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: 6796276
• 负责人: RUMI KATO PRICE
• 金额: $ 34.6万
• 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/6796276
• 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）：本修改后的申请（RO I MH/DA6096 1-01 A2）请求四年半的支持（200年7月伊藤2005年12月） 对越南退伍军人进行跟踪，他们目前的风险水平 华盛顿调查结果预测了自杀行为 大学越南时代研究 - 第三阶段 (VES-HI)，于 1996-97 年进行。这 VES队列源自白宫于1971年发起的一项研究 解决平民生活中的药物滥用和调整问题 部署到越南的归国军人。两波面对面采访 由华盛顿大学于 1972 年和 1974 年与两个国家 男性越战退伍军人的概率样本和比较样本 非退伍军人（总目标 N=1，227）。实施了 25 年随访 (VES-Ill) 实地考察期间发生自杀事件后的生活危机干预方案。 对 VES-Ill 和两项大型一般人群研究（国家 1993 年死亡率追踪调查和全国纵向酒精调查 1992 年流行病学调查共同证实了 越南退伍军人的自杀和自杀未遂，以及该年龄段男性的自杀和自杀未遂 40-60 人一组，控制人口风险和保护因素。 酗酒、吸毒、抑郁和创伤/创伤后应激障碍（PTSD）似乎在很大程度上解释了 越南退伍军人的过度风险。该应用程序（VES-IV）将密切关注 降低自杀风险的保护因素，以提高自杀率的准确性 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 该领域预期的产量和挑战。科学目标是 检查：1）使用混合的应对机制和其他保护因素 定性和定量测量，包括 a) 定性分析 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) 定量测量中使用的定性代码的定量测量 基于事件/事件的一般应对方式，以及 d) 的定量测量 时间依赖性保护因素； 2）风险和风险的相互作用 使用这些措施预测自杀行为的保护因素 包括 a) 基于事件/事件的或时间相关的定量风险和 从 VES-IV 获得的保护因素，以及 b) 先前的风险和保护 从 VES-III 和早期波浪中获得的因子。人类受试者保护目标 添加到：3) 提供后续治疗分类和随叫随到的服务 对当前有自杀风险的人进行自杀干预。该研究将 更好地了解保护因素的内部运作，以及 他们与风险因素的相互作用，被认为是 文献中的知识。我们希望研究结果能够帮助指导 对那些已知有自杀行为风险的人进行干预。