Weber Danielle M, Halverson Tate F, Daruwala Samantha E, Pugh Mary Jo, Calhoun Patrick S, Beckham Jean C, Kimbrel Nathan A
Arch Suicide Res. 2024 Jul-Sep;28(3):844-859. doi: 10.1080/13811118.2023.2237097. Epub 2023 Aug 7.
Research indicates that being married is associated with reduced risk of suicide and self-directed violence (SDV) relative to being divorced. Simultaneously, difficulties within relationships predict poorer health outcomes. However, research on relationship status rarely examines relationship functioning, obfuscating the joint contribution of these variables for SDV risk.
Veterans ( = 1,049) completed a survey that included assessment of relationship status, relationship functioning, and SDV history. Logistic regression models tested how (a) relationship status, (b) relationship dysfunction, and (c) being divorced compared to being in a low- or high-dysfunction relationship were associated with SDV, controlling for several intrapersonal risk factors.
Veterans in a relationship did not differ in SDV history compared to divorced/separated veterans. However, more dysfunction within relationships was associated with greater odds of a history of SDV and suicidal cognitions. Finally, SDV histories were more likely among veterans endorsing high-dysfunction relationships compared with (a) low-dysfunction relationships and (b) divorced veterans.
It may be insufficient to only consider relationship status when evaluating interpersonal risk factors for SDV. A single item assessing relationship dysfunction was associated with enacted SDV and suicidal cognitions over and above intrapersonal risk factors. Integrating such single-item measures into clinical practice could improve identification and subsequent tailored intervention for veterans at greater risk for SDV.
研究表明,相对于离婚而言,已婚人士自杀和自我导向暴力(SDV)风险较低。与此同时,人际关系中的困难预示着健康状况较差。然而,关于关系状况的研究很少考察关系功能,从而模糊了这些变量对SDV风险的共同影响。
退伍军人(n = 1049)完成了一项调查,其中包括对关系状况、关系功能和SDV史的评估。逻辑回归模型检验了(a)关系状况、(b)关系功能障碍以及(c)与处于低功能或高功能关系中的人相比,离婚者与SDV之间的关联,并控制了几个个人内部风险因素。
处于恋爱关系中的退伍军人与离婚/分居的退伍军人在SDV史上没有差异。然而,关系中更多的功能障碍与SDV史和自杀认知的几率增加有关。最后,与(a)低功能关系和(b)离婚退伍军人相比,认可高功能关系的退伍军人中SDV史的可能性更大。
在评估SDV的人际风险因素时,仅考虑关系状况可能是不够的。一项评估关系功能障碍的单项指标与已发生的SDV和自杀认知相关,且超出了个人内部风险因素。将此类单项测量方法纳入临床实践可以改善对SDV风险较高的退伍军人的识别及后续的针对性干预。