Overcoming the Fear of Lethal Injury: Evaluating Suicidal Behavior in the Military through the Lens of the Interpersonal-Psychological Theory of Suicide

摘要

Suicide rates have been increasing in military personnel since the start of Operation Enduring Freedom and Operation Iraqi Freedom, and it is vital that efforts be made to advance suicide risk assessment techniques and treatment for members of the military who may be experiencing suicidal symptoms. One potential way to advance the understanding of suicide in the military is through the use of the Interpersonal-Psychological Theory of Suicide (IPTS). This theory proposes that three factors are necessary to complete suicide: feelings that one does not belong with other people (thwarted belongingness), feelings that one is a burden on others or society (perceived burdensomeness), and an acquired capability to overcome the fear and pain associated with suicide. This review analyzes the various ways in which military service may influence suicidal behavior and integrates these findings into an overall framework with relevant implications. The findings suggest that, although there are many important factors in military suicide, the capability to commit suicide may be most influenced by military training and combat exposure, both of which can cause habituation to fear of painful experiences, including suicide. The painful and provocative situations resulting from combat may increase acquired capability and enhance one's ability to inflict lethal self-injury. Combat exposure also may result in feelings of thwarted belongingness and increased feelings of being a burden on others. When all three components are present, an individual's suicide risk is likely to be high. Suicide in the military is a complex phenomenon, but using the IPTS framework may help improve the situation for some of our nation's most valuable resources and the families of those who serve. Future research directions, ways to enhance risk assessment, and treatment implications also are discussed.