Kopacz Marek S, Bryan Craig J, Bishop Todd M, Ashrafioun Lisham
a U.S. Department of Veterans Affairs , VISN 2 Center of Excellence for Suicide Prevention , Canandaigua , New York , USA.
b U.S. Department of Veterans Affairs , Mid-Atlantic Mental Illness Research, Education and Clinical Center, Mental Health and Chaplaincy , Durham , North Carolina , USA.
J Dual Diagn. 2018 Oct-Dec;14(4):220-227. doi: 10.1080/15504263.2018.1513618. Epub 2018 Nov 19.
Conceptual understandings of meaning-making suggest that it may have protective value in regard to alcohol misuse and suicidal behavior. Accordingly, the aim of this study was to examine whether meaning-making attenuated the relationship between alcohol misuse and suicide risk severity in a population of active-duty service members.
The sample (N = 97) was recruited while presenting for emergency behavioral health services in circumstances indicative of high-risk suicidality: endorsing current suicidal ideation with intent to die. Those who reported ideation with a lifetime history of a past suicide attempt were conceptualized as being in a more severe category of suicide risk than ideation without a lifetime history of a past suicide attempt. Participants completed the Suicidal Behaviors Questionnaire-Revised, Meaning in Life Questionnaire, Alcohol Use Disorders Identification Test consumption questions, and items that assessed demographic variables. Data were analyzed using chi-squared test of independence, Fisher's exact test, Kendall rank correlation coefficient, and logistic regression modeling.
Regression analysis identified a statistically significant association between number of drinks consumed daily and reporting a lifetime history of a past suicide attempt, odds ratio (OR) = 1.60, 95% confidence interval (CI) [1.11, 2.32], p = .01. Number of drinks consumed remained significant even after adjusting for both the search for and presence of meaning, OR = 1.70, 95% CI [1.16, 2.51], p = .01. These results remained unchanged even when adjusting for gender, race, ethnicity, and relationship status. No statistically significant interaction effects were noted between meaning-making and alcohol consumption.
Meaning-making did not appear to attenuate the effect of alcohol misuse on suicide risk severity in a sample of service members at high-risk of suicidality. Additional research is needed to better understand the relationship among meaning-making, alcohol misuse, and suicidal behavior.
对意义建构的概念理解表明，它可能对酒精滥用和自杀行为具有保护价值。因此，本研究的目的是检验在现役军人人群中，意义建构是否减弱了酒精滥用与自杀风险严重程度之间的关系。
样本（N = 97）是在因高风险自杀倾向而寻求紧急行为健康服务时招募的：认可当前有自杀意念且有死亡意图。那些报告有自杀意念且有既往自杀未遂终生史的人被认为处于比没有既往自杀未遂终生史的自杀意念更严重的自杀风险类别。参与者完成了修订版自杀行为问卷、生命意义问卷、酒精使用障碍识别测试消费问题以及评估人口统计学变量的项目。数据采用独立性卡方检验、费舍尔精确检验、肯德尔等级相关系数和逻辑回归模型进行分析。
回归分析确定，每日饮酒量与报告有既往自杀未遂终生史之间存在统计学上的显著关联，比值比（OR）= 1.60，95%置信区间（CI）[1.11, 2.32]，p = 0.01。即使在调整了对意义的探寻和意义的存在之后，饮酒量仍然显著，OR = 1.70，95% CI [1.16, 2.51]，p = 0.01。即使在调整了性别、种族、民族和恋爱状况后，这些结果仍然不变。在意义建构和酒精消费之间未发现统计学上的显著交互作用。
在有高自杀风险的军人样本中，意义建构似乎并未减弱酒精滥用对自杀风险严重程度的影响。需要进一步的研究来更好地理解意义建构、酒精滥用和自杀行为之间的关系。
