Follow-Up of Vietnam Veterans at Risk for Suicide

对有自杀风险的越南退伍军人的后续行动

• 批准号: 6653098
• 负责人: RUMI KATO PRICE
• 金额: $ 40.56万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-28 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6653098
• 关键词: behavior prediction; behavioral /social science research tag; clinical research; coping; depression; disease /disorder proneness /risk; human subject; human therapy evaluation; interview; longitudinal human study; mental health epidemiology; posttraumatic stress disorder; psychotherapy; religion; social support network; southeast Asia; substance abuse related disorder; suicide; veterans

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.

描述（由申请人提供）：本修订申请（RO I MH/DA 6096 1-01 A2）请求支援4年半（2000年7月至2005年12月） 对越南退伍军人进行随访， 自杀行为已经从华盛顿的结果中预测出来 1996- 1997年进行的大学越南时代研究-第三阶段。的 VES队列起源于1971年由白宫发起的一项研究， 解决药物滥用和调整问题， 返回部署到越南的军人。两波面对面访谈 由华盛顿大学于1972年和1974年进行， 男性越南战争退伍军人的概率样本和 非退伍军人（总目标N= 1，227）。25年随访（VES-III） 生活危机干预方案后，自杀发生在现场工作。 VES-III和两项大型普通人群研究的分析， 1993年死亡率跟踪调查和全国纵向酒精中毒调查 流行病学调查，1992年，共同证实了一个显着的过度风险， 在这个年龄段的男性中， 40-60岁组，控制人口统计学风险和保护因素。 酗酒、吸毒、抑郁和创伤/创伤后应激障碍似乎在很大程度上解释了 越战老兵的过度风险本申请（VES-IV）将密切关注 降低自杀风险的保护因素，以提高 自杀行为预测基于自我报告和自杀行为 预测量表，高风险（n=168）和低风险（n=250）目标样本 从VES-III中选择，以平衡科学考虑 产量和该领域预期的挑战。科学的目的是 探讨：1）应对机制和其他保护因素的混合使用 质量和数量措施，包括分析a）质量 评估、应对、宗教信仰、乐观、物质使用、社会 网络，以及基于自杀事件或负面事件的护理障碍，B） a）、c）定量措施中使用的定性代码的定量措施 基于发作/事件的应对和一般应对，以及d） 时间依赖性保护因素; 2）风险和 保护因素在预测自杀行为，使用的措施 包括a）基于定量发作/事件或时间依赖性风险， 从VES-IV获得的保护因子，和B）先前的风险和保护因子 从VES-III和更早的波浪中获得的因子。人类受试者保护目标 增加了：3）提供后续治疗分诊和随时待命 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工作， 与风险因素的相互作用，这被确定为 文学中的知识。我们希望这项研究的结果将有助于指导 对那些有自杀行为风险的人进行干预。