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退伍军人和现役军人中的自杀意念、自杀未遂及自杀死亡:风险因素的综合荟萃分析。

Suicidal ideation, suicide attempts, and suicide death among Veterans and service members: A comprehensive meta-analysis of risk factors.

作者信息

Schafer Katherine Musacchio, Duffy Mary, Kennedy Grace, Stentz Lauren, Leon Jagger, Herrerias Gabriela, Fulcher Summer, Joiner Thomas E

机构信息

Department of Psychology, Florida State University, Tallahassee, Florida.

Department of Psychology, Walter Reed National Military Medical Center, Bethesda, Maryland.

出版信息

Mil Psychol. 2021 Nov 24;34(2):129-146. doi: 10.1080/08995605.2021.1976544. eCollection 2022.

Abstract

Suicide is the tenth leading cause of death in America. Particularly at risk, Veterans are 1.5 times more likely to die by suicide than non-Veterans, and the suicide rate among service members has risen over the last decade. In the present study, we (1) assessed risk factors for suicidal ideation, suicide attempts, and suicide death within and between Veterans and service members, (2) identified the most commonly studied and (3) the strongest risk factors for suicide-related outcomes among Veterans and service members, and (4) compared overall and risk factor-specific meta-analytic prediction of suicide-related outcomes in Veterans and service members, as determined in the present meta-analysis, to that of the general population. Authors harvested longitudinal effects predicting suicidal ideation, suicide attempts, or suicide deaths in Veterans or service members until May 1, 2020. Traumatic Brain Injury, substance/alcohol use disorders, prior Self-Injurious Thoughts and Behavior, PTSD, and depressive symptoms were among the most commonly studied risk factors. Anger/aggression was particularly strong risk factors, providing a source for future study and intervention efforts. When combined, risk factors conferred similar risk for suicide attempts and suicide death among Veterans, service members, and the general population. However, when analyzing -values, factors conferred significantly more risk of suicidal ideation among Veterans and service members as compared to the general population. That is, -values for risk factors were lower in an absolute sense but not necessarily to a statistically significant degree.

摘要

自杀是美国第十大死因。退伍军人尤其危险,他们自杀死亡的可能性是非退伍军人的1.5倍,而且在过去十年中,军人的自杀率有所上升。在本研究中,我们(1)评估了退伍军人和军人内部及之间自杀意念、自杀未遂和自杀死亡的风险因素,(2)确定了最常被研究的因素,(3)以及退伍军人和军人中与自杀相关结果的最强风险因素,(4)并将本荟萃分析中确定的退伍军人和军人自杀相关结果的总体及特定风险因素的荟萃分析预测与普通人群的预测进行了比较。作者收集了截至2020年5月1日预测退伍军人或军人自杀意念、自杀未遂或自杀死亡的纵向效应。创伤性脑损伤、物质/酒精使用障碍、既往自伤想法和行为、创伤后应激障碍以及抑郁症状是最常被研究的风险因素。愤怒/攻击行为是特别强的风险因素,为未来的研究和干预努力提供了一个来源。综合来看,风险因素在退伍军人、军人和普通人群中导致自杀未遂和自杀死亡的风险相似。然而,在分析效应值时,与普通人群相比,这些因素在退伍军人和军人中导致自杀意念的风险显著更高。也就是说,风险因素的效应值在绝对值上较低,但不一定达到统计学显著程度。

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