Moral Injury, Religiosity, and Suicide Risk in US Veterans and Active Duty Military with PTSD Symptoms
Moral Injury, Religiosity, and Suicide Risk in US Veterans and Active Duty Military with PTSD Symptoms
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DOI：
10.1093/milmed/usy148
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发表时间：
2019-03-01
影响因子：
1.2
通讯作者：
Koenig, Harold G.
中科院分区：
文献类型：
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作者：
Ames, Donna;Erickson, Zachary;Koenig, Harold G.
越来越多的证据表明，精神伤害（MI）与退伍军人和现役军人（V/ADM）的自杀风险有关。本研究探讨了MI和自杀风险之间的关系，以及宗教信仰对V/ADM与创伤后应激障碍（PTSD）症状之间关系的调节作用。材料和方法：这是一项横断面多中心研究，涉及来自美国各地的570 V/ADM。入选标准是曾在战区服役和存在创伤后应激障碍症状。多维度测量评估MI、宗教信仰、PTSD症状、焦虑和抑郁。在这项二次数据分析中，根据10个已知的风险因素创建了自杀风险指数。MI和自杀风险指数之间的关联进行了检查，控制人口统计学，宗教和军事特征，宗教虔诚度的调节作用进行了探讨。结果如下：总体而言，MI与自杀风险密切相关（r = 0.54），MI分量表也是如此（范围从r = 0.19的信任丧失到0.48的自我谴责）。控制其他特征对这种关系的影响很小（B = 0.016，SE = 0.001，p < 0.0001）。焦虑与自杀风险无关，也没有调节自杀风险与MI或其任何分量表之间的关系。结论：在有PTSD症状的V/ADM患者中，MI与自杀的危险因素密切相关，而宗教信仰并不介导或调节这种关系。针对MI的干预措施是否能降低自杀或自杀意念的风险仍不清楚，需要进一步研究。
Introduction: There is growing evidence that moral injury (MI) is related to greater suicide risk among Veterans and Active Duty Military (V/ADM). This study examines the relationship between MI and suicide risk and the moderating effect of religiosity on this relationship in V/ADM with post-traumatic stress disorder (PTSD) symptoms. Materials and Methods: This was a cross-sectional multi-site study involving 570 V/ADM from across the USA. Inclusion criteria were having served in a combat theater and the presence of PTSD symptoms. Multidimensional measures assessed MI, religiosity, PTSD symptoms, anxiety, and depression. In this secondary data analysis, a suicide risk index was created based on 10 known risk factors. Associations between MI and the suicide risk index were examined, controlling for demographic, religious, and military characteristics, and the moderating effects of religiosity were explored. Results: MI overall was correlated strongly with suicide risk (r = 0.54), as were MI subscales (ranging from r = 0.19 for loss of trust to 0.48 for self-condemnation). Controlling for other characteristics had little effect on this relationship (B = 0.016, SE = 0.001, p < 0.0001). Religiosity was unrelated to suicide risk and did not moderate the relationship between suicide risk and MI or any of its subscales. Conclusion: MI is strongly and independently associated with risk factors for suicide among V/ADM with PTSD symptoms, and religiosity does not mediate or moderate this relationship. Whether interventions that target MI reduce risk of suicide or suicidal ideation remains unknown and needs further study.