Between 2005 and 2009, during the peak war years in Iraq and Afghanistan, the US Army and US Marine Corps, the 2 services with the largest concentration of ground combat forces, experienced a significant increase in suicides. For the first time in decades, suicide rates surpassed civilian levels, and they have remained elevated since. This change precipitated considerable research by several teams to understand the causal factors,¹ including the more than $65 million Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), a population-based epidemiological study to identify “actionable recommendations to reduce Army suicides.”² However, these extensive efforts reached somewhat contradictory conclusions concerning key risk factors, such as the association of deployment with suicide.¹ The Army STARRS effort was the most prolific but generated the harshest criticism for its core scientific assumptions, methods, conclusions, and lack of actionable relevance.^3- 5 To date, none of these studies have been able to definitively answer the overarching question of why suicide rates rose so sharply in Army and Marine personnel but not in Air Force and Navy personnel.¹

在2005年至2009年之间的伊拉克和阿富汗战争高峰期间，地面部队战​​斗力最集中的两个部队-美国陆军和美国海军陆战队-自杀率大幅上升。数十年来，自杀率首次超过平民水平，此后一直保持较高水平。这种变化沉淀大量的研究由几支球队，了解偶然因素，¹包括超过$ 65万陆军研究，评估现役军人（陆军STARRS）风险和恢复力，基于人口的流行病学研究，以确定“可行的建议，以减少陆军自杀。” ^2个但是，这些广泛的努力在关键风险因素（如部署与自杀的关联）上得出了一些矛盾的结论。¹陆军STARRS的工作最多产，但由于其核心科学假设，方法，结论和缺乏可行的相关性而引起了最严厉的批评。^{3 - 5}迄今为止，没有一项研究已不能确切回答的首要问题，为什么自杀率在空军和海军人员在陆军和海军人员，以便大幅上涨，但没有。^1个