Temporal sequences of suicidal and nonsuicidal self-injurious thoughts and behaviors among inpatient and community-residing military veterans.
Temporal sequences of suicidal and nonsuicidal self-injurious thoughts and behaviors among inpatient and community-residing military veterans.
复制标题
住院和社区退伍军人自杀和非自杀自残想法和行为的时间序列。
DOI：
10.1016/j.jad.2021.07.088
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发表时间：
2021
影响因子：
6.6
通讯作者：
Marx,BrianP
中科院分区：
文献类型：
--
作者：
Kearns,JaclynC;Brown,SarahL;Cero,Ian;Gorman,KaitlynR;Nock,MatthewK;Keane,TerenceM;Marx,BrianP
背景自杀和非自杀的自伤思想和行为(SITB)是退伍军人的主要健康问题，但对这些结果之间的时间关系却知之甚少。这项研究考察了高危退伍军人中有自杀倾向和非自杀倾向的SITB之间的时间关系。具体地说，我们确定了SITB出现的时间，并评估了非自杀性自伤(NSSI)在自杀企图(SA)的医疗死亡率、相对风险和自杀性SITB的生存时间(即自杀意念[SI]，自杀计划，SA)中的作用。方法收集了两个样本的横断面数据，考察了接受住院精神护理的退伍军人(n=1 157)和社区居住的患有抑郁症和/或过去一个月抑郁的退伍军人(n=2 0 0)的自杀风险。参与者完成了一次访谈，以评估SITB。结果SITB出现在14-28岁之间，平均而言，住院退伍军人出现行为的时间更早。SITB之间的时间延迟在组间没有显著差异。住院退伍军人从SI到SA的时间明显较短。NSSI病史预测，所有自杀性SITB的相对风险增加，生存时间缩短。在两组中，NSSI病史与最严重SA的病死率之间没有相关性。限制包括使用横断面、回顾性的自我报告，并按年认可发病年龄，并且不是所有的SITB都被评估(例如，被动SI)。结论有NSSI病史的退伍军人发生自杀性SITB的风险很高，生存时间较短。结果表明，思想(即NSSI思想)出现在行为(即NSSI、SA)之前，NSSI出现在SA之前。
BackgroundSuicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) are major health concerns among military veterans yet little is known about the temporal relations among these outcomes. This study examined the temporal relations between suicidal and nonsuicidal SITBs among higher-risk veterans. Specifically, we identified when SITBs emerged and evaluated the role of nonsuicidal self-injury (NSSI) in the medical lethality of suicide attempts (SA), relative risk, and survival time of suicidal SITBs (i.e., suicide ideation [SI], suicide plan, SA).MethodCross-sectional data were collected from two samples examining suicide risk among veterans receiving inpatient psychiatric care (n= 157) and community-residing veterans with current depression and/or past month SI (n= 200). Participants completed an interview to assess SITBs.ResultsSITBs emerged between ages 14-28 years with behaviors emerging, on average, earlier among inpatient veterans. The time lag between SITBs was not significantly different between groups. Inpatient veterans had a significantly shorter time lag from SI to SA. NSSI history predicted an increase in relative risk for all suicidal SITBs and shorter survival time. There was no association between NSSI history and medical lethality of the most serious SA for both groups.LimitationsLimitations included use of cross-sectional, retrospective self-report with age-of-onset endorsed in years and not all SITBs were assessed (e.g., passive SI).ConclusionsVeterans with a NSSI history are at high risk for suicidal SITBs and have a shorter survival time. Results showed thoughts (i.e., NSSI thoughts, SI) emerged before behavior (i.e., NSSI, SA) and NSSI emerged before SA.