United States Reserve Component soldiers with late-onset and chronic trajectories of posttraumatic stress disorder (PTSD) symptoms have a higher risk for suicidal ideation compared with soldiers with other trajectories, according to research published in Psychiatry Research.

Based on their findings, researchers noted the importance of follow-up assessment of suicide risk, even among soldiers with a low level of PTSD symptoms when they return home.

To examine the association between suicidal ideation and PTSD symptom trajectories, symptoms related to a traumatic event during individuals’ most recent deployment were assessed among 682 Reserve Component soldiers over a 3-year period. 

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The longitudinal trajectories were assessed using latent growth mixture modeling. The identified trajectories were resilience (73.0%), recovery (11.7%), late-onset (11.6%), and chronic (3.6%). The prevalence of suicidal ideation was 4.0% for the resilience trajectory, 11.3% for recovery, 25.8% for late-onset, and 50.9% for the chronic trajectory. The elevated risk among the late-onset and chronic trajectories was significant even after controlling for baseline characteristics.

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The limitations involved include that data collection was not based on time of deployment, a single item was used to measure suicide ideation, self-reported measures of PTSD symptoms bay be biased, and there was low association between alcohol use and suicidal ideation in the alcohol assessments. Additionally, there were few female participants. Future studies will be necessary to assess gender differences of PTSD trajectories.

“Understanding these differences in risk related to the course of PTSD may have significant implications in the management of suicide risk over time amongst those with PTSD,” the researchers wrote.


Wang J, Ursano RJ, Gonzalez OI, et al. Association of suicidal ideation with trajectories of deployment-related PTSD symptoms. Psychiatry Res. 2018;267:455-460.