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干预挫败归属感和被感知累赘感以降低退伍军人自杀率:一项随机对照试验的亚组分析。

Intervening on Thwarted Belongingness and Perceived Burdensomeness to Reduce Suicidality Among Veterans: Subanalyses From a Randomized Controlled Trial.

机构信息

Florida State University.

Southeast Louisiana Veterans Health Care System.

出版信息

Behav Ther. 2019 Sep;50(5):886-897. doi: 10.1016/j.beth.2019.01.004. Epub 2019 Jan 24.

Abstract

Suicide is a growing public health crisis among military veterans. Despite recent attention to this area, there are few empirically supported preventative interventions for suicidality among veterans. In the context of an empirically supported theoretical framework, the Interpersonal Theory of Suicide, the current study targeted suicide risk factors (i.e., perceived burdensomeness and thwarted belongingness) among a sample of 46 veterans selected from a larger clinical trial. Participants were randomized to receive either a newly developed computerized intervention aimed at decreasing perceived burdensomeness and thwarted belongingness, or participate in a repeated contact control condition. Results indicated a direct effect of the intervention on both perceived burdensomeness and thwarted belongingness. Temporal mediation analyses also revealed an indirect effect of condition on suicidality at Month 1 follow-up via reductions in perceived burdensomeness. The current results are the first to indicate that factors from the interpersonal theory of suicide can be reduced among veterans, and to demonstrate that these reductions in perceived burdensomeness lead to reductions in suicidality. Because of the brevity and computer delivery system, this intervention could be widely and rapidly disseminated among military veterans to reduce the public health burden of suicide in this population.

摘要

自杀是退伍军人中日益严重的公共卫生危机。尽管最近关注了这一领域,但针对退伍军人自杀意念,几乎没有经过实证支持的预防干预措施。在一个经过实证支持的理论框架——人际理论的自杀框架下,本研究针对的是从一项大型临床试验中选取的 46 名退伍军人样本中的自杀风险因素(即感知负担和归属感受挫)。参与者被随机分配接受新开发的旨在降低感知负担和归属感受挫的计算机干预,或参加重复接触对照条件。结果表明,干预对感知负担和归属感受挫都有直接影响。时间中介分析还表明,通过降低感知负担,条件对 1 个月随访时自杀的间接影响。目前的结果首次表明,自杀的人际理论中的因素可以在退伍军人中减少,并且表明这些感知负担的减少会导致自杀率的降低。由于干预措施简短且采用计算机传递系统,因此可以在退伍军人中广泛快速传播,以减轻这一人群的自杀带来的公共卫生负担。

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本文引用的文献

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Suicide prevention in the military: a mechanistic perspective.军事人员自杀预防:一种机械论视角。
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The Role of Perceived Burden and Social Support in Suicide and Depression.感知负担和社会支持在自杀和抑郁中的作用。
Suicide Life Threat Behav. 2018 Feb;48(1):87-94. doi: 10.1111/sltb.12327. Epub 2017 Jan 17.

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