Associations Among Mental Health Symptom Severity, Loneliness, and Suicidal Thoughts and Behaviors in the Army...

There is ample research on the associations between mental health symptom severity, loneliness, and suicidal thoughts and behaviors (STB) in military veteran samples, yet research in National Guard members is sparse. National Guard members have part-time service roles differing from the full-time roles of active duty service members, with implications for access to military health and behavioral health services. Although Guard members exhibit similar stressors and suicide risk factors to active duty service members, Guard members have less consistent access to military mental health services. To improve understanding of the relationships among loneliness, mental health symptom severity, and STB among Army National Guard (ARNG) members, we tested associations between mental health symptom severity, loneliness, and STB in a population-based sample of ARNG members.

Multiple regression models examined associations between STB severity and posttraumatic stress disorder (PTSD) symptom severity, depression symptom severity, alcohol misuse severity, and loneliness severity in N = 1,991 ARNG members. Interactions between mental health symptom severity and loneliness on STB were also tested. The University of Kentucky Institutional Review Board (IRB) approved the survey and procedures.

Depression symptom severity had the strongest association with STB (β = .358) followed by loneliness (β = .224), and alcohol misuse (β = .075) but not PTSD; all associations held with adjustment for covariates. Significant interactions between loneliness and symptom severity of depression (β = .198), PTSD (β = .113), and alcohol misuse (β =.085) on STB were observed.

Associations between mental health symptom severity and STB in this ARNG sample are similar to findings in active duty military and veteran samples. Loneliness independently and in interaction with other mental health symptoms influences STB. Screening and intervention targeting loneliness may enhance suicide prevention efforts in ARNG. The large population-based sample is a study strength, yet its composition is predominantly male and White race, limiting generalizability of findings to women and different racial and ethnic groups. Future studies should investigate potential preventive benefits of integrating brief loneliness screeners into routine military behavioral health along with implementation of evidence-based approaches to address loneliness in ARNG.