Denneson Lauren M, Tompkins Kyla J, McDonald Katie L, Hoffmire Claire A, Britton Peter C, Carlson Kathleen F, Smolenski Derek J, Dobscha Steven K
HSR&D Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
HSR&D Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR, USA.
Soc Sci Med. 2020 Sep;260:113178. doi: 10.1016/j.socscimed.2020.113178. Epub 2020 Jul 9.
The rate of suicide mortality among women is increasing in the United States (U.S.), especially among military veterans. Prior research suggests that important gender differences in suicide risk exist, but not enough is known to tailor prevention approaches by gender.
The goal of this study is to understand gender differences in the development of suicidal behaviors (suicide risk) among U.S. veterans to inform future research and gender-tailored prevention efforts.
Using a modified grounded theory approach, this qualitative study interviewed 50 (25 men, 25 women) U.S. veterans who had made a recent (prior 6 months) suicide attempt. Veterans were recruited from Veterans Health Administration (VHA) healthcare facilities across the U.S. Semi-structured, hour-long interviews examined participants' experiences with military service, suicidal thoughts and attempts, and healthcare following their attempt.
The analysis revealed two gendered narratives of suicidal thoughts and attempts that incorporated the primary themes of self-concept, social power, relationships, coping, and stress. When discussing reasons for their suicide attempts, women discussed negative self-evaluative processes describing themselves as, "shameful," "tainted," and "worthless," whereas men discussed becoming overwhelmed, and recalled thinking, "it just wasn't worth it," "I've had enough," and, "screw this."
This study provides an in-depth, nuanced understanding of the gender differences in suicide risk among veterans and suggests several ways in which future work may address gender-tailored suicide prevention efforts. Specifically, women veterans may benefit from methods to increase self-worth through positive social relationships, while men veterans may benefit from methods that increase their sense of purpose in life and help them achieve their ideal selves through successful experiences.
在美国，女性自杀死亡率正在上升，尤其是在退伍军人中。先前的研究表明，自杀风险存在重要的性别差异，但对于根据性别调整预防方法的了解还不够。
本研究的目的是了解美国退伍军人自杀行为（自杀风险）发展中的性别差异，为未来的研究和针对性别的预防工作提供信息。
本定性研究采用改良的扎根理论方法，采访了50名（25名男性，25名女性）近期（前6个月）有过自杀未遂经历的美国退伍军人。退伍军人是从美国各地的退伍军人健康管理局（VHA）医疗设施中招募的。半结构化的一小时访谈考察了参与者的服役经历、自杀想法和未遂经历，以及未遂后的医疗情况。
分析揭示了关于自杀想法和未遂经历的两种性别化叙述，其中包含自我概念、社会权力、人际关系、应对方式和压力等主要主题。在讨论自杀未遂的原因时，女性讨论了负面的自我评估过程，将自己描述为“可耻的”、“有污点的”和“毫无价值的”，而男性则讨论了不堪重负的感觉，并回忆起曾想“这根本不值得”、“我受够了”和“见鬼去吧”。
本研究深入、细致地了解了退伍军人自杀风险中的性别差异，并提出了未来工作在针对性别预防自杀方面可以采取的几种方法。具体而言，女性退伍军人可能会从通过积极的社会关系提高自我价值的方法中受益，而男性退伍军人可能会从增强生活目标感并帮助他们通过成功经历实现理想自我的方法中受益。
