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Publication Briefs

Study Reveals Gender Differences in Thought Processes among Veterans who Attempted Suicide

Veterans are 1.5 times more likely to die by suicide than civilians, and women Veterans are 2.2 times more likely to die by suicide than women civilians. Further, the suicide rate among women Veterans increased 61% between 2005 and 2017, while the suicide rate among men Veterans increased 43%. Qualitative research may broaden our understanding of how suicidal behaviors develop by using an approach grounded in the experiences of those at risk for suicide; however, qualitative studies of Veterans at risk for suicide are scant and primarily reflect the experiences of male Veterans. Thus, this national qualitative study sought to better understand gender differences in the development of suicidal behaviors among U.S. Veterans to inform future research and gender-tailored prevention efforts. Investigators interviewed 50 Veterans (25 men, 25 women) who had made a recent (prior 6 months) suicide attempt. Veterans were recruited from VA healthcare facilities across the U.S and the resulting sample was demographically and clinically diverse. Interviews examined participants' experiences with military service, suicidal thoughts and attempts, and healthcare following their attempt.


  • This analysis revealed two gendered narratives of suicide attempts that incorporated the primary themes of self-concept, social power, relationships, coping, and stress.
  • When discussing reasons for their suicide attempts, women described feelings of worthlessness, saying they felt “nonexistent in an existing world,” and that they “don’t deserve to be anything.” Women appeared to internalize negative experiences and evaluations from others into negative assessments of their worth (i.e., ‘I am bad’).
  • In contrast to women, men discussed feeling like the world had let them down and that they no longer had any fight left to obtain the life they want to live. In the moments prior to their attempts, men Veterans recalled thinking, “I’ve had enough,” and, “this is just exhausting and pointless.” These feelings primarily reflected their interpretations of failed actions (i.e., ‘What I did was bad.’) rather than assessments of their worth.


  • In suicide prevention, women Veterans may benefit from methods to increase self-worth through positive social relationships, while men Veterans may benefit from methods that increase their sense of purpose in life and help them achieve their ideal selves through successful experiences.


  • Causal inferences cannot be drawn from these findings.

This study was funded by HSR&D (IIR 17-131). Dr. Denneson and Mss. Tompkins and McDonald are part of HSR&D’s Center to Improve Veteran Involvement in Care (CIVIC) in Portland, OR.

Denneson L, Tompkins K, McDonald K, et al. Gender Differences in the Development of Suicidal Behavior among United States Military Veterans: A National Qualitative Study. Social Science & Medicine. September 2020;260:113178.

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