O'Connor Stephen S, Johnson Lora L, Gutierrez Peter M, Singer Joshua, Marcum Jonathan K, Pierson Johnathan T, Brown Austin, Muehler Tanner, Allen Casey, Jobes David A
Department of Psychiatry and Behavioral Sciences.
Robley Rex Veterans Affairs Medical Center.
Psychol Serv. 2023 Feb;20(1):66-73. doi: 10.1037/ser0000451. Epub 2021 Dec 30.
The purpose of this study was to determine the long-term effects of a suicide prevention-focused group therapy for veterans recently discharged from an inpatient psychiatry setting following a suicidal crisis. There was interest in examining the impact of mechanisms of change identified in previous research on the group, including group cohesion, working alliance, and group sessions attended. Data were abstracted from the electronic medical record 3 years following completion of a previous study that involved the group therapy. A series of generalized linear and logistic mixed models were conducted to measure the associations between group cohesion, working alliance, session attendance, and health service utilization and suicide attempts. Thirty randomly selected veterans from the original sample completed a semistructured interview to discuss their experience in the group therapy. Study team members reviewed each transcription to identify themes related to veterans' experiences in the suicide prevention-focused group therapy. No suicides were observed in the 3-year follow-up period. When examining the full sample ( = 134), session attendance and inpatient hospitalization were not significantly associated but were positively associated after removing subjects who attended zero sessions ( = 93). Higher group cohesion was associated with a reduced likelihood of inpatient psychiatric hospitalization and greater engagement in outpatient mental health services. Four themes emerged regarding veterans' experience in the group through an analysis of the semistructured interviews. Suicide prevention-focused group therapy among veteran service members was not associated with an elevated risk of mortality. Future research is needed to further elucidate mechanisms of change and moderators of response. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
本研究的目的是确定一种以自杀预防为重点的团体治疗对近期因自杀危机而从住院精神科出院的退伍军人的长期影响。人们有兴趣研究先前研究中确定的团体改变机制的影响，包括团体凝聚力、工作联盟和参加的团体会议。数据取自先前一项涉及团体治疗的研究完成3年后的电子病历。进行了一系列广义线性和逻辑混合模型，以测量团体凝聚力、工作联盟、会议出席率与卫生服务利用和自杀企图之间的关联。从原始样本中随机抽取30名退伍军人完成了一次半结构化访谈，以讨论他们在团体治疗中的经历。研究团队成员审查了每份文字记录，以确定与退伍军人在以自杀预防为重点的团体治疗中的经历相关的主题。在3年的随访期内未观察到自杀事件。在检查整个样本（n = 134）时，会议出席率与住院治疗没有显著关联，但在剔除参加零次会议的受试者后（n = 93）呈正相关。较高的团体凝聚力与住院精神科治疗的可能性降低以及门诊心理健康服务的参与度提高有关。通过对半结构化访谈的分析，出现了四个关于退伍军人在团体中的经历的主题。退伍军人服务成员中以自杀预防为重点的团体治疗与死亡率升高无关。需要进一步的研究来阐明改变机制和反应调节因素。（PsycInfo数据库记录（c）2023美国心理学会，保留所有权利）
