PSYCHIATRY RESEARCH | 卷:220 |
The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality | |
Article | |
Kimbrel, Nathan A.1,2,3 Calhoun, Patrick S.1,2,3,4 Elbogen, Eric B.1,2,5 Brancu, Mira1,2,3 Beckham, Jean C.1,2,3 | |
[1] Durham Vet Affairs Med Ctr, Durham, NC 27705 USA | |
[2] VA Midatlantic Mental Illness Res Educ & Clin Ctr, Durham, NC USA | |
[3] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA | |
[4] Durham VAMC 152, VA Ctr Hlth Serv Res Primary Care, Durham, NC USA | |
[5] Univ N Carolina, Dept Psychiat, Chapel Hill, NC USA | |
关键词: PTSD; Depression; Substance abuse; Anxiety; Suicide; Violence; | |
DOI : 10.1016/j.psychres.2014.07.064 | |
来源: Elsevier | |
【 摘 要 】
The present research examined how incarceration, suicide attempts, suicidality, and difficulty controlling violence relate to the underlying factor structure of psychiatric comorbidity among a large sample of Iraq/Afghanistan-era veterans (N=1897). Diagnostic interviews established psychiatric diagnoses; self-report measures assessed history of incarceration, difficulty controlling violence, suicide attempts, and suicidality. A 3-factor measurement model characterized by latent factors for externalizing-substance-use disorders (SUD), distress, and fear provided excellent fit to the data. Alcohol-use disorder, drug-use disorder, and nicotine dependence were indicators on the externalizing-SUD factor. Posttraumatic stress disorder and depression were indicators on the distress factor. Panic disorder, social phobia, specific phobia, and obsessive-compulsive disorder were indicators on the fear factor. Incarceration was exclusively predicted by the externalizing-SUD factor. Difficulty controlling violence, suicidality, and suicide attempts were exclusively predicted by the distress factor. Contrary to hypotheses, the path from the externalizing/SUB factor to difficulty controlling violence was not significant. Taken together, these findings suggest that the distress factor of psychiatric comorbidity is a significant risk factor for suicidality, suicide attempts, and difficulty controlling violence and could help to explain the frequent co-occurrence of these critical outcomes among returning Iraq/Afghanistan veterans. Published by Elsevier Ireland Ltd.
【 授权许可】
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