Love Is Not All You Need: Understanding the Association Between Relationship Status and Relationship Dysfunction With Self-Directed Violence in Veterans

Arch Suicide Res. 2024 Jul-Sep;28(3):844-859. doi: 10.1080/13811118.2023.2237097. Epub 2023 Aug 7.

Abstract

Introduction: Research indicates that being married is associated with reduced risk of suicide and self-directed violence (SDV) relative to being divorced. Simultaneously, difficulties within relationships predict poorer health outcomes. However, research on relationship status rarely examines relationship functioning, obfuscating the joint contribution of these variables for SDV risk.

Method: Veterans (N = 1,049) completed a survey that included assessment of relationship status, relationship functioning, and SDV history. Logistic regression models tested how (a) relationship status, (b) relationship dysfunction, and (c) being divorced compared to being in a low- or high-dysfunction relationship were associated with SDV, controlling for several intrapersonal risk factors.

Results: Veterans in a relationship did not differ in SDV history compared to divorced/separated veterans. However, more dysfunction within relationships was associated with greater odds of a history of SDV and suicidal cognitions. Finally, SDV histories were more likely among veterans endorsing high-dysfunction relationships compared with (a) low-dysfunction relationships and (b) divorced veterans.

Conclusion: It may be insufficient to only consider relationship status when evaluating interpersonal risk factors for SDV. A single item assessing relationship dysfunction was associated with enacted SDV and suicidal cognitions over and above intrapersonal risk factors. Integrating such single-item measures into clinical practice could improve identification and subsequent tailored intervention for veterans at greater risk for SDV.

Keywords: Marital status; NSSI; relationship functioning; relationships; self-directed violence; suicide.

Plain language summary

Relationship dysfunction was related to self-directed violence (SDV) history independent of other risk factors.Being in a relationship alone was not related to SDV history relative to being divorced.A single item assessing relationship dysfunction was related to SDV history.

MeSH terms

  • Adult
  • Divorce / psychology
  • Female
  • Humans
  • Interpersonal Relations
  • Logistic Models
  • Love
  • Male
  • Marital Status
  • Middle Aged
  • Risk Factors
  • Suicidal Ideation
  • Suicide / psychology
  • Suicide / statistics & numerical data
  • United States / epidemiology
  • Veterans* / psychology
  • Veterans* / statistics & numerical data