Differences in childhood adversity, suicidal ideation, and suicide attempt among veterans and nonveterans.
Differences in childhood adversity, suicidal ideation, and suicide attempt among veterans and nonveterans.
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DOI：
10.1037/amp0000755
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Schneiderman A
中科院分区：
文献类型：
--
作者：
Blosnich JR;Garfin DR;Maguen S;Vogt D;Dichter ME;Hoffmire CA;Bernhard PA;Schneiderman A
不良童年经历（ACE）与一生中的身心健康问题密切相关。相对有限的研究已经检查了退伍军人人群中ACE的广度，对他们来说，ACE可能是与自杀意念和企图相关的军事创伤。使用来自比较健康评估访谈研究的数据，这是一项由美国退伍军人事务部赞助的大型全国性调查，这项调查研究了18岁之前22种自我报告的潜在创伤经历的患病率（即，ACE）在退伍军人和非退伍军人中的作用，并估计ACE与18岁或以上的自杀意念和企图的关联。对所有分析进行加权，以考虑复杂的抽样设计，并按性别分层。研究样本包括9，571名退伍军人，3，143名非退伍军人，5，543名退伍军人和1，364名非退伍军人。退伍军人的ACE平均发生率高于非退伍军人（分别为2.7次ACE和2.3次ACE，p<0.001）; 11.1%的退伍军人显示>6次ACE，而非退伍军人为7.3%（p<0.001）。退伍军人女性报告的ACE平均频率高于非退伍军人女性（分别为3.1例ACE和2.4例ACE，p<0.001）。在女性中，退伍军人比非退伍军人报告>6次ACE（分别为14.9%和8.6%，p<0.001）。退伍军人男性在18岁或以上自杀企图的最强相关性是有>6次ACE（aOR=4.20，95%CI=2.72-6.49）;退伍军人女性在18岁之前自杀意念或企图的最强相关性（aOR=5.37，95%CI=4.11-7.03）。自杀预防研究，政策和实践应解决ACE退伍军人中的突出的军事前的危险因素。
Adverse childhood experiences (ACEs) are robustly associated with physical and mental health problems over the lifespan. Relatively limited research has examined the breadth of ACEs among military veteran populations, for whom ACEs may be premilitary traumas associated with suicidal ideation and attempt. Using data from the Comparative Health Assessment Interview Research Study, a large national survey sponsored by the US Department of Veterans Affairs, this investigation examined the prevalence of 22 self-reported potentially traumatic experiences before the age of 18 (i.e., ACEs) among veterans and nonveterans and estimated the association of ACEs with suicidal ideation and attempt at age 18 or older. All analyses were weighted to account for complex sampling design and stratified by gender. The study sample included 9,571 veteran men, 3,143 nonveteran men, 5,543 veteran women, and 1,364 nonveteran women. Veteran men reported greater average frequency of ACEs than nonveteran men (2.7 ACEs vs. 2.3 ACEs, respectively, p<.001); 11.1% of veteran men indicated >6 ACEs compared to 7.3% of nonveteran men (p<.001). Veteran women reported greater average frequency of ACEs than nonveteran women (3.1 ACEs vs. 2.4 ACEs, respectively, p<.001). Among women, more veterans than nonveterans reported >6 ACEs (14.9% vs. 8.6%, respectively, p<.001). The strongest correlate of suicide attempt at age 18 or older for veteran men was having >6 ACEs (aOR=4.20, 95%CI=2.72-6.49); for veteran women, the strongest correlate was suicidal ideation or attempt prior to age 18 (aOR=5.37, 95%CI=4.11-7.03). Suicide prevention research, policy, and practice should address ACEs among veterans as salient premilitary risk factors.
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