Temporal sequences of suicidal and nonsuicidal self-injurious thoughts and behaviors among inpatient and community-residing military veterans

JOURNAL OF AFFECTIVE DISORDERS

卷:294

Article

Kearns, Jaclyn C.^1,2  Brown, Sarah L.^2,3  Cero, Ian⁴  Gorman, Kaitlyn R.^2,5  Nock, Matthew K.⁶  Keane, Terence M.^2,7,8  Marx, Brian P.^2,7,8 

[1] Univ Rochester, Dept Psychol, Meliora Hall, Rochester, NY 14627 USA

[2] VA Boston Healthcare Syst, Boston, MA USA

[3] Texas Tech Univ, Dept Psychol Sci, Lubbock, TX 79409 USA

[4] Univ Rochester, Med Ctr, Rochester, NY 14642 USA

[5] Univ Massachusetts, Boston, MA 02125 USA

[6] Harvard Univ, Dept Psychol, 33 Kirkland St, Cambridge, MA 02138 USA

[7] Natl Ctr PTSD, Boston, MA USA

[8] Boston Univ, Sch Med, Boston, MA 02118 USA

关键词: Suicide;    Nonsuicidal self-injury;    Military;    Veterans;    Suicide attempt;   

DOI  :  10.1016/j.jad.2021.07.088

来源: Elsevier

【 摘 要 】

Background: Suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) are major health concerns among military veterans yet little is known about the temporal relations among these outcomes. This study examined the temporal relations between suicidal and nonsuicidal SITBs among higher-risk veterans. Specifically, we identified when SITBs emerged and evaluated the role of nonsuicidal self-injury (NSSI) in the medical lethality of suicide attempts (SA), relative risk, and survival time of suicidal SITBs (i.e., suicide ideation [SI], suicide plan, SA). Method: Cross-sectional data were collected from two samples examining suicide risk among veterans receiving inpatient psychiatric care (n = 157) and community-residing veterans with current depression and/or past month SI (n = 200). Participants completed an interview to assess SITBs. Results: SITBs emerged between ages 14-28 years with behaviors emerging, on average, earlier among inpatient veterans. The time lag between SITBs was not significantly different between groups. Inpatient veterans had a significantly shorter time lag from SI to SA. NSSI history predicted an increase in relative risk for all suicidal SITBs and shorter survival time. There was no association between NSSI history and medical lethality of the most serious SA for both groups. Limitations: Limitations included use of cross-sectional, retrospective self-report with age-of-onset endorsed in years and not all SITBs were assessed (e.g., passive SI). Conclusions: Veterans with a NSSI history are at high risk for suicidal SITBs and have a shorter survival time. Results showed thoughts (i.e., NSSI thoughts, SI) emerged before behavior (i.e., NSSI, SA) and NSSI emerged before SA.

【 授权许可】

Free