Symposia
Suicide and Self-Injury
Catherine L. Dempsey, M.P.H., Ph.D.
Research Assistant Professor
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Catherine L. Dempsey, M.P.H., Ph.D.
Research Assistant Professor
Uniformed Services University of the Health Sciences
Bethesda, Maryland
David Benedek, M.D.
Professor & Chair, Department of Psychiatry
Uniformed Services University
Bethesda, Maryland
Matthew Nock, Ph.D.
Professor
Harvard University
Cambridge, Massachusetts
James West, MD
Associate Professor
Center For The Study Of Traumatic Stress, Uniformed Services University of the Health Sciences
Bethesda, Maryland
Kelly L. Zuromski, Ph.D.
Postdoctoral Fellow
Harvard University
Cambridge, Massachusetts
Matthew Georg, MPH
Data Analyst
Center For The Study Of Traumatic Stress, Contracted By: Henry M. Jackson Foundation
Bethesda, Maryland
Jingning Ao, M.P.H.
Data Analyst, Center for the Study of Traumatic Stress
Uniformed Services University
Bethesda, Maryland
Robert Bossarte, Ph.D.
Professor
University of South florida
Tampa, Florida
Robert Ursano, M.D.
Professor, Center for The Study Of Traumatic Stress
Uniformed Services University
Bethesda, Maryland
Background: In the US, firearms are the most common method of suicide. Veterans bear a disproportionate share of this burden, representing over 69.4% of suicide deaths by firearms. Unsafe storage practices have previously been linked to suicide deaths. Given that veterans are more likely than civilians to own firearms, there is an unmet need to elucidate the relationship between firearm use and suicide, to identify potential suicide prevention strategies.
Methods: We examined a subset of gun owners (n = 31 suicide decedent cases and n = 92 controls) from the Army STARRS psychological autopsy study (the Soldiers Health Outcomes Study [SHOS-B]) using a mixed methods approach consisting of qualitative and quantitative analyses. We used a conventional content analytic approach to analyze the text responses and created a qualitative codebook. We coded 123 responses using this codebook and generated descriptive statistics. Subsequent quantitative analyses of text responses consisted of logistic regression analyses to examine predictors of safe storage practices. Coefficients were exponentiated in logistic models to create ORs with 95% CIs.
Results: Safety and protection was the primary reason for gun ownership as reported by family members of suicide decedents (n = 18, 57.77%); followed by sports and recreation (n = 11, 36.31%), familiarity (military or family) (n = 4, 16.35 %), for work (n= 3, 8.88 %), collector/memento (n = 2, 5.92%), laws/rights (n = 1, 2.96%), and other (n = 2, 5.92%). Soldiers who reported to own guns for safety/protection were more likely to store their guns unsafely (OR = 3.8, 95% CI, 1.7-8.8, P=0.0017).
Conclusion: Safety and protection is the principal reason for ownership and an actionable target for intervention. It is important to note that even if ownership for safety does not turn out to predict greater risk of suicide, the fact that it is the most common reason for ownership means it may be a viable target for intervention. Future research is needed to further understand the motivations for gun ownership and the perceptions of safe storage.