Modifiable Risk and Protective Factors for Suicidal Behaviors in the US Army

美国陆军自杀行为的可改变风险和保护因素

• 批准号: 8110675
• 负责人: MURRAY B. STEIN
• 金额: $ 1000万
• 依托单位: HENRY M. JACKSON FDN FOR THE ADV MIL/MED
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-16 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8110675
• 关键词: Address; Aptitude Tests; Army Personnel; Autopsy; Baseline Surveys; Behavioral; Blood specimen; Candidate Disease Gene; Case-Control Studies; Characteristics; Clinical; Clinical Research; Collaborations; Computers; DSM-IV; Data; Data Collection; Data Files; Databases; Decision Making; Development; Disease; Drug usage; Epidemiologic Studies; Epidemiology; Evaluation; Event; Exposure to; Feeling suicidal; Future; General Population; Generations; Genetic; Genetic Risk; Health; Health Sciences; Hormones; Human Resources; Individual; Injury; Institution; Intervention; Interview; Judgment; Learning; Life; Link; Measurement; Medical; Medical Records; Mental Health; Mental disorders; Methods; Michigan; Military Personnel; Neurobiology; Outcome; Performance; Pharmacy facility; Phase; Population Attributable Risks; Preventive Intervention; Principal Investigator; Probability; Probability Samples; Procedures; Prospective Studies; Protocols documentation; Psychology; Recording of previous events; Records; Recruitment Activity; Registries; Relative (related person); Reporting; Research; Research Design; Research Personnel; Respondent; Risk; Risk Assessment; Risk Estimate; Saliva; Sample Size; Sampling; Series; Services; Soldier; Stress; Suicide; Suicide attempt; Suicide prevention; Surveys; Survival Analysis; System; Testing; The Sun; Time; Universities; Update; Work; accomplished suicide; administrative database; adverse outcome; base; career; case control; cohort; cost; cost effectiveness; design; drinking; effective intervention; evidence based guidelines; experience; follow-up; genome-wide; high risk; innovation; intervention effect; marital violence; medical schools; member; modifiable risk; mortality; neglect; prevent; primary outcome; programs; prospective; psychologic; psychosocial; reducing suicide; research study; resilience; response; secondary outcome; simulation; social; suicidal behavior; suicidal risk; suicide rate

DESCRIPTION (provided by applicant): This application is submitted in response to RFA-MH-09-140 by an interdisciplinary team from four institutions: the Uniformed Services University of the Health Sciences (USUHS), Harvard Medical School (HMS), the University of Michigan (UM), and Columbia University (CU), The team has unparalleled expertise in research on military mental health (USUHS), general population psychiatric epidemiology (HMS), large-scale epidemiological data collection (UM), and neurobiological-clinical research on suicidal behaviors (CU). We propose a multi-phase epidemiological study that considers diverse psychosocial and neurobiological risk and protective factors for suicidal behaviors and secondary outcomes in order to make evidence-based recommendations for implementation of Army suicide prevention interventions. An enriched version of the Army Suicide Event Report (ASER) system will be developed to define the primary outcomes incorporating information from the DoD Medical Mortality Registry (MMR) and Total Army Injury and Health Outcomes Database (TAIHOD). Our study design will include both a retrospective case-control component for quick efficient hypothesis testing and a prospective survey component to predict subsequent suicidal behaviors and secondary outcomes (onset, persistence, worsening of DSM-IV disorders, suicide ideation, suicide plans). We will also use data from the ongoing Pre- and Post-Deployment Health Reassessment Program (PDHRP) surveys as secondary outcomes. The case-control survey will study soldiers who made nonfatal attempts and relatives of soldiers who committed suicide in a psychological autopsy framework. Parallel data will be collected from carefully matched controls. Blood samples and, in the case of nonfatal attempters and their controls, saliva samples will be collected to allow neurobiological risk and protective factors to be studied. The survey component will include active duty personnel across all phases of Army service. Survey reports will be link to subsequent ASER records and PDHRP reports to study prospective associations of predictors with suicidal behaviors and secondary outcomes. A number of innovative measurement, design and analysis features will be used to increase chances of discovering effective intervention possibilities. RELEVANCE: The problem of Army suicide is one of great importance because an effective military force requires its members to be not only physically healthy but also mentally healthy. The relevance of a current study of Army suicide is heightened by the alarming rise in the suicide rate of US Army personnel over the past five years. The research proposed here has the potential to be of great value in helping the Army select optimally effective interventions to address this problem.

描述（由申请人提供）：本申请由来自四个机构的跨学科团队提交，以响应RFA-MH-09-140：健康科学统一服务大学（USUHS）、哈佛医学院（HMS）、密歇根大学（UM）和哥伦比亚大学（CU），该团队在军事心理健康研究方面拥有无与伦比的专业知识（USUHS），一般人群精神病学（HMS），大规模流行病学数据收集（UM）和自杀行为的神经生物学-临床研究（CU）。我们提出了一个多阶段的流行病学研究，考虑了不同的心理社会和神经生物学风险和自杀行为的保护因素和次要结果，以便为实施军队自杀预防干预措施提出循证建议。将开发陆军自杀事件报告（ASER）系统的丰富版本，以定义主要结局，并将国防部医疗死亡率登记处（MMR）和陆军总损伤和健康结局数据库（TAIHOD）的信息纳入其中。我们的研究设计将包括一个回顾性病例对照部分，用于快速有效的假设检验，以及一个前瞻性调查部分，用于预测随后的自杀行为和次要结局（DSM-IV疾病的发作、持续性、恶化、自杀意念、自杀计划）。我们还将使用正在进行的部署前和部署后健康重新评估计划（PDHRP）调查的数据作为次要结果。病例对照调查将在心理解剖框架内研究那些进行非致命性尝试的士兵和自杀士兵的亲属。将从仔细匹配的对照品中收集平行数据。将采集血液样本和唾液样本（对于非致命性肥胖者及其对照组），以研究神经生物学风险和保护因素。调查部分将包括陆军服役各个阶段的现役人员。调查报告将链接到随后的ASER记录和PDHRP报告，以研究预测因素与自杀行为和次要结局的前瞻性关联。将使用一些创新的测量、设计和分析功能，以增加发现有效干预可能性的机会。 相关性：军队自杀问题是一个非常重要的问题，因为一支有效的军队要求其成员不仅身体健康，而且精神健康。在过去的五年里，美国陆军人员自杀率的惊人上升，加强了目前对陆军自杀的研究的相关性。这里提出的研究有可能在帮助陆军选择最有效的干预措施来解决这个问题方面具有很大的价值。