دانلود رایگان مقاله انگلیسی خشونت خانوادگی مستند و خطر اقدام به خودکشی در میان سربازان ارتش ایالات متحده - الزویر 2018

ABSTRACT

Suicide attempt (SA) rates in the U.S. Army increased substantially during the wars in Afghanistan and Iraq. This study examined associations of family violence (FV) history with SA risk among soldiers. Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records of active duty, Regular Army, enlisted soldiers with medically documented SAs from 2004 to 2009 (n = 9650) and a sample of control person-months (n = 153,528). Logistic regression analyses examined associations of FV with SA, adjusting for socio-demographics, service-related characteristics, and prior mental health diagnosis. Odds of SA were higher in soldiers with a FV history and increased as the number of FV events increased. Soldiers experiencing past-month FV were almost five times as likely to attempt suicide as those with no FV history. Odds of SA were elevated for both perpetrators and those who were exclusively victims. Male perpetrators had higher odds of SA than male victims, whereas female perpetrators and female victims did not differ in SA risk. A discrete-time hazard function indicated that SA risk was highest in the initial months following the first FV event. FV is an important consideration in understanding risk of SA among soldiers.

4. Discussion

Soldiers with a documented history of family violence were almost three times as likely to attempt suicide as those with no history of family violence, with the risk of attempt increasing as the number and recency of family violence events increased. Suicide attempt risk was highest in the initial months following the first family violence event, followed by a sharp and generally steady decline as more time elapsed. Risk of suicide attempt was increased for both perpetrators of family violence and those who were exclusively victims. Risk was higher for those whose family violence was documented in legal or ACR (Family Services) records versus only medical records. These findings are supported by past research indicating that female military personnel who were victims of spousal abuse were over four times more likely to attempt suicide than non-victims (Belik et al., 2009). Assessment of suicide risk among soldiers would benefit from awareness of recent family violence events, and recognition of the association between family violence and suicide risk should be incorporated into evidenced-based family and marital therapies. There is a need for the development of interventions specific to suicidality following family violence and, more generally, suicide-specific interventions that consider context (e.g., Ursano et al., in press). It would also be beneficial to provide education on suicide risk to workers in the legal system and social support services.