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Post-Service Identity Disruption and Suicide Risk in U.S. Military Veterans: A Conceptual Review Cover

Post-Service Identity Disruption and Suicide Risk in U.S. Military Veterans: A Conceptual Review

Open Access
|Jun 2026

References

  1. Abel, E. A., Travaglini, L. E., Snow, J. L., & Goulet, J. L. (2025). The association of pain screening and pain level with suicide among US veterans with comorbid musculoskeletal and bipolar disorder diagnoses. Journal of Affective Disorders, 369, 429435. 10.1016/j.jad.2024.10.028
  2. Adler, A. (Ed.). (2011). The psychology of transition: Adapting to home after deployment. In A. B. Adler, P. D. Bliese, & C. C. Castro (Eds.), Deployment psychology: Evidence-based strategies to promote mental health in the military (pp. 153174). American Psychological Association. 10.1037/12300-006
  3. Ahern, J., Worthen, M., Masters, J., Lippman, S. A., Ozer, E. J., & Moos, R. (2015). The challenges of Afghanistan and Iraq veterans’ transition from military to civilian life and approaches to reconnection. PLoS ONE, 10(7), 113. 10.1371/journal.pone.0128599
  4. Ashforth, B. (2000). Role Transitions in Organizational Life: An Identity-based Perspective (1st ed.). Routledge. 10.4324/9781410600035
  5. Bartlett, M. L., & Schmitz, N. M. (2023). Moral Injury and Suicide Risk. Aether, Journal of Strategic Airpower and Spacepower, 2(3), 101114. https://www.airuniversity.af.edu/Portals/10/AEtherJournal/Journals/Volume-2_Number-3/Bartlett_Schmitz..pdf
  6. Binks, E., & Cambridge, S. (2018). The transition experiences of British military veterans. Political Psychology, 39(1), 125142. 10.1111/pops.12399
  7. Blakey, S. M., Wagner, H. R., Naylor, J., Brancu, M., Lane, I., Sallee, M., Kimbrel, N. A., VA Mid-Atlantic MIRECC Workgroup, & Elbogen, E. B. (2018). Chronic Pain, TBI, and PTSD in Military Veterans: A Link to Suicidal Ideation and Violent Impulses? The Journal of Pain, 19(7), 797806. 10.1016/j.jpain.2018.02.012
  8. Borowski, S., Rosellini, A., Street, A. E., Gradus, J. L., & Vogt, D. (2022). The First Year After Military Service: Predictors of U.S. Veterans Suicidal Ideation. American Journal of Preventive Medicine, 63(2), 233241. 10.1016/j.amepre.2022.03.017
  9. Boska, R. L., Bishop, T. M., & Ashrafioun, L. (2021). Pain Conditions and Suicide Attempts in Military Veterans: A Case-Control Design. Pain Medicine, 22(12), 28462850. 10.1093/pm/pnab287
  10. Britt, T. W., Adler, A. B., & Castro, C. A. (2006). Military Life: The Psychology of Serving in Peace and Combat. ABC-CLIO. https://search.worldcat.org/title/60776604
  11. Bryan, C. J., Hernandez, A. M., Allison, S., & Clemans, T. (2013). Combat exposure and suicide risk in two samples of military personnel. Journal of Clinical Psychology, 69(1), 6477. 10.1002/jclp.21932
  12. Cooper, L., Caddick, N., Godier, L., Cooper, A., & Fossey, M. (2018). Transition from the military into civilian life: An exploration of cultural competence. Armed Forces and Society, 44(1), 156177. 10.1177/0095327X16675965
  13. Demers, A. (2011). When Veterans Return: The Role of Community in Reintegration. Journal of Loss and Trauma, 16(2), 160179. 10.1080/15325024.2010.519281
  14. Frankfurt, S., & Frazier, P. A. (2016). A review of research on moral injury in combat veterans. Military Psychology, 28(5), 318330. 10.1037/mil0000132
  15. Frazee, K. M., & Shepler, D. K. (2022). Interpersonal needs and suicidality of discharged Army Veterans. Journal of Veterans Studies, 8(1), 1324. 10.21061/jvs.v8i3.337
  16. Godier-Mcbard, L. R., Cable, G., Wood, A. D., & Fossey, M. (2022). Gender differences in barriers to mental healthcare for UK military veterans: A preliminary investigation. BMJ Military Health, 168(1), 7075. 10.1136/bmjmilitary-2020-001754
  17. Griffin, B. J., Maguen, S., McCue, M. L., Pietrzak, R. H., McLean, C. P., Hamblen, J. L., Jendro, A. M., & Norman, S. B. (2025). Moral injury is independently associated with suicidal ideation and suicide attempt in high-stress, service-oriented occupations. NPJ Mental Health Res, 4(32). 10.1038/s44184-025-00151-9
  18. Griffin, B. J., Purcell, N., Burkman, K., Litz, B. T., Bryan, C. J., Schmitz, M., Villierme, C., Walsh, J., & Maguen, S. (2019). Moral Injury: An Integrative Review. Journal of Traumatic Stress, 32(3), 350362. 10.1002/jts.22362
  19. Griffith, J. (2002). Multilevel Analysis of Cohesion’s Relation to Stress, Well-Being, Identification, Disintegration, and Perceived Combat Readiness. Military Psychology, 14(3), 217239. 10.1207/S15327876MP1403_3
  20. Harden, L., & Murphy, D. (2018). Risk factors of suicidal ideation in a population of UK military veterans seeking support for mental health difficulties. Journal of the Royal Army Medical Corps, 164(5), 352356. 10.1136/jramc-2018-000921
  21. Hatch, S. L., Harvey, S. B., Dandeker, C., Burdett, H., Greenberg, N., Fear, N. T., & Wessely, S. (2013). Life in and after the Armed Forces: Social networks and mental health in the UK military. Sociology of Health and Illness, 35(7), 10451064. 10.1111/1467-9566.12022
  22. Higgins, D. M., Kerns, R. D., Brandt, C. A., Haskell, S. G., Bathulapalli, H., Gilliam, W., & Goulet, J. L. (2014). Persistent pain and comorbidity among Operation Enduring Freedom/Operation Iraqi Freedom/operation New Dawn veterans. Pain Medicine, 15(5), 782790. 10.1111/pme.12388
  23. Hockey, J. (1986). Squaddies: Portrait of a Subculture. University of Exeter.
  24. Huntington, S. P. (1957). The Soldier and the State: The Theory and Politics of Civil-Military Relations. Harvard University Press.
  25. Jamieson, N., Carey, L. B., Jamieson, A., & Maple, M. (2023). Examining the Association Between Moral Injury and Suicidal Behavior in Military Populations: A Systematic Review. Journal of Religion and Health, 62(6), 39043925. 10.1007/s10943-023-01885-6
  26. Joiner, T. (2005). Why people die by suicide. Harvard University Press.
  27. Karolaakso, T., Mikkonen, K., Pakkanen, T., Simola, P., & Peltonen, K. (2025). Returning home from a full-scale armed conflict: A rapid review of short post-deployment psychological practices. Military Psychology, 38(2), 112. 10.1080/08995605.2025.2469329
  28. Kelley, M. L., Bravo, A. J., Davies, R. L., Hamrick, H. C., Vinci, C., & Redman, J. C. (2019). Moral injury and suicidality among combat-wounded veterans: The moderating effects of social connectedness and self-compassion. Psychological Trauma: Theory, Research, Practice and Policy, 11(6), 621629. 10.1037/tra0000447
  29. Kennis, M., & Te Brake, H. (2022). Facilitating the transition home after military deployment: a systematic literature review of post-deployment adaptation programmes. European Journal of Psychotraumatology, 13(1), 2073111. 10.1080/20008198.2022.2073111
  30. Klonsky, E. D., & May, A. M. (2015). The Three-Step Theory (3ST): A New Theory of Suicide Rooted in the Ideation-to-Action Framework. International Journal of Cognitive Therapy, 8(2), 114129. 10.1521/ijct.2015.8.2.114
  31. Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695706. 10.1016/j.cpr.2009.07.003
  32. Logan, J., Bohnert, A., Spies, E., & Jannausch, M. (2016). Suicidal ideation among young Afghanistan/Iraq War Veterans and civilians: Individual, social, and environmental risk factors and perception of unmet mental healthcare needs, United States, 2013. Psychiatry Research, 245, 398405. 10.1016/j.psychres.2016.08.054
  33. Lu, Y. C., Wu, M. K., Zhang, L., Zhang, C. L., Lu, Y. Y., & Wu, C. H. (2020). Association between suicide risk and traumatic brain injury in adults: a population based cohort study. Postgraduate Medical Journal, 96(1142), 747752. 10.1136/postgradmedj-2019-136860
  34. Luethke, T. N., Thompson, H. L., & Folk, G. (2025). Coming Home Is the Hardest Part: An Interpretative Phenomenological Analysis of Sense Making in Military Post-deployment Reintegration. Journal of Community Psychology, 53(e23178). 10.1002/jcop.23178
  35. Markowitz, F. E., Kintzle, S., & Castro, C. A. (2023). Military-to-civilian transition strains and risky behavior among post-9/11 veterans. Military Psychology, 35(1), 3849. 10.1080/08995605.2022.2065177
  36. Mobbs, M. C., & Bonanno, G. A. (2018). Beyond war and PTSD: The crucial role of transition stress in the lives of military veterans. Clinical Psychology Review, 59, 137144. 10.1016/j.cpr.2017.11.007
  37. Murphy, D., Ashwick, R., Palmer, E., & Busuttil, W. (2019). Describing the profile of a population of UK veterans seeking support for mental health difficulties. Journal of Mental Health, 28(6), 654661. 10.1080/09638237.2017.1385739
  38. Nichter, B, Norman, S. B., Maguen, S., & Pietrzak, R. H. (2021). Moral injury and suicidal behavior among US combat veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study. Depression Anxiety, 38, 606614. 10.1002/da.23145
  39. Paat, Y. F., Dorado, A. V., Myers, N. W., Martinez, A., & Scully, S. (2025). Mental Health Challenges and Barriers to Veterans’ Adjustment to Civilian Life on the U.S.-Mexico Border. Healthcare, 13(3), 220. 10.3390/healthcare13030220
  40. Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., & Southwick, S. M. (2009). Psychological resilience and post-deployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom. Depression and anxiety, 26(8), 745751. 10.1002/da.20558
  41. Ravindran, C., Morley, S. W., Stephens, B. M., Stanley, I. H., & Reger, M. A. (2020). Association of Suicide Risk With Transition to Civilian Life Among US Military Service Members. JAMA Network, 3(9), e2016261. 10.1001/jamanetworkopen.2020.16261
  42. Robison, M., Udupa, N. S., Rice, T. B., Wilson-Lemoine, E., Joiner, T. E., & Rogers, M. L. (2024). The Interpersonal Theory of Suicide: State of the Science. Behavior Therapy, 55(6), 11581171. 10.1016/j.beth.2024.04.008
  43. Sachdev, S., & Dixit, S. (2025). Military to civilian retirement transition: Moderated mediation model of dispositional factors, transition difficulty, and well-being. Consulting Psychology Journal. 10.1037/cpb0000300
  44. Sayer, N. A., Noorbaloochi, S., Frazier, P., Carlson, K., Gravely, A., & Murdoch, M. (2010). Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care. Psychiatric Services, 61(6), 589597. 10.1176/ps.2010.61.6.589
  45. Shneidman, E. A. (1993). Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior. Aronson.
  46. Silva Santos, É. (2025). Existential Parallelism: A Theoretical Integration for Understanding a Modern Crisis of Meaning. Integr. Psych. Behavior, 59, 86. 10.1007/s12124-025-09962-z
  47. Silva Santos, É., & Antúnez, A. A. (2026). A Novel Five-Step Clinical Framework for Suicide Prevention. J Contemp Psychotherapy, 56, 1926. 10.1007/s10879-025-09687-5
  48. Smith, R. T., & True, G. (2014). Warring identities: Identity conflict and the mental distress of American veterans of the wars in Iraq and Afghanistan. Society and Mental Health, 4(2), 147161. 10.1177/2156869313512212
  49. Topçu, F., & Dinç, M. (2025). Symptoms of Moral Injury from a Psychological Perspective: A Systematic Review. Psikiyatride Güncel Yaklaşımlar, 17(4), 760772. 10.18863/pgy.1590616
  50. U.S. Department of Veterans Affairs. (n.d.). VA education and training benefits. https://www.va.gov/education/
  51. U.S. Department of Veterans Affairs. (2024). Office of Mental Health and Suicide Prevention. National veteran suicide prevention annual report. https://www.mentalhealth.va.gov/docs/data-sheets/2024/2024-Annual-Report-Part-1-of-2_508.pdf
  52. Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575600. 10.1037/a0018697
  53. Walker, D. I. (2013). Anticipating army exit: Identity constructions of final year UK career soldiers. Armed Forces and Society, 39(2), 284304. 10.1177/0095327X12437689
  54. Whitworth, J. D., Smet, B., & Anderson, B. (2020). Reconceptualizing the U.S. Military’s Transition Assistance Program: The Success in Transition Model. Journal of Veterans Studies, 6(1), 2535. 10.21061/jvs.v6i1.144
Language: English
Page range: 136 - 146
Submitted on: Mar 5, 2026
Accepted on: Jun 4, 2026
Published on: Jun 16, 2026
Published by: Virginia Tech Publishing
In partnership with: Paradigm Publishing Services

© 2026 Élison Silva Santos, published by Virginia Tech Publishing
This work is licensed under the Creative Commons Attribution 4.0 License.