Phenotypes of caregiver distress in military and veteran caregivers: Suicidal ideation associations

PLoS One. 2021 Jun 11;16(6):e0253207. doi: 10.1371/journal.pone.0253207. eCollection 2021.

Abstract

The United States (US) has been at war for almost two decades, resulting in a high prevalence of injuries and illnesses in service members and veterans. Family members and friends are frequently becoming the caregivers of service members and veterans who require long-term assistance for their medical conditions. There is a significant body of research regarding the physical, emotional, and social toll of caregiving and the associated adverse health-related outcomes. Despite strong evidence of the emotional toll and associated mental health conditions in family caregivers, the literature regarding suicidal ideation among family caregivers is scarce and even less is known about suicidal ideation in military caregivers. This study sought to identify clusters of characteristics and health factors (phenotypes) associated with suicidal ideation in a sample of military caregivers using a cross-sectional, web-based survey. Measures included the context of caregiving, physical, emotional, social health, and health history of caregivers. Military caregivers in this sample (n = 458) were mostly young adults (M = 39.8, SD = 9.9), caring for complex medical conditions for five or more years. They reported high symptomology on measures of pain, depression, and stress. Many (39%) experienced interruptions in their education and 23.6% reported suicidal ideation since becoming a caregiver. General latent variable analyses revealed three distinct classes or phenotypes (low, medium, high) associated with suicidality. Individuals in the high suicidality phenotype were significantly more likely to have interrupted their education due to caregiving and live closer (within 25 miles) to a VA medical center. This study indicates that interruption of life events, loss of self, and caring for a veteran with mental health conditions/suicidality are significant predictors of suicidality in military caregivers. Future research should examine caregiver life experiences in more detail to determine the feasibility of developing effective interventions to mitigate suicide-related risk for military caregivers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Caregivers / psychology*
  • Caregivers / statistics & numerical data
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Military Personnel* / statistics & numerical data
  • Phenotype
  • Quality of Life
  • Risk Factors
  • Stress, Psychological / epidemiology
  • Stress, Psychological / etiology*
  • Stress, Psychological / psychology
  • Suicidal Ideation*
  • Surveys and Questionnaires
  • Veterans* / statistics & numerical data

Grants and funding

RED This project was supported with a pilot grant awarded by the Center for Research to Advance Community Health (ReACH) at The University of Texas Health Science Center at San Antonio (UT Health San Antonio), San Antonio, TX. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.