Brown Lily A, Bryan Craig J, Butner Jonathan E, Tabares Jeffrey V, Young-McCaughan Stacey, Hale Willie J, Fina Brooke A, Foa Edna B, Resick Patricia A, Taylor Daniel J, Coon Hillary, Williamson Douglas E, Dondanville Katherine A, Borah Elisa V, McLean Carmen P, Wachen Jennifer Schuster, Pruiksma Kristi E, Hernandez Ann Marie, Litz Brett T, Mintz Jim, Yarvis Jeffrey S, Borah Adam M, Nicholson Karin L, Maurer Douglas M, Kelly Kevin M, Peterson Alan L
Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA, 19104, USA.
National Center for Veterans Studies, 260 S. Central Campus Dr., Suite 3525, Gardner Commons, Salt Lake City, UT, 84112, USA.
Contemp Clin Trials Commun. 2021 Feb 16;21:100752. doi: 10.1016/j.conctc.2021.100752. eCollection 2021 Mar.
Several recent studies have demonstrated that posttraumatic stress disorder (PTSD) and insomnia treatments are associated with significant reductions in suicidal ideation (SI) among service members. However, few investigations have evaluated the manner in which suicide risk changes over time among military personnel receiving PTSD or insomnia treatments. This paper describes the study protocol for a project with these aims: (1) explore potential genetic, clinical, and demographic subtypes of suicide risk in a large cohort of deployed service members; (2) explore subtype change in SI as a result of evidence-based psychotherapies for PTSD and insomnia; (3) evaluate the speed of change in suicide risk; and (4) identify predictors of higher- and lower-risk for suicide.
Active duty military personnel were recruited for four clinical trials (three for PTSD treatment and one for insomnia treatment) and a large prospective epidemiological study of deployed service members, all conducted through the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR Consortium). Participants completed similar measures of demographic and clinical characteristics and subsets provided blood samples for genetic testing. The primary measures that we will analyze are the Beck Scale for Suicide Ideation, Beck Depression Inventory, and the PTSD Checklist for DSM-IV.
Results from this study will offer new insights into the presence of discrete subtypes of suicide risk among active duty personnel, changes in risk over time among those subtypes, and predictors of subtypes. Findings will inform treatment development for military service members at risk for suicide.
近期的多项研究表明，创伤后应激障碍（PTSD）和失眠症的治疗与现役军人自杀意念（SI）的显著降低有关。然而，很少有研究评估接受PTSD或失眠症治疗的军人自杀风险随时间的变化方式。本文描述了一个旨在实现以下目标的项目的研究方案：（1）在一大群部署的现役军人中探索自杀风险的潜在遗传、临床和人口统计学亚型；（2）探索基于证据的PTSD和失眠症心理治疗导致的SI亚型变化；（3）评估自杀风险的变化速度；（4）确定自杀高风险和低风险的预测因素。
现役军人被招募参加四项临床试验（三项用于PTSD治疗，一项用于失眠症治疗）以及一项针对部署军人的大型前瞻性流行病学研究，所有这些都通过南德克萨斯研究组织网络创伤与复原力指导研究（STRONG STAR联盟）进行。参与者完成了类似的人口统计学和临床特征测量，部分参与者提供了血液样本用于基因检测。我们将分析的主要测量指标是贝克自杀意念量表、贝克抑郁量表和DSM-IV创伤后应激障碍检查表。
本研究的结果将为现役人员自杀风险离散亚型的存在、这些亚型随时间的风险变化以及亚型预测因素提供新的见解。研究结果将为有自杀风险的军人的治疗发展提供信息。
