Family Composition as a Moderator of PTSD and Suicidal Ideation-Related Risk for Non-Secure Firearm Storage Among U.S. Army Soldiers and Veterans.

Rice, Alexander J; Lachman, Louis N; Zhou, Jing; Stanley, Ian H; Cozza, Stephen J · Am J Prev Med · 2026

cross_sectional · Level IV

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Abstract

Non-secure firearm storage is a key suicide risk factor among U.S. Army soldiers and veterans. Though PTSD and suicidal ideation correlate with storage practices, the role of household context remains unclear. This study examined whether family composition moderates associations of PTSD and suicidal ideation with non-secure storage of personal firearms. Data were drawn from the Army Study to Assess Risk and Resilience in Service Members-Longitudinal Study (STARRS-LS; collected April 2018-July 2019; analyzed August 2025-May 2026). Analyses included soldiers and veterans with household firearms (N = 5,583). Logistic regressions assessed associations of lifetime PTSD, suicidal ideation, and family composition (partner status, child presence) with non-secure storage (≥1 loaded and unlocked firearm), controlling for demographics, firearm count, and military status. Overall, 26.5% reported non-secure storage. Lifetime PTSD (adjusted OR = 1.38, 95% CI: 1.13, 1.70) and suicidal ideation (unadjusted OR = 1.39, 95% CI: 1.13, 1.72) were associated with non-secure storage. Family composition moderated the PTSD-storage relationship (p = .015), but not suicidal ideation. Among those with PTSD, single individuals without children had the highest odds of non-secure storage, whereas partnered parents had the lowest. Risk for non-secure firearm storage among personnel with PTSD varies by family composition. Interventions should consider combining clinical risk assessment with household context, specifically targeting single, childless individuals.