Brenner Lisa A, Bahraini Nazanin, Homaifar Beeta Y, Monteith Lindsey L, Nagamoto Herbert, Dorsey-Holliman Brooke, Forster Jeri E
Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Neurology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.
Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.
Arch Phys Med Rehabil. 2015 Aug;96(8):1411-8. doi: 10.1016/j.apmr.2015.04.010. Epub 2015 Apr 28.
To examine the relationship between executive dysfunction, as a multidimensional construct (ie, decision-making, impulsivity, aggression, concept formation), and suicide attempt (SA) history in a high-risk sample of veterans with moderate to severe traumatic brain injury (TBI).
Observational, 2×2 factorial design. To estimate group differences, linear regression was used to model the primary and secondary outcomes of interest as a function of history of SA, TBI, and the interaction between the 2 variables. Additionally, to determine the pattern of performance over the course of the Iowa Gambling Test (IGT), scores were modeled across the 5 IGT blocks by using a varying-coefficient model.
Veterans Health Administration.
Veterans (N=133; no SA/no TBI, n=48; no SA/yes TBI, n=51; yes SA/no TBI, n=12; yes SA/yes TBI, n=22) completed the study measures.
Not applicable.
IGT, Immediate and Delayed Memory Test, State-Trait Anger Expression Inventory-2, Wisconsin Card Sorting Test.
All groups demonstrated learning over the course of the IGT, except for veterans with a history of both SA and TBI. No group differences were identified on other measures of executive functioning.
These findings highlight the potential, unique decision-making challenges faced by veterans with a history of TBI and SA. Specialized interventions focused on overall distress reduction and means restriction may be required to prevent future self-directed violence.
在中度至重度创伤性脑损伤（TBI）的高危退伍军人样本中，研究作为多维结构（即决策、冲动、攻击性、概念形成）的执行功能障碍与自杀未遂（SA）史之间的关系。
观察性2×2析因设计。为了估计组间差异，使用线性回归将感兴趣的主要和次要结果建模为SA史、TBI以及这两个变量之间相互作用的函数。此外，为了确定爱荷华赌博测试（IGT）过程中的表现模式，使用变系数模型对5个IGT模块的得分进行建模。
退伍军人健康管理局。
退伍军人（N = 133；无SA/无TBI，n = 48；无SA/有TBI，n = 51；有SA/无TBI，n = 12；有SA/有TBI，n = 22）完成了研究测量。
不适用。
IGT、即时和延迟记忆测试、状态-特质愤怒表达量表-2、威斯康星卡片分类测试。
除了有SA和TBI史的退伍军人外，所有组在IGT过程中均表现出学习能力。在执行功能的其他测量中未发现组间差异。
这些发现突出了有TBI和SA史的退伍军人面临的潜在独特决策挑战。可能需要专注于整体痛苦减轻和手段限制的专门干预措施，以防止未来的自我伤害暴力行为。
