VA Connecticut Healthcare System, West Haven, Connecticut; Yale University School of Medicine, New Haven, Connecticut.
VA Connecticut Healthcare System, West Haven, Connecticut; Yale University School of Medicine, New Haven, Connecticut.
Am J Prev Med. 2020 May;58(5):675-682. doi: 10.1016/j.amepre.2019.12.006. Epub 2020 Feb 7.
Previous research has demonstrated an association between military sexual trauma and risk for suicide; however, risk for self-directed violence such as suicide attempt or nonsuicidal self-injury following military sexual trauma is understudied. This study examines the relationship between military sexual trauma and serious self-directed violence resulting in hospitalization, as well as whether this relationship differs by sex.
Participants were 750,176 Operations Enduring Freedom/Iraqi Freedom/New Dawn veterans who were enrolled in Veterans Health Administration care during the period of October 1, 2001-September 30, 2014 and who were screened for military sexual trauma. Data were analyzed in 2019. Bivariate analyses and Cox proportional hazards regression models were employed.
Women veterans were more likely to screen positive for military sexual trauma (21.33% vs 1.63%), and women and men were equally likely to experience serious self-directed violence (1.19% women vs 1.18% men). Controlling for demographic variables and psychiatric morbidity, military sexual trauma predicted serious self-directed violence for both men and women. Further, men with military sexual trauma were 15% less likely to experience self-directed violence compared with women with military sexual trauma (hazard ratio=0.85, 95% CI=0.74, 0.98).
Military sexual trauma is associated with risk for serious self-directed violence for both men and women veterans, and the relationship may be pronounced among women. Results underscore the importance of incorporating military sexual trauma into treatment and preventative efforts for self-directed violence.
先前的研究表明，军事性创伤与自杀风险之间存在关联；然而，军事性创伤后自我导向暴力（如自杀未遂或非自杀性自伤）的风险研究较少。本研究探讨了军事性创伤与导致住院的严重自我导向暴力之间的关系，以及这种关系是否因性别而异。
参与者为 750,176 名参加持久自由行动/伊拉克自由行动/新黎明行动的退伍军人，他们在 2001 年 10 月 1 日至 2014 年 9 月 30 日期间在退伍军人健康管理局接受护理，并接受了军事性创伤筛查。数据分析于 2019 年进行。采用双变量分析和 Cox 比例风险回归模型。
女性退伍军人更有可能筛查出患有军事性创伤（21.33%对 1.63%），而女性和男性经历严重自我导向暴力的可能性相同（女性 1.19%对男性 1.18%）。控制人口统计学变量和精神疾病发病率后，军事性创伤预测了男性和女性的严重自我导向暴力。此外，与患有军事性创伤的女性相比，患有军事性创伤的男性经历自我导向暴力的可能性降低了 15%（风险比=0.85，95%CI=0.74，0.98）。
军事性创伤与男性和女性退伍军人自我导向暴力的风险相关，这种关系在女性中可能更为明显。结果强调了将军事性创伤纳入自我导向暴力治疗和预防工作的重要性。
