Dempsey Catherine L, Benedek David M, Zuromski Kelly L, Nock Matthew K, Brent David A, Ao Jingning, Georg Matthew W, Haller Katy, Aliaga Pablo A, Heeringa Steven G, Kessler Ronald C, Stein Murray B, Ursano Robert J
Department of Psychiatry Center for the Study of Traumatic Stress Uniformed Services University of the Health Sciences Bethesda MD.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc Bethesda MD.
Psychiatr Res Clin Pract. 2023 Jan 13;5(1):24-36. doi: 10.1176/appi.prcp.20220027. eCollection 2023 Spring.
To identify the extent to which the presence of recent stressful events are risk factors for suicide among active-duty soldiers as reported by informants.
Next-of-kin (NOK) and supervisors (SUP) of active duty soldiers ( = 135) who died by suicide and two groups of living controls: propensity-matched ( = 128) and soldiers who reported suicidal ideation in the past year, but did not die (SI) ( = 108) provided data via structured interviews from the Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Multivariate logistic regression analyses were used to create a risk score for suicide.
The odds of suicide increased significantly for soldiers experiencing relationship problems, military punishment, and perceived failure or humiliation in the month prior to death. Suicide risk models with these risk factors predicted suicide death among those who reported SI in the past year (OR = 5.9, [95% CI = 1.5, 24.0] = 6.24, = 0.0125, AUC, 0.73 (0.7, 0.8) NOK) and (OR = 8.6, [95% CI = 1.4, 51.5] = 5.49, = 0.0191, AUC, 0.78 (0.7, 0.8); SUP) suggesting the combination of these recent stressors may contribute to the transition from ideation to action.
Our findings suggest for the first time recent stressors distinguished suicide ideating controls from suicide decedents in the month prior to death as reported by informants. Implications for preventive intervention efforts for clinicians, supervisors and family members in identifying the transition from ideation to action are discussed.
确定由举报人报告的近期应激事件在现役军人自杀风险因素中所占的比例。
通过对现役军人自杀死亡者（n = 135）的近亲（NOK）和上级（SUP）以及两组在世对照：倾向匹配组（n = 128）和过去一年报告有自杀意念但未死亡的军人（SI）（n = 108）进行结构化访谈，收集来自军人风险与恢复力评估研究（陆军STARRS）的数据。采用多变量逻辑回归分析创建自杀风险评分。
在死亡前一个月经历人际关系问题、军事惩罚以及感到失败或受辱的军人自杀几率显著增加。包含这些风险因素的自杀风险模型预测了过去一年报告有自杀意念者中的自杀死亡情况（比值比=5.9，[95%置信区间=1.5，24.0]，卡方=6.24，p = 0.0125，曲线下面积，0.73（0.7，0.8）NOK）以及（比值比=8.6，[95%置信区间=1.4，51.5]，卡方=5.49，p = 0.0191，曲线下面积，0.78（0.7，0.8）；SUP），这表明这些近期应激源的组合可能促使从意念向行动的转变。
我们的研究结果首次表明，举报人报告称，近期应激源在死亡前一个月将有自杀意念的对照者与自杀死亡者区分开来。讨论了对临床医生、上级和家庭成员在识别从意念到行动的转变方面进行预防性干预的意义。
