Modifiable Risk and Protective Factors for Suicidal Behaviors in the US Army

美国陆军自杀行为的可改变风险和保护因素

基本信息

批准号：
8110675
负责人：
MURRAY B. STEIN
金额：
$ 1000万
依托单位：
HENRY M. JACKSON FDN FOR THE ADV MIL/MED
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-16 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8110675
关键词：
Address Aptitude Tests Army Personnel Autopsy Baseline Surveys Behavioral Blood specimen Candidate Disease Gene Case-Control Studies Characteristics Clinical Clinical Research Collaborations Computers DSM-IV Data Data Collection Data Files Databases Decision Making Development Disease Drug usage Epidemiologic Studies Epidemiology Evaluation Event Exposure to Feeling suicidal Future General Population Generations Genetic Genetic Risk Health Health Sciences Hormones Human Resources Individual Injury Institution Intervention Interview Judgment Learning Life Link Measurement Medical Medical Records Mental Health Mental disorders Methods Michigan Military Personnel Neurobiology Outcome Performance Pharmacy facility Phase Population Attributable Risks Preventive Intervention Principal Investigator Probability Probability Samples Procedures Prospective Studies Protocols documentation Psychology Recording of previous events Records Recruitment Activity Registries Relative (related person)Reporting Research Research Design Research Personnel Respondent Risk Risk Assessment Risk Estimate Saliva Sample Size Sampling Series Services Soldier Stress Suicide Suicide attempt Suicide prevention Surveys Survival Analysis System Testing The Sun Time Universities Update Work accomplished suicide administrative database adverse outcome base career case control cohort cost cost effectiveness design drinking effective intervention evidence based guidelines experience follow-up genome-wide high risk innovation intervention effect marital violence medical schools member modifiable risk mortality neglect prevent primary outcome programs prospective psychologic psychosocial reducing suicide research study resilience response secondary outcome simulation social suicidal behavior suicidal risk suicide rate

项目摘要

DESCRIPTION (provided by applicant): This application is submitted in response to RFA-MH-09-140 by an interdisciplinary team from four institutions: the Uniformed Services University of the Health Sciences (USUHS), Harvard Medical School (HMS), the University of Michigan (UM), and Columbia University (CU), The team has unparalleled expertise in research on military mental health (USUHS), general population psychiatric epidemiology (HMS), large-scale epidemiological data collection (UM), and neurobiological-clinical research on suicidal behaviors (CU). We propose a multi-phase epidemiological study that considers diverse psychosocial and neurobiological risk and protective factors for suicidal behaviors and secondary outcomes in order to make evidence-based recommendations for implementation of Army suicide prevention interventions. An enriched version of the Army Suicide Event Report (ASER) system will be developed to define the primary outcomes incorporating information from the DoD Medical Mortality Registry (MMR) and Total Army Injury and Health Outcomes Database (TAIHOD). Our study design will include both a retrospective case-control component for quick efficient hypothesis testing and a prospective survey component to predict subsequent suicidal behaviors and secondary outcomes (onset, persistence, worsening of DSM-IV disorders, suicide ideation, suicide plans). We will also use data from the ongoing Pre- and Post-Deployment Health Reassessment Program (PDHRP) surveys as secondary outcomes. The case-control survey will study soldiers who made nonfatal attempts and relatives of soldiers who committed suicide in a psychological autopsy framework. Parallel data will be collected from carefully matched controls. Blood samples and, in the case of nonfatal attempters and their controls, saliva samples will be collected to allow neurobiological risk and protective factors to be studied. The survey component will include active duty personnel across all phases of Army service. Survey reports will be link to subsequent ASER records and PDHRP reports to study prospective associations of predictors with suicidal behaviors and secondary outcomes. A number of innovative measurement, design and analysis features will be used to increase chances of discovering effective intervention possibilities. RELEVANCE: The problem of Army suicide is one of great importance because an effective military force requires its members to be not only physically healthy but also mentally healthy. The relevance of a current study of Army suicide is heightened by the alarming rise in the suicide rate of US Army personnel over the past five years. The research proposed here has the potential to be of great value in helping the Army select optimally effective interventions to address this problem.

描述（由申请人提供）：该申请是由四个机构的跨学科团队响应RFA-MH-09-140提交的：卫生科学服务大学（USUHS），哈佛医学院（HMS），密歇根大学（UM）（UM）和哥伦比亚大学（UM）和哥伦比亚大学（CU），整体精神培训，是一般的精神培训，是一般的精神培训，是一般的精神知识。流行病学（HMS），大规模流行病学数据收集（UM）和自杀行为的神经生物学临床研究（CU）。我们提出了一项多相流行病学研究，该研究考虑了自杀行为和次要结果的各种心理社会和神经生物学风险以及保护因素，以便提出基于证据的建议，以实施陆军自杀预防干预措施。将开发一个富裕版的陆军自杀事件报告（ASER）系统，以定义结合国防部医疗死亡率登记册（MMR）以及全军伤害和健康成果数据库（TAIHOD）信息的主要结果。我们的研究设计将包括用于快速有效假设检验的回顾性病例对照组件，以及预测随后的自杀行为和次要结果的前瞻性调查组成部分（发作，持久性，DSM-IV疾病的恶化，自杀率，自杀计划，自杀计划）。我们还将使用正在进行的前和部署后健康重新评估计划（PDHRP）调查中的数据作为次要结果。案件对照调查将研究士兵，他们在心理尸检框架中自杀的士兵进行了非致命的尝试和亲戚。并行数据将从精心匹配的控件中收集。血液样本以及在非致命性假定及其对照的情况下，将收集唾液样本，以允许研究神经生物学风险和保护因素。调查部分将包括陆军服务所有阶段的现役人员。调查报告将链接到随后的ASER记录和PDHRP报告，以研究与自杀行为和次要结果的预测因子的前瞻性关联。许多创新的测量，设计和分析功能将用于增加发现有效干预可能性的机会。相关性：陆军自杀问题是非常重要的之一，因为有效的军事力量要求其成员不仅身体健康，而且还必须在精神上健康。过去五年中，美国陆军人员的自杀率令人震惊，当前对军队自杀的研究的相关性加剧了。这里提出的研究有可能在帮助陆军选择最佳有效干预措施以解决这一问题方面具有重要价值。