Ursano Robert J, Heeringa Steven G, Stein Murray B, Jain Sonia, Raman Rema, Sun Xiaoying, Chiu Wai Tat, Colpe Lisa J, Fullerton Carol S, Gilman Stephen E, Hwang Irving, Naifeh James A, Nock Matthew K, Rosellini Anthony J, Sampson Nancy A, Schoenbaum Michael, Zaslavsky Alan M, Kessler Ronald C
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Depress Anxiety. 2015 Jan;32(1):3-12. doi: 10.1002/da.22317. Epub 2014 Oct 22.
The prevalence of suicide among U.S. Army soldiers has risen dramatically in recent years. Prior studies suggest that most soldiers with suicidal behaviors (i.e., ideation, plans, and attempts) had first onsets prior to enlistment. However, those data are based on retrospective self-reports of soldiers later in their Army careers. Unbiased examination of this issue requires investigation of suicidality among new soldiers.
The New Soldier Study (NSS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) used fully structured self-administered measures to estimate preenlistment histories of suicide ideation, plans, and attempts among new soldiers reporting for Basic Combat Training in 2011-2012. Survival models examined sociodemographic correlates of each suicidal outcome.
Lifetime prevalence estimates of preenlistment suicide ideation, plans, and attempts were 14.1, 2.3, and 1.9%, respectively. Most reported onsets of suicide plans and attempts (73.3-81.5%) occurred within the first year after onset of ideation. Odds of these lifetime suicidal behaviors among new soldiers were positively, but weakly associated with being female, unmarried, religion other than Protestant or Catholic, and a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic.
Lifetime prevalence estimates of suicidal behaviors among new soldiers are consistent with retrospective reports of preenlistment prevalence obtained from soldiers later in their Army careers. Given that prior suicidal behaviors are among the strongest predictors of later suicides, consideration should be given to developing methods of obtaining valid reports of preenlistment suicidality from new soldiers to facilitate targeting of preventive interventions.
近年来，美国陆军士兵的自杀率急剧上升。先前的研究表明，大多数有自杀行为（即自杀意念、计划和企图）的士兵在入伍前就首次出现这些情况。然而，这些数据是基于士兵在军队生涯后期的回顾性自我报告。对这个问题进行无偏差的研究需要调查新兵中的自杀倾向。
陆军研究以评估军人风险与恢复力（陆军STARRS）中的新兵研究（NSS）使用完全结构化的自我管理措施，来估计2011 - 2012年报到接受基础战斗训练的新兵入伍前的自杀意念、计划和企图的历史。生存模型研究了每种自杀结果的社会人口学相关因素。
入伍前自杀意念、计划和企图的终生患病率估计分别为14.1%、2.3%和1.9%。大多数报告的自杀计划和企图的首次出现（73.3 - 81.5%）发生在意念出现后的第一年内。新兵中这些终生自杀行为的几率呈正相关，但与女性、未婚、非新教或天主教的宗教信仰以及非西班牙裔白人、非西班牙裔黑人或西班牙裔以外的种族/族裔的关联较弱。
新兵中自杀行为的终生患病率估计与从军队生涯后期的士兵那里获得的入伍前患病率的回顾性报告一致。鉴于先前的自杀行为是后期自杀最强的预测因素之一，应考虑开发方法以从新兵那里获得入伍前自杀倾向的有效报告，以便于针对性地进行预防干预。
