affiliation toward materialism and social status.

In a subsequent study, Twenge, Campbell, and Freeman (2012) examined cohort effects in life goals, concern for others, and civic orientation among American high school seniors (from Monitoring the Future data, N = 463,753, 1976–2008) and among students entering college (The American Freshman data, N = 8.7 million, 1966–2009). Consistent with their earlier study, findings suggest that recent generations valued community and interpersonal connections less and valued money, image, and fame more than earlier generations. Compared to baby boomers (born 1946–1961) of the same age, Gen Xers (born 1962–1981) and Millennials (born approximately after 1980 through 2000) considered goals related to extrinsic values (e.g., money, image, and fame) to be more important, whereas goals related to intrinsic values (e.g., self-acceptance, affiliation, and community) were considered less important. In addition, concern for others (e.g., empathy for outgroups, charity donations, the importance of having a job worthwhile to society, etc.) and civic orientation (e.g., interest in social problems, political participation, trust in government, taking action to help the environment, and saving energy) decreased from earlier to later generations, with about half the decline occurring between Gen Xers and the Millennials. Although community service increased from earlier to later generations, it is important to note that such service is increasingly required for high school graduation (Griffith, 2012b).

Most recently, Twenge (2015) reported findings that are more directly related to suicide risk—depressive symptoms and suicidal behaviors among young adult Americans. When examining depressive symptoms among young adult Americans across four large-scale surveys spanning several decades (N = 6.9 million), a greater proportion of Americans during the 2000–2010 decade reported more depressive symptoms, particularly somatic symptoms, as compared to the 1980–1990 decade. High school students in the 2010s reported more symptoms such as shortness of breath and trouble sleeping, thinking, and remembering, and were twice as likely to have seen a professional for mental health concerns. Likewise, college students in later years were much more likely to report feeling overwhelmed and below average in mental and physical health, and young adults had higher depression scores on the Center for Epidemiological Studies Depression scale in 2000 compared to 1988. Taken together, these series of studies suggest a trend for increasingly troubled generations (i.e., increased rates of mental health and related conditions) combined with less social integration (i.e., a shift in values away from community and interpersonal connections toward material objects and social status).

Summary

In this article, we have proposed that the increased suicides in the U.S. military, in part, are consequential of early developmental experiences found in recent generations. Birth cohort size and number of nonmarital births, presumed indicators of Durkheim’s social integration and behavioral regulation, have increased in recent birth cohorts, leaving cohort members less assimilated and idiosyncratic behaviors less regulated and, thus, more vulnerable to behavioral health conditions. On the whole, members of recent birth cohorts are expected to have greater vulnerability, though there is likely substantial variability in being vulnerable, depending on heredity, other early developmental experiences, developed coping strategies, and so forth. Indeed, several studies of young adults over time have documented shifts in behavioral health conditions (more) and values (more emphasis on material things and less on interpersonal relationships) among recent generations. Stressful events unique to military service likely interact with this vulnerability, making some, but not all, individuals more distressed, leading to suicidal risk. Suicide is a low-occurring event, so just a few of such cases would result in increased suicides affecting suicide rates. Another consideration is that the U.S. military population is a circumscribed population—few volunteers, many of whom are young in age and male (among the primary risk factors for suicide) and often from nontraditional family structure associated with less social integration and suicide risk. These factors would make any increased vulnerability more evident among U.S. military service members than among the U.S. population.

New Directions for Examining Suicide in the U.S. Military

Durkheim’s early work on suicide has not been sufficiently used to understand social and generational factors that can influence suicide in the U.S. military. Owing to its unique population, increased vulnerability to suicide is more evident in the U.S. military than in the civilian population. In light of evidence supporting birth cohort characteristics that reflect behavioral regulation and social integration, some benefit may be achieved in considering Durkheim’s theoretical tenets to examine and explain suicides in the U.S. military. Several new directions for future suicide research, policy, and practice in the U.S. military are therefore implicated.

Implications for Suicide Research

Aspects of Durkheim’s theory are useful to examine and to explain suicide. Durkheim’s theory provides a framework for organizing existing research findings, providing for coherent basis of further hypothesis testing. Specifically, it provides a conceptual basis for synthesizing findings from studies conducted in both military and civilian samples. To our knowledge, none of the U.S. Department of Defense studies focused on suicide (totaling over US$165 million in funding to date; Ramchand et al., 2014) has examined aggregate level data as described here. The present review suggests that a number of relevant questions are not being asked in current studies. For example, research studies focused on cohort characteristics that might indicate young adults’ level of social integration and behavioral regulation prior to and during military service may yield new insights and information about how broad social factors (e.g., birth cohort size and nonmarital births) may operate on the individual soldier (e.g., being integrated into their community and regulating their behaviors). Along these lines, greater efforts to identify archival aggregate data relevant to such conditions are needed.

More consideration should also be given to broad societal trends relative to those who are most likely to serve in the U.S. military and how these individuals might be more vulnerable to behavioral health conditions and suicide. More research needs to be done to describe processes at the macro-societal level, the meso-community level, and the micro-individual level and their relationships, in particular, as they relate to social integration and behavioral regulation. Findings would offer a better understanding of connections between social change and individual behavior, which could lead to refinement and enhancement of existing interventions.

Finally, the proposal here requires a different method of examining suicide prevalence rates and associated factors. At present, suicide rates are compared year by year overall and by age-groups, but this method obscures potential cohort or generational differences. Rather, several time periods should be chosen, and for each, age distribution of soldiers would be identified relevant to suicide trends in the U.S. military. Some time periods might be chosen after the rise in suicides—2014, 2010, 2006, 2002, and other time periods before the rise in suicides—1998, 1994, 1994, and so on insofar as military data allow. For each of the time periods, age intervals would be identified along with the corresponding suicide rates. Suicides, being a rare event, would necessitate wide age intervals, such as 17–24 years of age, 25–29 years of age, and all others. Birth cohort number and percentage of nonmarital births obtained from U.S. Census data could be appended to each age interval.

Implications for Suicide Prevention

Regarding suicide prevention, current approaches such as enhancing individual resilience through cognitive behavioral methods (Reivich, Seligman, & McBride, 2011) should be examined more closely, given broad societal factors that likely operate on increased vulnerability to suicide. Findings here suggest underlying individual vulnerability associated with cohort-specific social processes, which under circumstances wanting of social integration, predispose the individual to suicidal behaviors. It seems, then, that current preventive programs should be aimed more directly at these domains, such as training and experiences associated with group identity and solidarity, leadership, and group norms that develop individual-to-group ties, providing social connections and control of individual-level behaviors. Such processes strengthen bonds among members of groups through the physical and social environments that promote proximity and communication, through behaviors that are interdependently satisfying individual and group needs, through shared feelings, and through having commonly identified personal characteristics (Moreland, 1987). Reexamining the Army’s current and past practices, in particular those associated with soldier bonding and cohesive ties among unit members, would benefit not only readiness but also soldiers’ identification with others, the unit, and the Army.

Implications for Suicide Policy

Institutional preventive policy strategies should also be considered. It is possible that negative effects of cohort-related factors might be mitigated by social/cultural contexts through supplementing social capital—making up what has been lost through societal supports and diminished social integration. Stockard and O’Brien (2006), for example, observed the negative effects of birth cohort size and nonmarital births on suicide rates to be less evident among Nordic countries, attributable to these countries’ historical commitment to caring for others and tradition of cultural and political tolerance toward nontraditional family forms. An open question is whether a large organization like the U.S. military can develop ways to do this. In the past, the U.S. military has successfully implemented procedures and policies to counter other types of social problems, most importantly issues of segregation (Moskos & Butler, 1996) and issues of gender identification (Moradi & Miller, 2010).

Finally, consideration should be given to examining the AVF and its appeal to a particular segment of the general population, which may be inherently more vulnerable to suicide, whether via preenlistment suicide risk (Nock, Stein, et al., 2014; Ursano et al., 2015), waivered entry status (Gallaway et al., 2013), and/or family background and childhood experiences (Griffith, 2014; Spence, Henderson, & Elder, 2013). A broader concern, too, is how the AVF might add to diminished social integration among members of society by attracting specific subpopulations who serve versus those of other subpopulations who do not.

Footnotes

Acknowledgment

Special thanks are extended to Jean Stockard, PhD, professor emerita, University of Oregon, for her encouragement, support, and guidance on this topic. Also, we extend thanks to three anonymous reviewers who provided helpful feedback.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Supplemental Material

An online appendix and an associated podcast are available at .

Note

References

Armor

D. J.

Gilroy

C. J.

(2010). Changing minority representation in the U.S. military. Armed Forces & Society, 36, 223–246.

Army Institute of Public Health. (2015, 4). Surveillance of suicidal behavior: January–December 2012 (p. 12). Aberdeen, MD: Behavioral and Social Health Outcomes Program (BSHOP), Epidemiology and Disease Surveillance (EDS) Portfolio, Army Institute of Public Health (AIPH), United States Army Public Health Command (USAPHC).

Army National Guard. (2015, 5). Practical implications of findings from ARNG CY2007-2014 suicides. Briefing presented at ARNG annual Suicide Prevention Program Mangers conference, Soldier and Family Support Division, National Guard Bureau, Camp Attaberry, IN.

Black

S. A.

Gallaway

M. S.

Bell

M. R.

(2011). Prevalence and risk factors associated with suicide of army soldiers 2001–2009. Military Psychology, 23, 433–451.

Blosnich

J. R.

Dichter

M. E.

Cerulli

Batten

S. V.

Bossarte

R. M.

(2014). Disparities in adverse childhood experiences among individuals with a history of military service. JAMA Psychiatry, 71, 1041–1048.

Cassimatis

E. G.

Rothberg

J. M.

(1997). Suicide in the U.S. military. In Botsis

A. J.

Soldatos

C. R.

Stefanis

C. N.

(Eds.), Suicide: Biopsychosocial approaches (pp. 23–32). Amsterdam, the Netherlands: Elsevier Science.

Chambers

(1987). To raise an army: The draft comes to modern America. New York, NY: Free Press.

Diekstra

R. F. W.

(1995). Depression and suicidal behaviors in adolescence: Sociocultural and time trends. In Rutter

(Ed.), Psychosocial disturbances in young people: Challenges for prevention (pp. 212–246). Cambridge, England: Cambridge University Press.

Durkheim

(1951). Suicide: A study in sociology. New York, NY: Free Press. (Original work published 1897)

10.

Gallaway

M. S.

Bell

M. R.

Lagana-Riordan

Fink

D. S.

Meyer

C. E.

Millikan

A. M.

(2013). The association between U.S. Army enlistment waivers and subsequent behavioral and social health outcomes and attrition from service. Military Medicine, 178, 261–266.

11.

Gibbs

J. T.

(1997). African-American suicide: A cultural paradox. Suicide and Life-Threatening Behavior, 27, 68–79.

12.

Griffith

(2012a). Army suicides—‘Knowns’ and an interpretative framework for future directions. Military Psychology, 24, 488–512.

13.

Griffith

(2012b). A decade of helping: Community service among recent high school graduates attending college. Nonprofit and Voluntary Sector Quarterly, 41, 786–801.

14.

Griffith

(2012c). Suicide in the Army National Guard: An empirical inquiry. Suicide and Life-Threatening Journal, 42, 104–119.

15.

Griffith

(2013, 11). Analysis of CY 2007-2012 Army National Guard Suicides, report prepared for the soldier and family division. Arlington, VA: National Guard Bureau.

16.

Griffith

(2014). Prevalence of childhood abuse among Army National Guard soldiers and its relationship to suicidal behavior. Military Behavioral Health Journal, 2, 114–122.

17.

Headquarters, Department of the Army (2006). Blacks in the U.S. Army: Then and now. The Pentagon, Washington, D.C.: Office of the Army Demographic, Headquarters, Department of the Army, Deputy Chief of Staff, Army G-1.

18.

Hetherington

E. M.

Parke

R. D.

(1975). Child psychology: A contemporary viewpoint. New York, NY: McGraw-Hill.

19.

Holinger

P. C.

Offer

Barter

J. T.

Bell

C. C.

(1994). Suicide and homicide among adolescents. New York, NY: Guilford Press.

20.

Karch

D. L.

Logan

Patel

(2011). Surveillance for violent deaths—National Violent Death Reporting System, 16 States, 2008 . In MMWR Surveillance Summaries, 60 (pp. 1–54). Atlanta, GA: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

21.

Kessler

R. C.

Berglund

P. A.

Borges

Nock

Wang

P. S.

(2005). Trends in suicide ideation, plans, gestures, and attempts in the United States 1990-92 to 2001-03. Journal of the American Medical Association, 293, 2487–2495.

22.

Kubrin

C. E.

Wadsworth

(2009). Explaining suicide among Blacks and Whites: How socioeconomic factors and gun availability affect race-specific suicide rates. Social Science Quarterly, 90, 1203–1227.

23.

LeardMann

C. A.

Powell

T. M.

Smith

T. C.

Bell

M. R.

Smith

Boyko

E. J.

… Hoge

C. W.

(2013). Risk factors associated with suicide in current and former US military personnel. Journal of the American Medical Association, 310, 496–506.

24.

Lipscomb

(2015, 7). Changes in enlistment standards for the army. Retrieved July 15, 2015, from http://woman.thenest.com/changes-enlistment-standards-army-19585.html

25.

McIntosh

J. L.

Santos

J. F.

(1981). Suicide among minority elderly: A preliminary investigation. Suicide and Life-Threatening Behavior, 11, 151–166.

26.

Millikan

Spiess

Mitchell

Watts

Porter

(2011, 10). Analyses of army suicides, 2005–2010 (epidemiological report No. 14-HK-0DS8-10p). Aberdeen Proving Ground, MD: U.S. Army Public Health Command.

27.

Moradi

Miller

(2010). Attitudes of Iraq and Afghanistan war veterans toward gay and lesbian service members. Armed Forces & Society, 36, 397–419.

28.

Moreland

R. L.

(1987). The formation of small groups. In Hendrick

(Ed.), Review of personality and social psychology: Group process (Vol. 8, pp. 80–110). Newbury Park, CA: Sage.

29.

Morris

(2006). The effects of the draft on U.S. presidential approval ratings during the Vietnam War, 1954–1975 (Doctoral dissertation). University of Alabama, Tuscaloosa, AL.

30.

Moskos

Butler

J. S.

(1996). All that we can be: Black leadership and racial integration the army way. New York, NY: Basic Books.

31.

Nock

M. K.

Deming

C. A.

Fullerton

C. S.

Gilman

S. E.

Goldenberg

Kessler

R. C.

… Ursano

R. J.

(2014). Suicide among soldiers: A review of psychosocial risk and protective factors. Psychiatry, 76, 97–125.

32.

Nock

M. K.

Stein

M. B.

Heeringa

S. G.

Ursano

R. J.

Colpe

L. J.

Fullerton

C. S.

… Kessler

R. C.

(2014). Prevalence and correlates of suicidal behavior among soldiers: Results from the Army Study to Assess Risk and Resilience in Service members (Army STARRS). JAMA Psychiatry, 71, 514–522.

33.

O’Brien

R. M.

Stockard

(2002). Variations in age-specific homicide death rates: A cohort explanation for changes in the age distribution of homicide deaths. Social Science Research, 3, 124–150.

34.

Phillips

J. A.

(2014). A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United States. Social Science and Medicine, 114, 151–160.

35.

Ramchand

Eberhart

N. K.

Guo

Pedersen

Savitsky

T. D.

Tanielian

Voorhies

(2014). Developing a research strategy for suicide prevention in the Department of Defense: Status of current research, prioritizing areas of need, and recommendations for moving forward. Santa Monica, CA: Rand.

36.

Reivich

K. J.

Seligman

M. E. P.

McBride

(2011). Master resilience training in the U.S. army. American Psychologist, 66, 25–34.

37.

Rothberg

Holloway

Ursano

(1987). Suicide in the United States military. Psychiatric Annals, 17, 545–548.

38.

Sackett

P. R.

Mavor

A. S.

(2006). Assessing fitness for military enlistment. National Research Council, Washington, DC: National Academics Press.

39.

Schoenbaum

Kessler

R. C.

Gilman

S. E.

Colpe

L. J.

Heeringa

S. G.

Stein

M. B.

… Cox

K. L.

(2014). Predictors of suicide and accident death in the Army Study to Assess Risk and Resilience in Service members (Army STARRS). JAMA Psychiatry, 71, 493–503.

40.

Spence

N. J.

Henderson

K. A.

Elder

G. H.

(2013). Does adolescent family structure predict military enlistment? A comparison of post–high school activities. Journal of Family Issues, 34, 1194–1216.

41.

Stockard

O’Brien

R. M.

(2002). Cohort variations and changes in age-specific suicide rates over time: Explaining variations in youth suicide. Social Forces, 81, 605–642.

42.

Stockard

O’Brien

R. M.

(2006). Cohort variations in suicide rates among families of nations: An analysis of cohorts born from 1875 through 1985. International Journal of Comparative Sociology, 47, 5–33.

43.

Taylor

R. J.

Chatters

L. M.

Tucker

M. B.

Lewis

(1990). Developments in research on Black families: A decade in review. Journal of Marriage and the Family, 52, 993–1014.

44.

Twenge

J. M.

(2015). Time period and birth cohort differences in depressive symptoms in the U.S., 1982–2013. Social Indicators Research, 121, 437–454.

45.

Twenge

J. M.

Campbell

W. K.

Freeman

E. C.

(2012, 3 5). Generational differences in young adults’ life goals, concern for others, and civic orientation, 1966–2009. Journal of Personality and Social Psychology, 102, 1045–1062.

46.

Twenge

J. M.

Gentile

DeWall

C. N.

Lacefield

Schurtz

D. R.

(2010). Birth cohort increases in psychopathology among young Americans, 1938–2007: A cross-temporal meta-analysis of the MMPI. Clinical Psychology Review, 30, 145–154.

47.

U.S. Army Office of the Chief of Public Affairs. (2010). Army health promotion, risk reduction, and suicide prevention report, Report prepared for the U.S. Army Vice Chief of Staff. Washington, DC: Headquarters, Department of the Army.

48.

U.S. Army Office of the Chief of Public Affairs. (2012). Army 2020: Generating health and discipline in the force, ahead of the strategic reset, Report prepared for the U.S. Army Vice Chief of Staff. Washington, DC: Headquarters, Department of the Army.

49.

U.S. Army Public Health Command. (2015, 5). Surveillance of suicidal behavior: Summary of rates. Aberdeen, MD: Behavioral and Social Health Outcome Program (BSHOP), Epidemiology and Disease Surveillance (EDS), Army Institute of Public Health (AIPH), United States Army Public Health Command (USAPHC).

50.

U.S. Department of Commerce. (2015a). Table 1, Living arrangements of children: Detailed living arrangements of children by race, Hispanic origin and age: 2009. Retrieved July 3, 2015, from http://www.census.gov/hhes/socdemo/children/data/sipp/living2009/tables.html

51.

U.S. Department of Commerce. (2015b). Table 20, Poverty status of related children under 6 years of age: 1969 to 2013. Retrieved July 3, 2015, from http://www.census.gov/hhes/www/poverty/data/historical/people.html

52.

U.S. Department of Veterans Affairs. (2011, 11). America’s wars. Retrieved June 7, 2012, from http://www.va.gov/opa/publications/factsheets.asp

53.

Ursano

R. J.

Heeringa

S. G.

Stein

M. B.

Jain

Raman

Sun

… Kessler

R. C.

(2015). Prevalence and correlates of suicidal behavior among new soldiers in the U.S. Army: Results from Army STARRS. Depression and Anxiety, 32, 3–12.

54.

Wray

Colen

Pescosolido

(2011). The sociology of suicide. Annual Review of Sociology, 37, 505–528.

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