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• What is the primary question addressed by this study? What are the correlates of successful aging in US veterans who screened positive for mental health conditions (i.e., major depressive disorder, generalized anxiety disorder, and/or PTSD)? • What is the main finding of this study? Resilience and gratitude were the strongest positive correlates of successful aging while greater somatic symptoms were the strongest negative correlate. The positive effects of gratitude moderated the negative effects of somatic symptoms. • What is the meaning of the finding? Positive psychiatry interventions on psychosocial factors such as resilience and gratitude may help promote successful aging in US veterans who screened positive for mental health conditions. To determine the prevalence and correlates of successful aging in US veterans who screened positive for current major depressive disorder (MDD), generalized anxiety disorder (GAD), and/or posttraumatic stress disorder (PTSD). In a nationally representative sample of 475 US military veterans (mean age=58.3, SD=14.7; range 24–92) who screened positive for MDD, GAD, and/or PTSD, multivariable logistic regression and relative importance analyses were conducted to identify independent correlates of successful aging. One-in-five (20.6%) veterans rated themselves as aging successfully. Resilience and gratitude were the strongest positive correlates of successful aging, accounting for 38.1% and 32.4% of the explained variance, respectively. Greater somatic symptoms were the strongest negative correlate, accounting for 11.2% of the explained variance. Higher gratitude moderated the negative association between somatic symptoms and successful aging. Positive psychiatry interventions targeting psychosocial factors such as resilience and gratitude may help promote successful aging among US veterans with mental disorders. [ABSTRACT FROM AUTHOR]

This cross-sectional study uses data from 1135 male, European-American US military veterans to assess whether risk and protective factors influenced associations between posttraumatic stress disorder and epigenetic age. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? What are the 10-year trajectories of posttraumatic stress disorder (PTSD) symptoms in older U.S. military Veterans and what defines those at risk for increasing symptoms with aging? • What is the main finding of this study? No/Low PTSD symptoms over time was most common, followed by consistently high, consistently sub-threshold, and increasing symptoms. Those with increasing symptoms were more likely to report cognitive and functional change, negative expectations of aging, and traumatic events over the study period. • What is the meaning of the finding? Most older Veterans are resilient, but some may have continuing or increasing PTSD symptoms with aging indicating a need to consider age-related changes, internalized ageism, and the occurrence and timing of traumatic events. To examine the nature and correlates of 10-year trajectories of posttraumatic stress disorder (PTSD) symptoms in older U.S. military Veterans. A nationally representative web-based survey of older U.S. Veterans who participated in the National Health and Resilience in Veterans Study over 5 waves between 2011 and 2021. A total of 1,843 U.S. Veterans aged 50 and older (mean age = 67). PTSD symptoms were assessed using the PTSD Checklist. Self-report measures at baseline assessed sociodemographic characteristics; trauma exposures; psychiatric and substance use disorders; mental, cognitive, and physical functioning; and psychosocial factors including expectations of aging. Latent growth mixture modeling identified the nature and correlates of 10-year PTSD symptom trajectories. Most of the sample had no/low PTSD symptoms (88.7%), while 6.0% had consistently subthreshold symptoms, 2.7% consistently high symptoms, and 2.6% increasing symptoms. Relative to the no/low symptom group, the subthreshold and high symptom groups reported more medical conditions and cognitive difficulties, with younger age and more lifetime traumatic events additionally linked to the high symptom trajectory. Relative to the no/low symptom group, Veterans with increasing symptoms were more likely to report functional disability and lifetime nicotine use disorder, cognitive difficulties, negative expectations regarding physical and emotional aging, and traumatic events over the study period. Despite high rates of trauma exposure, most older Veterans do not evidence symptomatic PTSD trajectories; however, about 11% do. Results underscore the importance of assessing PTSD symptoms in this population and considering longitudinal trajectories as well as associated risk and protective factors. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? What is the prevalence and correlates of suicidal thoughts and behaviors (STBs) in a nationally representative sample of older U.S. military veterans? • What is the main finding of this study? In this cross-sectional study (N = 3,356) of older U.S. veterans (mean age = 70.6), a total of 6.6% reported past year suicidal ideation (SI), 4.1% reported a lifetime suicide plan, 1.8% reported a lifetime suicide attempt, and 0.9% report future suicide intent. Higher levels of loneliness and lower levels of purpose in life were most strongly associated with past-year SI; lifetime history of major depressive disorder with suicide plan and suicide attempt; and frequency of past-year SI and more negative expectations regarding emotional aging with future suicide intent. • What is the meaning of the finding? Correlates of late-life suicidal behavior among U.S. military veterans may differ from those of younger veterans. Additional longitudinal research is needed to identify specific risk and protective factors for suicidal behavior in this population. To identify the prevalence and correlates associated with suicidal thoughts and behaviors (STBs) in a nationally representative sample of older (55+) US military veterans. Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study (N = 3,356; mean age = 70.6). Self-report measures of past-year suicidal ideation (SI), lifetime suicide plan, lifetime suicide attempt(s), and future suicide intent were examined in relation to sociodemographic, neuropsychiatric, trauma, physical health, and protective factors. A total of 6.6% (95% CI = 5.7%–7.8%) of the sample endorsed past-year SI, 4.1% (CI = 3.3%–5.1%) a lifetime suicide plan, 1.8% (CI = 1.4%–2.3%) a lifetime suicide attempt, and 0.9% (CI = 0.5%–1.3%) future suicide intent. Higher levels of loneliness and lower levels of purpose in life were most strongly associated with past-year SI; lifetime history of major depressive disorder with suicide plan and suicide attempt; and frequency of past-year SI and more negative expectations regarding emotional aging with future suicide intent. These findings provide the most up-to-date nationally representative prevalence estimates of STBs among older military veterans in the United States. Several modifiable vulnerability factors were found to be associated with suicide risk in older US military veterans, suggesting that these factors may be targets for intervention in this population. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? This study examined the population-based prevalence and correlates of prolonged grief disorder (PGD) in U.S. veterans. • What is the main finding of this study? In this nationally representative study of 2,441 veterans, 158 (weighted 7.3%) screened positive for PGD. Adverse childhood experiences, female sex, non-natural causes of death, knowing someone who died from coronavirus disease 2019, and number of losses were strongly associated with PGD. Veterans with PGD were significantly more likely to screen positive for posttraumatic stress, major depressive, and generalized anxiety disorders; endorse suicidal thoughts and attempts; and utilize mental health treatment. • What is the meaning of the finding? PGD is prevalent in veterans, and associated with increased psychiatric burden and suicide risk. To examine the point prevalence and correlates of prolonged grief disorder (PGD) in a nationally-representative sample of United States (U.S.) veterans. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative study of 2,441 U.S. veterans. A total of 158 (weighted 7.3%) veterans screened positive for PGD. The strongest correlates of PGD were adverse childhood experiences, female sex, non-natural causes of death, knowing someone who died from coronavirus disease 2019, and number of close losses. After adjusting for sociodemographic, military, and trauma variables, veterans with PGD were 5-to-9 times more likely to screen positive for post-traumatic stress disorder, major depressive disorder, and generalized anxiety disorder. After additional adjustment for current psychiatric and substance use disorders, they were 2–3 times more likely to endorse suicidal thoughts and behaviors. Results underscore the importance of targeting PGD as an independent risk factor for psychiatric disorders and suicide risk. [ABSTRACT FROM AUTHOR]

This cohort study analyzes survey data from US veterans at 3 time points before and during the COVID-19 pandemic to gauge trends in their suicidal thoughts and behaviors. Key Points: Question: Have suicidal thoughts and behaviors increased in US military veterans over the course of the first 3 years of the pandemic? Findings: In this cohort study, the prevalence of suicidal ideation did not significantly increase among US veterans during the pandemic, and the prevalence of suicide planning and suicide attempts remained low and consistent with prepandemic levels. Greater severity of prepandemic psychiatric distress and loneliness and lower purpose in life were the strongest predictors of new-onset suicidal thoughts and behaviors. Meaning: The prevalence of suicidal thoughts and behaviors has not increased for most US veterans during the first 3 years of the COVID-19 pandemic. Importance: Concerns have been raised since the onset of the COVID-19 pandemic that vulnerable populations, such as military veterans, may be at increased risk of suicidal thoughts and behaviors (STBs). Objective: To examine longitudinal trends in STBs in US military veterans during the first 3 years of the COVID-19 pandemic. Design, Setting, and Participants: This cohort study is a population-based longitudinal study including US military veterans that used 3 surveys from the National Health and Resilience in Veterans Study. Median dates of data collection were November 21, 2019 (prepandemic); November 14, 2020; and August 18, 2022. Main Outcomes and Measures: Lifetime and past-year suicidal ideation, suicide planning, and suicide attempt. Results: In this longitudinal study including 2441 veterans (mean [SD] age, 63.2 years [14.0]; 2182 [92.1%] male), past-year suicidal ideation decreased from 9.3% prepandemic (95% CI, 8.2%-10.6%) to 6.8% a year later (95% CI%, 5.8-7.9%) and then slightly increased to 7.7% (95% CI, 6.7%-8.9%) 2 years later. In total, 9 veterans (0.4%) reported attempting suicide at least once during the follow-up period, while 100 (3.8%) developed new-onset suicidal ideation and 28 (1.2%) developed new-onset suicide planning. After adjusting for sociodemographic and military characteristics, factors strongly associated with new-onset suicidal ideation included higher education (odds ratio [OR], 3.27; 95% CI, 1.95-5.46), lifetime substance use disorder (OR, 2.07; 95% CI, 1.23-3.46), prepandemic loneliness (OR, 1.28; 95% CI, 1.09-1.49), and lower prepandemic purpose in life (OR, 0.92; 95% CI, 0.86-0.97). Factors associated with new-onset suicide planning included lifetime substance use disorder (OR, 3.03; 95% CI, 1.22-7.55), higher prepandemic psychiatric distress (OR, 1.52; 95% CI, 1.06-2.18), and lower prepandemic purpose in life (OR, 0.88; 95% CI, 0.81-0.95). Conclusions and Relevance: Contrary to expectations, the prevalence of STBs did not increase for most US veterans during the COVID-19 pandemic. However, veterans with preexisting loneliness, psychiatric distress, and lower purpose in life were at heightened risk of developing new-onset suicidal ideation and suicide planning during the pandemic. Evidence-based prevention and intervention efforts that target these factors may help mitigate suicide risk in this population. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? What is the prevalence and potential mental health benefits of purpose in life in a nationally representative sample of older U.S. military veterans? • What is the main finding of this study? In this cross-sectional study (N = 4,069), most veterans endorsed average purpose in life (71.7%), while 16.0% endorsed low purpose in life and 12.4% endorsed high purpose in life. High purpose in life was associated with 42%–94% reduced odds of screening positive for major depressive, generalized anxiety, posttraumatic stress, and substance use disorders, as well as suicide attempts, ideation, and future intent. • What is the meaning of the finding? Given the "dose-response" relationship found between purpose in life and a broad range of mental health outcomes, purpose in life may be an important transdiagnostic prevention and treatment target. To determine the current prevalence of perceived purpose in life (PIL) and its association with screening positive for mental disorders and suicidality in a nationally representative sample of predominantly older U.S. veterans. Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study (N = 4,069; M age = 62.2). Veterans were classified into three groups based on perceived PIL level (i.e., low, average, and high). Self-report assessments were administered to screen for mental disorders and suicidality. Most veterans endorsed average PIL (71.7%), while 16.0% endorsed low PIL and 12.4% endorsed high PIL. A "dose-response" association was observed between PIL and outcomes. High PIL was associated with 42%–94% reduced odds of screening positive for major depressive, generalized anxiety, posttraumatic stress, and substance use disorders, as well as suicide attempts, ideation, and future intent. Higher PIL is associated with lower odds of mental disorders and suicidality in U.S. veterans, underscoring the potential importance of interventions to bolster PIL in this population. [ABSTRACT FROM AUTHOR]