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军事自杀研究联合会通用数据元素:在临床样本中自杀意念和自杀企图的双因素分析和纵向预测能力。

Military Suicide Research Consortium common data elements: Bifactor analysis and longitudinal predictive ability of suicidal ideation and suicide attempts within a clinical sample.

机构信息

Department of Psychology.

Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC).

出版信息

Psychol Assess. 2020 Jul;32(7):609-622. doi: 10.1037/pas0000817. Epub 2020 Apr 6.

DOI:10.1037/pas0000817
PMID:32250139
Abstract

To enhance and standardize the assessment of suicidal self-directed violence (SDV) in military populations, the Military Suicide Research Consortium developed the Common Data Elements (CDEs). Previous research supported the CDEs as assessing a higher-order factor of suicidal SDV in military populations. The present study had two aims: 1) confirm the bifactor structure of the CDEs in a high-risk sample, and 2) assess the ability of the factorially derived suicidal SDV factor to predict suicide attempts and return to care for suicidal ideation over 3-month follow-up. Utilizing a sample of service members referred for a psychiatric evaluation ( = 1,044), the CDE structure was assessed with confirmatory bifactor modeling. Logistic regressions and receiver operating characteristic (ROC) analyses were used to assess the suicidal SDV risk factor's prediction of suicide attempts and return to care for suicidal ideation during follow-up ( = 758). Bifactor modeling suggested adequate fit for the overarching suicidal SDV risk factor. Logistic regressions supported the overarching suicidal SDV risk factor as a predictor of suicide attempts (OR = 4.07, < .001) and return to care for suicidal ideation (OR = 2.81, < .001) over follow-up. However, ROC analyses suggested that the model including the suicidal SDV risk factor was only significantly better at classifying suicide attempts over follow-up (not return to care for suicidal ideation) than the model that did not include it (AUC difference = 0.15, < .001). Findings suggest that the shared variance assessed across CDEs better predicts future suicide attempts beyond any individual suicide-related constructs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

为了增强和规范对军事人群自杀自我伤害(SDV)的评估,军事自杀研究联合会制定了通用数据元素(CDE)。先前的研究支持 CDEs 可评估军事人群自杀 SDV 的高阶因素。本研究有两个目的:1)在高危样本中确认 CDE 的双因素结构,2)评估因子衍生的自杀 SDV 因子在 3 个月随访期间预测自杀企图和因自杀意念而复诊的能力。利用因精神科评估而转介的军人样本(n=1044),采用验证性双因素模型评估 CDE 结构。逻辑回归和受试者工作特征(ROC)分析用于评估自杀 SDV 风险因素在随访期间对自杀企图和因自杀意念而复诊的预测(n=758)。双因素模型表明,总体自杀 SDV 风险因素具有较好的拟合度。逻辑回归支持总体自杀 SDV 风险因素是自杀企图(OR=4.07,<.001)和因自杀意念而复诊(OR=2.81,<.001)的预测因素。然而,ROC 分析表明,包括自杀 SDV 风险因素的模型仅在随访期间(而不是因自杀意念而复诊)对自杀企图的分类明显优于不包括该因素的模型(AUC 差异=0.15,<.001)。研究结果表明,CDEs 评估的共享方差可更好地预测未来的自杀企图,而不仅仅是个体自杀相关构念。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。

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