背景:自残和自杀行为是一个主要的公共卫生问题。在军事社区中,有几个因素与这些行为有关。确定这些因素可能对政策和临床服务具有重要意义。这项审查的目的是确定与联合王国武装部队现役和退役人员自残和自杀行为相关的风险和保护因素,加拿大武装部队,澳大利亚国防军和新西兰国防军。
方法:对七个在线数据库(PubMed,WebofScience,Embase,全球卫生,PsycINFO,PTSDpubs和CINAHL)与交叉引用一起进行,2022年10月。按照事先批准的PROSPERO协议(CRD42022348867),论文进行独立筛选和质量评估。数据是使用叙事方法合成的。
结果:总体而言,包括28篇论文:来自加拿大的13篇,10来自英国,五个来自澳大利亚,一个来自新西兰。已确定的风险因素包括单身/离职关系,早期服务离职者,服务年限较短(但不一定是提前离职),初级队伍,暴露于部署相关的创伤事件,身心健康诊断,经历童年的逆境。保护因素包括结婚/恋爱关系,较高的教育程度,employment,高层,和更高水平的感知社会支持。
结论:足够的照顾和支持是军事团体的必要条件。自我伤害和自杀行为的预防和干预策略可能会尽早引入,并可能促进社交网络作为主要的支持来源。这篇综述发现一些人群中缺乏同行评审的研究。需要更多的同行评审研究,特别是在目前工作有限的人群中,以及可修改的风险和保护因素。
BACKGROUND: Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. The aim of this
review was to identify the risk and protective factors associated with self-harm and suicide behaviours among serving and ex-serving personnel of the United Kingdom Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force.
METHODS: A systematic search of seven online databases (PubMed, Web of Science, Embase, Global Health, PsycINFO, PTSDpubs and CINAHL) was conducted alongside cross-referencing, in October 2022. Following an a priori PROSPERO approved protocol (CRD42022348867), papers were independently screened and assessed for quality. Data were synthesised using a narrative approach.
RESULTS: Overall, 28 papers were included: 13 from Canada, 10 from the United Kingdom, five from Australia and none from New Zealand. Identified risk factors included being single/ex-relationship, early service leavers, shorter length of service (but not necessarily early service leavers), junior ranks, exposure to deployment-related traumatic events, physical and mental health diagnoses, and experience of childhood adversity. Protective factors included being married/in a relationship, higher educational attainment, employment, senior ranks, and higher levels of perceived social support.
CONCLUSIONS: Adequate care and support are a necessity for the military community. Prevention and intervention strategies for self-harm and suicide behaviours may be introduced early and may promote social networks as a key source of support. This
review found a paucity of peer-reviewed research within some populations. More peer-reviewed research is needed, particularly among these populations where current work is limited, and regarding modifiable risk and protective factors.