Ursano Robert J, Kessler Ronald C, Heeringa Steven G, Cox Kenneth L, Naifeh James A, Fullerton Carol S, Sampson Nancy A, Kao Tzu-Cheg, Aliaga Pablo A, Vegella Patti, Mash Holly Herberman, Buckley Christina, Colpe Lisa J, Schoenbaum Michael, Stein Murray B
Psychiatry. 2015;78(1):1-21. doi: 10.1080/00332747.2015.1006512.
Although the U.S. Army suicide rate is known to have risen sharply over the past decade, information about medically documented, nonfatal suicidal behaviors is far more limited. Here we examine trends and sociodemographic correlates of suicide attempts, suspicious injuries, and suicide ideation among regular Army soldiers.
Data come from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) Historical Administrative Data Study (HADS), which integrates administrative records for all soldiers on active duty during the years 2004 through 2009 (n = 1.66 million).
We identified 21,740 unique regular Army soldiers with a nonfatal suicidal event documented at some point during the HADS study period. There were substantial increases in the annual incidence rates of suicide attempts (179-400/100,000 person-years) and suicide ideation (557-830/100,000 person-years), but not suspicious injuries. Using hierarchical classification rules to identify the first instance of each soldier's most severe behavior, we found increased risk of all outcomes among those who were female, non-Hispanic White, never married, lower-ranking enlisted, less educated, and of younger age when entering Army service. These sociodemographic associations significantly differed across outcomes, despite some patterns that appear similar.
Results provide a broad overview of nonfatal suicidal trends in the U.S. Army during 2004 through 2009 and demonstrate that integration of multiple administrative data systems enriches analysis of the predictors of such events.
尽管已知美国陆军自杀率在过去十年中急剧上升,但有关医学记录的非致命自杀行为的信息却极为有限。在此,我们研究了正规陆军士兵自杀未遂、可疑受伤及自杀意念的趋势和社会人口学相关因素。
数据来自陆军服役人员风险与恢复力评估研究(Army STARRS)历史行政数据研究(HADS),该研究整合了2004年至2009年期间所有现役士兵的行政记录(n = 166万)。
我们在HADS研究期间的某个时间点确定了21740名有非致命自杀事件记录的独特正规陆军士兵。自杀未遂(179 - 400/100000人年)和自杀意念(557 - 830/100000人年)的年发病率大幅上升,但可疑受伤情况未出现此类变化。使用分层分类规则来确定每名士兵最严重行为的首次发生情况,我们发现女性、非西班牙裔白人、从未结婚、军衔较低、受教育程度较低以及入伍时年龄较小的士兵出现所有结果的风险增加。尽管有些模式看似相似,但这些社会人口学关联在不同结果之间存在显著差异。
研究结果提供了2004年至2009年美国陆军非致命自杀趋势的全面概述,并表明整合多个行政数据系统丰富了对此类事件预测因素的分析。