Kentucky Veteran and nonveteran suicide 2010–2019: A feasible solution algorithm test of perfect storm theory

Abstract: Veteran suicide remains a pressing public health problem in Kentucky (KY) and the United States. Perfect storm theory (PST) suggests that human behavior arises from the intensity of interactions between instigating, impelling, and disinhibiting forces and could be used to study the effects of interacting factors related to catastrophic behaviors such as self-directed violence. Suicide data were obtained from the KY Violent Death Reporting System for 2010–2019. Subgroups of veteran (n = 1,203, 17.8%) and nonveteran (n = 5,559, 82.2%) decedents were categorized by suicide characteristics, and Feasible Solution Algorithm was used to test the main proposition of PST. KY male veterans differed from nonveteran decedents in that they were significantly more likely to have been White, older, married, educated beyond high school, used a firearm, left a note, lived in a rural area, and had physical health problems. A three-way interaction, χ²(1) = 5.01, p = .0252, supported the main proposition of PST for veterans who were rural and older, in the presence of one or more of the following disinhibiting factors: alcohol found at the scene, recent death/suicide of a friend or family member, traumatic anniversary, blood alcohol content ≥.08, or a positive drug test. The identified interactions contribute to a better understanding of the complex nature of suicide and confirm that PST could be used to guide further research on the antecedents of veteran suicide and its prevention. Our tests of perfect storm theory uncovered important differences in factors related to suicide for older rural veterans. Findings highlight the utility of perfect storm theory, the use of a comprehensive statistical technique, and the need to tailor suicide prevention and intervention efforts to meet older rural veterans’ unique needs.

Read the full article
Report a problem with this article

Related articles

  • More for Researchers

    Examining the factor structure of the nine-item avoidant/restrictive food intake disorder screen in a national US military Veteran sample

    Abstract: Disordered eating is a prevalent and relevant health concern that remains understudied among U.S. military veterans. Avoidant/restrictive food intake disorder (ARFID) is a newly recognized feeding and eating disorder characterized by overly restrictive eating due to (a) picky eating, (b) lack of appetite, and (c) fear of aversive consequences related to eating. The Nine-Item ARFID Screen (NIAS) is a recently developed ARFID screening tool with initial validation studies demonstrating psychometric support. However, the psychometric properties of the NIAS have not been investigated in a veteran sample. To advance our understanding of ARFID screening tools that may be appropriate for use in veterans, the present study examined the factor structure of the NIAS using survey data from a large national sample of recently separated veterans (N = 1,486). Measurement invariance across key subgroups was tested in addition to exploring differential associations between the NIAS and related constructs. Results suggested that a three-factor model provided an excellent fit of the data and demonstrated scalar invariance across self-identified men and women, race and ethnicity, and sexual and gender minority (SGM) identity. Some subgroups had higher latent means on the picky eating (women, SGM, non-Hispanic Black), appetite (women, SGM), and fear (women) factors. The NIAS had some overlap with another measure of disordered eating and was moderately correlated with psychosocial impairment and mental health. Overall, the NIAS may be a useful screening tool for ARFID in veterans, given support for the three proposed subscales and equivalence across diverse identities.

    Mental Health Peer reviewed