Self-Harm and Suicide in the Army: Systematic Review

  • M. M. RibeiroEmail author
  • M. M. Fernandes
  • M. I. Santos
  • T. F. B. X. Silva
Part of the Studies in Systems, Decision and Control book series (SSDC, volume 277)


As one of the three main causes of death in people between the ages of 15 and 44 years old, Suicide is, according to data from WHO, responsible, annually, for a million deaths. These numbers do not include suicide attempts, that are usually 10–20 times more frequent that suicide itself. This systematic review proposes to gather relevant information on the topic of self-harm and suicide in the Army, in accordance with the PRISMA-P statement for systematic review and meta-analysis protocols. This systematic review was based on relevant published articles found on five online databases (SCOPUS, PubMed, Science Direct, EBSCOhost e Web of Science), with a total of six keywords combinations. The information from the 13 selected articles was compiled into three groups. The first group addresses issues regarding the use of licit and illicit drugs and their relationship with self-harm and suicide; the second group focuses gender-related issues; and the third group addresses issues related to the identification of the main causes and of the individuals that resort to self-harm and suicide. No significant answers were found for the prevention of suicide and self-inflicted injuries in Armed forces.


Self-harm Suicide Army 


  1. 1.
    Baer, M.M., LaCroix, J.M., Browne, J.C., Hassen, H.O., Perera, K.U., Weaver, J., Soumoff, A., Ghahramanlou-Holloway, M.: Non-suicidal self-injury elevates suicide risk among United States Military personnel with lifetime attempted suicide. Arch. Suicide Res. 22(3), 453–464 (2018)CrossRefGoogle Scholar
  2. 2.
    Botega, N.J.: Comportamento suicida: epidemiologia. Psicologia Usp 25(3), 231–236 (2014)CrossRefGoogle Scholar
  3. 3.
    Carlotto, P.A.C., Cruz, R.M., Guilland, R.: Riscos Psicossociais Relacionados ao Trabalho: perspectivas teóricas e conceituais. Revista Interamericana de Psicología Ocupacional 37(1), 52 (2018)CrossRefGoogle Scholar
  4. 4.
    Cohen, G.H., Fink, D.S., Sampson, L., Tamburrino, M., Liberzon, I., Calabrese, J.R., Galea, S.: Coincident alcohol dependence and depression increases risk of suicidal ideation among Army National Guard soldiers. Ann. Epidemiol. 27(3), 157–163 (2017)CrossRefGoogle Scholar
  5. 5.
    Delazar, R., Farahi, H.: Processing of suicidal thoughts and acts of religious ritual in patients with depression. Ardabil Univ. Med. Sci. J. 3, 224–234 (2009)Google Scholar
  6. 6.
    Ennis, J., Fathi-Ashtiani, A., Soltaninejad, A., Amiri, M.: Prevalence of suicidal thoughts and associated factors among the soldiers. Mil. Med. J. 2, 7–11 (2006)Google Scholar
  7. 7.
    Giusti, J.S.: Automutilação: características clinicas e comparação com pacientes com transtorno obsessivo-compulsivo. Doctoral dissertation, Universidade de São Paulo (2013)Google Scholar
  8. 8.
    Hajebi, A., Ahmadzeh-Asl, M., Zaman, M., Nasrbkht, M., Mohammad, N., Davwdi, F.: Suicides recorded in the system design. Iran J. Psychiatr. Clin. Psychol. 2, 106–109 (2011)Google Scholar
  9. 9.
    Herberman Mash, H.B., Fullerton, C.S., Ng, T.H.H., Nock, M.K., Wynn, G.H., Ursano, R.J.: Alcohol use and reasons for drinking as risk factors for suicidal behavior in the US Army. Mil. Med. 181(8), 811–820 (2016)CrossRefGoogle Scholar
  10. 10.
    Herrra, A., Dahlblom, K., Dahlgren, L., Kullgren, G.: Pathways to suicidal behavior among adolescent girls in Nicaragua. Soc. Sci. Med. 62, 805–814 (2006)CrossRefGoogle Scholar
  11. 11.
    International Labour Organization (ILO): Work-Related Stress and Psychosocial Risks. (P. and D. B. (PRODOC) of the I. Document and Publications Production, Ed.), 8th edn. International Labour Office, Geneva (2017)Google Scholar
  12. 12.
    Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., Gøtzsche, P.C., Ioannidis, J.P.A., et al.: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339, b2700 (2009).
  13. 13.
    Linehana, M., Rizvi, L.: Psychiatric aspects of suicidal behavior: personality disorders. In: Hawton, K., Heeringen, K. (eds.) The International Handbook of Suicide and Attempted Suicide. Wiley, New Jersey (2000)Google Scholar
  14. 14.
    Liu, X., Tein, J.Y., Zhao, Z.: Suicidal and correlates among rural adolescents of china. J. Adolsc. Health. 37, 443–451 (2005)CrossRefGoogle Scholar
  15. 15.
    Mash, H.B.H., Fullerton, C.S., Ramsawh, H.J., Ng, T.H.H., Wang, L., Kessler, R.C., Stein, M.B., Ursano, R.J.: Risk for suicidal behaviors associated with alcohol and energy drink use in the US Army. Soc. Psychiatry Psychiatr. Epidemiol. 49(9), 1379–1387 (2014)CrossRefGoogle Scholar
  16. 16.
    Matarazzo, B.B., Barnes, S.M., Pease, J.L., Russell, L.M., Hanson, J.E., Soberay, K.A., Gutierrez, P.M.: Suicide risk among lesbian, gay, bisexual, and transgender military personnel and veterans: what does the literature tell us? Suicide Life-Threat. Behav. 44(2), 200–217 (2014)CrossRefGoogle Scholar
  17. 17.
    Millner, A.J., Ursano, R.J., Hwang, I., King, A.J., Naifeh, J.A., Sampson, N.A., Zaslavsky, A.M., Stein, M.B., Kessler, R.C., Nock, M.K., STARRS‐LS Collaborators: Lifetime suicidal behaviors and career characteristics among US Army soldiers: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Suicide Life‐Threat. Behav. 48(2), 230–250 (2018)Google Scholar
  18. 18.
    Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L.A.: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst. Rev. 4(1), 1 (2015)CrossRefGoogle Scholar
  19. 19.
    Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., The Prisma Group: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLOS Med. 6(7), e1000097 (2009)Google Scholar
  20. 20.
    Nouri, R., Fathi-Ashtiani, A., Salimi, S.H., Soltani Nejad, A.: Effective factors of suicide in soldiers of a military force. J. Mil. Med. 14(2), 99–103 (2012)Google Scholar
  21. 21.
    Ribeiro, J.D., Gutierrez, P.M., Joiner, T.E., Kessler, R.C., Petukhova, M.V., Sampson, N.A., Stein, M.B., Ursano, R.J., Nock, M.K.: Health care contact and suicide risk documentation prior to suicide death: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). J. Consult. Clin. Psychol. 85(4), 403 (2017)CrossRefGoogle Scholar
  22. 22.
    Santiago, E.S., Ribeiro, L.S.L.: Vivências subjetivas de psicólogos em seu dia a dia de trabalho: O contato com pacientes suicidas. Trabalho, Economia e Educação, Anais VI Seminário do Trabalho (2008)Google Scholar
  23. 23.
    Shakeri, J., Parvizifard, A., Sadeghi, K.H., Moradi, R.: Personality traits, stress, coping and religious attitudes in people with suicidal attempt. Razi Univ. Med. Sci. J. 1(2), 6–9 (2000)Google Scholar
  24. 24.
    Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L.A.: Preferred reporting items for systematic review and metaanalysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 349, g7647 (2015)CrossRefGoogle Scholar
  25. 25.
    Shelef, L., Fruchter, E., Spiegel, D.O., Shoval, G., Mann, J.J., Zalsman, G.: Characteristics of soldiers with self-harm in the Israeli Defense Forces. Arch. Suicide Res. 18(4), 410–418 (2014)CrossRefGoogle Scholar
  26. 26.
    Street, A.E., Gilman, S.E., Rosellini, A.J., Stein, M.B., Bromet, E.J., Cox, K.L., Colpe, L.J., Fullerton, C.S., Gruber, M.J., Heeringa, S.G., Lewandowski-Romps, L., Little, R.J., Naifeh, J.A., Nock, M.K., Sampson, N.A., Schoenbaum, M., Ursano, R.J., Zaslavsky, A.M., Kessler, R.C.: Understanding the elevated suicide risk of female soldiers during deployments. Psychol. Med. 45(4), 717–726 (2015).
  27. 27.
    Ursano, R.J., Kessler, R.C., Stein, M.B., Naifeh, J.A., Aliaga, P.A., Fullerton, C.S., Wynn, G.H., Vegella, P.L., Ng, T.H.H., Zhang, B.G., Wryter, C.L., Sampson, N.A., Kao, T.C., Colpe, L.J., Schoenbaum, M., McCarroll, J.E., Cox, K.L., Heeringa, S.G.: Risk factors, methods, and timing of suicide attempts among US Army soldiers. JAMA Psychiatry. 73(7), 741–749 (2016).
  28. 28.
    Ursano, R.J., Kessler, R.C., Stein, M.B., Naifeh, J.A., Nock, M.K., Aliaga, P.A., Fullerton, C.S., Wynn, G.H., Ng, T.H.H., Dinh, H.M., Sampson, N.A., Kao, T.C., Schoenbaum, M., McCarroll, J.E., Cox, K.L., Heeringa, S.G.: Medically documented suicide ideation among US Army soldiers. Suicide Life‐Threat. Behav. 47(5), 612–628 (2017a).
  29. 29.
    Ursano, R.J., Kessler, R.C., Naifeh, J.A., Mash, H.H., Fullerton, C.S., Bliese, P.D., Zaslavsky, A.M., Ng, T.H.H., Aliaga, P.A., Wynn, G.H., Dinh, H.M., McCarroll, J.E., Sampson, N.A., Kao, T.C., Schoenbaum, M., Heeringa, S.G., Stein, M.B.: Risk of suicide attempt among soldiers in army units with a history of suicide attempts. JAMA Psychiatry. 74(9), 924–931 (2017b).
  30. 30.
    World Health Organization: Country reports and charts available. Recuperado de, acessado a 03/08/2019 (2014)

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Mining EngineeringFaculty of Engineering of University of PortoPortoPortugal

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