# Measurement and Prediction of Reintegration Difficulty and Suicide Risk During the Military to Civilian Transition Period

> **NIH VA IK1** · JAMES J PETERS VA  MEDICAL CENTER · 2024 · —

## Abstract

Background: Approximately 200K transitioning service members/Veterans (TSMVs) separate
from the military annually and they face elevated suicide risk levels for at least six years after
separation. Suicide risk is greatest for those with the most difficulty reintegrating into civilian life
roles at home, work, and in the community. Current research on the military-to-civilian
reintegration process suffers from a lack of systematized measurement, longitudinal studies, and
attention to modifiable factors that influence how individuals respond to disruptive life events. This
CDA-1 proposal will leverage longitudinal data from a VA research repository to address these
gaps by conducting the first in-depth psychometric investigation of the Military-to-Civilian
Questionnaire (M2CQ), followed by an investigation of how reintegration difficulties develop over
time. Further, it will evaluate DSM-5 personality functioning as a modifiable predictor of
reintegration challenges and subsequent suicide risk during the transition period. Significance:
Rehabilitation is relevant to the reintegration of all TSMVs, who share the goal of adapting to post-
military life roles. This CDA-1 will deliver recommendations for assessing reintegration and yield
critical insights for identifying TSMVs prone to reintegration difficulty. These are essential steps
for detecting intervention targets that promote positive functional outcomes and disrupt suicide
risk trajectories. Identifying modifiable predictors of reintegration difficulty will inform a future
CDA-2 application focused on developing targeted interventions to address those factors. This
CDA-1 is aligned with priorities outlined by the White House’s National Strategy for Preventing
Veteran Suicide and the VA’s National Roadmap to Empower Veterans and End Suicide. This
project is also responsive to RR&D’s request for suicide prevention research that involves
Veterans not currently receiving VA healthcare. Innovativeness: The proposed research
represents the first comprehensive psychometric evaluation of the M2CQ in a longitudinal sample
of TSMVs. Second, by incorporating the construct of personality functioning, it suggests new ways
of thinking about reintegration difficulty and its relationship to suicide risk. Third, the longitudinal
design includes pre- and post-transition timepoints, which provide a unique opportunity to directly
evaluate temporal changes in reintegration difficulties as a function of co-occurring personality
functioning problems and the major life event of separation from service. Specific Aims: Aim 1 is
(a) to investigate the M2CQ’s structural validity, reliability, and item-level properties; (2) evaluate
how well M2CQ scores/items detect meaningful and expected change in functioning over time; (3)
to determine whether total scores and items have particularly strong associations with negative
clinical outcomes. Aim 2 is to evaluate personality functioning as a potentially modifiable
individual...

## Key facts

- **NIH application ID:** 10752907
- **Project number:** 1IK1RX004551-01A1
- **Recipient organization:** JAMES J PETERS VA  MEDICAL CENTER
- **Principal Investigator:** Ashley L. Greene
- **Activity code:** IK1 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-11-01 → 2025-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10752907

## Citation

> US National Institutes of Health, RePORTER application 10752907, Measurement and Prediction of Reintegration Difficulty and Suicide Risk During the Military to Civilian Transition Period (1IK1RX004551-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10752907. Licensed CC0.

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