Campbell-Sills Laura, Kessler Ronald C, Ursano Robert J, Rosellini Anthony J, Afifi Tracie O, Colpe Lisa J, Heeringa Steven G, Nock Matthew K, Sampson Nancy A, Sareen Jitender, Schoenbaum Michael, Sun Xiaoying, Jain Sonia, Stein Murray B
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Depress Anxiety. 2017 Aug;34(8):701-710. doi: 10.1002/da.22621. Epub 2017 Apr 3.
Prior studies have documented associations of childhood bullying victimization with suicidal behaviors. However, many failed to adjust for concomitant risk factors and none investigated this relationship in military personnel. This study aimed to estimate independent associations of childhood bullying victimization with suicidal behaviors among U.S. Army soldiers.
Soldiers reporting for basic training completed a cross-sectional survey assessing mental disorders, suicidal behaviors, and childhood adversities including two types of bullying victimization: (1) Physical Assault/Theft and (2) Bullying Comments/Behaviors. Associations of childhood bullying experiences with suicidal behaviors were estimated using discrete-time survival analysis of person-year data from 30,436 soldiers. Models adjusted for sociodemographic factors, childhood maltreatment by adults, and mental disorders.
After comprehensive adjustment for other risk factors, more frequent Physical Assault/Theft by peers during childhood was associated with increased odds of lifetime suicidal ideation (adjusted odds ratio [AOR] = 1.18, 95% CI: 1.11-1.26, P < .001) and attempt (AOR = 1.30, 95% CI: 1.13-1.50, P < .001). More frequent Bullying Comments/Behaviors were associated with increased risk of ideation (AOR = 1.30, 95% CI: 1.26-1.35, P < .001), plan (AOR = 1.44, 95% CI: 1.35-1.54, P < .001), attempt (AOR = 1.24, 95% CI: 1.15-1.33, P < .001), and onset of plan among ideators (AOR = 1.09, 95% CI: 1.03-1.15, P = .002). Relative to no bullying victimization, exposure to the most persistent bullying was associated with two- to fourfold increase in risk for suicidal behaviors.
Childhood bullying victimization is associated with lifetime suicidal behaviors among new soldiers. Exposure to Bullying Comments/Behaviors during childhood is associated with progression from suicidal ideation to plan. Improved recognition of these relationships may inform risk mitigation interventions for soldiers.
先前的研究已记录了童年期受欺凌与自杀行为之间的关联。然而，许多研究未能对伴随的风险因素进行调整，且没有一项研究在军事人员中调查这种关系。本研究旨在评估美国陆军士兵童年期受欺凌与自杀行为之间的独立关联。
报到参加基础训练的士兵完成了一项横断面调查，评估心理障碍、自杀行为和童年逆境，包括两种受欺凌类型：（1）身体攻击/盗窃和（2）欺凌言论/行为。使用来自30436名士兵的人年数据进行离散时间生存分析，估计童年欺凌经历与自杀行为之间的关联。模型对社会人口学因素、成人对儿童的虐待以及心理障碍进行了调整。
在对其他风险因素进行全面调整后，童年期同伴更频繁的身体攻击/盗窃与终生自杀意念（调整后的优势比[AOR]=1.18，95%可信区间：1.11-1.26，P<.001）和自杀未遂（AOR=1.30，95%可信区间：1.13-1.50，P<.001）的几率增加相关。更频繁的欺凌言论/行为与意念风险增加（AOR=1.30，95%可信区间：1.26-1.35，P<.001）、计划（AOR=1.44，95%可信区间：1.35-1.54，P<.001）、未遂（AOR=1.24，95%可信区间：1.15-1.33，P<.001）以及意念者中计划的开始（AOR=1.09，95%可信区间：1.03-1.15，P=.002）相关。相对于未受欺凌，遭受最持久欺凌与自杀行为风险增加两到四倍相关。
童年期受欺凌与新兵的终生自杀行为相关。童年期遭受欺凌言论/行为与从自杀意念发展到计划相关。更好地认识这些关系可能为士兵的风险缓解干预提供信息。
