The present study compared the utility of categorical (i.e., diagnostic status) and dimensional (i.e., symptom severity) approaches to measuring posttraumatic stress disorder (PTSD) in predicting future suicide attempts among participants in a nationwide, longitudinal study of U.S. military veterans who were deployed in support of operations in Iraq or Afghanistan after the September 11, 2001, terrorist attacks (9/11) and were enrolled in Veterans Health Administration services (N = 1,649). Following an initial assessment of PTSD symptoms, we assessed for suicide attempts at two subsequent time points (M = 28.74 months, SD = 8.72 and M = 55.11 months, SD = 6.89 following the initial assessment). Between the initial and final assessments, 125 participants (7.58%) made at least one suicide attempt. All categorical and dimensional indicators of PTSD predicted suicide attempts at both time points except the categorical indicator for reexperiencing symptoms. Categorical indicators predicting suicide attempts demonstrated excellent sensitivity but poor specificity and overall accuracy. The point along the continuum at which PTSD symptom severity was most accurate regarding the prediction of future suicide attempts was well above the threshold previously established as indicating a probable diagnosis. Although this score was less sensitive than diagnostic indicators, it demonstrated greater specificity and overall accuracy in predicting future suicide attempts. The present results indicate that veterans whose PTSD symptoms satisfy the diagnostic criteria have a higher risk of future suicide attempts, but this risk appears to be even higher for veterans with symptom levels above the diagnostic threshold.

中文翻译：

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描述创伤后应激障碍与未来自杀企图之间关联的维度和分类方法的比较

本研究比较了分类（即诊断状态）和维度（即症状严重程度）方法测量创伤后应激障碍 (PTSD) 在预测未来自杀企图方面的效用，该研究对美国退伍军人进行了全国性纵向研究。在 2001 年 9 月 11 日恐怖袭击 (9/11) 之后部署以支持伊拉克或阿富汗的行动，并参加了退伍军人健康管理服务 ( N = 1,649)。在对 PTSD 症状进行初步评估后，我们在随后的两个时间点评估了自杀企图（M = 28.74 个月，SD = 8.72 和M = 55.11 个月，SD= 初始评估后的 6.89）。在初始和最终评估之间，125 名参与者 (7.58%) 至少有一次自杀未遂。创伤后应激障碍的所有分类和维度指标都预测了两个时间点的自杀企图，但重新体验症状的分类指标除外。预测自杀未遂的分类指标表现出极好的敏感性，但特异性和总体准确性较差。PTSD 症状严重程度在预测未来自杀企图方面最准确的连续点远高于先前确定的指示可能诊断的阈值。尽管该分数不如诊断指标敏感，但它在预测未来的自杀企图方面表现出更高的特异性和整体准确性。