Psychology, Department of


First Advisor

David DiLillo

Date of this Version



A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy, Major: Psychology, Under the Supervision of Professor David DiLillo. Lincoln, Nebraska: May, 2018

Copyright 2018 Christina Lynn Hein


Veterans experience high rates of both posttraumatic stress disorder (PTSD) and suicidal behaviors when compared to the general public. Moreover, PTSD is a significant predictor of suicidal behavior among clinical and non-clinical adult populations. Joiner’s Interpersonal-Psychological Theory (IPT) of suicide (Joiner et al., 2005) identifies three etiological factors that greatly increase risk of suicide, with PTSD potentially increasing risk of suicide by exacerbating these three components of IPT. Conversely, prior work has also identified resilience factors that may serve to buffer against the risk of suicide, particularly by counteracting the three components of IPT. These resilience factors fall into primary classes of social support and protective psychological factors. Thus, the current study tests the possibility that resilience factors related to social support (i.e., social connectedness and social engagement) and various psychological factors (i.e., protective psychosocial characteristics and altruism) moderate the relations between PTSD (Wave 1) and suicide (Wave 2) in a nationally representative sample of 565 U.S. military veterans. Consistent with expectations, results showed that PTSD was significantly positively associated with suicidal ideation (SI) for the veterans from a majority of combat eras (i.e., non-combat, Vietnam War, and OEF/OIF/OND veterans), while resiliency was generally negatively associated with SI across eras. Furthermore, the relation between PTSD and SI was moderated by specific resiliency factors for Vietnam War veterans (altruism) and OEF/OIF/OND veterans (social connectedness, perceived ability to cope). The findings from the present study are relevant to suicide intervention strategies among veterans with trauma symptoms and from distinct combat eras. Specifically, the various resiliency factors that are associated with reduced risk for suicide among veterans of different combat eras may be useful points of intervention for treatment providers seeking to reduce risk for suicidal behaviors among this high-risk population.

Advisor: David DiLillo