1 Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba.
2 Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba.
Can J Psychiatry. 2017 Nov;62(11):795-804. doi: 10.1177/0706743717699174. Epub 2017 May 10.
Worldwide, there has been substantial controversy with respect to whether military deployment is a risk factor for suicidal behaviour. The present study examined the relationship between lifetime exposure to deployment and deployment-related traumatic events (DRTEs) and past-year suicidal ideation (SI), suicidal plans (SP), and suicidal attempts (SA).
Data were analysed from the 2013 Canadian Forces Mental Health Survey (8161 respondents; response rate, 79.8%; aged 18-60 years). A total of 12 individual items assessed exposure to DRTEs (e.g., combat, witnessing human atrocities, feeling responsible for the death of Canadian or ally personnel, knowing someone who was injured or killed). We examined each individual DRTE type as well as the number of types of DRTEs in relation to suicidal behaviour.
Lifetime deployment was not significantly associated with suicidal behaviour. In models adjusted for sociodemographic variables, most of the individual DRTE items and the DRTE count variable were significantly associated with suicidal behaviours (adjusted odds ratio ranged between 1.10 and 5.32). When further adjusting for child abuse exposure, these associations were minimally attenuated, and some became nonsignificant. In models adjusting for mental disorders and child abuse, most DRTEs and number of types of DRTEs became nonsignificant in relation to SI, SP, and SA.
Active military personnel exposed to increasing number of DRTEs are at increased risk for SI, SP, and SA. However, most of the association between DRTEs and suicidal behaviour is accounted for by child abuse exposure and mental disorders.
在全球范围内,军事部署是否是自杀行为的风险因素存在很大争议。本研究调查了一生中接触部署和与部署相关的创伤性事件(DRTE)与过去一年自杀意念(SI)、自杀计划(SP)和自杀尝试(SA)之间的关系。
对 2013 年加拿大军队心理健康调查的数据进行了分析(8161 名受访者;响应率为 79.8%;年龄在 18-60 岁之间)。共有 12 个单独的项目评估了接触 DRTE(例如,战斗、目睹人类暴行、对加拿大或盟军人员的死亡感到负责、认识受伤或死亡的人)。我们研究了每种单独的 DRTE 类型以及 DRTE 类型的数量与自杀行为的关系。
一生中的部署与自杀行为没有显著关联。在调整了社会人口变量的模型中,大多数单独的 DRTE 项目和 DRTE 计数变量与自杀行为显著相关(调整后的优势比在 1.10 到 5.32 之间)。当进一步调整了儿童期虐待暴露情况时,这些关联略有减弱,有些变得不显著。在调整了精神障碍和儿童期虐待的模型中,大多数 DRTE 和 DRTE 类型的数量与 SI、SP 和 SA 之间的关联变得不显著。
接触越来越多 DRTE 的现役军人自杀意念、自杀计划和自杀尝试的风险增加。然而,DRTE 与自杀行为之间的大多数关联可归因于儿童期虐待暴露和精神障碍。