@article{ref1,
title="Suicidal behaviors among American Indian/Alaska Native firefighters: evidence for the role of painful and provocative events",
journal="Transcultural psychiatry",
year="2019",
author="Stanley, Ian H. and Hom, Melanie A. and Gallyer, Austin J. and Gray, Jacqueline S. and Joiner, Thomas E.",
volume="ePub",
number="ePub",
pages="1363461519847812-1363461519847812",
abstract="Firefighters represent a group at elevated suicide risk. Identifying segments of the fire service at increased risk may facilitate the targeted provision of suicide prevention initiatives. Among the general population, American Indian/Alaska Native (AI/AN) individuals report higher rates of suicide attempts. This study sought to examine suicide attempt rates among AI/AN firefighters and to determine if greater exposure to painful and provocative events and/or fearlessness about death explains the relationship between AI/AN identity and suicidal behaviors. A total of 917 US firefighters completed a web-based mental health survey (6.2% AI/AN). Participants completed a modified version of the Self-Injurious Thoughts and Behaviors Interview-Short Form, the Painful and Provocative Events Scale, and the Acquired Capability for Suicide Scale-Fearlessness About Death scale. Bootstrap mediation analyses were conducted, controlling for years of service as a firefighter. Although AI/AN firefighters accounted for only 6.2% of the sample, they accounted for 34.4% of the career suicide attempts. AI/AN firefighters were 16.31 (95% CI = 7.96, 33.42) times more likely to report a career suicide attempt history than non-AI/AN firefighters, adjusting for years of service as a firefighter. Painful and provocative events, but not fearlessness about death, was a statistically significant mediator of the relationship between AI/AN identity and suicide attempts. Firefighters identifying as AI/AN represent a subgroup within the fire service at increased risk for suicide. <br><br>FINDINGS suggest that greater exposure to painful and provocative events among AI/AN firefighters may explain the elevated suicide risk among this population.<p /> <p>Language: en</p>",
language="en",
issn="1363-4615",
doi="10.1177/1363461519847812",
url="http://dx.doi.org/10.1177/1363461519847812"
}