Co-Occurrence of Suicidal Ideation, Depressed Mood, and Recent Substance Use Among Military-Connected Adolescents: A Latent Class Analysis

Background and Purpose:  Substance use in adolescence has been found to co-occur with poor mental health. This is of particular interest among military-connected youth in the United States who have been found to be at increased risk for suicidal ideation, depressed mood, and substance use in recent research.  Thus, the present study seeks to examine the co-occurrence of substance use, suicidal ideation, and depressed mood among military and non-military connected adolescents. 

Methods: Latent class analysis of a sub-sample of data from 9^th and 11^th graders in the 2011 California Healthy Kids Survey was utilized to examine variation in the co-occurrence of past 30 day use of ATOD with suicidal ideation or sad/hopeless mood and their association with perceptions and experiences of being  military connected or not (n=7167). The perceptions included were whether youth felt their family sacrifice was important, whether they felt their family was supported by the military, whether they felt their family was supported by other military families, being worried about their family member who is serving, and whether they believed their teachers appreciated their family’s sacrifice.

Results: The latent class analysis revealed a four class solution. Youth in the first class were not military connected and had a 13% chance of reporting co-occurring substance use and mental health issues.  The second class included youth who had an 80% chance of having a parent on active duty. These youth reported feeling that the military supported their family and that their family sacrifice is important.  They also had a 13% chance of co-occurring outcomes.  The third class included youth who were 60% likely to have a parent serving. These youth had a lower probability of feeling supported by the military or that their family sacrifice was important. The likelihood of co-occurrence for this class was 16.2%.  Finally, the fourth class represented youth who had a 57% chance to have a sibling on active duty.  They reported that they did not feel supported by the military or that their sacrifice was important.  These youth had a 21.3% chance for co-occurring substance use, suicidal ideation, or depressed mood. 

Conclusions and Implications: Much of the literature currently focuses on the influence of parental military service.  The results of this analysis revealed that a majority of military connected youth experience co-occurrence of substance use and mental distress at rates similar to their civilian counterparts.  However, a significant proportion of military connected youth may be at elevated risk for co-morbidity.  Additionally, those at greater risk were also likely to report feeling unsupported or that their family’s sacrifice is not important.  Finally, these findings support a need for additional research on the adolescent siblings of military service persons as the class that was predominantly defined by those who had a sibling serving had the highest risk of co-occurrence of substance use, suicidality, and depressed mood.