TY - JOUR
T1 - Gender differences in the development of suicidal behavior among United States military veterans
T2 - A national qualitative study
AU - Denneson, Lauren M.
AU - Tompkins, Kyla J.
AU - McDonald, Katie L.
AU - Hoffmire, Claire A.
AU - Britton, Peter C.
AU - Carlson, Kathleen F.
AU - Smolenski, Derek J.
AU - Dobscha, Steven K.
N1 - Funding Information:
This material is based upon work supported by the United States Department of Veterans Affairs, Veterans Health Administration, and VA Health Services Research & Development project IIR17-131. Dr. Denneson is a core investigator at the VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC). We gratefully acknowledge Shelley Varner Perez, MDiv, MPH for her contributions during the analysis phase of this study and are grateful for the participation of the women and men who agreed to be interviewed for this study. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or United States government.
Funding Information:
This material is based upon work supported by the United States Department of Veterans Affairs , Veterans Health Administration, and VA Health Services Research & Development project IIR17-131. Dr. Denneson is a core investigator at the VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC). We gratefully acknowledge Shelley Varner Perez, MDiv, MPH for her contributions during the analysis phase of this study and are grateful for the participation of the women and men who agreed to be interviewed for this study. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or United States government.
Publisher Copyright:
© 2020
PY - 2020/9
Y1 - 2020/9
N2 - Rationale: The rate of suicide mortality among women is increasing in the United States (U.S.), especially among military veterans. Prior research suggests that important gender differences in suicide risk exist, but not enough is known to tailor prevention approaches by gender. Objective: The goal of this study is to understand gender differences in the development of suicidal behaviors (suicide risk) among U.S. veterans to inform future research and gender-tailored prevention efforts. Methods: Using a modified grounded theory approach, this qualitative study interviewed 50 (25 men, 25 women) U.S. veterans who had made a recent (prior 6 months) suicide attempt. Veterans were recruited from Veterans Health Administration (VHA) healthcare facilities across the U.S. Semi-structured, hour-long interviews examined participants' experiences with military service, suicidal thoughts and attempts, and healthcare following their attempt. Results: The analysis revealed two gendered narratives of suicidal thoughts and attempts that incorporated the primary themes of self-concept, social power, relationships, coping, and stress. When discussing reasons for their suicide attempts, women discussed negative self-evaluative processes describing themselves as, “shameful,” “tainted,” and “worthless,” whereas men discussed becoming overwhelmed, and recalled thinking, “it just wasn't worth it,” “I've had enough,” and, “screw this.” Conclusions: This study provides an in-depth, nuanced understanding of the gender differences in suicide risk among veterans and suggests several ways in which future work may address gender-tailored suicide prevention efforts. Specifically, women veterans may benefit from methods to increase self-worth through positive social relationships, while men veterans may benefit from methods that increase their sense of purpose in life and help them achieve their ideal selves through successful experiences.
AB - Rationale: The rate of suicide mortality among women is increasing in the United States (U.S.), especially among military veterans. Prior research suggests that important gender differences in suicide risk exist, but not enough is known to tailor prevention approaches by gender. Objective: The goal of this study is to understand gender differences in the development of suicidal behaviors (suicide risk) among U.S. veterans to inform future research and gender-tailored prevention efforts. Methods: Using a modified grounded theory approach, this qualitative study interviewed 50 (25 men, 25 women) U.S. veterans who had made a recent (prior 6 months) suicide attempt. Veterans were recruited from Veterans Health Administration (VHA) healthcare facilities across the U.S. Semi-structured, hour-long interviews examined participants' experiences with military service, suicidal thoughts and attempts, and healthcare following their attempt. Results: The analysis revealed two gendered narratives of suicidal thoughts and attempts that incorporated the primary themes of self-concept, social power, relationships, coping, and stress. When discussing reasons for their suicide attempts, women discussed negative self-evaluative processes describing themselves as, “shameful,” “tainted,” and “worthless,” whereas men discussed becoming overwhelmed, and recalled thinking, “it just wasn't worth it,” “I've had enough,” and, “screw this.” Conclusions: This study provides an in-depth, nuanced understanding of the gender differences in suicide risk among veterans and suggests several ways in which future work may address gender-tailored suicide prevention efforts. Specifically, women veterans may benefit from methods to increase self-worth through positive social relationships, while men veterans may benefit from methods that increase their sense of purpose in life and help them achieve their ideal selves through successful experiences.
KW - Gender
KW - Military veterans
KW - Psychosocial risk
KW - Qualitative methods
KW - Suicide prevention
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U2 - 10.1016/j.socscimed.2020.113178
DO - 10.1016/j.socscimed.2020.113178
M3 - Article
C2 - 32682205
AN - SCOPUS:85087983116
SN - 0277-9536
VL - 260
JO - Ethics in Science and Medicine
JF - Ethics in Science and Medicine
M1 - 113178
ER -