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Addressing Suicides in Special Operations Forces: Enhancing Resilience in a Unique Population

  • Bruce Bongar
  • Catherine Hausman
  • Gabrielle Agin-Liebes
Chapter

Abstract

Suicides within the US military’s most elite personnel, the Special Operations Forces (SOF), are on the rise. With these highly trained and versatile service members representing a crucial military asset due to the unpredictable nature of modern warfare, preserving the ability of these individuals to carry out their deployments is a high priority. As opposed to efforts that explicitly aim to prevent suicide, recent programmes have emerged that aim to increase resilience. The research on the potential utility of resilience enhancement as suicide prevention will be reviewed. Example programmes that have been implemented with SOF and related groups such as other military branches, law enforcement, and first responders will be examined. Lastly, caveats and future directions in addressing the strain on these unique individuals will be described.

Keywords

Military suicide Resilience Special operations forces Suicide prevention Unique population 

References

  1. Acosta, J. D., Becker, A., Cerully, J. L., Fisher, M. P., Martin, L. T., Vardavas, R., … Schell, T. L. (2014). Mental health stigma in the military. Santa Monica, California: Rand Corporation. Retrieved from http://www.rand.org/content/dam/rand/pubs/research_reports/RR400/RR426/RAND_RR426.pdf.
  2. American Psychological Association. (2002). Ethical Principles of Psychologists and Code of Conduct. Retrieved from http://www.apa.org/ethics/code/index.aspx?item=1.
  3. American Psychological Association (2015). The road to resilience. APA Help Center. Retrieved from http://www.apa.org/helpcenter/road-resilience.aspx.
  4. Andersen, J. P., Papazoglou, K., Koskelainen, M., Nyman, M., Gustafsberg, H., & Arnetz, B. B. (2015). Applying resilience promotion training among special forces police officers. SAGE Open, 5(2), 1–8.Google Scholar
  5. Arnetz, B. B., Arble, E., Backman, L., Lynch, A., & Lublin, A. (2013). Assessment of a prevention program for work-related stress among urban police officers. International Archives of Occupational and Environmental Health, 86(1), 79–88.CrossRefPubMedGoogle Scholar
  6. Bartone, P., Roland, R., Picano, J., & Williams, T. (2008). Psychological hardiness predicts success in U.S. Army special forces candidates. International Journal of Selection and Assessment, 16(1), 78–81.CrossRefGoogle Scholar
  7. Bennett, J. (2012, January 24). Obama administration quietly altering military’s global presence. U.S. News. Retrieved from http://www.usnews.com/news/articles/2012/01/24/obama-administration-quietly-altering-militarys-global-presence.
  8. Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20–28.CrossRefPubMedGoogle Scholar
  9. Bonanno, G. A., Mancini, A. D., Horton, J. L., Powell, T. M., LeardMann, C. A., Boyko, E.J., … Smith, T. C. (2012). Trajectories of trauma symptoms and resilience in deployed U.S. military service members: prospective cohort study. The British Journal of Psychiatry: The Journal of Mental Science, 200(4), 317–323.Google Scholar
  10. Brim, W. (2013). Staff perspective: The history of the new military culture course. [Web blog post]. Retrieved from http://deploymentpsych.org/blog/staff-perspective-history-new-military-culture-course.
  11. Brown, N. (2015). A critical examination of the U.S. Army’s Comprehensive Soldier Fitness program. The Winnower. Retrieved from https://thewinnower.com/papers/49-a-critical-examination-of-the-u-s-army-s-comprehensive-soldier-fitness-program.
  12. Campbell-Sills, L., Cohan, S. L., & Stein, M. B. (2006). Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. Behaviour Research and Therapy, 44(4), 585–599.CrossRefPubMedGoogle Scholar
  13. Castro, C. A., & Kintzle, S. (2014). Suicides in the military: The post-modern combat veteran and the Hemingway effect. Current Psychiatry Reports, 16(8), 460.CrossRefPubMedGoogle Scholar
  14. Checkley, S. (1996). The neuroendocrinology of depression and chronic stress. British Medical Bulletin, 52(3), 597–617.CrossRefPubMedGoogle Scholar
  15. Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18(2), 76–82.CrossRefPubMedGoogle Scholar
  16. Cornum, R., Matthews, M., & Seligman, M. (2011). Comprehensive soldier fitness: Building resilience in a challenging institutional context. American Psychologist, 66(1), 4–9.CrossRefPubMedGoogle Scholar
  17. Council on Foreign Relations. (2013). The future of U.S. Special Operations Forces. (Council on Foreign Relations Report No. 66). New York, NY: Robinson, L.Google Scholar
  18. Dean, P., & McNeil, J. (2012). Breaking the stigma of behavioural healthcare. Special Warfare, 25(2), 7.Google Scholar
  19. Department of Defense. (2011). Maintenance of psychological health in military operation. DODI 6490.05. Washington, DC.Google Scholar
  20. Feickert, A. (2015). U.S. Special Operations Forces (SOF): Background and Issues for Congress. Congressional Research Service. Retrieved from https://www.fas.org/sgp/crs/natsec/RS21048.pdf.
  21. Feskanich, D., Hastrup, J. L., Marshall, J. R., Colditz, G. A., Stampfer, M. J., Willett, W. C., & Kawachi, I. (2002). Stress and suicide in the Nurse’s Health Study. Journal of Epidemiology and Community Health, 56(2), 95–98.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Fredriksen, J.C. (2011). Fighting elites: A history of U.S. Special Forces. Santa Barbara, CA: ABC-CLIO.Google Scholar
  23. Garamone, J. (2015). DOD News, Defense Media Activity. Care coalition supports wounded, ill special ops troops. Retrieved from http://www.defense.gov/News-Article-View/Article/604112/care-coalition-supports-wounded-ill-special-ops-troops.
  24. Gilmartin, K. M. (2002). Emotional survival for law enforcement: A guide for officers and their families. Tucson, AZ: E-S Press.Google Scholar
  25. Gonzalez, G., Singh, R., Schell, T. L., Weineck, R.M., & Rand Corporation. (2014). An evaluation of the implementation and perceived utility of the Airman Resilience Training program. RAND Health Quarterly, 4(2). Google Scholar
  26. Harms, P. D., Herian, M. N., Krasikova, D. V., Vanhove, A., & Lester, P. B. (2013). The Comprehensive Soldier and Family Fitness program evaluation report #4: Evaluation of resilience training and mental and behavioural health outcomes. Retrieved from http://csf2.army.mil/supportdocs/TR4.pdf.
  27. Hartmann, E., & Grønnerød, C. (2009). Rorschach variables and Big Five scales as predictors of military training completion: A replication study of the selection of candidates to the naval special forces in Norway. Journal of Personality Assessment, 91(3), 254–264.CrossRefPubMedGoogle Scholar
  28. Hoffman, F. G. (2006). Complex irregular warfare: The next revolution in military affairs. Orbis, 50(3), 395–411.CrossRefGoogle Scholar
  29. Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22.CrossRefPubMedGoogle Scholar
  30. Institute of Medicine. (2014). Committee on the assessment of ongoing efforts in the treatment of posttraumatic stress disorder; Board on the health of select populations; Institute of Medicine. Treatment for posttraumatic stress disorder in military and veteran populations: Final assessment. Washington, DC: National Academies Press (US). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK224875.
  31. Johnson, J., Wood, A. M., Gooding, P., Taylor, P. J., & Tarrier, N. (2011). Resilience to suicidality: The buffering hypothesis. Clinical Psychology Review, 31(4), 563–591.CrossRefPubMedGoogle Scholar
  32. Kessler, R. C., Borges, G., & Walters, E. E. (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry, 56(7), 617–626.CrossRefPubMedGoogle Scholar
  33. Kilcullen, R. N., Mael, F. A., Goodwin, G. F., & Zazanis, M. M. (1999). Predicting U.S. Army Special Forces field performance. Human Performance in Extreme Environments, 4, 53–63.Google Scholar
  34. Krueger, J. I. (2011). Shock without awe. American Psychologist, 66(7), 642–643.CrossRefPubMedGoogle Scholar
  35. Kulesza, M., Pedersen, E., Corrigan, P., & Marshall, G. (2015). Help-seeking stigma and mental health treatment seeking among young adult veterans. Military Behavioural Health, 3(4), 230–239.CrossRefGoogle Scholar
  36. Liu, D. W., Fairweather-Schmidt, A. K., Roberts, R. M., Burns, R., & Anstey, K. J. (2014). Does resilience predict suicidality? A lifespan analysis. Archives of Suicide Research, 18(4), 453–464.CrossRefPubMedGoogle Scholar
  37. Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Masten, A. S., Cutuli, J. J., Herbers, J. E., & Reed, M. G. J. (2009). Resilience in development. In C. R. Snyder & S. J. Lopez (Eds.), Oxford handbook of positive psychology (2nd ed., pp. 117–131). New York: Oxford University Press.Google Scholar
  39. Matheson, F. I., Moineddin, R., Dunn, J. R., Creatore, M. I., Gozdyra, P., & Glazier, R. H. (2006). Urban neighborhoods, chronic stress, gender and depression. Social Science and Medicine, 63(10), 2604–2616.CrossRefPubMedGoogle Scholar
  40. McCalman, J., Bainbridge, R., Russo, S., Rutherford, K., Tsey, K., Wenitong, M., … Jacups, S. (2016). Psycho-social resilience, vulnerability and suicide prevention: Impact evaluation of a mentoring approach to modify suicide risk for remote Indigenous Australian students at boarding school. BMC Public Health, 16(1).Google Scholar
  41. McClintock, M. (1992). Instruments of Statecraft: U.S. Guerrilla Warfare, Counterinsurgency, and Counter-Terrorism, 1940–1990. New York, NY: Pantheon Books.Google Scholar
  42. Nock, M. K., Stein, M. B., Heeringa, S. G., Ursona, R., Colpe, L. J., Fullerton, C. S., … Kessler, R. (2014). Prevalence and correlates of suicidal behaviour among soldiers: Results from the army study to assess risk and resilience in service members (Army STARRS). JAMA Psychiatry, 71(5), 514–522.Google Scholar
  43. Patty, B. (personal communication, May 17, 2016).Google Scholar
  44. Pawelski, J. O. (2003). William James, positive psychology, and healthy-mindedness. The Journal of Speculative Philosophy (New Series), 17(1), 53–67.CrossRefGoogle Scholar
  45. Pendleton, J., Ullengren, M., Barnes, T., Carr, T., Grant, C., Lundsford, T., … Silver, M. (2015). Special operations forces: Opportunities exist to improve transparency of funding and assess potential to lessen some deployments. Government Accountability Office Washington D. C. Retrieved from http://oai.dtic.mil/oai/oai?verb=getRecord&metadataPrefix=html&identifier=ADA621551.
  46. Picano, J., & Roland, R. R. (2012). Assessing psychological suitability for high-risk military jobs. In J. H. Laurence & M. D. Matthews (Eds.), The Oxford handbook of military psychology (pp. 148–157). New York, NY: Oxford University Press.Google Scholar
  47. Pompili, M., Innamorati, M., Szanto, K., Di Vittorio, C., Conwell, Y., Lester, D., … Amore, M. (2011). Life events as precipitants of suicide attempts among first-time suicide attempters, repeaters, and non-attempters. Psychiatry Research, 186(2–3), 300–305.Google Scholar
  48. Prados, J. (2015). The US special forces: What everyone needs to know?. Oxford, UK: Oxford University Press.Google Scholar
  49. Prigerson, H. G., Maciejewski, P. K., & Rosenheck, R. A. (2001). Combat trauma: Trauma with highest risk of delayed onset and unresolved posttraumatic stress disorder symptoms, unemployment, and abuse among men. The Journal of Nervous and Mental Disease, 189(2), 99–108.CrossRefPubMedGoogle Scholar
  50. Ramchand, R., Eberhart, N. K., Guo, C. Pedersen, E. R., Savitsky, T. D., Tanielian, T., & Voorhies, P. (2014). Developing a research strategy for suicide prevention in the Department of Defense: Status of current research, prioritizing areas of need, and recommendations for moving forward. Santa Monica, CA: RAND Corporation. Retrieved from http://www.rand.org/pubs/research_reports/RR559.html.
  51. Reivich, K. J., Seligman, M. E., & McBride, S. (2011). Master resilience training in the U. S. Army. American Psychologist, 66(1), 25–34.CrossRefPubMedGoogle Scholar
  52. Roy, A., Sarchiapone, M., & Carli, V. (2007). Low resilience in suicide attempters. Archives of Suicide Research, 11(3), 265–269.CrossRefPubMedGoogle Scholar
  53. Rzepka, R. L. (2015). Humans not hardware: Families key to special forces success. Retrieved from https://www.army.mil/article/154603/Humans_Not_Hardware__Families_Key_to_Special_Forces_Success/.
  54. Sarkesian, S., & Connor, R. (2006). The US military profession into the 21st century: War, peace and politics. Abingdon, UK: Routledge.Google Scholar
  55. Schemmer, B. F., & Carney, J. T. (2003). U.S. Special Operations Forces. Fairfield, CT: Hugh Lauter Levin Associates.Google Scholar
  56. Seligman, M. E. P. (1990). Learned optimism. New York, NY: Knopf.Google Scholar
  57. Seligman, M. E. P (1998). The President’s address from the 1998 APA Annual Report. Retrieved from http://www.ppc.sas.upenn.edu/aparep98.htm.
  58. Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5–14.CrossRefPubMedGoogle Scholar
  59. Shanker, T. & Oppel, R. A. War’s elite tough guys, hesitant to seek healing. The New York Times, p. A1. Retrieved from http://www.nytimes.com/2014/06/06/us/politics/wars-elite-tough-guys-hesitant-to-seek-healing.html?_r=0. Accessed 6 June 2016.
  60. Steenkamp, M. M., Nash, W. P., & Litz, B. T. (2013). Post-traumatic stress disorder: Review of the comprehensive soldier fitness program. American Journal of Preventive Medicine, 44(5), 507–512.CrossRefPubMedGoogle Scholar
  61. Stewart, D., Sun, J., Patterson, C., Lemerie, K., & Hardie, M. (2004). Promoting and building resilience in primary school communities: Evidence from a comprehensive ‘health promoting school’ Approach. International Journal of Mental Health Promotion, 6(3), 26–33.CrossRefGoogle Scholar
  62. Strobel, W. (2014). U.S. Special forces struggle with record suicides: Admiral. Retrieved from http://www.reuters.com/article/us-usa-military-suicides-idUSBREA3G2EK20140417.
  63. The United States Congress (2015). Committee Reports 113th Congress (2013–2014): House Report 113-473. Retrieved from http://thomas.loc.gov/cgi-bin/cpquery/?&dbname=cp113&sid=cp113HLTLZ&refer=&r_n=hr473.113&item=&&&sel=TOC_119947&.
  64. The United States Department of Defense. (2016). “Department of Defense Releases Fiscal Year 2017 President’s Budget Proposal”. Retrieved from http://www.defense.gov/News/News-Releases/News-Release-View/Article/652687/department-of-defense-DOD-releases-fiscal-year-2017-presidents-budget-proposal.
  65. Tondo, L., Baldessarini, R. J., Hennen, J., Minnai, G. P., Salis, P., Scamonatti, L., … Mannu, P. (1999). Suicide attempts in major affective disorder patients with comorbid substance use disorders. Journal of Clinical Psychiatry, 60 (suppl 2), 63–69.Google Scholar
  66. Turnley, J. (2008). Retaining a precarious value as Special Operations go mainstream. MacDill Air Force Base, Florida: Joint Special Operations University.Google Scholar
  67. United States Army. (2012). Q&A with Admiral William H. McRaven. Special Warfare. Retrieved from http://www.soc.mil/swcs/SWmag/archive/SW2502/SW2502QAAdmiralWilliamMcRaven.html.
  68. United States Government Accountability Office. (2015). Special Operations Forces: Opportunities exist to improve transparency of funding and access potential to lessen some deployments. Retrieved from http://www.gao.gov/assets/680/671462.pdf.
  69. United States Special Operations Command. (2014a). Joint publication—JP 3–05, Special Operations. Retrieved from http://www.dtic.mil/doctrine/new_pubs/jp3_05.pdf.
  70. United States Special Operations Command. (2014b). ARSOF Operating Concept 2022. Retrieved from http://www.soc.mil/Assorted%20Pages/ARSOF%20Operating%20Concept%202014.pdf.
  71. United States Special Operations Command. (n.d.). Director’s Emphasis. Retrieved from http://www.socom.mil/POTFF/Shared%20Documents/POTFF_DirectorsEmphasis.aspx.
  72. U.S. Government Accountability Office. (2015). Opportunities exist to improve transparency of funding and assess potential to lessen some deployments (GAO-15-571). Washington, D.C: U.S. G.P.O.Google Scholar
  73. Wood, D. (2016). These elite troops spent 15 years at war. This program tries to prepare their minds and bodies for the next 15. Huffington Post. Retrieved from http://www.huffingtonpost.com/entry/special-forces-preservation-force-family_us_5710180ae4b0018f9cb991d0.

Copyright information

© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  • Bruce Bongar
    • 1
  • Catherine Hausman
    • 1
  • Gabrielle Agin-Liebes
    • 1
  1. 1.Palo Alto UniversityPalo AltoUSA

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