Ressler Kerry J, Schoomaker Eric B
Psychiatry. 2014 Summer;77(2):120-9. doi: 10.1521/psyc.2014.77.2.120.
Although historically the Army suicide rate has been significantly lower than the civilian rate, in 2004, the suicide and accidental death rates began trending upward. By 2008, the Army suicide rate had risen above the national average (20.2 per 100,000). In 2009, 160 active duty Soldiers took their lives, making suicide the third leading cause of death among the Army population. If accidental death, frequently the result of high-risk behavior, is included, then more Soldiers died by their own actions than in combat in 2009. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) was thus created in 2009 to begin to address these problems. The Army STARRS project is a large consortium of seven different studies to develop data-driven methods for mitigating or preventing suicide behaviors and improving the overall mental health and behavioral functioning of Army Soldiers during and after their Army service. The first research articles from the Army STARRS project were published in late 2013 and early 2014. This work has already begun to outline important facets of risk in the military, and it is helping to drive an empirically derived approach to improvements in understanding mental disorders and risk behavior and to improve prevention and support of mental health and resilience. The Framingham Heart Study, started in the 1940s, marked a watershed event in utilizing large cross-sectional and prospective longitudinal collaborative research to identify and understand risk factors for cardiovascular disease. The Army STARRS project, through its collaborative, prospective, and robust innovative design and implementation, may provide the beginning of a similar scientific cohort in mental disorders. The work of this project will help understand biological and psychological aspects of military service, including those leading to suicide. When coupled with timely feedback to Army leadership, it permits near real-time steps to diagnose, mitigate, and manage emerging mental health issues and the root causes of risk and resilience in Army Soldiers, with potential impact extending across many traumatized populations-not unlike a parallel process that has markedly improved survival and recovery from physical combat wounds.
尽管从历史上看，陆军的自杀率一直显著低于 civilian rate，但在 2004 年，自杀率和意外死亡率开始呈上升趋势。到 2008 年，陆军自杀率已超过全国平均水平（每 10 万人中有 20.2 人自杀）。2009 年，160 名现役军人自杀，使自杀成为陆军人群中第三大死因。如果将经常因高风险行为导致的意外死亡包括在内，那么 2009 年因自身行为死亡的军人比在战斗中死亡的军人还要多。因此，陆军于 2009 年启动了“军人风险与复原力评估研究”（Army STARRS），以着手解决这些问题。陆军 STARRS 项目是一个由七项不同研究组成的大型联盟，旨在开发基于数据的方法，以减轻或预防自杀行为，并改善陆军军人在服役期间及退役后的整体心理健康和行为功能。陆军 STARRS 项目的首批研究文章于 2013 年末和 2014 年初发表。这项工作已经开始勾勒出军队中风险的重要方面，并有助于推动一种基于实证的方法，以改进对精神障碍和风险行为的理解，并改善对心理健康和复原力的预防与支持。始于 20 世纪 40 年代的弗雷明汉心脏研究，标志着在利用大型横断面和前瞻性纵向合作研究来识别和理解心血管疾病风险因素方面的一个分水岭事件。陆军 STARRS 项目通过其协作、前瞻性和强大的创新设计与实施，可能为精神障碍领域提供一个类似的科学队列研究的开端。该项目的工作将有助于理解军事服役的生物学和心理学方面，包括那些导致自杀的因素。当与及时反馈给陆军领导层相结合时，它允许采取近乎实时的措施来诊断、减轻和管理新出现的心理健康问题以及陆军军人风险与复原力的根本原因，其潜在影响将扩展到许多受创伤的人群——这与一个显著改善了身体战斗创伤后的生存和恢复情况的类似过程并无不同。
