Abstract：
BACKGROUND: This study reports on gender differences in psychosocial symptoms and suicidal thoughts and behaviors from the first longitudinal, national survey of veterans with a recent nonfatal suicide attempt to inform women-tailored suicide prevention.
METHODS: We recruited all female veterans with a documented nonfatal suicide attempt between October 2018 and September 2019 and a stratified matched sample of males. Surveys were administered at baseline, month 6, and month 12; 968 veterans completed the baseline survey with valid gender data. Surveys assessed psychosocial constructs, suicidal ideation severity, and suicidal behavior. Administrative datasets provided healthcare and suicide attempt data during the one year follow up.
RESULTS: Women retained higher social rejection and institutional betrayal, and lower self-compassion and autonomy than men over follow up. Higher overall self-compassion was associated with lower baseline suicide ideation for both women and men; however, this association was stronger for women (Δ = -0.19; 95 % CI = -0.31, -0.07; d = -0.15). Individuals with higher overall psychological distress had greater odds of a subsequent suicide attempt (AOR = 2.20, 95 % CI = 1.56, 3.11). Social rejection had the strongest association with worsening psychological distress, both within individuals (b = 0.18; 95 % CI = 0.14, 0.23; d = 0.23) and between individuals (b = 0.07; 95 % CI = 0.04, 0.10; d = 0.09).
CONCLUSIONS: Results may not generalize beyond a VHA-utilizing veteran population.
CONCLUSIONS: Findings from this study inform potential therapeutic targets and topics for future research on tailoring suicide prevention for women veterans. While all veterans may need support reducing distress, women may need additional support in multiple other areas.
METHODS: We recruited all female veterans with a documented nonfatal suicide attempt between October 2018 and September 2019 and a stratified matched sample of males. Surveys were administered at baseline, month 6, and month 12; 968 veterans completed the baseline survey with valid gender data. Surveys assessed psychosocial constructs, suicidal ideation severity, and suicidal behavior. Administrative datasets provided healthcare and suicide attempt data during the one year follow up.
RESULTS: Women retained higher social rejection and institutional betrayal, and lower self-compassion and autonomy than men over follow up. Higher overall self-compassion was associated with lower baseline suicide ideation for both women and men; however, this association was stronger for women (Δ = -0.19; 95 % CI = -0.31, -0.07; d = -0.15). Individuals with higher overall psychological distress had greater odds of a subsequent suicide attempt (AOR = 2.20, 95 % CI = 1.56, 3.11). Social rejection had the strongest association with worsening psychological distress, both within individuals (b = 0.18; 95 % CI = 0.14, 0.23; d = 0.23) and between individuals (b = 0.07; 95 % CI = 0.04, 0.10; d = 0.09).
CONCLUSIONS: Results may not generalize beyond a VHA-utilizing veteran population.
CONCLUSIONS: Findings from this study inform potential therapeutic targets and topics for future research on tailoring suicide prevention for women veterans. While all veterans may need support reducing distress, women may need additional support in multiple other areas.
摘要：
背景：这项研究报告了心理社会症状和自杀想法和行为的性别差异，全国退伍军人调查最近的非致命自杀企图告知女性量身定制的自杀预防。
方法：我们招募了所有在2018年10月至2019年9月期间有非致命自杀企图的女性退伍军人，并对男性进行了分层匹配样本。调查在基线进行，6个月和12个月;968名退伍军人使用有效的性别数据完成了基线调查.调查评估了社会心理结构，自杀意念的严重程度，和自杀行为。行政数据集提供了一年随访期间的医疗保健和自杀企图数据。
结果：女性保留了更高的社会排斥和制度背叛，自我同情和自主性比男人低。较高的整体自我同情与女性和男性较低的基线自杀意念相关；然而，女性的这种关联更强(Δ=-0.19;95%CI=-0.31,-0.07;d=-0.15).总体心理困扰较高的个体随后自杀未遂的可能性更大（AOR=2.20，95％CI=1.56，3.11）。社会排斥与心理困扰恶化有最强烈的联系，个体内部(b=0.18;95%CI=0.14,0.23;d=0.23)和个体之间(b=0.07;95%CI=0.04,0.10;d=0.09)。
结论：结果可能不会超出使用VHA的退伍军人人群。
结论：这项研究的结果为未来针对退伍军人女性自杀预防的研究提供了潜在的治疗目标和主题。虽然所有退伍军人可能都需要帮助来减轻痛苦，女性可能需要其他多个领域的额外支持。
方法：我们招募了所有在2018年10月至2019年9月期间有非致命自杀企图的女性退伍军人，并对男性进行了分层匹配样本。调查在基线进行，6个月和12个月;968名退伍军人使用有效的性别数据完成了基线调查.调查评估了社会心理结构，自杀意念的严重程度，和自杀行为。行政数据集提供了一年随访期间的医疗保健和自杀企图数据。
结果：女性保留了更高的社会排斥和制度背叛，自我同情和自主性比男人低。较高的整体自我同情与女性和男性较低的基线自杀意念相关；然而，女性的这种关联更强(Δ=-0.19;95%CI=-0.31,-0.07;d=-0.15).总体心理困扰较高的个体随后自杀未遂的可能性更大（AOR=2.20，95％CI=1.56，3.11）。社会排斥与心理困扰恶化有最强烈的联系，个体内部(b=0.18;95%CI=0.14,0.23;d=0.23)和个体之间(b=0.07;95%CI=0.04,0.10;d=0.09)。
结论：结果可能不会超出使用VHA的退伍军人人群。
结论：这项研究的结果为未来针对退伍军人女性自杀预防的研究提供了潜在的治疗目标和主题。虽然所有退伍军人可能都需要帮助来减轻痛苦，女性可能需要其他多个领域的额外支持。
