National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, Resilience Laboratory, VA Connecticut Healthcare System, West Haven, CT 06516, USA.
J Psychiatr Res. 2011 Jun;45(6):720-6. doi: 10.1016/j.jpsychires.2010.11.015. Epub 2010 Dec 23.
Recent epidemiologic studies have found an increased risk of suicide among Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF) with psychiatric disorders. However, little is known about whether variables other than psychiatric conditions, such as coping strategies, resilience, and social support, may be related to suicidality in this population.
A total of 167 OEF-OIF Veterans seeking behavioral or primary care services completed a survey containing measures of combat exposure, psychopathology, pain, psychological resilience, social support, and cognitive coping strategies.
Thirty-six respondents (21.6%) reported contemplating suicide in the two weeks prior to completing the survey. Compared to suicide non-contemplators, suicide contemplators were older, and more likely to screen positive for depression and posttraumatic stress disorder (PTSD), and to report a deployment-related pain condition or complaint. They also scored higher on measures of worry, self-punishment, and cognitive-behavioral avoidance strategies, and lower on measures of psychological resilience and postdeployment social support. Multivariate analysis revealed that a positive depression screen, and higher scores on measures of self-punishment and cognitive-social avoidance coping were positively associated with suicidal ideation, while higher scores on measures of psychological resilience (i.e., positive acceptance of change) were negatively related to suicidal ideation. Moderator analysis revealed that a positive screen for depression or PTSD significantly diminished the protective effect of postdeployment social support on suicidal ideation.
1 in 5 treatment-seeking OEF-OIF Veterans may contemplate suicide. Interventions to reduce depressive symptoms, and maladaptive cognitive-behavioral coping strategies of self-punishment and cognitive social avoidance, and to bolster psychological resilience may help mitigate suicidality in this population.
最近的流行病学研究发现，患有精神障碍的持久自由行动和伊拉克自由行动（OEF-OIF）退伍军人自杀的风险增加。然而，对于除精神状况以外的变量，例如应对策略、适应力和社会支持，是否与该人群的自杀倾向有关，人们知之甚少。
共有 167 名寻求行为或初级保健服务的 OEF-OIF 退伍军人完成了一项调查，其中包含了战斗暴露、精神病理学、疼痛、心理适应力、社会支持和认知应对策略的测量。
36 名受访者（21.6%）报告在完成调查前两周内曾考虑过自杀。与非自杀思考者相比，自杀思考者年龄较大，更有可能筛查出抑郁和创伤后应激障碍（PTSD）阳性，报告与部署相关的疼痛状况或抱怨。他们还在担忧、自我惩罚和认知-行为回避策略的测量上得分较高，而在心理适应力和部署后社会支持的测量上得分较低。多变量分析显示，抑郁筛查阳性以及自我惩罚和认知-社会回避应对措施得分较高与自杀意念呈正相关，而心理适应力（即对变化的积极接受）得分较高与自杀意念呈负相关。调节分析显示，抑郁或 PTSD 筛查阳性显著降低了部署后社会支持对自杀意念的保护作用。
在寻求治疗的 OEF-OIF 退伍军人中，每 5 人就有 1 人可能考虑自杀。干预措施可以减少抑郁症状，以及自我惩罚和认知-社会回避的适应不良认知应对策略，并增强心理适应力，这可能有助于减轻该人群的自杀倾向。
