Suicide and Self-Injury
Characteristics of suicide attempts associated with lethality and method: A latent class analysis of the Military Suicide Research Consortium
Molly A. Gromatsky, Ph.D.
Advanced Postdoctoral Fellow
US Department of Veterans Affairs
Huntington, New York
Emily R. Edwards, Ph.D.
Assistant Director, TASC Research & Clinical Care
US Department of Veterans Affairs
The Bronx, New York
Sarah R. Sullivan, M.S.
Graduate Student Researcher
Hunter College, City University of New York
Bronx, New York
Caspar J. Van Lissa, Ph.D.
Assistant Professor
University of Utrecht
Utrecht, Utrecht, Netherlands
Robert Lane, Ph.D.
Associated Health Fellow
VISN 2 MIRECC of NY and NJ
PLAINVIEW, New York
Angela Page Spears, B.S.
Graduate Student
Columbia University
New York, New York
Emily L. Mitchell, PhD
Clinical Research Coordinator
James J. Peters VA Medical Center
Bronx, New York
Michael F. Armey, Ph.D.
Associate Professor of Psychiatry and Human Behavior
Brown University & Butler Hospital
Providence, Rhode Island
Ricardo Cáceda, M.D., Ph.D.
Associate Professor
Stony Brook University
Northport, New York
Marianne Goodman, M.D.
Associate Director, VISN-2 MIRECC
US Department of Veterans Affairs
The Bronx, New York
While suicide prevention is a national priority, particularly among service members and veterans (SMVs), understanding of suicide-related outcomes remains poor. Person-centered approaches (e.g., latent class analysis) have promise to identify unique risk profiles and subgroups in the larger population. The current study identified latent subgroups characterized by prior self-directed violence history and proximal risk factors for suicide among suicide attempt survivors, and compared subgroups on demographics and most-lethal attempt characteristics. Participants included civilians and SMVs reporting lifetime suicide attempt(s) (n=2,643) from the Military Suicide Research Consortium. Two classes emerged from Common Data Elements: suicide attempt and non-suicidal self-injury frequency, suicide attempt method, perceived likelihood of future suicide, suicide disclosure, suicide intent, and perceived and actual lethality of attempt. A Higher-Risk History class was characterized by greater intent to die, certainty about attempt fatality and method lethality, belief injury would be medically unfixable, and likelihood of prior non-suicidal self-injury. A Lower-Risk History class was characterized by greater ambivalence toward death and methods. Higher-Risk class members were more likely to be male, older, SMVs, have less formal education, use firearms as most-lethal attempt method, and require a higher degree of medical attention. Lower-Risk class members were more likely to be female, civilian, use cutting as most-lethal attempt method, and require less medical attention for attempts. Findings have implications for risk assessments and highlight the importance of subjective perceptions about suicidal behavior. Further investigation of real-time individual-level is necessary, especially for SMVs who may be at greatest risk for potentially lethal suicidal behavior.