Loneliness is receiving more and more attention for being an important psychosocial contributor to the deterioration of quality of life, psychological well-being, onset of mental health disorders, but also to the increased mortality and morbidity, through the mediation of general health problems and suicide. While studies on the impact of loneliness in the civilian population have been steadily increasing in number over the past decade, research on the same phenomenon in military settings has progressed at a comparatively slower pace. This article is a two-stage analysis of the perceived lack of social connectedness among active-duty and former military personnel, including (1) a conceptual exploration and literature review based on searches in three electronic databases (PubMed, Google Scholar, and Web of Science/Clarivate), and (2) a pragmatical set of recommended strategies to reduce the impact of loneliness in these populations. Based on the review of 42 primary and secondary sources, the paper explores the prevalence, risk and protective factors, characteristics, and consequences of loneliness, with particular attention to various minorities, female military personnel experiencing motherhood during active duty, civilian spouses of deployed service members, and other significant subgroups. Recommended directions of interventions are threefold, i.e., screening for loneliness and its risk factors, initiation of prophylactic strategies and therapeutic interventions targeting this phenomenon in vulnerable categories. In conclusion, further research on loneliness in both active and former military personnel is strongly warranted, given its significant consequences for multiple dimensions of health and overall functioning.
The assessment of suicide risk is a highly debated topic in the literature due to the complex interplay between social, psychological, cultural, and biological factors that contribute to the pathogenesis of self-harm. There is no unanimously accepted predictive model of suicide and no widely recognized evidence-based algorithm for psychiatric and psychological evaluation in clinical and non-clinical populations for early detection of self-harm. Therefore, this narrative review is focused on identifying the validated clinical instruments that may contribute to the construction of a possible screening and monitoring plan for suicide risk in military and civilian populations. Four electronic databases were searched (PubMed, CINAHL, Google Scholar, and Clarivate/Web of Science) for relevant reports on psychometric tools for detecting suicide risk published between the inception of each archive and January 2025. Seventeen instruments dedicated to the measurement of suicide and suicide-related aspects were reviewed, as well as three tools for the evaluation of depression severity that include specific items for assessing self-harm. The advantages and vulnerabilities of each instrument were assessed, and the particular features of using these tools in the military population were also explored. In conclusion, although a large number of validated instruments for the assessment of suicide risk exist, it is not possible to recommend the use of a single tool, either for clinical and nonclinical populations or for military and civilian personnel. The endeavor of finding an algorithm for the assessment of suicide risk is still far from reaching its end, as new psychometric instruments and possibly a new paradigm for the phenomenon of self-harm are sorely needed.
