Resilience and Vulnerability: Suicide-Specific Cognitions in a Nationally Representative Sample of US Military...

Objective: US military veterans are at elevated risk for suicide. High levels of suicide-specific cognitions, an indicator of chronic suicide risk, have been found to predict suicidal behaviors. The objective of this study was to examine data from a large, nationally representative sample of US veterans to determine the prevalence and correlates of high chronic suicide risk, with the goal of providing population-level insight into veterans who may be most at risk.

Methods: This study utilized data from the 2019-2022 National Health and Resilience in Veterans Study, a nationally representative sample (N = 2,430), to determine the prevalence of veterans who screened positive for high chronic risk for suicide based on the Brief Suicide Cognitions Scale. The relative importance of sociodemographic, military, health, and psychosocial characteristics associated with high chronic risk was also examined.

Results: In total, 250 veterans screened positive for high chronic suicide risk. Analyses revealed that veterans at high risk were lower educated and more likely to report suicidal ideation and disability in activities of daily living. They also endorsed a higher number of adverse childhood experiences and scored lower on measures of protective psychosocial characteristics and social connectedness. Relative importance analyses revealed that lower levels of perceived resilience, social support, and purpose in life accounted for the majority of the explained variance in high chronic suicide risk.

Conclusions: Results suggest that interventions to bolster these positive psychological traits may help reduce suicide risk and death by suicide in veterans.

Prim Care Companion CNS Disord 2025;27(1):24m03821.

Author affiliations are listed at the end of this article.