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退伍军人的国民健康与恢复力研究:一项叙述性综述及未来方向

The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions.

作者信息

Fogle Brienna M, Tsai Jack, Mota Natalie, Harpaz-Rotem Ilan, Krystal John H, Southwick Steven M, Pietrzak Robert H

机构信息

U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, United States.

Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.

出版信息

Front Psychiatry. 2020 Dec 9;11:538218. doi: 10.3389/fpsyt.2020.538218. eCollection 2020.

Abstract

United States (U.S.) veterans are substantially older than their non-veteran counterparts. However, nationally representative, population-based data on the unique health needs of this population are lacking. Such data are critical to informing the design of large-scale outreach initiatives, and to ensure the effectiveness of service care delivery both within and outside of the Veterans Affairs healthcare system. The National Health and Resilience in Veterans Study (NHRVS) is a contemporary, nationally representative, prospective study of two independent cohorts ( = 3,157 and = 1,484) of U.S. veterans, which is examining longitudinal changes, and key risk and protective factors for several health outcomes. In this narrative review, we summarize the main findings of all NHRVS studies ( = 82) published as of June 2020, and discuss the clinical implications, limitations, and future directions of this study. Review of these articles was organized into six major topic areas: post-traumatic stress disorder, suicidality, aging, resilience and post-traumatic growth, special topics relevant to veterans, and genetics and epigenetics. Collectively, results of these studies suggest that while a significant minority of veterans screen positive for mental disorders, the majority are psychologically resilient. They further suggest that prevention and treatment efforts designed to promote protective psychosocial characteristics (i.e., resilience, gratitude, purpose in life), and social connectedness (i.e., secure attachment, community integration, social engagement) help mitigate risk for mental disorders, and promote psychological resilience and post-traumatic growth in this population.

摘要

美国退伍军人的年龄比非退伍军人要大得多。然而,目前缺乏基于全国代表性人群的关于这一群体独特健康需求的数据。此类数据对于指导大规模外展计划的设计以及确保退伍军人事务医疗系统内外服务提供的有效性至关重要。退伍军人健康与恢复力研究(NHRVS)是一项针对美国退伍军人的两个独立队列(n = 3157和n = 1484)的当代、全国代表性的前瞻性研究,该研究正在考察纵向变化以及几种健康结果的关键风险和保护因素。在这篇叙述性综述中,我们总结了截至2020年6月发表的所有NHRVS研究(n = 82)的主要发现,并讨论了该研究的临床意义、局限性和未来方向。对这些文章的综述分为六个主要主题领域:创伤后应激障碍、自杀倾向、衰老、恢复力和创伤后成长、与退伍军人相关的特殊主题以及遗传学和表观遗传学。总体而言,这些研究结果表明,虽然有相当少数的退伍军人心理健康筛查呈阳性,但大多数人心理上具有恢复力。研究结果还表明,旨在促进保护性心理社会特征(即恢复力、感恩、生活目标)和社会联系(即安全依恋、社区融入、社会参与)的预防和治疗措施有助于降低精神障碍风险,并促进该人群的心理恢复力和创伤后成长。

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