Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Department of Psychiatry and Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California and VA San Diego Healthcare System, San Diego, CA, USA.
Psychiatry Res. 2018 Apr;262:575-582. doi: 10.1016/j.psychres.2017.09.046. Epub 2017 Sep 20.
Suicide attempt (SA) rates in the U.S. Army increased substantially during the wars in Afghanistan and Iraq. This study examined associations of family violence (FV) history with SA risk among soldiers. Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records of active duty, Regular Army, enlisted soldiers with medically documented SAs from 2004 to 2009 (n = 9650) and a sample of control person-months (n = 153,528). Logistic regression analyses examined associations of FV with SA, adjusting for socio-demographics, service-related characteristics, and prior mental health diagnosis. Odds of SA were higher in soldiers with a FV history and increased as the number of FV events increased. Soldiers experiencing past-month FV were almost five times as likely to attempt suicide as those with no FV history. Odds of SA were elevated for both perpetrators and those who were exclusively victims. Male perpetrators had higher odds of SA than male victims, whereas female perpetrators and female victims did not differ in SA risk. A discrete-time hazard function indicated that SA risk was highest in the initial months following the first FV event. FV is an important consideration in understanding risk of SA among soldiers.
美国军队在阿富汗和伊拉克战争期间自杀企图（SA）率大幅上升。本研究探讨了士兵中家庭暴力（FV）史与 SA 风险的关联。利用来自军队风险和复原力研究（Army STARRS）的行政数据，我们确定了 2004 年至 2009 年期间有医疗记录的 SA 的现役、正规军、入伍士兵的人员月份记录（n = 9650）和一个对照人员月份样本（n = 153528）。Logistic 回归分析考察了 FV 与 SA 的关联，调整了社会人口统计学、与服务相关的特征和先前的心理健康诊断。有 FV 史的士兵发生 SA 的可能性更高，并且随着 FV 事件数量的增加而增加。过去一个月经历过 FV 的士兵自杀的可能性几乎是没有 FV 史的士兵的五倍。过去的受害者和施害者都有更高的 SA 风险。男性施害者的 SA 风险高于男性受害者，而女性施害者和女性受害者的 SA 风险没有差异。离散时间风险函数表明，SA 风险在首次 FV 事件后的最初几个月最高。FV 是理解士兵中 SA 风险的重要考虑因素。
