Background

A burgeoning body of research suggests that specific types of combat experiences may be a stronger predictor of suicidality among veterans than a history of combat exposure itself. To date, however, little population-based data exist about these associations in representative samples of veterans. This study examined the association between overall severity of combat exposure and specific combat experiences with suicidal ideation and suicide attempt(s) (SI/SA) in a nationally representative sample of combat veterans.

Methods

Data were from the National Health and Resilience in Veterans Study, a nationally representative survey of U.S. combat veterans (n = 1100). Analyses (a) compared veterans with/without current SI and lifetime SA on sociodemographic, military, and clinical characteristics; and (b) examined associations between overall combat exposure and specific combat experiences, and SI/SA.

Results

Hierarchical regression analyses revealed that overall combat exposure was positively, albeit weakly, associated with SI/SA, after adjusting for sociodemographic characteristics and lifetime trauma burden [odds ratios (ORs) = 1.02–1.03]. Combat experiences involving direct exposure to death, killing, or grave injury were independently associated with SI/SA (ORs = 1.46–1.70), whereas several general combat experiences (e.g., combat patrols) were negatively associated with SI/SA (ORs = 0.44–0.65).

Discussion

Results indicate that U.S. combat veterans who have witnessed others be killed or wounded in combat are at substantially higher risk for SI/SA relative to those without such histories. Collectively, findings suggest that combat exposure, when examined as an aggregate severity measure, may yield a poor prognostication of suicide risk, as it may be insufficiently sensitive to detect the effects of specific combat-related experiences.

中文翻译：

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特定战斗经历对美军退伍军人自杀意念和自杀未遂的影响：《国家退伍军人健康与复原力》研究的结果。

背景

蓬勃发展的研究表明，与战斗经历本身的历史相比，特定类型的战斗经验可能是退伍军人自杀倾向的更强预测指标。但是，到目前为止，在退伍军人的代表性样本中，关于这些关联的基于人群的数据很少。这项研究在全国代表性的退役退伍军人样本中检验了总体战役暴露严重程度与具体的战役经历与自杀意念和自杀未遂之间的关联（SI / SA）。

方法

数据来自《美国退伍军人健康与抵御能力研究》，这是一项针对美国退伍军人的全国代表性调查（n = 1100）。分析（a）比较了具有/没有当前SI和一生中SA的退伍军人在社会人口统计学，军事和临床特征方面的优势；（b）研究了整体战斗经历与特定战斗经验之间的关联以及SI / SA。

结果

分层回归分析显示，在调整了社会人口统计学特征和终生创伤负担[比值比（OR）= 1.02-1.03]之后，总体战斗暴露与SI / SA呈正相关，尽管较弱。与直接死亡，杀戮或重伤直接接触有关的战斗经历与SI / SA独立相关（OR = 1.46-1.70），而一些一般战斗经验（例如，战斗巡逻）与SI / SA呈负相关（OR = 0.44） –0.65）。

讨论区

结果表明，目睹其他人在战斗中丧生或受伤的美国退伍军人与没有此类经历的人相比，SI / SA的风险要高得多。总体而言，研究结果表明，作为总体严重性指标进行检查，对战役的暴露可能会导致自杀风险的预后不良，因为它可能不足以检测出与战役相关的特定经历的影响。