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美国印第安人社区样本中的创伤、历史创伤、创伤后应激障碍和自杀。

Trauma, historical trauma, PTSD and suicide in an American Indian community sample.

机构信息

Neuroscience Department, The Scripps Research Institute, La Jolla, CA, USA.

James J. Peters Bronx Medical Center and Psychiatry Department, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

J Psychiatr Res. 2022 Dec;156:214-220. doi: 10.1016/j.jpsychires.2022.10.012. Epub 2022 Oct 7.

Abstract

AIMS

To study the associations between perceived historical trauma, current traumatic events, diagnoses of post-traumatic stress disorder (PTSD), and suicidal behaviors in an American Indian community sample.

METHODS

Participants were American Indians recruited from reservations who were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), as well as the Historical Loss Scale, Historical Loss Associated Symptoms Scale, and Stressful Life Events Scale.

RESULTS

In data from 447 American Indian adults (mean age = 33 years), twenty percent reported lifetime experiences of suicidal thoughts (ideation and/or plans) and 14% reported suicidal acts, (including either a suicide attempt history or verified death by suicide (n = 4)). Diagnosis of PTSD and experience of assaultive trauma were each significantly associated with suicidal thoughts and acts, although assaultive trauma did not remain significant in models adjusting for gender and PTSD. High endorsement of symptoms associated with historical trauma was significantly associated with suicidal acts, and this remained significant when adjusting for gender and PTSD.

CONCLUSIONS

PTSD and historical trauma have an association with suicide and suicidal attempts in this American Indian community. Although further research is needed to evaluate the causal nature of these relations, these findings suggest treatment and prevention programs for American Indian suicide may benefit from addressing issues related to feelings of historical losses, PTSD, and their associated symptomatology.

摘要

目的

在美国印第安人社区样本中研究感知的历史创伤、当前创伤事件、创伤后应激障碍 (PTSD) 诊断与自杀行为之间的关联。

方法

从保留地招募的参与者接受了半结构化酒精遗传学评估 (SSAGA) 以及历史丧失量表、历史丧失相关症状量表和生活压力事件量表的评估。

结果

在来自 447 名美国印第安成年人(平均年龄 33 岁)的数据中,20%的人报告有过自杀念头(意念和/或计划),14%的人报告有过自杀行为,(包括自杀未遂史或经证实的自杀死亡(n=4))。PTSD 诊断和攻击创伤经历均与自杀念头和行为显著相关,但在调整性别和 PTSD 后,攻击创伤不再具有统计学意义。与历史创伤相关的症状高度表达与自杀行为显著相关,当调整性别和 PTSD 后,这种关联仍然显著。

结论

在这个美国印第安人社区中,PTSD 和历史创伤与自杀和自杀企图有关。尽管需要进一步研究来评估这些关系的因果性质,但这些发现表明,针对美国印第安人自杀的治疗和预防计划可能受益于解决与历史丧失感、PTSD 及其相关症状相关的问题。

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