Parental well-being predicts post-9/11 veterans’ suicidal ideation during the transition from military service to civilian life
摘要
Military veterans are at elevated risk for suicide, with rates particularly high during the reintegration period following discharge from service. Research has revealed that women veterans’ parental well-being is associated with their experiences of suicidal ideation. However, there is limited research on this topic among men veterans and specific to the reintegration period, despite evidence that veterans’ readjustment in other life domains impacts their risk for suicidal ideation. The bi-directional relationship between US veterans’ parental well-being (i.e., functioning and satisfaction) and suicidal ideation during the first two years following military separation was evaluated using data from a population-based, longitudinal, post-9/11 U.S. veteran cohort study (N = 4583). Data for the current study were collected between 2016 and 2018. Logistic regressions were used to evaluate the cross-sectional associations between parenting experiences and suicidal ideation at 9- and 21-months post-separation. To examine the reciprocal, longitudinal relations between parenting and suicidal ideation in the total sample, cross-lagged panels models were fit. Separate structural equation models examined four mental health conditions as potential mediators of these relationships: depression, anxiety, PTSD, and alcohol misuse. Finally, gender differences in cross-sectional relationships were explored via stratified logistic regressions. Covariates considered across models included gender, age at separation, race/ethnicity, type of separation, relationship status, and education level. Approximately 12–13% of veterans reported poor parenting satisfaction and/or functioning at both timepoints, with prevalence higher among men than women. The odds of endorsing suicidal ideation were higher among veterans reporting poorer parental functioning and satisfaction at both time points; exploratory analyses suggested these relationships may be stronger among men. Moreover, longitudinal analyses revealed a bidirectional relationship between suicidal ideation and parenting satisfaction and functioning, with the effect of parental well-being on suicidal ideation larger than the effect of suicidal ideation on parental well-being. Finally, all four mental health conditions partially mediated these associations. Depression was the strongest mediator, explaining 50% of the effect of parenting satisfaction on suicidal ideation and 41% of the total effect of parental functioning on suicidal ideation. Findings for PTSD and anxiety were similar, whereas alcohol misuse minimally mediated both relationships (3%). Reintegration into civilian life following military separation introduces challenges across many life domains, including parenting. Findings indicate a robust, bidirectional relationship of parenting satisfaction and functioning with suicidal ideation during this high-risk time, highlighting the importance of addressing parental well-being as part of comprehensive suicide risk management among reintegrating veterans.