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Hopelessness and Suicidal Ideation in Iraq and Afghanistan War Veterans Reporting Subthreshold and Threshold Posttraumatic Stress Disorder

Jakupcak, Matthew PhD*†; Hoerster, Katherine D. PhD, MS*†; Varra, Alethea PhD*†; Vannoy, Steven PhD, MPH; Felker, Bradford MD*; Hunt, Stephen MD, MPH*

The Journal of Nervous and Mental Disease: April 2011 - Volume 199 - Issue 4 - p 272-275
doi: 10.1097/NMD.0b013e3182124604
Brief Reports

We examined hopelessness and suicidal ideation in association with subthreshold and threshold posttraumatic stress disorder (PTSD) in a sample of Iraq and Afghanistan War Veterans (U.S., N = 275) assessed within a specialty VA postdeployment health clinic. Veterans completed paper-and-pencil questionnaires at intake. The military version of the PTSD Checklist was used to determine PTSD levels (No PTSD; subthreshold PTSD; PTSD), and endorsement of hopelessness or suicidal ideation were used as markers of elevated suicide risk. Veterans were also asked if they received mental health treatment in the prior 6 months. Veterans reporting subthreshold PTSD were 3 times more likely to endorse these markers of elevated suicide risk relative to the Veterans without PTSD. We found no significant differences in likelihood of endorsing hopelessness or suicidal ideation comparing subthreshold and threshold PTSD groups, although the subthreshold PTSD group was less likely to report prior mental health treatment. Clinicians should be attentive to suicide risk in returned Veterans reporting both subthreshold and threshold PTSD.

*VA Puget Sound Health Care System, VISN-20 Northwest Mental Illness Research, Education, and Clinical Center, Seattle, WA; and †Department of Psychiatry and Behavioral Medicine, University of Washington, Seattle, WA.

Send reprint requests to Matthew Jakupcak (S-116), Deployment Health Clinic, VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.