Department of Psychology, Ohio University, Athens, OH USA.
Department of Psychology, Ohio University, Athens, OH USA.
J Affect Disord. 2021 Mar 1;282:133-140. doi: 10.1016/j.jad.2020.12.079. Epub 2020 Dec 24.
Studies examining Posttraumatic Stress Disorder symptom clusters, suicidal ideation, and variables described in the Joiner's interpersonal theory of suicidal behavior were cross-sectional.
We tested whether the relation between the Posttraumatic Stress Disorder symptom clusters and suicidal ideation is mediated by perceived burdensomeness and thwarted belongingness (variables of the interpersonal theory of suicidal behavior) in military personnel with current suicidal ideation using longitudinal design. DSM-IV model with reexperiencing, avoidance, numbing, and hyperarousal clusters was used. Structural equation modelling was used to test separate models for each symptom cluster with a symptom cluster at baseline, month 1 perceived burdensomeness and thwarted belongingness, and month 3 suicidal ideation, controlling for baseline values of the month 1 and month 3 variables.
Analysis of direct non-mediation models showed that baseline reexperiencing (p = .08) and avoidance (p = .07) symptom clusters marginally predicted month 3 suicidal ideation. The mediation analyses showed indirect effects from baseline reexperiencing, avoidance, and hyperarousal to suicidal ideation at month 3 through perceived burdensomeness at month 1. Thwarted belongingness did not mediate the relations between symptom clusters and suicidal ideation.
The mechanism driving development of suicidal ideation in military personnel with PTSD may be different from the mechanism in other samples. Doing a phone interview limited us to use questionnaires instead of a clinical interview.
Our findings suggest that interventions targeting perceived burdensomeness in military personnel with reexperiencing, avoidance, and hyperarousal symptoms may be beneficial to reduce suicidal ideation.
研究 PTSD 症状群、自杀意念以及 Joiner 的自杀行为人际理论中描述的变量，均为横断研究。
我们采用纵向设计，测试了当前有自杀意念的军人中，PTSD 症状群与自杀意念之间的关系是否通过被感知到的累赘感和归属感缺失（自杀行为人际理论的变量）来中介。采用 DSM-IV 模型的再体验、回避、麻木和警觉性增高症状群。结构方程模型用于测试各症状群的单独模型，以基线、第 1 个月的被感知到的累赘感和归属感缺失以及第 3 个月的自杀意念为预测因子，控制第 1 个月和第 3 个月变量的基线值。
直接非中介模型分析显示，基线的再体验（p=.08）和回避（p=.07）症状群边缘预测第 3 个月的自杀意念。中介分析显示，基线的再体验、回避和警觉性增高症状群通过第 1 个月的被感知到的累赘感对第 3 个月的自杀意念产生间接影响。归属感缺失不能中介症状群与自杀意念之间的关系。
在 PTSD 军人中驱动自杀意念发展的机制可能与其他样本不同。进行电话访谈限制了我们使用问卷而不是临床访谈。
我们的研究结果表明，针对有再体验、回避和警觉性增高症状的军人的被感知到的累赘感进行干预，可能有助于减少自杀意念。
