Andrew Anglemyer, PhD; Matthew L. Miller, MS; Samuel Buttrey, PhD; Lyn Whitaker, PhD
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2785.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol, statistical code, and data set: Available from Dr. Anglemyer (e-mail, email@example.com).
Requests for Single Reprints: Andrew Anglemyer, PhD, Operations Research Department, U.S. Naval Postgraduate School, 1411 Cunningham Road, G-239, Monterey, CA 93943; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Anglemyer, Buttrey, and Whitaker and Mr. Miller: Operations Research Department, U.S. Naval Postgraduate School, 1411 Cunningham Road, G-239, Monterey, CA 93943.
Author Contributions: Conception and design: A. Anglemyer, M. Miller.
Analysis and interpretation of the data: A. Anglemyer, M. Miller, S. Buttrey, L. Whitaker.
Drafting of the article: A. Anglemyer, M. Miller, S. Buttrey.
Critical revision for important intellectual content: A. Anglemyer, S. Buttrey.
Final approval of the article: A. Anglemyer, M. Miller, S. Buttrey, L. Whitaker.
Statistical expertise: M. Miller, S. Buttrey, L. Whitaker.
Administrative, technical, or logistic support: A. Anglemyer.
Collection and assembly of data: M. Miller, S. Buttrey.
Suicide prevention programs have become ubiquitous among military units; identifying temporal trends and nonclinical factors associated with the chosen suicide methods may help improve suicide prevention strategies.
To calculate suicide rates of active duty military personnel and identify those who are at risk for firearm-specific suicide.
Retrospective cohort study.
Military units in the United States.
All active duty enlisted U.S. military personnel from 2005 to 2011.
Suicide rates per 100 000 were calculated for each branch. Adjusted odds ratios for firearm-specific suicide were calculated with 95% CIs.
1455 military personnel committed suicide from 2005 to 2011. From 2006 to 2011, the rates were highest among army personnel (19.13 to 29.44 cases per 100 000). Among suicides with a known cause of death, 62% were attributed to firearms. The results of this study also suggest that among army personnel or marines who committed suicide, those with infantry or special operations job classifications were more likely than those in noninfantry positions to use a firearm.
Results are generalizable only to enlisted personnel and reflect only stateside suicides. Data regarding previous psychiatric illness, deployment history, and firearms ownership were lacking.
These results may help inform policymakers and advisors about differences in risks of suicide and violent suicide among the armed services and may help guide efforts to prevent self-harm within the military.
Directed acyclic graph evaluating the relationship between branch of service and firearm-specific suicide and potential confounders.
AFQT = Armed Forces Qualification Test; ops = operations.
Appendix Table 1. Selected Variables and Percentage With a Missing Cause of Suicide
Suicide rates per 100 000 persons (2005 to 2011), by branch of service.
Table 1. Suicide Rates per 100 000 Persons for Active Duty, Regular Component Enlisted Personnel*
Table 2. Characteristics of Suicides Among Active Duty Military Personnel, 2005–2011*
Table 3. Adjusted Odds Ratios of Firearm-Specific Suicide Among Men*
Appendix Table 2. Complete Case Analysis of Firearm-Specific Suicide Among Men*
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Anglemyer A, Miller ML, Buttrey S, Whitaker L. Suicide Rates and Methods in Active Duty Military Personnel, 2005 to 2011: A Cohort Study. Ann Intern Med. [Epub ahead of print 7 June 2016]165:167–174. doi: 10.7326/M15-2785
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Published: Ann Intern Med. 2016;165(3):167-174.
Published at www.annals.org on 7 June 2016
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