Disaggregating Data Regarding Suicidal Ideation and Suicide Attempts among Post-9/11 Asian American and Pacific Islander Veterans

Lindsey L. Monteith, Jeri E. Forster, Ryan Holliday, Christin Miller, Nazanin H. Bahraini, F. Akhtar, Aaron I. Schneiderman, Lisa A Brenner, Claire A. Hoffmire
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Abstract

The suicide rate among Asian American and Pacific Islander veterans has increased; however, data aggregation for these groups, combined with underinclusion in research, limits understanding regarding risk. We conducted a secondary analysis of Comparative Health Assessment Interview Research Study 2018 data to compare suicidal ideation (SI) and suicide attempt (SA) prevalence among 668 post-9/11 veterans who identified as Asian American, Pacific Islander, or both and described SI and SA prevalence among specific subgroups. Veterans who identified as both Asian American and Pacific Islander were more likely to report experiencing SI (lifetime and during their military service), compared to those who identified solely as Asian American or Pacific Islander (military SI only). Statistically significant differences were not detected for SI preceding or following military service or for lifetime SA. Weighted estimates for lifetime SI and SA were 24.2% and 6.5%, respectively, and prevalence varied widely among specific Asian American and Pacific Islander groups. However, small cell sizes and wide confidence intervals were limitations. Increased clinical attention to screen for and mitigate suicide risk among veterans who identify as both Asian American and Pacific Islander may be warranted. To ensure that suicide prevention strategies optimally address their needs and experiences, research is needed to elucidate suicide drivers in this population. Considering the heterogeneity in SI and SA prevalence among different Asian American and Pacific Islander groups, continued research with larger subsamples that disaggregates analyses by race and ethnicity is essential to deliver prevention and health promotion strategies targeted to the highest-risk groups.
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有关 9/11 事件后美国亚裔和太平洋岛民退伍军人自杀意念和自杀未遂的分类数据
亚裔美国人和太平洋岛民退伍军人的自杀率有所上升;然而,这些群体的数据汇总,加上未被充分纳入研究,限制了对风险的了解。我们对 "2018 年健康评估访谈比较研究 "的数据进行了二次分析,比较了 668 名 9/11 事件后退伍军人中自杀意念(SI)和自杀未遂(SA)的发生率,这些退伍军人有的被认定为亚裔美国人,有的被认定为太平洋岛民,有的则同时被认定为亚裔美国人和太平洋岛民,我们还描述了特定亚群中自杀意念和自杀未遂的发生率。与那些仅被认定为亚裔美国人或太平洋岛民的退伍军人相比,那些被认定为亚裔美国人和太平洋岛民的退伍军人更有可能报告经历过SI(终生和服兵役期间)(仅军事SI)。对于服兵役前后的 SI 或终生 SA,未发现有统计学意义的差异。终生 SI 和 SA 的加权估计值分别为 24.2% 和 6.5%,特定亚裔美国人和太平洋岛民群体之间的流行率差异很大。然而,小样本量和较宽的置信区间是研究的局限性。临床上可能需要更多关注那些同时被认定为亚裔美国人和太平洋岛民的退伍军人,以筛查和降低他们的自杀风险。为确保自杀预防策略能最有效地满足他们的需求和经历,需要开展研究来阐明这一人群的自杀动因。考虑到不同亚裔美国人和太平洋岛民群体在 SI 和 SA 发生率方面的异质性,继续对更大的子样本进行研究,并按种族和民族进行分类分析,对于提供针对高危群体的预防和健康促进策略至关重要。
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