Follow-Up of Vietnam Veterans at Risk for Suicide

描述(由申请人提供)：本修订申请(RO I MH/DA6096 1-01 A2)请求提供四年半的支持(2005年7月至2005年12月) 对越战老兵进行跟踪调查，他们目前的风险水平 根据华盛顿大学的研究结果，自杀行为已经被预测出来。 越南大学时代研究--第三阶段(VES-HI)，于1996-97年间进行。这个 VES队列起源于1971年由白宫发起的一项研究 解决物质滥用和适应平民生活的问题 被派往越南的回国军人。两波面对面的采访 由华盛顿大学在1972年和1974年与两个国家的 越南战争男性退伍军人的概率样本和比较样本 非退伍军人(总目标N=L，227人)。实施为期25年的随访(VES-Ill) 田野调查中发生自杀事件后的生活危机干预方案。 VES-Ill和两项大型总体人口研究的分析 1993年死亡率回溯调查与全国纵向酒精 1992年的流行病学调查，共同证实了严重的超额风险 越南退伍军人中的自杀和自杀企图，在同龄男性中 40-60岁组，控制人口学风险和保护性因素。 酗酒、吸毒、抑郁和创伤/创伤后应激障碍似乎是主要原因 越战老兵的过度冒险。这项申请(VES-IV)将密切关注 减少自杀风险的保护因素提高自杀风险的精确度 自杀行为预测。基于自我报告和自杀行为 预测性量表，高风险(n=168)和低风险(n=250)目标样本 都是从VES-III中挑选出来的，以平衡科学研究的考虑 预计该领域的产量和挑战。科学的目标是 检验：1)MIXED应对机制和其他保护因素 定性和定量措施，包括a)定性分析 评估、应对、宗教、乐观、物质使用、社交的测量 基于自杀事件或负面事件的网络和护理障碍，b) A)、c)中使用的定性代码的定量度量 事件/事件应对和一般应对，以及d)量化措施 依赖于时间的保护因素；2)风险和风险的相互作用 自杀行为预测中的保护性因素及其应用 包括a)基于事件/事件或依赖时间的定量风险以及 从VES-IV中获得的保护因素，以及b)先前的风险和保护 从VES-III和早期波获得的因子。人的主体保护目标 添加到：3)提供后续治疗、分诊和随叫随到服务 对目前有自杀风险的人进行自杀干预。这项研究将 更好地了解保护因素的内部作用，以及 它们与风险因素的相互作用，这些因素被确定为 文献中的知识。我们希望研究结果将有助于指导 对那些有自杀行为已知风险的人进行干预。

DESCRIPTION (provided by applicant): This amended application (RO I MH/DA6096 1-01 A2) requests support for four and a half years (July 200 Ito December2005) to conduct a follow-up of Vietnam veterans whose risk levels for current suicidal behaviors have been projected from the results from the Washington University Vietnam Era Study - Phase III (VES-HI), carried out in 1996-97. The VES cohort originates from a study initiated by the White House in 1971 to address substance abuse and adjustment problems to civilian life among returning servicemen deployed to Vietnam. Two waves of in-person interviews were conducted by Washington University in 1972 and 1974 with two national probability samples of male Vietnam War veterans and a comparison sample of nonveterans (total target N=l,227). The 25-year follow-up (VES-Ill) implemented life crisis intervention protocols after a suicide occurred during fieldwork. Analyses of VES-Ill and two large general-population studies, the National Mortality Followback Survey, 1993, and the National Longitudinal Alcohol Epidemiologic Survey, 1992, together confirmed a significant excess risk of both suicide and suicide attempts among Vietnam veterans, within men of the age group of 40-60, controlling for demographic risk and protective factors. Alcoholism, drug use, depression, and trauma/PTSD appear to largely explain Vietnam veterans' excess risk. This application (VES-IV) will attend closely to protective factors mitigating suicidal risk to improve the precision of suicidal behavior prediction. Based on self-reports and a suicide behavior predictive scale, higher-risk (n=168) and lower-risk (n=250) target samples have been selected from VES-III to balance the considerations for scientific yields and challenges expected in the field. The scientific aims are to examine: 1) the mechanisms of coping and other protective factors using mixed qualitative and quantitative measures, including analyses of a) qualitative measures of appraisal, coping, religiosity, optimism, substance use, social networks, and barriers to care based on suicide episodes or negative events, b) quantitative measures of qualitative codes used in a), c) quantitative measures of episode/event-based and general coping, and d) quantitative measures of time-dependent protective factors; and 2) the interactions of risk and protective factors in predicting suicidal behaviors, using the measures including a) quantitative episode/event -based or time-dependent risk and protective factors obtained from VES-IV, and b) previous risk and protective factors obtained from VES-III and earlier waves. A human subject protection aim is added to: 3) provide follow-up treatment triage and access to an on-call suicide intervention for those with current suicidal risk. The study will provide a better understanding of the inner working of protective factors, and their interaction with risk factors, which were identified as a gap in knowledge in the literature. We hope the study's results will help guide intervention for those with known risks for suicidal behavior.