Alcohol use, intimate partner violence, and suicide-related thoughts and behaviors among U.S. service members and veterans who experienced military sexual assault.

Objective: Survivors of military sexual assault (MSA) are at risk for experiencing intimate partner violence (IPV) and alcohol misuse. IPV and MSA survivors are also at elevated risk for suicide-related thoughts and behaviors (SRTB) compared to those without MSA. Heightened risk for suicide may occur through higher alcohol misuse, an association that may be significantly stronger among males given their higher propensity for both alcohol misuse and death by suicide. The present study examined whether alcohol use was a mechanism of the association between IPV experience and SRTB, and whether these effects varied by sex. Method: Participants were an anonymous convenience sample of 343 veterans/service members (51% male) who completed self-report measures of past-year IPV, alcohol use, and SRTB. SRTB were regressed on IPV variables (any, physical, psychological, and sexual coercion), alcohol use, and covariates with an indirect effect of alcohol use specified. Sex was entered as a moderator of the “a” and “b” mediation paths. Results: The regression of SRTB on any and each type of IPV accounted for 37%–39% of the variance. The indirect effects of alcohol use on any and each type of IPV experience and SRTB were significant (ps <.05), but the moderated effects of sex were nonsignificant (ps >.05). The strength of the mediated effect for males was stronger than the effect for females; however, this difference was not significantly different (ps >.05). Conclusion: Interventions to decrease SRTB among people who have experienced IPV and MSA may consider incorporating strategies to prevent and reduce alcohol misuse.