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Interplay of combat deployment harassment, testosterone concentrations and post-deployment suicide risk in male veterans

Published online by Cambridge University Press:  26 March 2024

Leo Sher*
Affiliation:
James J. Peters VA Medical Center, New York, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
Linda M. Bierer
Affiliation:
James J. Peters VA Medical Center, New York, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
Janine Flory
Affiliation:
James J. Peters VA Medical Center, New York, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
Iouri Makotkine
Affiliation:
James J. Peters VA Medical Center, New York, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
Rachel Yehuda
Affiliation:
James J. Peters VA Medical Center, New York, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
*
Corresponding author: Leo Sher; Email: Leo.Sher@mssm.edu

Abstract

Objective:

Many combat veterans exhibit suicidal ideation and behaviour, but the relationships among experiences occurring during combat deployment and suicidality are still not fully understood. In this study, we tested the hypothesis that harassment during a combat deployment is associated with post-deployment suicidality and testosterone function.

Methods:

Male combat veterans who made post-deployment suicide attempts and demographically matched veterans without a history of suicide attempts were enrolled in the study. Demographic and clinical parameters of study participants were assessed and recorded. Study participants were interviewed by a trained clinician using the Mini-International Neuropsychiatric Interview (MINI), the Deployment Risk and Resilience Inventory (DRRI) – Relationships within unit scale, the Scale for Suicidal Ideation (SSI), and the Brown–Goodwin Aggression Scale. Free testosterone levels were assessed in morning blood samples.

Results:

DRRI harassment scores were higher and free testosterone levels were lower among suicide attempters in comparison with non-attempters. In the whole sample, DRRI harassment scores positively correlated with SSI scores and negatively correlated with free testosterone levels. Free testosterone levels negatively correlated with SSI scores. Aggression scale scores positively correlated with DRRI harassment scores among non-attempters but not among attempters.

Conclusion:

Our observations that harassment scores are associated with suicidality and testosterone levels, and suicidality is associated with testosterone levels may indicate that there is a link between deployment harassment, testosterone function and suicidality.

Type
Original Article
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology

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References

Beck, AT, Kovacs, M and Weissman, A (1979) Assessment of suicidal intention: the scale for suicide ideation. Journal of Consulting and Clinical Psychology 47(2), 343352.CrossRefGoogle ScholarPubMed
Brown, GL and Goodwin, FK (1986) Human aggression and suicide. Suicide and Life-Threatening Behavior 16(2), 223243.CrossRefGoogle ScholarPubMed
Bullman, T and Schneiderman, A (2021) Risk of suicide among U.S. veterans who deployed as part of operation enduring freedom, operation Iraqi freedom, and operation new dawn. Injury Epidemiology 8(1), 40.CrossRefGoogle ScholarPubMed
Campbell-Sills, L, Sun, X, Kessler, RC, Ursano, RJ, Jain, S and Stein, MB (2023) Exposure to bullying or hazing during deployment and mental health outcomes among US Army soldiers. JAMA Network Open 6(1), e2252109. DOI: 10.1001/jamanetworkopen.2022.52109.CrossRefGoogle ScholarPubMed
Carre, JM and Archer, J (2018) Testosterone and human behavior: the role of individual and contextual variables. Current Opinion in Psychology 19, 149153.CrossRefGoogle ScholarPubMed
Cigrang, JA, Balderrama-Durbin, C, Snyder, DK, Talcott, GW, Tatum, J, Baker, M, Cassidy, D, Sonnek, S, Smith Slep, AM and Heyman, RE (2015) Predictors of suicidal ideation across deployment: a prospective study. Journal of Clinical Psychology 71(9), 828842.CrossRefGoogle ScholarPubMed
Denneson, LM, Teo, AR, Ganzini, L, Helmer, DA, Bair, MJ and Dobscha, SK (2015) Military veterans’ experiences with suicidal ideation: implications for intervention and prevention. Suicide and Life-Threatening Behavior 45(4), 399414.CrossRefGoogle ScholarPubMed
Department of Veterans Affairs (2022) Office of Mental Health and Suicide Prevention, 2022 National Veteran Suicide Prevention Annual Report. September 2022 Available at https://www.mentalhealth.va.gov/suicide_prevention/data.asp.Google Scholar
Dreher, JC, Dunne, S, Pazderska, A, Frodl, T, Nolan, JJ and O’Doherty, JP (2016) Testosterone causes both prosocial and antisocial status-enhancing behaviors in human males. Proceedings of the National Academy of Sciences of the USA 13(41), 1163311638. DOI: 10.1073/pnas.1608085113. Epub 2016-09-26.CrossRefGoogle Scholar
Ejdesgaard, BA, Zøllner, L, Jensen, BF, Jørgensen, HO and Kähler, H (2015) Risk and protective factors for suicidal ideation and suicide attempts among deployed Danish soldiers from 1990 to 2009. Military Medicine 180(1), 6167.CrossRefGoogle ScholarPubMed
Elman, I, Borsook, D and Volkow, ND (2013) Pain and suicidality: insights from reward and addiction neuroscience. Progress in Neurobiology 109, 127. DOI: 10.1016/j.pneurobio.2013.06.003. Epub 2013-07-01.CrossRefGoogle ScholarPubMed
Gilberd, K (2018) New military policy on harassment. Military Law Task Force https://nlgmltf.org/military-law/2018/new-military-policy-on-harassment/ Google Scholar
Griffith, J (2019) The sexual harassment-suicide connection in the U.S. Military: contextual effects of hostile work environment and trusted unit leaders. Suicide and Life-Threatening Behavior 49(1), 4153.CrossRefGoogle ScholarPubMed
Hom, MA, Stanley, IH, Spencer-Thomas, S and Joiner, TE (2017) Women firefighters and workplace harassment: associated suicidality and mental health sequelae. Journal of Nervous and Mental Disease 205(12), 910917.CrossRefGoogle ScholarPubMed
Hutschemaekers, MHM, de Kleine, RA, Davis, ML, Kampman, M, Smits, JAJ and Roelofs, K (2020) Endogenous testosterone levels are predictive of symptom reduction with exposure therapy in social anxiety disorder. Psychoneuroendocrinology 115, 104612.CrossRefGoogle ScholarPubMed
Inoue, Y, Burriss, RP, Hasegawa, T and Kiyonari, T (2023) Testosterone promotes dominance behaviors in the ultimatum game after players’ status increases. Scientific Reports 13(1), 18029. DOI: 10.1038/s41598-023-45247-4.CrossRefGoogle ScholarPubMed
Kang, HK and Bullman, TA (2008) Risk of suicide among US veterans after returning from the Iraq or Afghanistan war zones. JAMA 300(6), 652653.Google ScholarPubMed
King, LA, King, DW, Vogt, DS, Knight, JA and Samper, R (2006) Deployment risk and resilience inventory: a collection of measures for studying deployment-related experiences of military personnel and veterans. Military Psychology 18(2), 89120.CrossRefGoogle Scholar
Lemaire, CM and Graham, DP (2011) Factors associated with suicidal ideation in OEF/OIF veterans. Journal of Affective Disorders 130(1-2), 231238.CrossRefGoogle ScholarPubMed
Livingston, WS, Tannahill, HS, Meter, DJ, Fargo, JD and Blais, RK (2022) The association of military sexual harassment/assault with suicide ideation, plans, attempts, and mortality among US service members/veterans:A meta-analysis. Trauma Violence & Abuse 24(4), 26162629.CrossRefGoogle ScholarPubMed
Mazur, A and Booth, A (1998) Testosterone and dominance in men. Behavioral and Brain Sciences 21(3), 353363.CrossRefGoogle ScholarPubMed
Mehta, PH and Beer, J (2010) Neural mechanisms of the testosterone-aggression relation: the role of orbitofrontal cortex. Journal of Cognitive Neuroscience 22(10), 23572368.CrossRefGoogle ScholarPubMed
Mitchell, KJ, Jones, LM and Turner, HA (2021) Past year technology-involved peer harassment victimization and recent depressive symptoms and suicide ideation among a National sample of youth. Journal of Interpersonal Violence 36(3–4), NP1165–1179NP. DOI: 10.1177/0886260517748413.CrossRefGoogle ScholarPubMed
Monteith, LL, Hoffmire, CA, Holliday, R, Park, CL, Mazure, CM and Hoff, RA (2018) Do unit and post-deployment social support influence the association between deployment sexual trauma and suicidal ideation? Psychiatry Research 270, 673681.CrossRefGoogle ScholarPubMed
Pietrzak, RH, Goldstein, MB, Malley, JC, Rivers, AJ, Johnson, DC and Southwick, SM (2010) Risk and protective factors associated with suicidal ideation in veterans of operations enduring freedom and Iraqi freedom. Journal of Affective Disorders 123(1-3), 102107.CrossRefGoogle ScholarPubMed
Reger, MA, Tucker, RP, Carter, SP and Ammerman, BA (2018) Military deployments and suicide: a critical examination. Perspectives on Psychological Science 13(6), 688699.CrossRefGoogle ScholarPubMed
Rihmer, Z and Gonda, X (2012) Predisposition for self-destruction? Affective temperaments as a suicide risk factor in patients with mood disorders. Crisis 33(6), 309312. DOI: 10.1027/0227-5910/a000192.CrossRefGoogle ScholarPubMed
Sachs-Ericsson, N, Hames, JL, Joiner, TE, Corsentino, E, Rushing, NC, Palmer, E, Gotlib, IH, Selby, EA, Zarit, S and Steffens, DC (2014) Differences between suicide attempters and nonattempters in depressed older patients: depression severity, white-matter lesions, and cognitive functioning. The American Journal of Geriatric Psychiatry 22(1), 7585.CrossRefGoogle ScholarPubMed
Schoenbaum, M, Kessler, RC, Gilman, SE, Colpe, LJ, Heeringa, SG, Stein, MB, Ursano, RJ, Cox, KL and Army STARRS Collaborators (2014) Predictors of suicide and accident death in the army study to assess risk and resilience in servicemembers (Army STARRS): results from the army study to assess risk and resilience in servicemembers (Army STARRS). JAMA Psychiatry 71(5), 493503.CrossRefGoogle ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R and Dunbar, GC (1998) The mini-international neuropsychiatric interview (M.I.N.I.): development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59(Suppl 20), 2233.Google ScholarPubMed
Shen, YC, Cunha, JM and Williams, TV (2016) Time-varying associations of suicide with deployments, mental health conditions, and stressful life events among current and former US military personnel: a retrospective multivariate analysis. Lancet Psychiatry 3(11), 10391048.CrossRefGoogle ScholarPubMed
Sher, L (2023) Testosterone and suicidal behavior in bipolar disorder. International Journal of Environmental Research and Public Health 20(3), 2502.CrossRefGoogle ScholarPubMed
Sher, L (2024) The uncounted casualties of war: suicide in combat veterans. QJM: An International Journal of Medicine 117(3), 163–167. DOI: 10.1093/qjmed/hcad240. Epub ahead of print.CrossRefGoogle ScholarPubMed
Sher, L, Bierer, LM, Flory, J, Makotkine, I and Yehuda, R (2020) Neuropeptide Y plasma levels and suicidal behavior in combat veterans. European Neuropsychopharmacology 40, 3137.CrossRefGoogle ScholarPubMed
Sher, L, Bierer, LM, Makotkine, I and Yehuda, R (2021) The effect of oral dexamethasone administration on testosterone levels in combat veterans with or without a history of suicide attempt. Journal of Psychiatric Research 143, 499503. DOI: 10.1016/j.jpsychires.2020.11.034. Epub 2020-11-20.CrossRefGoogle ScholarPubMed
Sher, L and Yehuda, R (2011) Preventing suicide among returning combat veterans: a moral imperative. Military Medicine 176(6), 601602.CrossRefGoogle ScholarPubMed
Terburg, D, Syal, S, Rosenberger, LA, Heany, SJ, Stein, DJ and Honk, Jv (2016) Testosterone abolishes implicit subordination in social anxiety. Psychoneuroendocrinology 72, 205211.CrossRefGoogle ScholarPubMed
Thomas, S, Hummel, KV, Schäfer, J, Wittchen, HU and Trautmann, S (2023) Harassment and its association with depressive symptoms and suicidal behavior: the role of perceived stigma and nondisclosure. Psychological Services 20(1), 8493.CrossRefGoogle ScholarPubMed
van Heeringen, K and Mann, JJ (2014) The neurobiology of suicide. Lancet Psychiatry 1(1), 6372. DOI: 10.1016/S2215-0366(14)70220-2. Epub 2014-06-04.CrossRefGoogle ScholarPubMed
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