Graziano Robert C, Aunon Frances M, LoSavio Stefanie T, Elbogen Eric B, Beckham Jean C, Dillon Kirsten H
Durham VA Health Care System, Durham, NC, USA.
Durham VA Health Care System, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA.
J Psychiatr Res. 2021 Jun;138:264-271. doi: 10.1016/j.jpsychires.2021.03.065. Epub 2021 Apr 5.
Suicidal ideation (SI) is a prevalent issue in the veteran population. A number of factors have been identified as risk factors for suicidal ideation (SI) in veterans, including suicide attempts, depression, posttraumatic stress disorder (PTSD), and drug use. However, clinicians' ability to predict suicide is poor, particularly given the interplay between various factors such as previous suicide attempts. As such, there is a gap in our knowledge of which factors most saliently predict suicide risk and which should be targets for interventions designed to lower SI. Network analysis, a method allowing for an examination of how variables relate within the context of a network of factors, may bridge this gap by simultaneously evaluating the interrelationships between risk factors for suicide in veterans. Current study used network analysis and data from 2268 Iraq/Afghanistan-era military veterans to examine the relationships between suicidal ideation and several factors related to suicide risk, such as past suicide attempts, PTSD symptoms, depression, drug use, trauma exposure. Partial correlation network results showed suicidal ideation to be strongly related to depression, with smaller connections to past suicide attempts and anger. Additionally, past suicide attempts was strongly related to history of childhood trauma and weakly related to problematic drug use and PTSD symptoms. These results offer valuable information for both predicting suicide risk and differentiating targets for interventions lowering suicide risk in veterans.
自杀意念(SI)在退伍军人中是一个普遍存在的问题。一些因素已被确定为退伍军人自杀意念(SI)的风险因素,包括自杀未遂、抑郁症、创伤后应激障碍(PTSD)和药物使用。然而,临床医生预测自杀的能力很差,尤其是考虑到诸如既往自杀未遂等各种因素之间的相互作用。因此,在我们了解哪些因素最能显著预测自杀风险以及哪些因素应成为旨在降低自杀意念的干预目标方面存在差距。网络分析是一种能够在因素网络背景下考察变量之间关系的方法,它可以通过同时评估退伍军人自杀风险因素之间的相互关系来弥补这一差距。当前的研究使用网络分析和来自2268名伊拉克/阿富汗战争时期退伍军人的数据,来检验自杀意念与几个与自杀风险相关的因素之间的关系,如既往自杀未遂、PTSD症状、抑郁症、药物使用、创伤暴露。偏相关网络结果显示,自杀意念与抑郁症密切相关,与既往自杀未遂和愤怒的联系较小。此外,既往自杀未遂与童年创伤史密切相关,与问题药物使用和PTSD症状的关系较弱。这些结果为预测自杀风险和区分降低退伍军人自杀风险的干预目标提供了有价值的信息。