Varker Tracey, Cowlishaw Sean, Baur Jenelle, McFarlane Alexander C, Lawrence-Wood Ellie, Metcalf Olivia, Van Hooff Miranda, Sadler Nicole, O'Donnell Meaghan L, Hodson Stephanie, Benassi Helen, Forbes David
Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Australia.
Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Australia.
J Psychiatr Res. 2022 Jul;151:57-64. doi: 10.1016/j.jpsychires.2022.04.004. Epub 2022 Apr 13.
Problem anger is increasingly identified as an important issue, and may be associated with suicidality and violence. This study investigates the relationship between problem anger, suicidality, and violence amongst veterans and military personnel.
Cross-sectional survey data from n = 12,806 military personnel and veterans were subject to analyses. These considered the weighted prevalence of problem anger, while further analyses of veterans (n = 4326) considered risk factors and co-occurrence with other psychiatric conditions. Path analyses examined inter-relationships involving anger, violence and suicidality.
There were 30.7% of veterans and 16.4% of military personnel that reported past month problem anger, while 14.9% of veterans and 7.4% of military personnel reported physical violence. There were higher levels of suicidality among veterans (30.3%), than military personnel (14.3%). Logistic regression models indicated that PTSD was the strongest risk factor for problem anger (PCL-5, OR = 21.68), while there were small but substantial increases in anger rates associated with depression (OR = 15.62) and alcohol dependence (OR = 6.55). Path models indicated that problem anger had an influence on suicide attempts, occurring primarily through suicidal ideation, and an influence on violence. Influences of problem anger on suicidal ideation and violence remained significant when controlling for co-occurring mental health problems.
Problem anger, violence, and suicidality are common and inter-related issues among military personnel and veterans. Problem anger is a unique correlate of suicidality, supporting the need for anger to be included as part of violence and suicide risk assessment, and clinician training.
问题性愤怒日益被视为一个重要问题，可能与自杀倾向和暴力行为有关。本研究调查退伍军人和军事人员中问题性愤怒、自杀倾向和暴力行为之间的关系。
对来自n = 12,806名军事人员和退伍军人的横断面调查数据进行分析。这些分析考虑了问题性愤怒的加权患病率，而对退伍军人（n = 4326）的进一步分析考虑了风险因素以及与其他精神疾病的共病情况。路径分析检验了涉及愤怒、暴力和自杀倾向的相互关系。
有30.7%的退伍军人和16.4%的军事人员报告过去一个月存在问题性愤怒，而14.9%的退伍军人和7.4%的军事人员报告存在身体暴力行为。退伍军人中的自杀倾向水平（30.3%）高于军事人员（14.3%）。逻辑回归模型表明，创伤后应激障碍是问题性愤怒的最强风险因素（PCL - 5，比值比 = 21.68），而与抑郁症（比值比 = 15.62）和酒精依赖（比值比 = 6.55）相关的愤怒发生率虽有小幅但显著的增加。路径模型表明，问题性愤怒对自杀未遂有影响，主要通过自杀意念发生，并且对暴力行为有影响。在控制共病的心理健康问题时，问题性愤怒对自杀意念和暴力行为的影响仍然显著。
问题性愤怒、暴力行为和自杀倾向是军事人员和退伍军人中常见且相互关联的问题。问题性愤怒是自杀倾向的一个独特相关因素，支持将愤怒纳入暴力和自杀风险评估以及临床医生培训的必要性。
