The relationship between military identity, substance use, and suicide risk in combat Veterans

Experiencing combat-related trauma can contribute to the development of conditions like posttraumatic stress disorder (PTSD) and depression, often leading some veterans to misuse substances as a coping mechanism. In turn, substance use exacerbates mental health issues and increases the risk for suicidal thoughts and behaviors. Military identity, a unique set of values, culture, and camaraderie within the Armed Forces, is hypothesized to further shape these relationships. Using data from 1,459 U.S. military Veterans, we examined whether three dimensions of military identity - idealism, professionalism, and individualism - moderated the associations between combat exposure, substance use, and suicide risk. Following a confirmatory factor analysis of military identity, logistic and multiple linear regression models were conducted to examine the moderating effects of each military identity domain on substance use and suicide risk, respectively. Our results revealed that strong idealism buffered the associations between combat exposure and both substance use and suicide risk, whereas higher levels of professionalism were associated with a weaker relationship between combat exposure and substance use but were not significantly related to suicide risk. Conversely, a highly individualistic military identity strengthened the association between combat exposure and substance use. These findings suggest that strengthening protective aspects of military identity through targeted interventions may enhance active-duty military members' and combat Veterans' overall well-being and reduce substance use and suicide risk.