Disturbing Surge in Suicides

[Tobra]

That this is not too surprising makes it no less disturbing, quintupling of suicide rate for military since Iraq began

http://www.cnn.com/2008/US/02/01/military.suicides/index.html

[frogger]

It's very sad.

[nostatic]

we're doing our part. One of our researchers has had great success treating PTSD with immersive systems. We have modified commercial game engines to recreate scenarios allowing them to relive situations safely. Goes a long way towards getting them sorted out. Very cool stuff.

[frogger]

How does that help them? Just curious.

[legion]

Back in WWII, you used to spend two weeks on a boat with your fellow soldiers to get home. You'd discuss your shared experiences and how excited you were to see your family and friends again.

Today, you get on a plane and you are back in the U.S. in a few hours. You might be the only one who you fought with sitting on that plane. Sure, you spend two weeks on base before being released.

I think there was some value in "detoxing" with the people you fought with. Slowly leaving the war behind as the anticipation of home grew nearer...

[cool_chick]

Originally Posted by frogger

How does that help them? Just curious.

I would venture a guess it allows them to work through the trauma mentally. Phobias are treated this way as well.

[old man neri]

I wonder if these are all real attemps or might some be purposely botched attempts as a means of getting out?

[varmint]

i'd kill myself if i fell for a story presented by cnn

Researchers and the media did their best this week to scare military personnel and their families with the widely reported headline, “Military Service Doubles Suicide Risk.”

“Male veterans are twice as likely as their civilian counterparts to die by suicide,” Portland State University professor Mark Kaplan told the Atlanta Journal Constitution. “We don’t know why. But this finding may foreshadow what is going to come with the current cohort of military personnel who have served in Afghanistan and Iraq,” he added.

Published in the Journal of Epidemiology and Community Health (July 2007), Kaplan’s study consisted of 320,890 men who were followed for 12 years. As it is a statistical correlation study – rather than an investigation into whether an actual cause-and-effect relationship exists between military service and suicide – I naturally was skeptical. From the very beginning, the study didn’t disappoint me.

The study summary stated that the veterans’ suicide rate was 2.04 times that of non-veterans. When I read the study to see how the 2.04 figure was derived, I found no explanation. Mysteriously, the 2.04 figure did not even appear in the study itself – that’s pretty unusual.




I did, however, find a bar graph in the study that presented 2.13 as the difference in suicide rate between veterans and non-veterans.

You might think that this solved the mystery. A typographical or editorial foul-up must have inadvertently led to the 2.04-figure, rather than the 2.13 figure, being spotlighted in the study summary, right? We’ll get to that later. In the meantime, my discovery of the 2.13-figure only deepened the mystery.

Kaplan wrote in his study that the 2.13-figure represented the difference in suicide rates between veterans and non-veterans after statistical adjustment to account for other potential risk factors for suicide, including age, marital status, living arrangement, race, education, family income, employment status, geographic region, interval since last visit to a doctor, self-rated health and body mass index.

This list seemed impressively comprehensive and ostensibly strengthened the case for his claimed result – until, that is, I discovered that a key potential suicide risk factor apparently was omitted from his statistical adjustment.

There’s a table in Kaplan’s study in which he presents the difference in veteran suicide rates by individual risk factors, including age, race, marital status, living arrangement, education, employment status, region of residence, urban/rural locality, self-rated health, body mass index, psychiatric conditions and activity limitation.

With the exception of race, education and activity limitation, none of these risk factors were statistically significantly associated with increased suicide rates. But since race, education and activity limitation were associated with increased suicide risk, all three should have been among the potential risk factors Kaplan considered when he did his statistical adjustments to produce the 2.13-figure.

If you compare the above-mentioned lists of suicide risk factors, however, you’ll note that while activity limitation was identified as a significant risk factor for suicide, it apparently was not included in the statistical adjustment that produced the 2.13-figure.

And of the three statistically significant risk factors for suicide, activity limitation was by far the greatest – veterans with activity limitations had a 4.44 times greater rate of suicide than veterans with no activity limitations, as compared to race (3.23) and education (2.67).

Is the omission of the activity limitation factor another study typo? Was it inadvertently omitted from the statistical adjustment? Or was it omitted from the analysis because it would produce a non-result that rendered the study non-publishable and non-newsworthy?

It certainly cannot be said that Kaplan was ignorant of the significance of the activity limitation risk factor. “According to Kaplan, the risk of suicide was highest among men whose activities were limited by health problems,” reported the Atlanta Journal-Constitution.

Kaplan also published a study earlier this year entitled, “Physical illness, functional limitations and suicide risk: A population-based study” in the American Journal of Orthopsychiatry (Jan. 2007) in which he stated, “After controlling for potential [confounding risk factors], functional limitations were shown to be a significant predictor of suicide.”

When I contacted Kaplan about these issues, he immediately acknowledged that the 2.04-figure was a typo and that the 2.13-figure was correct. Interestingly, he also provided me with a dubious error bar for the 2.13 figure. When I asked him about that, another acknowledgment of error was made. These may seem like small errors, but they certainly build no confidence.

As to the crucial omission of activity limitation as a risk factor, Kaplan deferred responding, writing that he needed to consult with one of his statistician co-authors.

As of the time of this column, I had not heard back from Kaplan on that point. But you might think that a lead study author who gave many media interviews this week would be readily familiar with such a key component of his analysis. Of all the researchers I’ve interviewed over the years about their results, none has ever failed to immediately provide an answer to such a basic question.

I don’t know whether Kaplan ultimately will produce a satisfactory explanation for the activity limitation omission – the study’s remaining mystery. In some ways it doesn’t matter.

The study’s other shortcomings – particularly that veteran suicide rates weren’t higher across the vast majority of demographic groups examined, which indicates that military service itself isn’t a causative factor in suicide – are alone enough to debunk it and the scary headlines it spawned.

But the wide reporting of a paper with such major and easily discoverable problems – as well as Kaplan’s questionable effort to foment concern about suicide risk among veterans of Afghanistan and Iraq – reflects poorly on him and his co-authors, the publishing journal and the media.

Steven Milloy publishes JunkScience.com and CSRWatch.com. He is a junk science expert, and advocate of free enterprise and an adjunct scholar at the Competitive Enterprise Institute.

Respond to the Writer

[Racerbvd]

I have to go to a Memorial service at 2PM today for a good friend's son-n-law who hung himself last week. Not military, but a victim of depression

[nostatic]

Originally Posted by frogger

How does that help them? Just curious.

"The Virtual Reality (VR) Assessment and Treatment of Combat-Related Post-Traumatic Stress Disorder (PTSD) project develops immersive virtual environment applications for the treatment of Iraq War veterans diagnosed with PTSD. This project is funded as part of a larger multi-year effort by the US Office of Naval Research (ONR). The project uses a VR environment as the basis of treatment, whereby a veteran with PTSD can experience a combat-relevant scenario in a low-threat context to therapeutically process emotions and decondition the effects of the disorder."

[fintstone]

I imagine coming home after war to see your countrymen daily claim that your efforts were wasted or downright criminal...might be a bit depressing.

I suspect that blaming PTSD is a bit overdone....as this year is up over other equally stressful years of war. After 5 years away from home...I imagine a lot return to find that girlfriends, wives, and husbands have just moved on...

[BeyGon]

Originally Posted by legion

Back in WWII, you used to spend two weeks on a boat with your fellow soldiers to get home. You'd discuss your shared experiences and how excited you were to see your family and friends again.

Today, you get on a plane and you are back in the U.S. in a few hours. You might be the only one who you fought with sitting on that plane. Sure, you spend two weeks on base before being released.

I think there was some value in "detoxing" with the people you fought with. Slowly leaving the war behind as the anticipation of home grew nearer...

I got on a plane in Danang, flew, I am not sure the exact order, Middway, Guam, then Okinawa, Hawaii, and Travis AB. bussed to Treasure Island for a few days, never saw anybody I was with again,and went home. got home and out 22 December 1968. I try to have a little party that day every year.
Anyway, I don't remember any re entry program at the time. You are there, you are here. Quite a switch.
I just dug out a watch I bought in Feb. 1968 at the PX in Danang. Still works great.

[DonDavis]

I also think suicides are increasing due to a speading belief that it's "ok" to do it.
When I was a teenager, suicide was dumb.

Here's a question for the over 40 crowd. How much more often do you hear people say "I'll go out on MY terms. It's my life."? That mindset is quite often. Hunter Dumbass Thompson did it and people all over regarded him as a "hero". What a joke. IMO, he was weak and a quitter. Life got to be an "S" sandwich and he quit. It's the ultimate act of selfishness. Puts everyone close in a state of anguish and heartache.

I would guess that far more people doing it have less to do with war and more to do with "life is tough, I can't take it". Just look at the "mortgage thread". They get in an ARM and cry foul when it bites 'em in the ass. They signed paperwork telling 'em it could happen!

Oh, another thing, all those idiots doing ecstacy in the mid-late 90's are susceptible to severe depression. That drug screwed up their brain chemistry and now they don't feel emotions correctly. How many of our veterans did that prior to service?

Ugh. NOTHING is worth killing yourself.

[Mule]

I didn't know this was thread was going to be war related. I thought it was going to related to trying to make sense in a discussion with WI Widebody or Janus.

[Jim Bremner]

And with ALL of the Anti War crowd getting press in the news, I'm sure that this does not help our service men one iota.

[Tobra]

Originally Posted by old man neri

I wonder if these are all real attemps or might some be purposely botched attempts as a means of getting out?

To me this is a distinction of little value, either way they have gotten to a point where they would do themselves in, not a good place to be

Originally Posted by Mule

I didn't know this was thread was going to be war related. I thought it was going to related to trying to make sense in a discussion with WI Widebody or Janus.

now is that a very nice thing to say? Good points about the differing view of suicide and the impact of various street drugs.

I don't think I would kill myself over a CNN article, phony or not. Yes, it is manufactured BS to a large degree, but it makes for interesting discussion. It is plausible, considering the stress involved, and the depression that seems so common in developed societies.

I can't think of anything I would kill myself over, someone else maybe, but not me.

[nostatic]

well, my psychologist colleagues indicate that this is a real problem, but you guys are probably right...you likely know a lot more about the situation than they do. I'll tell them to quit wasting their time.

[Tobra]

Seems to me the stress you have been under constantly in the last 2 years will play more of a role than the Esctasy you did a couple times 15 years ago, but I don't know much psych. Probably more productive to talk about it before they eat their gun than not to talk about it at all. Talking never killed anyone.(except for a few folks that used to work for the Clintons )

There is an interesting question, which is more psychologically stressful. Taking a drug like Acid or Esctasy a few times vs being in a war zone under fire for a few years, or maybe loading burned bodies after an orphanage burned down. Nasty situations will fuch with your head pretty bad.

[fintstone]

Originally Posted by nostatic

well, my psychologist colleagues indicate that this is a real problem, but you guys are probably right...you likely know a lot more about the situation than they do. I'll tell them to quit wasting their time.

As you are well aware, no one said PTSD was not a problem...rather, the problem is blown out of proportion and the increase is sadly being used as an anti-war argument...while, I believe there have been higher peacetime suicide rates reported in the military.

Personally, I take most things reportedly said by psychologists with a grain of salt. They spend all day talking to nuts....or worse...other psychologists. When you take everything I say about military subjects as indisputable fact...I will do the same for your area of expertise.

[cool_chick]

Originally Posted by fintstone

I imagine coming home after war to see your countrymen daily claim that your efforts were wasted or downright criminal...might be a bit depressing.

Yeah man, thats it man. And wow man, it's 1968...whoa, where's the acid?