军事性创伤幸存者精神障碍的保护因素：加拿大基于人群的研究：加拿大人群研究中军事性创伤幸存者精神障碍的保护因素
Protective Factors for Mental Disorders Among Survivors of Military Sexual Trauma: A Canadian Population-Based Study: Facteurs de protection relatifs à l'apparition de troubles mentaux chez les survivantes et survivants de traumatismes sexuels liés au service militaire : une étude basée sur la population canadienne.
机构信息
Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
出版信息
Can J Psychiatry. 2024 Nov;69(11):820-830. doi: 10.1177/07067437241293977. Epub 2024 Nov 8.
OBJECTIVES
Military sexual trauma (MST) is a prevalent issue among actively serving members and Veterans, and is associated with adverse health outcomes including mental disorders. This study sought to identify correlates and protective factors for the development of mental disorders among Canadian MST survivors.
METHODS
We analyzed data from participants of the longitudinal 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) who experienced MST (rounded = 455; 9.6%). A semi-structured diagnostic interview assessed MST and mental disorders in accordance with DSM-IV criteria. Multivariable logistic regressions examined associations between sample characteristics (2002 and 2018) and psychosocial factors (at baseline [i.e., 2002] and 2018) and any mental disorder since 2002. Analyses were run among the full subsample of MST survivors and additionally stratified by sex, when possible.
RESULTS
Among MST survivors, 66.5% had a mental disorder since 2002. Among the total sample, those who were officers (odds ratio [OR] = 0.58) or on active duty (OR = 0.52) had reduced odds of any mental disorder since 2002. In addition, less frequent use of avoidance coping in 2002 and 2018 (adjusted odds ratio [AOR]: 0.86, 0.64), more frequent use of active coping in 2018 (AOR = 0.64), less frequent use of self-medication coping in 2018 (AOR = 0.79), greater perceived social support in 2018 (AOR = 0.94), and reduced work stress across various domains in 2018 (AOR: 0.67-0.87) were associated with reduced odds of any mental disorder since 2002. Some variability emerged according to sex (e.g., types of work stress or coping emerging as protective).
CONCLUSIONS
Results highlight certain sample characteristics and psychosocial factors that illustrated a protective relationship with mental disorders among MST survivors. Findings may inform targeted intervention strategies that could help mitigate adverse mental health impacts of MST.
目的
军事性创伤（MST）是现役军人和退伍军人中普遍存在的问题，与包括精神障碍在内的不良健康后果有关。本研究旨在确定加拿大 MST 幸存者精神障碍发展的相关因素和保护因素。
方法
我们分析了 2018 年加拿大武装部队成员和退伍军人心理健康随访调查（CAFVMHS）中经历过 MST（四舍五入=455；9.6%）的参与者的数据。半结构式诊断访谈根据 DSM-IV 标准评估 MST 和精神障碍。多变量逻辑回归检查了样本特征（2002 年和 2018 年）和心理社会因素（基线[即 2002 年]和 2018 年）与 2002 年以来任何精神障碍之间的关联。在 MST 幸存者的全样本中进行了分析，并在可能的情况下按性别进行了分层。
结果
在 MST 幸存者中，66.5%自 2002 年以来患有精神障碍。在总样本中，军官（优势比[OR] = 0.58）或现役军人（OR = 0.52）自 2002 年以来患有任何精神障碍的可能性降低。此外，2002 年和 2018 年较少使用回避应对方式（调整后的优势比[AOR]：0.86，0.64），2018 年更频繁使用积极应对方式（AOR = 0.64），2018 年较少使用自我药物应对方式（AOR = 0.79），2018 年感知到更多的社会支持（AOR = 0.94），以及 2018 年各领域工作压力降低（AOR：0.67-0.87）与自 2002 年以来患有任何精神障碍的可能性降低相关。根据性别，出现了一些差异（例如，某些类型的工作压力或应对方式表现出保护作用）。
结论
结果突出了某些样本特征和心理社会因素，这些因素表明 MST 幸存者与精神障碍之间存在保护关系。研究结果可以为有针对性的干预策略提供信息，这些策略可以帮助减轻 MST 的不良心理健康影响。
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