Suicide Risk and Prevention in Military Families: Data from the after Deployment, Adaptive Parenting Tools Effectiveness Trial

Highly publicized and alarming data have highlighted the risk for suicide among military personnel and veterans. Military suicide rates almost doubled between 2001 and 2009, and rates remain high among veterans – in 2010 alone, 15,000 suicide attempts were reported by this population.  Among the troops of the National Guard, Minnesota has the highest suicide rate in the country. Nonetheless, there have been few, if any, investigations to examine whether family-based prevention programs might reduce the risk of suicidal behaviors among Reserve military personnel (members of the National Guard and Reserve/NGR) or veterans. Modifiable risk factors for suicidal behavior include anxiety and depression symptoms, other psychiatric and physical problems, and social isolation (Bertolote, 2004). In this presentation we report baseline risk and outcome data on suicide risk behaviors from a randomized controlled trial of a parenting program for NGR families in Minnesota. Families (N=336) with at least one parent deployed to the recent conflicts in Iraq and Afghanistan, and a child between 5-12, were randomly assigned to a 14-week group based, web-enhanced parenting program.  The program, After Deployment, Adaptive Parenting Tools/ADAPT, is a modification of Parent Management Training-Oregon (PMTO) model, with an enhanced focus on strengthening parents’ emotion regulation skills. Prior PMTO data from a civilian single mother sample documented reductions in maternal depression symptoms as an outcome of the parenting program (Patterson, Forgatch & DeGarmo, 2010).  In this presentation, we report baseline suicide risk among military parents and civilian spouses/co-parents (N=608) via scores on self-report measures of depression and related risk behaviors (substance use, PTSD symptoms, physical injury). Using intent-to-treat analyses, we examined whether the program had significant effects on parents’ depression symptoms. At post-intervention follow-up, 12 months post baseline, both mothers and fathers in the intervention group reported significant reductions in depression symptoms compared to the control group; the direct effect was particularly pronounced for deployed fathers. We also report baseline risk by treatment interactions. Results are discussed in terms of the promise of group-based family prevention programs to modify key risk behaviors for suicide in the military, including social isolation, hopelessness, and psychiatric symptoms.