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退伍军人事务部创伤后应激障碍住院治疗环境中的自杀意念:归属感受挫和感知到自身负担过重的作用。

Suicidal Ideation in a Veterans Affairs Residential Posttraumatic Stress Disorder Treatment Setting: The Roles of Thwarted Belongingness and Perceived Burdensomeness.

作者信息

Martin Colleen E, Pukay-Martin Nicole D, Blain Rachel C, Dutton-Cox Courtney, Chard Kathleen M

机构信息

Cincinnati VA Medical Center, Trauma Recovery Center, Cincinnati, Ohio, USA.

Durham VA Medical Center, Durham, North Carolina, USA.

出版信息

J Trauma Stress. 2021 Dec;34(6):1188-1198. doi: 10.1002/jts.22540. Epub 2020 Jun 29.

Abstract

Suicide is a significant public health concern, and, specifically, the veteran population has exhibited a 22% higher risk of death by suicide than the general population (Department of Veterans Affairs, 2017). The interpersonal psychological theory of suicide (IPTS; Joiner, 2005) appears to be the most widely researched theory to examine factors associated with suicidal ideation. The IPTS applies to veteran suicidal ideation in that veterans may feel they are burdensome to others or that they do not belong following their transition from active duty. The current study sought to (a) identify the prevalence and correlates of the IPTS constructs perceived burdensomeness and thwarted belongingness; (b) examine the main and interactive effects of these constructs on suicidal ideation; and (c) examine their indirect effects in the associations between posttraumatic stress disorder (PTSD) symptomatology, depressive symptomatology, and substance use with suicidal ideation in a sample of veterans in PTSD residential treatment (N = 125). Regression results demonstrated that perceived burdensomeness was significantly associated with suicidal ideation, β = .50, p < .001; however, thwarted belongingness and the interaction of the two were not. In the models of indirect effects, perceived burdensomeness emerged as the only significant indirect effect in the association between PTSD symptomatology and suicidal ideation, β = .01 (SE = .00), 95% CI [.0050, .0149], as well as between depressive symptomatology and suicidal ideation, β = .02 (SE = .01), 95% CI [.0109, .0311]. Study limitations and future directions are also discussed.

摘要

自杀是一个重大的公共卫生问题,具体而言,退伍军人的自杀死亡风险比普通人群高出22%(退伍军人事务部,2017年)。自杀的人际心理理论(IPTS;乔伊纳,2005年)似乎是研究与自杀意念相关因素的研究最为广泛的理论。IPTS适用于退伍军人的自杀意念,因为退伍军人在从现役过渡后可能会觉得自己对他人是负担,或者觉得自己不属于这个群体。本研究旨在:(a)确定IPTS构念感知负担感和归属感受挫的患病率及其相关因素;(b)检验这些构念对自杀意念的主效应和交互效应;(c)在创伤后应激障碍(PTSD)住院治疗的退伍军人样本(N = 125)中,检验它们在PTSD症状、抑郁症状和物质使用与自杀意念之间的关联中的间接效应。回归结果表明,感知负担感与自杀意念显著相关,β = 0.50,p <.001;然而,归属感受挫以及两者的交互作用则不然。在间接效应模型中,感知负担感在PTSD症状与自杀意念之间的关联中,以及在抑郁症状与自杀意念之间的关联中,均成为唯一显著的间接效应,β = 0.01(标准误 = 0.00),95%置信区间[0.0050, 0.0149],以及β = 0.02(标准误 = 0.01),95%置信区间[0.0109, 0.0311]。还讨论了研究的局限性和未来方向。

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