Markers of suicide risk on the MMPI-3 among post-9/11 Veterans

Abstract: Suicide among post-9/11 U.S. military veterans has increased dramatically, with effective identification of veteran suicide risk remaining a national priority. We investigated the utility of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) in assessing suicide risk within this population. Participants were 189 post-9/11 veterans, predominantly male (75.1%) and White/Caucasian (77.8%), who completed the MMPI-3 and self-report measures of suicidality. In this cross-sectional study, we compared MMPI-3 profiles of veterans reporting a lifetime history of suicidal ideation only or suicide attempts to those who did not, with a focus on the Suicidal/Death Ideation (SUI) scale and markers of internalizing and externalizing psychopathology. One-way ANOVAs revealed large effect sizes for SUI in differentiating veterans who reported no suicidal ideation from those with suicide attempts (d=3.33) and those with suicidal ideation only (d=1.81), as well as veterans who reported suicidal ideation only from those who also reported past suicide attempts (d=.88). With a few exceptions, markers of internalizing (e.g., Demoralization [RCd]) significantly differentiated the no suicidal ideation group from the suicidal ideation only (ds = .52–1.12) and suicide attempt groups (ds = .48–1.59), while markers of externalizing (e.g., DISC) differentiated the suicidal ideation only and suicide attempt groups (ds = .50–.60). Analyses also revealed very large correlations between SUI and the Inventory of Depression and Anxiety Symptoms-II (IDAS-II) Suicidality scale (r = .74), and Self-Harm Inventory (r = .51). The SUI scale incremented the RC scales and other SP scales in predicting IDAS-II Suicidality scores (11%–16% additional variance) and SHI scores (2%–4% additional variance). These findings underscore the clinical utility of the MMPI-3, particularly the SUI scale, in comprehensive suicide risk assessments.