Department of Psychiatry, University of California, San Diego, La Jolla.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla.
JAMA Netw Open. 2023 Jan 3;6(1):e2252109. doi: 10.1001/jamanetworkopen.2022.52109.
Workplace bullying is associated with mental disorders and suicidality in civilians, but few studies have examined associations of bullying with these outcomes among military personnel.
To evaluate associations of being bullied or hazed during deployment with major depressive disorder (MDD), intermittent explosive disorder, posttraumatic stress disorder (PTSD), suicidal ideation, and substance use disorder (SUD).
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) New Soldier Study (NSS; April 1, 2011, to November 30, 2012) and wave 1 of the STARRS Longitudinal Study (STARRS-LS1; September 1, 2016, to April 30, 2018). A computerized survey administered at 3 US Army installations (NSS) and a web/telephone survey (STARRS-LS1) were used to collect data. Data were analyzed from October 11, 2021, to October 28, 2022. The STARRS-LS1 recruited a probability sample of active-duty soldiers and veterans who had participated in Army STARRS baseline surveys while on active duty (weighted response rate, 35.6%). Respondents whose baseline was the NSS and who had deployed to a combat theater at least once were eligible for this study.
Being bullied or hazed during a combat deployment.
The primary outcomes were MDD, intermittent explosive disorder, PTSD, and suicidal ideation in the 12 months before STARRS-LS1 and SUD in the 30 days before STARRS-LS1, assessed with items from the Composite International Diagnostic Interview Screening Scales, PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Columbia-Suicide Severity Rating Scale. Logistic regression was used to estimate associations of bullying or hazing exposure with the outcomes.
The 1463 participants were predominantly male (weighted percentage [SE], 90.4% [0.9%]) and had a mean (SE) age of 21.1 (0.1) years at baseline. At STARRS-LS1, 188 respondents (weighted percentage [SE], 12.2% [1.1%]) reported bullying or hazing during deployment. Weighted outcome prevalences were 18.7% (1.3%) for MDD, 5.2% (0.9%) for intermittent explosive disorder, 21.8% (1.5%) for PTSD, 14.2% (1.2%) for suicidal ideation, and 8.7% (1.0%) for SUD. In models that adjusted for baseline sociodemographic and clinical characteristics and other potential traumas, exposure to bullying or hazing was significantly associated with MDD (adjusted odds ratio [aOR], 2.92; 95% CI, 1.74-4.88), intermittent explosive disorder (aOR, 2.59; 95% CI, 1.20-5.59), PTSD (aOR, 1.86; 95% CI, 1.23-2.83), suicidal ideation (aOR, 1.91; 95% CI, 1.17-3.13), and SUD (aOR, 2.06; 95% CI, 1.15-3.70).
In this cohort study of combat-deployed soldiers, reports of being bullied or hazed during deployment were associated with mental disorders and suicidal thoughts. Recognition of these associations may inform efforts to prevent and address mental health problems among service members.
工作场所欺凌与平民中的精神障碍和自杀意念有关，但很少有研究调查欺凌与军事人员这些结果之间的关系。
评估在部署期间被欺负或骚扰与重度抑郁症（MDD）、间歇性爆发障碍、创伤后应激障碍（PTSD）、自杀意念和物质使用障碍（SUD）之间的关联。
设计、地点和参与者：这项队列研究使用了来自陆军研究评估风险和复原力的士兵研究（陆军 STARRS）新兵研究（NSS；2011 年 4 月 1 日至 2012 年 11 月 30 日）和 STARRS 纵向研究第 1 波（STARRS-LS1；2016 年 9 月 1 日至 2018 年 4 月 30 日）的数据。在 3 个美国陆军设施（NSS）和一个网络/电话调查（STARRS-LS1）中使用计算机化调查收集数据。数据分析于 2021 年 10 月 11 日至 2022 年 10 月 28 日进行。STARRS-LS1 招募了一个现役士兵和退伍军人的概率样本，他们在现役期间参加了陆军 STARRS 基线调查（加权回应率，35.6%）。基线为 NSS 且至少在一次战斗战区部署过的受访者有资格参加本研究。
在战斗部署期间被欺负或骚扰。
主要结果是 STARRS-LS1 前 12 个月内的 MDD、间歇性爆发障碍、PTSD 和自杀意念，以及 STARRS-LS1 前 30 天内的 SUD，使用来自国际诊断综合访谈筛查量表、精神障碍诊断和统计手册第五版 PTSD 清单和哥伦比亚自杀严重程度评定量表的项目进行评估。使用逻辑回归来估计欺凌或骚扰暴露与这些结果之间的关联。
1463 名参与者主要是男性（加权百分比[SE]，90.4%[0.9%]），基线时的平均（SE）年龄为 21.1（0.1）岁。在 STARRS-LS1 中，188 名受访者（加权百分比[SE]，12.2%[1.1%]）报告在部署期间遭受欺凌或骚扰。加权结果发生率分别为 MDD（18.7%[1.3%]）、间歇性爆发障碍（5.2%[0.9%]）、PTSD（21.8%[1.5%]）、自杀意念（14.2%[1.2%]）和 SUD（8.7%[1.0%]）。在调整基线社会人口统计学和临床特征以及其他潜在创伤的模型中，暴露于欺凌或骚扰与 MDD（调整后的优势比[aOR]，2.92；95%置信区间[CI]，1.74-4.88）、间歇性爆发障碍（aOR，2.59；95%CI，1.20-5.59）、PTSD（aOR，1.86；95%CI，1.23-2.83）、自杀意念（aOR，1.91；95%CI，1.17-3.13）和 SUD（aOR，2.06；95%CI，1.15-3.70）显著相关。
在这项对战斗部署士兵的队列研究中，报告在部署期间受到欺负或骚扰与精神障碍和自杀意念有关。认识到这些关联可能有助于预防和解决现役军人的心理健康问题。
