McKinney Jessica M, Hirsch Jameson K, Britton Peter C
Department of Psychology, East Tennessee State University, United States.
Department of Psychology, East Tennessee State University, United States.
J Affect Disord. 2017 May;214:100-107. doi: 10.1016/j.jad.2017.03.008. Epub 2017 Mar 7.
Suicide rates are higher in veterans compared to the general population, perhaps due to trauma exposure. Previous literature highlights depressive symptoms and anger as contributors to suicide risk. PTSD symptoms may indirectly affect suicide risk by increasing the severity of such cognitive-emotional factors.
A sample of community dwelling veterans (N=545) completed online surveys, including the PTSD Checklist-Military Version, Suicidal Behaviors Questionnaire-Revised, Multidimensional Health Profile-Psychosocial Functioning, and Differential Emotions Scale -IV. Bivariate and serial mediation analyses were conducted to test for direct and indirect effects of PTSD symptoms on suicide risk.
In bivariate analyses, PTSD symptoms, depression, anger, and internal hostility were positively related to suicide risk. In serial mediation analyses, there was a significant total effect of PTSD symptoms on suicide risk in both models. PTSD symptoms were also indirectly related to suicidal behavior via depression and internal hostility, and via internal hostility alone. Anger was not a significant mediator.
Our cross-sectional sample was predominantly White and male; prospective studies with diverse veterans are needed.
Our findings may have implications for veteran suicide prevention. The effects of PTSD and depression on anger, particularly internal hostility, are related to suicide risk, suggesting a potential mechanism of action for the PTSD-suicide linkage. A multi-faceted therapeutic approach, targeting depression and internal hostility, via cognitive-behavioral techniques such as behavioral activation and cognitive restructuring, may reduce suicide risk in veterans who have experienced trauma.
与普通人群相比，退伍军人的自杀率更高，这可能是由于他们经历过创伤。以往的文献强调抑郁症状和愤怒是自杀风险的促成因素。创伤后应激障碍（PTSD）症状可能通过加剧此类认知 - 情感因素的严重程度而间接影响自杀风险。
对一组居住在社区的退伍军人（N = 545）进行在线调查，调查内容包括PTSD检查表 - 军事版、自杀行为问卷修订版、多维健康概况 - 心理社会功能以及差异情绪量表 - IV。进行双变量和系列中介分析，以检验PTSD症状对自杀风险的直接和间接影响。
在双变量分析中，PTSD症状、抑郁、愤怒和内敌意与自杀风险呈正相关。在系列中介分析中，两个模型中PTSD症状对自杀风险均有显著的总体影响。PTSD症状还通过抑郁和内敌意，以及仅通过内敌意与自杀行为间接相关。愤怒不是一个显著的中介因素。
我们的横断面样本主要是白人和男性；需要对不同退伍军人进行前瞻性研究。
我们的研究结果可能对退伍军人自杀预防有启示。PTSD和抑郁对愤怒，尤其是内敌意的影响与自杀风险相关，这表明了PTSD与自杀之间联系的潜在作用机制。一种多方面的治疗方法，通过行为激活和认知重构等认知行为技术来针对抑郁和内敌意，可能会降低经历过创伤的退伍军人的自杀风险。
