National Center for PTSD, VA Boston Healthcare System,Boston,MA,USA.
Departments of Social and Behavioral Sciences, and Epidemiology,Harvard School of Public Health,Boston,MA,USA.
Psychol Med. 2015 Mar;45(4):717-26. doi: 10.1017/S003329171400258X. Epub 2014 Oct 31.
The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) has found that the proportional elevation in the US Army enlisted soldier suicide rate during deployment (compared with the never-deployed or previously deployed) is significantly higher among women than men, raising the possibility of gender differences in the adverse psychological effects of deployment.
Person-month survival models based on a consolidated administrative database for active duty enlisted Regular Army soldiers in 2004-2009 (n = 975,057) were used to characterize the gender × deployment interaction predicting suicide. Four explanatory hypotheses were explored involving the proportion of females in each soldier's occupation, the proportion of same-gender soldiers in each soldier's unit, whether the soldier reported sexual assault victimization in the previous 12 months, and the soldier's pre-deployment history of treated mental/behavioral disorders.
The suicide rate of currently deployed women (14.0/100,000 person-years) was 3.1-3.5 times the rates of other (i.e. never-deployed/previously deployed) women. The suicide rate of currently deployed men (22.6/100,000 person-years) was 0.9-1.2 times the rates of other men. The adjusted (for time trends, sociodemographics, and Army career variables) female:male odds ratio comparing the suicide rates of currently deployed v. other women v. men was 2.8 (95% confidence interval 1.1-6.8), became 2.4 after excluding soldiers with Direct Combat Arms occupations, and remained elevated (in the range 1.9-2.8) after adjusting for the hypothesized explanatory variables.
These results are valuable in excluding otherwise plausible hypotheses for the elevated suicide rate of deployed women and point to the importance of expanding future research on the psychological challenges of deployment for women.
美国陆军风险与适应研究（Army STARRS）发现，与从未部署或之前部署过的士兵相比，在部署期间，美国陆军应征士兵的自杀率呈比例上升，女性的上升幅度明显高于男性，这表明部署对女性的心理影响可能存在性别差异。
使用基于 2004-2009 年现役正规陆军应征士兵综合管理数据库的人员-月生存模型，对性别与部署交互作用预测自杀的情况进行分析。探讨了四个解释性假设，涉及每个士兵职业中的女性比例、每个士兵部队中的同性士兵比例、士兵在前 12 个月是否报告性侵犯受害情况以及士兵在部署前是否有治疗过的精神/行为障碍史。
目前部署的女性（14.0/100,000 人年）自杀率是其他（即从未部署/之前部署）女性的 3.1-3.5 倍。目前部署的男性（22.6/100,000 人年）自杀率是其他男性的 0.9-1.2 倍。调整（时间趋势、社会人口统计学和陆军职业变量）后，目前部署的女性与其他女性和男性相比的自杀率比值为 2.8（95%置信区间 1.1-6.8），排除直接作战兵种的士兵后，该比值变为 2.4，在调整了假设的解释变量后，该比值仍处于较高水平（在 1.9-2.8 范围内）。
这些结果有助于排除其他可能的假设，并突出了未来研究女性在部署期间面临的心理挑战的重要性。
