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231.
Mental Disorders,Comorbidity, and Pre‐enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)
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Matthew K. Nock PhD Robert J. Ursano MD Steven G. Heeringa PhD Murray B. Stein MD MPH Sonia Jain PhD Rema Raman PhD Xiaoying Sun MS Wai Tat Chiu AM Lisa J. Colpe PhD MPH Carol S. Fullerton PhD Stephen E. Gilman ScD Irving Hwang MA James A. Naifeh PhD Anthony J. Rosellini PhD Nancy A. Sampson BA Michael Schoenbaum PhD Alan M. Zaslavsky PhD Ronald C. Kessler PhD the Army STARRS Collaborators 《Suicide & life-threatening behavior》2015,45(5):588-599
We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre‐enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6–8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention‐deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre‐enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts. 相似文献
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An Examination of Potential Misclassification of Army Suicides: Results from the Army Study to Assess Risk and Resilience in Servicemembers
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Kenneth L. Cox MD MPH Matthew K. Nock PhD Quinn M. Biggs PhD MPH Jennifer Bornemann MSSW Lisa J. Colpe PhD MPH Catherine L. Dempsey PhD MPH Steven G. Heeringa PhD James E. McCarroll PhD MPH Tsz Hin Ng MPH Michael Schoenbaum PhD Robert J. Ursano MD Bailey G. Zhang MS David M. Benedek MD the Army STARRS Collaborators 《Suicide & life-threatening behavior》2017,47(3):257-265
Debate continues about the accuracy of military suicide reporting due to concerns that some suicides may be classified as accidents to minimize stigma and ensure survivor benefits. We systematically reviewed records for 998 active duty Army deaths (510 suicides; 488 accident, homicide, and undetermined deaths; 2005‐2009) and, using research criteria, reclassified 8.2% of the nonsuicide cases to definite suicide (1), suicide probable (4), or suicide possible (35). The reclassification rate to definite suicide was only 0.2% (1/488). This low rate suggests that flagrant misclassification of Army deaths is uncommon and surveillance reports likely reflect the “true” population of Army suicides. 相似文献
235.
The main procedure used by clinicians to determine whether an individual may be at risk of suicidal behaviors is the suicide risk assessment (SRA). The purpose of the SRA is to identify risk and protective factors that then provide the data for the formulation of suicide risk. The suicide risk formulation (SRF) assigns a level of suicide risk that ideally leads to triage and treatment deemed appropriate for that level of risk. Some of the problems with the SRA are explored here, with an emphasis on addressing the over reliance on communicated suicide ideation, and recommendations are made for improvements. Part II of this article (Berman & Silverman, 2013, also appears in this issue of STLB) examines the process of an SRF and, similarly, makes recommendations to improve clinical practice toward the desired end of saving lives. 相似文献
236.
Paul N. Pfeiffer MD Hyungjin M. Kim ScD Dara Ganoczy MPH Kara Zivin PhD Marcia Valenstein MD 《Suicide & life-threatening behavior》2013,43(4):356-365
We evaluated whether treatment‐resistant depression (TRD) as measured by the Massachusetts General Hospital (MGH) staging method was associated with suicide in a large U.S. health system. Data from the Veterans Health Administration and the National Death Index were used to conduct a case–control study of patients newly diagnosed with depression who received antidepressant treatment between 2003 and 2006. Suicide cases (N = 499) were matched with nonsuicide controls (N = 1994). Conditional logistic regression was used to assess whether MGH stage at time of suicide (or matched date) was associated with case status, adjusting for patient demographic characteristics, comorbidity, and service use. Results indicated 11.6% of suicide cases had MGH stage 3 or greater (indicating at least two antidepressant trials) compared to 6.4% of controls (p < .001). In adjusted analyses, suicide was not significantly more likely among patients with stage 3 or greater (OR 1.52; 95% CI: 0.98, 2.37) or stages 1.5–2.5 (OR 1.19; 95% CI: 0.91, 1.55) compared to patients with stage 1 or less (<10 weeks of antidepressant medication). Staging TRD using MGH criteria is unlikely to substantially improve suicide risk assessment of depressed patients beyond existing measures contained in health system records. 相似文献
237.
Harold Levitan MD 《Suicide & life-threatening behavior》1984,14(3):201-206
ABSTRACT: The author presents several dreams reported by psychosomatic patients which contain an overt or disguised act of suicide. In the latter instances various transformations of the act of suicide had been brought about by the defensive functions of the dreaming ego. Paradoxically, in several of these instances it was the very efforts of the dreaming ego to defend itself which allowed the suicidal impulse to reach its consummation. 相似文献
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239.
Moving Beyond Self‐Report: Implicit Associations about Death/Life Prospectively Predict Suicidal Behavior among Veterans
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Sean M. Barnes PhD Nazanin H. Bahraini PhD Jeri E. Forster PhD Kelly A. Stearns‐Yoder BA Trisha A. Hostetter MPH Geoffrey Smith PsyD Herbert T. Nagamoto MD Matthew K. Nock PhD 《Suicide & life-threatening behavior》2017,47(1):67-77
Reliance on self‐report limits clinicians' ability to accurately predict suicidal behavior. In this study the predictive validity of an objective measure, the death/suicide Implicit Association Test (d/sIAT), was tested among psychiatrically hospitalized veterans. Following acute stabilization, 176 participants completed the d/sIAT and traditional suicide risk assessments. Participants had similar d/sIAT scores regardless of whether they had recently attempted suicide. However, d/sIAT scores significantly predicted suicide attempts during the 6‐month follow‐up above and beyond other known risk factors for suicidal behavior (OR = 1.89; 95% CI: 1.15–3.12; based on 1SD increase). The d/sIAT may augment the accuracy of suicide risk assessment. 相似文献
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