Personal growth initiative as a resilience factor against death ideation in OIF, OEF, and OND veterans

According to the interpersonal psychological theory of suicidal behavior, states of perceived burdensomeness and thwarted belongingness directly predict death ideation. Personal Growth Initiative (PGI) has been shown to protect against perceived burdensomeness, thwarted belongingness, and active suicidal ideation. The current study examined relationships between PGI, perceptions of burdensomeness, thwarted belongingness, and death ideation in OIF/OEF/OND veterans, a group that is at greater risk for suicide as compared to non-veterans in the general population. Due to overdispersion and zero-inflation in death ideation, a zero-inflated negative binomial regression was employed to account for excess zeros in the dependent variable and to identify individuals who are non-ideators vs. potential ideators. Participants were 318 OIF/OEF/OND veterans from the community and the local university population. Consistent with hypotheses 1, 2, and 5, PGI was negatively associated with death ideation, perceived burdensomeness, and thwarted belongingness. Two moderated mediation analyses were conducted, with perceived burdensomeness serving as the mediator in the first model (hypotheses 3 and 4) and thwarted belongingness serving as the mediator in the second model (hypotheses 6 and 7). PGI served as both the independent variable and moderator in both models, and death ideation served as the dependent variable. Perceived burdensomeness was found to partially mediate the relationship between PGI and death ideation (H3), and PGI was simultaneously found to moderate the mediating relationship of perceived burdensomeness and death ideation, with higher levels of PGI associated with a decreased relationship between perceived burdensomeness and death ideation and lower levels of PGI associated with an increased relationship between perceived burdensomeness and death ideation (H4), offering support for the first moderated mediation model. For the second moderated mediation model, thwarted belongingness was found to partially mediate the relationship between PGI and death ideation (H6), but PGI did not moderate the mediating relationship of thwarted belongingness and death ideation, contrary to hypothesis 7. Results suggest that veterans with stronger PGI skills may be less likely to perceive themselves as burdens on others and less likely to experience thwarted belongingness, which in turn may result in less death ideation. For those veterans who have strong PGI skills and who perceive themselves to be a burden on others, PGI may serve as an additional protective factor against the effects of perceived burdensomeness on death ideation. Results of the logit model suggest that elevated scores on thwarted belongingness, perceived burdensomeness, and PTSD measures are associated with a greater probability that veterans are experiencing death ideation even if it is not reported. Elevated scores on PGI are associated with a lower probability that veterans are experiencing death ideation when it is not reported. Assessment of perceived burdensomeness, thwarted belongingness, PTSD symptoms, and PGI may be helpful in identifying veterans who have thoughts about death even when these thoughts remain unreported. Implications of study findings are discussed and directions for future research suggested.