Multiple brain injuries seen to increase
risk of suicide
May 15, 2013
A service member receives a Diffusion Tensor Imaging scan of his brain
at Landstuhl Regional Medical Center in Germany.
Michael Abrams/Stars and Stripes
By Matt Millham
Stars and Stripes
KAISERSLAUTERN, Germany — Deployed military personnel who’ve had
multiple traumatic brain injuries from roadside bombs or other incidents
may be at increased risk for suicide, a new study suggests.
Earlier research had already drawn a link between brain injuries and
increased suicide risk, but the study published Wednesday by the Journal
of the American Medical Association suggests the risk increases even
further in personnel who’ve had more than one brain injury. However, the
majority of those with multiple TBIs were not suicidal, the study found.
Study author Craig J. Bryan, a psychologist and former Air Force captain
who is now associate director of the National Center for Veterans
Studies at the University of Utah, said his findings, gleaned from data
on 161 patients who came into his clinic in Balad, Iraq, in 2009, were
While the increase in suicidal thoughts among those who’d suffered
multiple brain injuries was expected, it was interesting, he said, that
the “dose effect” of multiple injuries appeared to level out after two
“I really was expecting guys who had been blown up or had sustained five
or six concussions in their lives, they would probably look even worse
or be at greater risk than the guys who had only sustained two TBIs,”
Bryan said Tuesday in a phone interview, “but that was not the case.”
Personnel who visited Bryan’s clinic in Iraq after sustaining a
suspected head injury, each completed a standardized assessment in which
they reported feelings of depression, post-traumatic stress and suicidal
thoughts and behaviors, as well as their lifetime history of traumatic
brain injury, including concussions they had had as children.
Those who’d never had a TBI reported having no suicidal thoughts or
behaviors, while 6.9 percent of those who’d had one TBI reported such
feelings. Among those who’d had two or more injuries, 21.7 percent
expressed suicidal thoughts or behaviors.
“I think these numbers could be disturbing to some of our servicemembers
who know they’ve had brain injuries,” said John D. Corrigan, director of
the Division of Rehabilitation Psychology and a professor in the
Department of Physical Medicine and Rehabilitation at Ohio State
University. He was not involved in the study.
But he cautioned those who’ve had an injury to keep in mind that the
study only shows a relationship between TBI and suicidal thoughts and
doesn’t consider factors that could mitigate suicide risk.
Like previous research, Corrigan said, the study doesn’t prove that
traumatic brain injuries cause suicidal thoughts, but it “inches us
The most interesting finding, Corrigan said, is that, of those who’d
never had a TBI, none reported suicidal thoughts. “I’ll be interested in
looking a little closer at that.”
Bryan said his best guess for why none of the 18 servicemembers in the
zero TBI group reported suicidal thoughts is that there weren’t enough
people in the group to render an accurate result. In general, 2 percent
to 3 percent of people will report having suicidal thoughts in the past
year, he said, which equates to roughly 1 person in 40.
While those with multiple TBIs were “significantly more likely to be
suicidal,” Bryan said, “the vast majority, 75 to 80 percent, of those
who had multiple TBIs were not suicidal.”
Corrigan said he doesn’t know if this study alone is reason enough for
the U.S. military to change its handling of traumatic brain injuries.
Its policy in Afghanistan of requiring personnel caught in vehicle
rollovers and bombings to be pulled from the fight to undergo testing
for brain injuries “appears to have had a very positive effect in terms
of folks being able to heal quickly from the most minor of the traumatic
“Probably what this does say,” Bryan said, “is that immediately
following a head injury, whether from an explosion, a motor-vehicle
accident, whatever the case may be, we definitely do need to take people
out and give them a break.”