Healthy behaviors may help prevent suicide among veterans

Veterans returning from serving in Iraq and Afghanistan have a higher risk of suicide than the general population, and part of this risk may be tied to symptoms of post-traumatic stress disorder (PTSD). Texas A&M researchers are studying a variety of ways to treat PTSD and prevent suicide, but perhaps some of the best methods might also be the simplest: health-promoting behaviors like regular exercise, stress management and good nutrition. The team reported its findings in the journal PLOS One.

“Health promoting behaviors are promising simply because they are habits that can be modified,” Bryann B. DeBeer, PhD, a psychologist at the U.S. Department of Veterans Affairs VISN 17 Center of Excellence for the Study of Returning War Veterans and an assistant professor at the Texas A&M College of Medicine. “If these behaviors can help reduce suicidal ideation, we may be able to leverage existing health promotion programs in the service of preventing suicide,” she said. “However, further research is needed to better understand the link between health promoting behaviors and suicide prevention.”

The researchers assessed 108 American veterans of Operation Enduring Freedom and Operation Iraqi Freedom who received health care at the Central Texas Veterans Health Care System. The veterans reported the health promoting behaviors they engaged in currently, including good nutrition, physical activity, stress management, spiritual growth, interpersonal relationships and taking responsibility for one’s own health. Each veteran was also evaluated to determine their PTSD symptoms and their levels of suicidal ideation, or having suicidal thoughts, which is one of the strongest predictors of suicidal actions.

The results indicated that health promoting moderated the association between PTSD symptoms and suicidal ideation. Specifically, when PTSD symptoms were high, those who engaged in health promoting behaviors had far fewer thoughts of suicide than those who did not engaged in health promoting behaviors. Thus, these behaviors helped mitigate the usual connection between PTSD and higher suicidal ideation. “Veterans with high levels of PTSD symptoms who engaged in health promoting behaviors had similar levels of suicidal ideation as individuals with low PTSD symptoms,” DeBeer said. “In other words, health promoting behaviors may help buffer against suicide risk in individuals experiencing high PTSD symptoms.”

However, DeBeer cautions that the study used self-reported measures at one point in time, which are limitations. A future study would have to be done using an experimental method to prove that engaging in health promoting behaviors actually reduces suicidal ideation or suicidal behaviors. Studying veterans with PTSD in existing health promoting programs at the VA might help answer this question.

“I also think that suicide prevention should be the responsibility of all health care providers, not just those involved with mental health,” DeBeer said. “I think this study helps show the importance of addressing risk factors for suicide in a holistic way and employing multiple approaches to helping veterans.”