Deliberate Self-Harm and Suicidal Ideation Among Male Iraq/Afghanistan-Era Veterans Seeking Treatment for PTSD

Authors

  • Nathan A. Kimbrel,

    Corresponding author
    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
    • Correspondence concerning this article should be sent to Nathan A. Kimbrel, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705. E-mail: Nathan.Kimbrel@va.gov

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  • Margaret E. Johnson,

    1. Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, California, USA
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  • Carolina Clancy,

    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Michael Hertzberg,

    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Claire Collie,

    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Elizabeth E. Van Voorhees,

    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Michelle F. Dennis,

    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Patrick S. Calhoun,

    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
    4. VA Center for Health Services Research in Primary Care, Durham, North Carolina, USA
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  • Jean C. Beckham

    1. Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
    2. The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • This work was supported by a Career Development Award-2 (IK2 CX000525) to Dr. Kimbrel and a Research Career Scientist Award to Dr. Beckham from the Clinical Science Research and Development Service of the VA Office of Research and Development. This work was also supported by the Research and Development and Mental Health Services of the Durham VA Medical Center and the VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA or the United States government.

Abstract

The objectives of the present research were to examine the prevalence of deliberate self-harm (DSH) among 214 U.S. male Iraq/Afghanistan-era veterans seeking treatment for posttraumatic stress disorder (PTSD) and to evaluate the relationship between DSH and suicidal ideation within this population. Approximately 56.5% (n = 121) reported engaging in DSH during their lifetime; 45.3% (n = 97) reported engaging in DSH during the previous 2 weeks. As hypothesized, DSH was a significant correlate of suicidal ideation among male Iraq/Afghanistan-era veterans, OR = 3.88, p < .001, along with PTSD symptom severity, OR = 1.03, p < .001, and combat exposure, OR = 0.96, p = .040. A follow-up analysis identified burning oneself, OR = 17.14, p = .017, and hitting oneself, OR = 7.93, p < .001, as the specific DSH behaviors most strongly associated with suicidal ideation. Taken together, these findings suggest that DSH is quite prevalent among male Iraq/Afghanistan-era veterans seeking treatment for PTSD and is associated with increased risk for suicidal ideation within this population. Routine assessment of DSH is recommended when working with male Iraq/Afghanistan veterans seeking treatment for PTSD.

Resumen

Los objetivos del presente trabajo fueron examinar la prevalencia de Autoagresión Deliberada (AD) entre hombres veteranos Iraquíes/Afganistanes que solicitan tratamiento por el Trastorno por Estrés Post Traumático (TEPT) y evaluar la relación entre AD e ideación suicida en esta población.

Se incluyeron como participantes 214 veteranos hombres Iraquíes/Afganistanes que solicitaron tratamiento por TEPT. Aproximadamente el 56,5% (n:121) reportó haberse realizado AD a lo largo de su vida; el 45,3% (n:97) reportó haberse realizado AD durante las dos semanas previas. Como hipotetizamos, AD fue un predictor importante de ideación suicida entre veteranos hombres Iraquíes/Afganistanes,OR = 3.88,p <.001, junto con la severidad de los síntomas de TEPT, OR = 1,03,p<.001 y la exposición a combate, OR = 0,96,p = .040. El análisis de seguimiento identificó el quemarse, OR:17,14, p = 0.17, y golpearse, OR = 7,93,p<.001, como conductas específicas más fuertemente asociadas a la ideación suicida. En conjunto, estos hallazgos sugieren que AD es altamente prevalente entre veteranos hombres Iraquíes/Afganistanes que solicitan tratamiento por TEPT y se asocia con mayor riesgo de ideación suicida en esta población. Se recomienda evaluar de rutina el AD cuando se trabaja con veteranos hombres Iraquíes/Afganistanes que solicitan tratamiento por TEPT.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題 : 接受PTSD治療的伊拉克/阿富汗退役男軍人的自殘和自殺念頭

撮要: 本研究旨在檢視接受創傷後壓力症(PTSD)治療的伊拉克/阿富汗男退役兵的自殘行為(DSH)流行率,和評估其中DSH與自殺念頭的關係。樣本為214名伊拉克/阿富汗男退役軍人,其中終生DSH比率約為56.5%(n=121);而前兩週DSH比率為45.3%(n=97)。DSH恰如假設一樣,是伊拉克/阿富汗男退役兵自殺念頭的重要預測因素,OR=3.88,P < .001,與PTSD症狀嚴重程度的關連,OR=1.03,P < .001;和戰鬥經歷有關係OR=0.96,p=.040。跟進分析發現:燒傷自己,OR=17.14,p=.017,和打傷自己,OR=7.93,p < .001,顯示個別DSH行為與自殺念頭呈強烈關連。綜觀而言,本研究發現DSH在接受PTSD治療的伊拉克/阿富汗退役軍人中非常流行, 而且與自殺念頭的風險增加有關係。我們建議在接受PTSD治療的伊拉克/阿富汗男兵中進行例行DSH評估。

标题 : 接受PTSD治疗的伊拉克/阿富汗退役男军人的自残和自杀念头

撮要: 本研究旨在检视接受创伤后压力症(PTSD)治疗的伊拉克/阿富汗男退役兵的自残行为(DSH)流行率,和评估其中DSH与自杀念头的关系。样本为214名伊拉克/阿富汗男退役军人,其中终生DSH比率约为56.5%(n=121);而前两周DSH比率为45.3%(n=97)。DSH恰如假设一样,是伊拉克/阿富汗男退役兵自杀念头的重要预测因素,OR=3.88,P < .001,与PTSD症状严重程度的关连,OR=1.03,P < .001;和战斗经历有关系OR=0.96,p=.040。跟进分析发现: 烧伤自己,OR=17.14,p=.017,和打伤自己,OR=7.93,p < .001,显示个别DSH行为与自杀念头呈强烈关连。综观而言,本研究发现DSH在接受PTSD治疗的伊拉克/阿富汗退役军人中非常流行, 而且与自杀念头的风险增加有关系。我们建议在接受PTSD治疗的伊拉克/阿富汗男兵中进行例行DSH评估。

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