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遭受不良童年经历的男性伊拉克和阿富汗退伍军人寻求创伤后应激障碍治疗与自杀行为风险。

Adverse childhood experiences and risk for suicidal behavior in male Iraq and Afghanistan veterans seeking PTSD treatment.

机构信息

Psychology Department, University of South Alabama.

National Center for PTSD, Dissemination and Training Division.

出版信息

Psychol Trauma. 2017 Sep;9(5):583-586. doi: 10.1037/tra0000250. Epub 2017 Jan 12.

Abstract

OBJECTIVE

Adverse childhood experiences (ACEs) are associated with increased risk for suicide and appear to occur in disproportionately high rates among men who served in the U.S. military. However, research has yet to examine a comprehensive range of ACEs among Iraq/Afghanistan veterans with combat-related posttraumatic stress disorder (PTSD) or whether these premilitary stressors may contribute to suicidal behavior in this highly vulnerable population.

METHOD

A sample of 217 men entering a residential program for combat-related PTSD completed measures for ACEs, combat exposure, and lifetime suicidal ideation and attempts.

RESULTS

The majority of patients had experienced multiple types of adversity or traumas during childhood/adolescence. In particular, 83.4% endorsed at least 1 ACE category and 41.5% reported experiencing 4 or more ACEs. When accounting for effects of deployment-related stressors, we further found that accumulation of ACEs was uniquely linked with thoughts of suicide or attempts among these patients. Namely, for every 1-point increase on the ACE Questionnaire, veterans' risk of suicidal ideation and attempts increased by 23% and 24%, respectively.

CONCLUSION

This brief report provides initial evidence that veterans seeking treatment for combat-related PTSD often have extensive histories of premilitary stressors that may increase suicide risk beyond probable deployment-related traumas. (PsycINFO Database Record

摘要

目的

不良的童年经历(ACEs)与自杀风险增加有关,而且似乎在曾在美国军队服役的男性中发生率过高。然而,研究尚未探讨在患有与战斗相关的创伤后应激障碍(PTSD)的伊拉克/阿富汗退伍军人中,是否存在广泛的 ACEs,以及这些入伍前的应激源是否可能导致这群高度脆弱人群的自杀行为。

方法

一项针对 217 名进入与战斗相关 PTSD 的住院治疗项目的男性的研究,完成了 ACEs、战斗暴露和终生自杀意念和自杀尝试的测量。

结果

大多数患者在童年/青少年时期经历了多种类型的逆境或创伤。特别是,83.4%的人至少有 1 个 ACE 类别,41.5%的人报告经历了 4 个或更多 ACEs。在考虑到与部署相关的应激源的影响后,我们进一步发现,ACEs 的积累与这些患者的自杀意念和自杀尝试有着独特的联系。也就是说,ACE 问卷每增加 1 分,退伍军人自杀意念和自杀尝试的风险分别增加 23%和 24%。

结论

这份简短的报告提供了初步证据,表明寻求与战斗相关 PTSD 治疗的退伍军人通常有广泛的入伍前应激源史,这些应激源可能会增加自杀风险,超过可能与部署相关的创伤。

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