Bing-Canar Hanaan, Ranney Rachel M, McNett Sage, Tran Jana K, Berenz Erin C, Vujanovic Anka A
Department of Psychology, University of Illinois at Chicago, Chicago, Illinois.
Houston Fire Department.
J Nerv Ment Dis. 2019 Mar;207(3):192-198. doi: 10.1097/NMD.0000000000000947.
Alcohol use problems are associated with suicidal desire and may provide an avenue to suicidal ideation and behavior. However, the influence of posttraumatic stress disorder (PTSD) on the nature of the relationship between alcohol use problems and suicide risk is not well understood. In particular, the potential for PTSD to moderate the association between alcohol use problems and suicide risk remains unexplored. The present study investigated the main and interactive effects of alcohol use problems (Alcohol Use Disorders Identification Test) and PTSD symptoms (PTSD Checklist for DSM-5) on suicide risk (Suicide Behaviors Questionnaire-Revised) in a sample of 632 trauma-exposed firefighters (93.5% men; Mage = 38.44 years, SD = 8.59). Hierarchical logistic regression analyses evaluated whether the main and interactive effects of PTSD symptom severity and alcohol use disorders were significantly related to suicide risk, above and beyond age and cumulative trauma. The main effects of PTSD symptom severity (odds ratio, 1.76; p < 0.001) and alcohol use problems (odds ratio, 1.37; p = 0.391) significantly positively predicted suicide risk; however, PTSD symptoms did not moderate an association between alcohol use problems and suicide risk after accounting for these main effects (p > 0.05). A secondary, exploratory aim demonstrated that all PTSD symptom clusters significantly positively predicted suicide risk (p's < 0.001), although none of these clusters interacted with alcohol use problems to predict suicide risk (p's > 0.05). Theoretical and clinical implications are discussed as they relate to the importance of screening for PTSD and alcohol use disorder among firefighter populations.
酒精使用问题与自杀意愿相关，可能为自杀意念和行为提供途径。然而，创伤后应激障碍（PTSD）对酒精使用问题与自杀风险之间关系性质的影响尚未得到充分理解。特别是，PTSD调节酒精使用问题与自杀风险之间关联的可能性仍未得到探索。本研究调查了632名经历过创伤的消防员样本（93.5%为男性；年龄中位数=38.44岁，标准差=8.59）中酒精使用问题（酒精使用障碍识别测试）和PTSD症状（DSM-5的PTSD检查表）对自杀风险（自杀行为问卷修订版）的主要和交互作用。分层逻辑回归分析评估了PTSD症状严重程度和酒精使用障碍的主要和交互作用是否在年龄和累积创伤之外与自杀风险显著相关。PTSD症状严重程度的主要作用（优势比，1.76；p<0.001）和酒精使用问题的主要作用（优势比，1.37；p=0.391）显著正向预测自杀风险；然而，在考虑这些主要作用后，PTSD症状并未调节酒精使用问题与自杀风险之间的关联（p>0.05）。一个次要的探索性目标表明，所有PTSD症状簇均显著正向预测自杀风险（p值<0.001），尽管这些簇均未与酒精使用问题相互作用来预测自杀风险（p值>0.05）。讨论了与消防员群体中PTSD和酒精使用障碍筛查重要性相关的理论和临床意义。
