SHOS-B

The Soldier Health Outcomes Study B (SHOS-B) represents the psychological autopsy component of the Army STARRS project and broadly aims to identify risk and protective factors for suicide among Army Soldiers. SHOS-B is the study of those Soldiers who have died by suicide while on active duty in the Army. Soldiers who are regular Army, as well as Soldiers who are Reserve and National Guard are included in the study.

A "psychological autopsy" is a term for a detailed and broad investigation of a person and the circumstances surrounding that person’s death. It is frequently used if the death was from suicide. The investigators attempt to reconstruct what the person thought, felt, and did before death, based on information gathered from personal documents, police reports, medical and coroner’s records, and interviews with families, friends and others who had contact with the person before death.

There are many advantages to using psychological autopsy. These studies aim to reconstruct an individual’s psychological makeup (e.g., thoughts, feelings, behaviors, intentions, motivations, life circumstances), identify risk factors for death, and understand the mode and details of the suicidal behavior. Psychological autopsy studies offer a unique opportunity to gather information on a number of areas linked to suicide that are not generally accessible to epidemiological studies.

In addition to the strengths of psychological autopsy studies in general, SHOS-B is unique relative to other Army STARRS components as it is the only component of the study to obtain new data on risk and protective factors for suicide among Soldiers who have recently died by suicide. SHOS-A will collect information on risk and protective factors from recent suicide attempters (a group known to differ somewhat from those who actually die by suicide), and the aggregate database component will examine information about risk and protective factors available among Army records.

The SHOS-B study seeks to recruit and interview two Informants (a next of kin and an Army Supervisor) for each Soldier who has died. The research team will also examine administrative data for the Soldiers, in order to better understand the circumstances of that Soldier’s time in the Army, and subsequent death.

SHOS-B is a case/control study. For every Case Soldier (a Soldier who has died), we will recruit two Control Soldiers. These will be healthy Soldiers who may have similar backgrounds and/or experiences but have not died. SHOS-B will interview two Informants (next of kin and Army Supervisor) for each Control Soldier. The inclusion of this control group allows for the possibility of assessing which risk factors are most linked with suicide. In other words, we will compare the two groups of Soldiers to determine what leads some Soldiers to be more resilient to experiences common to Soldiers, and what decreases resilience in others.

The SHOS-B project is necessary to provide previously unavailable information about a wide range of factors that may be useful in better understanding and predicting suicide death among Army Soldiers. Ultimately, we hope that this information will help to prevent unnecessary deaths among Soldiers.