n the 1960s and 1970s, results from early outcome studies of civilian and veteran cohorts with traumatic brain injury (TBI) noted higher numbers of suicides than would be expected from the general population rates. Despite these initial findings, the following three decades saw only sporadic attention paid to researching this important area of post-injury adjustment. However, the past ten years has seen a quickening of interest, due in part to the high rate of TBIs being sustained by military personnel in Iraq and Afghanistan, and the growing concern regarding suicidal behavior among members of this population. Overall, the increased research output across military, veteran and civilian groups has addressed three principal areas.
First, the growing convergence in evidence from both population-based and large sample studies of the elevated risk of suicide associated with TBI will be delineated. Importantly this data is cross-national, with studies from Europe (including the United Kingdom), the United States, and Australia all contributing to the picture. Furthermore, this increased rate seems to be an issue of concern for both military and civilian populations.
Second, research that has been conducted on identifying mechanisms and risk factors associated with elevated suicide risk will be outlined. This includes (i) studies investigating potential neurobiological and neuropsychological mechanisms underlying suicidal thoughts and behavior, and (ii) research employing multivariate analyses to examine the relative contribution of pre-morbid, demographic, injury, and post-injury cognitive, behavioral and psychosocial variables to elevated suicide. Factors of interest may vary between cohorts (civilian, military).
Third, research aimed at enhancing the clinical management of suicide will be detailed. This includes initiatives for the screening of suicide risk, the psychological treatment of individuals with elevated suicide risk, and the development of service-related suicide prevention protocols. Finally, areas for future research will also be presented.