Association of Child Abuse Exposure With Suicidal Ideation, Suicide Plans, and Suicide Attempts in Military Personnel and the General Population in Canada
Association of Child Abuse Exposure With Suicidal Ideation, Suicide Plans, and Suicide Attempts in Military Personnel and the General Population in Canada
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DOI：
10.1001/jamapsychiatry.2015.2732
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发表时间：
2016-03-01
期刊：
影响因子：
25.8
通讯作者：
Sareen, Jitender
中科院分区：
文献类型：
--
作者：
Afifi, Tracie O.;Taillieu, Tamara;Sareen, Jitender
重要性 最近的证据表明，在现代美国退伍军人中，儿童虐待事件的发生率很高，这可能在一定程度上解释了他们相对于平民而言自杀的可能性更高。然而，军事人员相对于平民而言，儿童虐待经历与自杀相关结果之间的关系尚不清楚。此外，军事人员中与部署相关的创伤、儿童虐待经历和自杀相关结果之间的关联尚未得到研究。 目的 确定与加拿大普通民众 (CGP) 相比，加拿大武装部队 (CAF) 人员中儿童虐待经历是否更普遍；比较 CAF 和 CGP 中儿童虐待经历与自杀意念、自杀计划和自杀企图之间的关联；数据、设置和参与者 数据收集自以下 2 个具有全国代表性的数据集：2013 年 CAF 加拿大军队心理健康调查 (CFMHS)（8161 名受访者；答复率为 79.8%）和 2012 年加拿大社区健康调查CGP 心理健康调查 (CCHS-MH)（23 395 名受访者；答复率为 68.9%[其中抽取了 15 981 名年龄匹配的参与者]）。 CFMHS 的数据收集时间为2013 年4 月15 日至8 月31 日，CCHS-MH 的数据收集时间为2012 年1 月2 日至12 月31 日。数据分析时间为 2014 年 10 月至 2015 年 10 月 22 日。统计权重应用于两个数据集。 主要结果和测量 儿童虐待经历，包括身体虐待、性虐待和亲密伴侣暴力，以及部署相关创伤与自杀相关结果的关系进行了评估。 结果 数据分析来自 24 142 名 18 至 60 岁的受访者（正规部队，86.1% 为男性和女性占 13.9%；预备役部队中男性占 90.6%，女性占 8.9%；CGP 中男性占 49.9%，女性占 50.1%。与 CGP (33.1%; 95% CI, 31.8%-34.4%) 相比，正规部队 (47.7%; 95% CI, 46.4%-49.1%) 和阿富汗任务部署的后备部队 (49.4%; 95% CI, 46.3%-51.5%) 中的任何虐待儿童事件都较高。所有类型的儿童虐待经历均与 CGP 中自杀意念、自杀计划和自杀企图的几率增加相关（调整后比值比范围 [AOR]，3.0 [95% CI，2.3-3.9] 至 7.7 [95% CI，5.7-10.3]；P
IMPORTANCE Recent evidence indicates a high prevalence of child abuse exposure in modern US veterans, which may explain in part their higher likelihood of suicide relative to civilians. However, the relationship between child abuse exposure and suicide-related outcomes in military personnel relative to civilians is unknown. Furthermore, the associations among deployment-related trauma, child abuse exposure, and suicide-related outcomes in military personnel have not been examined.OBJECTIVES To determine whether child abuse exposure is more prevalent in Canadian Armed Forces (CAF) personnel compared with the Canadian general population (CGP); to compare the association between child abuse exposure and suicidal ideation, suicide plans, and suicide attempts among the CAF and CGP; and to determine whether child abuse exposure has an additive or interaction effect on the association of deployment-related trauma and past-year suicidal ideation and suicide plans among Regular Forces personnel.DATA, SETTING, AND PARTICIPANTS Data were collected from the following 2 nationally representative data sets: the 2013 Canadian Forces Mental Health Survey (CFMHS) for the CAF (8161 respondents; response rate, 79.8%) and the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH) for the CGP (23 395 respondents; response rate, 68.9%[of these, 15 981 age-matched participants were drawn]). Data were collected from April 15 to August 31, 2013, for the CFMHS and January 2 to December 31, 2012, for the CCHS-MH. Data were analyzed from October 2014 to October 22, 2015. Statistical weights were applied to both data sets.MAIN OUTCOMES AND MEASURES Child abuse exposure, including physical abuse, sexual abuse, and exposure to intimate partner violence, and deployment-related trauma were assessed in relation to suicide-related outcomes.RESULTS Data were analyzed from 24 142 respondents aged 18 to 60 years (Regular Forces, 86.1% male and 13.9% female; Reserve Forces, 90.6% male and 8.9% female; and CGP, 49.9% male and 50.1% female). Any child abuse exposure was higher in the Regular Forces (47.7%; 95% CI, 46.4%-49.1%) and Afghanistan mission-deployed Reserve Forces (49.4%; 95% CI, 46.3%-51.5%) compared with the CGP (33.1%; 95% CI, 31.8%-34.4%). All types of child abuse exposures were associated with increased odds of suicidal ideation, suicide plans, and suicide attempts in the CGP (range of adjusted odds ratios [AORs], 3.0 [95% CI, 2.3-3.9] to 7.7 [95% CI, 5.7-10.3]; P