Loneliness in Veterans: A Commonality Across Multiple Pathways Toward Suicidality

Abstract: Veterans are significantly more likely to experience suicidality than the general population. A substantial amount of research has centered on risk factors of suicidality among veterans, identifying associations between Military-relevant risk factors including traumatic brain injuries (TBIs) and combat exposure with suicidality. Likewise, loneliness has been shown to be a strong correlate of suicidality. Among these constructs, loneliness is proposed by multiple recent theories of suicide to contribute to the development of suicidality. Thus, in the present study, we investigate the link between these three variables (i.e., TBI, combat exposure, and loneliness) with suicidality. We then investigate the mediating role of loneliness between TBI and combat exposure with suicidality. Using cross-sectional data from 1,469 veterans recruited in the Military Health and Well-Being Project, we conducted linear regression analyses and mediational models. Findings indicated that loneliness (β = .32) was most closely associated with the outcome variable (suicidality) compared to combat exposure (β = .11) and TBI (β = .12). Further, loneliness partially mediated the link between all other variables with suicidality at p < .001. These findings underscore the importance of loneliness in the experience of suicidality among veterans and indicate that cross-sectional effects between military-relevant risk factors including TBI and combat exposure with suicidality are driven through loneliness. Within the relationships between TBI and suicidality as well as combat exposure and suicidality, loneliness plays an integral role, channeling the effects of the independent variables.