Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel - abstract

Some years ago, after reading an article by Gen. Shinseki, then Army Chief of Staff and now heading the VA, expressing his concern about the high rates  of suicide in recruits, I wrote to him explaining that the ACE Study questionnaire would likely predict who the suicides would be because ACE Score 6 individuals were 4,600% more likely to attempt suicide than are ACE Score 0 individuals.  He passed this on to Col. David Orman, then Psychiatric Consultant to the US Army.  Orman decided to use the ACE Questionnaire with all incoming recruits at Ft. Hood, a huge infantry training base.  Rob Anda at CDC and I met with Orman and were very pleased because we saw this as a tremendous opportunity to figure out how to protectively help these high ACE recruits.  After 2.5 months of doing this, Orman had to temporarily halt the process because of complaints from the Drill Instructors who could not handle the number of recruits who were breaking down crying while filling out the ACE Questionnaire! Orman's idea was to figure out how to help the DIs and then restart the program.  Unfortunately, his wife developed cerebral metastases at that point and the whole program was lost.  Nevertheless, the insight was important, reminding me that the Army is a strong metaphor for a supportive family, especially if you didn't have one.

Some years earlier, I was on an Institute of Medicine committee to study the unexpectedly high rates of PTSD in Gulf War 1.  You may recall that GW1 had only 170 hours of ground combat, the conventional explanation for PTSD; it basically was aerial bombardment of the enemy.  However, GW1 was the first time an all volunteer Army was in combat.  In other words, we had  unwittingly created a highly vulnerable Army by going from one that was a cross-section of the population to one that is self-selecting those unconsciously selecting a metaphor for something they never had.  I've spoken with senior people at the Army Surgeon General's office about this, but they don't want to touch it, fearing this would be bad publicity and would reduce volunteers.  This obviously is not definitive proof of anything, but suggests we may be close to a profound insight on military suicide in current times.