Mental Illness Research, Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA 19104, USA.
Soc Psychiatry Psychiatr Epidemiol. 2013 Feb;48(2):233-43. doi: 10.1007/s00127-012-0534-5. Epub 2012 Jun 22.
The current study examined the independent association between positive (e.g., emotional and instrumental support) and negative (e.g., insensitive behavior, unwanted advice from others) social exchanges and suicidal ideation among veterans referred for a behavioral health assessment.
The sample included 606 veterans [mean age = 54.96 (SD = 14.96)] referred by primary care for a clinical mental health/substance abuse (MH/SA) assessment following a positive MH/SA screen. Data on sociodemographics, MH/SA conditions (e.g., depression, PTSD, anxiety, and alcohol abuse), the self-reported frequency of positive and negative social exchanges, and suicidal ideation were extracted from clinical interviews and evaluated.
Veterans were primarily male, non-married, and had adequate financial resources, and approximately half were White. 74.4 and 20.3% met criteria for a MH/SA condition and suicidal ideation, respectively. Multiple logistic regression analyses revealed that, adjusting for sociodemographics, physical functioning, and comorbid MH/SA conditions, veterans reporting more frequent negative exchanges with network members were significantly more likely to report suicidal ideation. Positive exchanges, in contrast, were not significantly related to the outcome. Inadequate finances and MH/SA conditions also were significantly related to suicidal ideation.
Findings highlight the value of exploring the quality of social exchanges among veterans in primary care who screen positive for behavioral health issues, as such information has the potential to inform screening and intervention efforts aimed at reducing suicidal ideation.
本研究考察了积极（如情感和工具支持）和消极（如不敏感行为、他人的不请自来的建议）社会交往与接受行为健康评估的退伍军人自杀意念之间的独立关联。
该样本包括 606 名退伍军人[平均年龄=54.96（SD=14.96）]，他们因心理健康/物质滥用（MH/SA）筛查阳性而由初级保健转介进行临床心理健康/物质滥用评估。从临床访谈中提取了社会人口统计学、心理健康/物质滥用状况（如抑郁、创伤后应激障碍、焦虑和酗酒）、自我报告的积极和消极社会交往频率以及自杀意念的数据，并进行了评估。
退伍军人主要是男性、未婚且有足够的经济资源，约一半是白人。74.4%和 20.3%分别符合 MH/SA 状况和自杀意念的标准。多变量逻辑回归分析显示，在调整社会人口统计学、身体机能和共病 MH/SA 状况后，与网络成员报告更频繁的消极交往的退伍军人更有可能报告自杀意念。相比之下，积极交往与结果没有显著关系。经济拮据和 MH/SA 状况也与自杀意念显著相关。
研究结果强调了在初级保健中筛查行为健康问题呈阳性的退伍军人中探索社会交往质量的价值，因为这些信息有可能为旨在减少自杀意念的筛查和干预工作提供信息。
