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: 8333455
• 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/8333455
• 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.

申请者描述(由申请人提供)：本申请是针对RFA-MH-09-140，由来自四个机构的跨学科团队提交的：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)，该团队在军事精神健康(USUHS)、普通人群精神流行病学(HMS)、大规模流行病学数据收集(UM)和自杀行为(CU)的神经生物学-临床研究(CU)方面拥有无与伦比的专业知识。我们提出了一项多阶段流行病学研究，考虑自杀行为和继发性后果的不同心理社会和神经生物学风险和保护因素，以期为军队自杀预防干预的实施提供循证建议。将开发陆军自杀事件报告(ASER)系统的丰富版本，以定义纳入国防部医疗死亡登记(MMR)和陆军总伤害和健康结果数据库(TAIHOD)的信息的主要结果。我们的研究设计将包括用于快速有效假设检验的回溯性病例对照部分和用于预测后续自杀行为和次要结果(DSM-IV障碍的发病、持续、恶化、自杀意念、自杀计划)的前瞻性调查部分。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尸检框架内研究进行非致命性企图的士兵和自杀士兵的亲属。平行数据将从仔细匹配的对照中收集。将采集血液样本，在非致命性未遂者及其对照组的情况下，收集唾液样本，以便于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所有阶段的现役人员。调查报告将链接到后续的ASER记录和PDHRP报告，以研究预测因素与自杀行为和二次结局的预期关联。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：军队自杀问题是非常重要的问题之一，因为一支有效的军事力量不仅要求其成员身体健康，而且要求其精神健康。过去五年美国陆军人员自杀率的惊人上升，增强了当前一项关于陆军自杀的研究的相关性。这里提出的研究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潜在价值。