Ronald C. Kessler, Robert M. Bossarte, Irving Hwang, Alex Luedtke, James A. Naifeh, Matthew K. Nock, Maria Petukhova, Ekaterina Sadikova, Nancy A. Sampson, Erik Sverdrup, Jose R. Zubizarreta, Stefan Wager, James Wagner, Murray B. Stein, Robert J. Ursano
{"title":"美军士兵对作战相关压力影响的不同适应力预测模型。","authors":"Ronald C. Kessler, Robert M. Bossarte, Irving Hwang, Alex Luedtke, James A. Naifeh, Matthew K. Nock, Maria Petukhova, Ekaterina Sadikova, Nancy A. Sampson, Erik Sverdrup, Jose R. Zubizarreta, Stefan Wager, James Wagner, Murray B. Stein, Robert J. Ursano","doi":"10.1002/mpr.70006","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To develop a composite score for differential resilience to effects of combat-related stressors (CRS) on persistent DSM-IV post-traumatic stress disorder (PTSD) among US Army combat arms soldiers using survey data collected before deployment.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A sample of <i>n</i> = 2542 US Army combat arms soldiers completed a survey shortly before deployment to Afghanistan and then again two to three and 8–9 months after redeployment. Retrospective self-reports were obtained about CRS. Precision treatment methods were used to determine whether differential resilience to persistent PTSD in the follow-up surveys could be developed from pre-deployment survey data in a 60% training sample and validated in a 40% test sample.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>40.8% of respondents experienced high CRS and 5.4% developed persistent PTSD. Significant test sample heterogeneity was found in resilience (<i>t</i> = <i>2</i>.<i>1</i>, <i>p</i> = <i>0</i>.<i>032</i>), with average treatment effect (ATE) of high CRS in the 20% least resilient soldiers of 17.1% (SE = 5.5%) compared to ATE = 3.8% (SE = 1.2%) in the remaining 80%. The most important predictors involved recent and lifetime pre-deployment distress disorders.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>A reliable pre-deployment resilience score can be constructed to predict variation in the effects of high CRS on persistent PTSD among combat arms soldiers. Such a score could be used to target preventive interventions to reduce PTSD or other resilience-related outcomes.</p>\n </section>\n </div>","PeriodicalId":50310,"journal":{"name":"International Journal of Methods in Psychiatric Research","volume":"33 4","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mpr.70006","citationCount":"0","resultStr":"{\"title\":\"A prediction model for differential resilience to the effects of combat-related stressors in US army soldiers\",\"authors\":\"Ronald C. Kessler, Robert M. Bossarte, Irving Hwang, Alex Luedtke, James A. Naifeh, Matthew K. Nock, Maria Petukhova, Ekaterina Sadikova, Nancy A. Sampson, Erik Sverdrup, Jose R. Zubizarreta, Stefan Wager, James Wagner, Murray B. Stein, Robert J. Ursano\",\"doi\":\"10.1002/mpr.70006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To develop a composite score for differential resilience to effects of combat-related stressors (CRS) on persistent DSM-IV post-traumatic stress disorder (PTSD) among US Army combat arms soldiers using survey data collected before deployment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A sample of <i>n</i> = 2542 US Army combat arms soldiers completed a survey shortly before deployment to Afghanistan and then again two to three and 8–9 months after redeployment. Retrospective self-reports were obtained about CRS. Precision treatment methods were used to determine whether differential resilience to persistent PTSD in the follow-up surveys could be developed from pre-deployment survey data in a 60% training sample and validated in a 40% test sample.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>40.8% of respondents experienced high CRS and 5.4% developed persistent PTSD. Significant test sample heterogeneity was found in resilience (<i>t</i> = <i>2</i>.<i>1</i>, <i>p</i> = <i>0</i>.<i>032</i>), with average treatment effect (ATE) of high CRS in the 20% least resilient soldiers of 17.1% (SE = 5.5%) compared to ATE = 3.8% (SE = 1.2%) in the remaining 80%. The most important predictors involved recent and lifetime pre-deployment distress disorders.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>A reliable pre-deployment resilience score can be constructed to predict variation in the effects of high CRS on persistent PTSD among combat arms soldiers. Such a score could be used to target preventive interventions to reduce PTSD or other resilience-related outcomes.</p>\\n </section>\\n </div>\",\"PeriodicalId\":50310,\"journal\":{\"name\":\"International Journal of Methods in Psychiatric Research\",\"volume\":\"33 4\",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-10-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mpr.70006\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Methods in Psychiatric Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/mpr.70006\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Methods in Psychiatric Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/mpr.70006","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
A prediction model for differential resilience to the effects of combat-related stressors in US army soldiers
Objectives
To develop a composite score for differential resilience to effects of combat-related stressors (CRS) on persistent DSM-IV post-traumatic stress disorder (PTSD) among US Army combat arms soldiers using survey data collected before deployment.
Methods
A sample of n = 2542 US Army combat arms soldiers completed a survey shortly before deployment to Afghanistan and then again two to three and 8–9 months after redeployment. Retrospective self-reports were obtained about CRS. Precision treatment methods were used to determine whether differential resilience to persistent PTSD in the follow-up surveys could be developed from pre-deployment survey data in a 60% training sample and validated in a 40% test sample.
Results
40.8% of respondents experienced high CRS and 5.4% developed persistent PTSD. Significant test sample heterogeneity was found in resilience (t = 2.1, p = 0.032), with average treatment effect (ATE) of high CRS in the 20% least resilient soldiers of 17.1% (SE = 5.5%) compared to ATE = 3.8% (SE = 1.2%) in the remaining 80%. The most important predictors involved recent and lifetime pre-deployment distress disorders.
Conclusions
A reliable pre-deployment resilience score can be constructed to predict variation in the effects of high CRS on persistent PTSD among combat arms soldiers. Such a score could be used to target preventive interventions to reduce PTSD or other resilience-related outcomes.
期刊介绍：
The International Journal of Methods in Psychiatric Research (MPR) publishes high-standard original research of a technical, methodological, experimental and clinical nature, contributing to the theory, methodology, practice and evaluation of mental and behavioural disorders. The journal targets in particular detailed methodological and design papers from major national and international multicentre studies. There is a close working relationship with the US National Institute of Mental Health, the World Health Organisation (WHO) Diagnostic Instruments Committees, as well as several other European and international organisations.
MPR aims to publish rapidly articles of highest methodological quality in such areas as epidemiology, biostatistics, generics, psychopharmacology, psychology and the neurosciences. Articles informing about innovative and critical methodological, statistical and clinical issues, including nosology, can be submitted as regular papers and brief reports. Reviews are only occasionally accepted.
MPR seeks to monitor, discuss, influence and improve the standards of mental health and behavioral neuroscience research by providing a platform for rapid publication of outstanding contributions. As a quarterly journal MPR is a major source of information and ideas and is an important medium for students, clinicians and researchers in psychiatry, clinical psychology, epidemiology and the allied disciplines in the mental health field.
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