Centre for Traumatic Stress Studies (CTSS), Level 1, Helen Mayo North, 30 Frome Road, University of Adelaide, SA, 5000, Australia.
Institute of Mental Health, University of Nottingham, Nottingham, UK.
Psychol Med. 2019 Oct;49(14):2421-2431. doi: 10.1017/S0033291718003355. Epub 2018 Nov 13.
To better understand the associations of childhood trauma and childhood disorder with past-year suicidality (thoughts, plans or attempts), we compared male military and civilian populations aged 18-60 years old.
Data derived from the 2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study and the 2007 Australian Bureau of Statistics Australian National Survey of Mental Health and Wellbeing were compared using logistic regression and Generalized Structural Equation Modelling (GSEM).
A greater proportion of the ADF experienced suicidality than civilians. Those who experienced childhood trauma that was not interpersonal in nature were not at increased odds of suicidality, in either population. A higher proportion of the ADF experienced three or more types of trauma in childhood and first experienced three or more types of trauma in adulthood. Both were associated with suicidality in the ADF and civilians. Childhood anxiety had a strong and independent association with suicidality in the ADF (controlling for demographics and childhood trauma, adult trauma and adult onset disorder). Childhood anxiety fully mediated the relationship between childhood trauma and suicidality in the ADF, but not in civilians.
These data highlight the need to take a whole life approach to understanding suicidality, and the importance of categorizing the nature of childhood trauma exposure. Importantly, childhood anxiety was not only associated with suicidality, it fully mediated the relationship between childhood trauma and suicidality in the more trauma exposed (military) population only. These findings have the potential to inform the development of strategies for suicide prevention.
为了更好地理解童年创伤和童年障碍与过去一年自杀意念（想法、计划或尝试）的关联，我们比较了 18-60 岁的男性军人和非军人人群。
数据来自于 2010 年澳大利亚国防军（ADF）心理健康流行状况和幸福感研究以及 2007 年澳大利亚统计局澳大利亚国家心理健康和幸福感调查，使用逻辑回归和广义结构方程模型（GSEM）进行比较。
ADF 中经历自杀意念的比例高于非军人。在两个群体中，经历非人际性质的童年创伤的人，自杀意念的几率并没有增加。ADF 中经历三种或更多种童年创伤的比例更高，而且成年后首次经历三种或更多种创伤的比例也更高。这两个因素都与 ADF 和非军人中的自杀意念相关。童年焦虑在 ADF 中与自杀意念有很强的独立关联（控制人口统计学、童年创伤、成年创伤和成年发病障碍）。童年焦虑在 ADF 中完全中介了童年创伤与自杀意念之间的关系，但在非军人中则不然。
这些数据强调了需要采用整体生活方法来理解自杀意念，以及对童年创伤暴露性质进行分类的重要性。重要的是，童年焦虑不仅与自杀意念相关，而且在创伤暴露程度更高的（军人）人群中，完全中介了童年创伤与自杀意念之间的关系。这些发现有可能为制定预防自杀的策略提供信息。
