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Objective: Attachment style and social support networks (SSN) are associated with suicide ideation (SI) and suicide attempt (SA). How these two factors interact is important to understanding the mechanisms of risk for suicidal behaviors and identifying interventions. Method: Using the Army Study to Assess Risk and Resilience in Servicemembers New Soldier Study (N = 38,507 soldiers), we examined how three attachment styles (preoccupied, fearful, and secure) and SSN (smaller vs larger) were associated with lifetime SI, SA, and SA among soldiers with SI. The interaction of each attachment style by SSN was examined. Results: All three attachment styles were associated with SI and SA in the total sample (for SA: preoccupied OR = 2.82, fearful OR = 2.84, and secure OR = 0.76). Preoccupied and fearful attachment were associated with SA among suicide ideators. Smaller SSN was associated with a higher risk for all three outcomes (range of ORs = 1.23–1.52). The association of SSN with SI and with SA among suicide ideators was significantly modified by the presence or absence of preoccupied attachment style. Among soldiers without preoccupied attachment, larger SSN was associated with lower risk of SI. Among suicide ideators with preoccupied attachment, a larger SSN was associated with lower risk of SA. Conclusion: This study highlights the need for increased understanding of the role of attachment style and social networks in suicide risk, in particular preoccupied attachment among soldiers with SI. A critical next step is to explore these relationships prospectively to guide intervention development. [ABSTRACT FROM AUTHOR]

In Ukraine, soldiers' psychological resilience is of paramount concern. Therefore, the Armed Forces of Ukraine have developed a new intervention, Combat Path Debriefing, designed to address combat stress and promote unit readiness for soldiers returning to combat. This article outlines the components of Combat Path Debriefing and discusses how it is rooted in principles of combat and operational stress control and the unique characteristics of Ukrainian military life. This perspective offers US and allied leaders real-world experience that can inform future efforts to support soldiers' mental health and combat performance. [ABSTRACT FROM AUTHOR]

This article summarizes updates from the 2023 U.S. Department of Veterans Affairs and Department of Defense guideline for the management of posttraumatic stress disorder (PTSD) and acute stress disorder. It summarizes changes from the 2017 guideline and describes 34 recommendations in 5 topic areas—assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of PTSD with co-occurring conditions—while highlighting 6 recommendations rated as strong. Description: The U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. This article summarizes the 2023 clinical practice guideline (CPG) and its development process, focusing on assessments and treatments for which evidence was sufficient to support a recommendation for or against. Methods: Subject experts from both departments developed 12 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method. Recommendations were made after consensus was reached; they were based on quality and strength of evidence and informed by other factors, including feasibility and patient perspectives. Once the draft was peer reviewed by an external group of experts and their inputs were incorporated, the final document was completed. Recommendations: The revised CPG includes 34 recommendations in the following 5 topic areas: assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of posttraumatic stress disorder (PTSD) with co-occurring conditions. Six recommendations on PTSD treatment were rated as strong. The CPG recommends use of specific manualized psychotherapies over pharmacotherapy; prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy; paroxetine, sertraline, or venlafaxine; and secure video teleconferencing to deliver recommended psychotherapy when that therapy has been validated for use with video teleconferencing or when other options are unavailable. The CPG also recommends against use of benzodiazepines, cannabis, or cannabis-derived products. Providers are encouraged to use this guideline to support evidence-based, patient-centered care and shared decision making to optimize individuals' health outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Physicians are exposed to a range of traumatic events throughout training and professional practice, including workplace violence, disasters, and hazardous exposures (Table 1). Physicians experience psychological and behavioral effects of [...]

The article discusses the psychological and behavioral impacts of exposure to weapons of mass destruction (WMD) during the war in Ukraine. Topics covered include lessons from historical WMD events in Japan, the importance of communication and collaboration between physical and mental health services, and the challenges faced by healthcare workers during such events.

Research on disaster behavioral health presents significant methodological challenges. Challenges are even more complex for research on mass violence events that involve military members, families, and communities, due to the cultural and logistical considerations of working with this population. The current article aims to inform and educate on this specialized area of research, by presenting a case study on the experience of designing and conducting disaster behavioral health research after a mass violence event in a military setting: the 2013 mass shooting at the Washington Navy Yard, in Washington, D.C. Using the case example, the authors explore methodological challenges and lessons learned from conducting research in this context, and provide guidance for future researchers. [ABSTRACT FROM AUTHOR]

Objective: Suicide and suicide attempts among U.S. Army soldiers are a significant concern for public health. This study examined the association of parental suicide attempt prior to age 13 of the soldier with subsequent risk of pre‐enlistment suicide attempt. Method: We conducted secondary analyses of survey data from new soldiers who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) (N = 38,396). A series of logistic regression analyses were conducted. Results: Of all new soldiers, 1.4% reported that they attempted suicide between age 13 and entering the Army, and 2.3% reported a parental suicide attempt prior to age 13. Parental suicide attempt was associated with increased odds of subsequent suicide attempt; however, this association was moderated by gender and was significant only among male soldiers. The association between parental suicide attempt and pre‐enlistment suicide attempt among male soldiers was still significant after controlling for socio‐demographic characteristics, soldier/parental psychopathology, and childhood adversities. Conclusions: These results highlight parental suicide attempt as a unique pre‐enlistment risk factor for suicide attempt, especially among male new soldiers. Further studies are needed to separate the genetic and environmental contributions to intra‐familial risk for suicidal behavior. [ABSTRACT FROM AUTHOR]