Pre-deployment predictors of suicide attempt during and after combat deployment: Results from the Army Study to Assess Risk and Resilience in Servicemembers.

Autor: Zuromski KL; Department of Psychology, Harvard University, Cambridge, MA, USA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA., Bernecker SL; Department of Psychology, Harvard University, Cambridge, MA, USA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA., Chu C; Department of Psychology, Harvard University, Cambridge, MA, USA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA., Wilks CR; Department of Psychology, Harvard University, Cambridge, MA, USA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA., Gutierrez PM; Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA; Rocky Mountain Mental Illness Research, Education, and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA., Joiner TE; Department of Psychology, Florida State University, Tallahassee, FL, USA., Liu H; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA., Naifeh JA; Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, USA., Nock MK; Department of Psychology, Harvard University, Cambridge, MA, USA., Sampson NA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA., Zaslavsky AM; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA., Stein MB; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA., Ursano RJ; Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, USA., Kessler RC; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. Electronic address: kessler@hcp.med.harvard.edu.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2020 Feb; Vol. 121, pp. 214-221. Date of Electronic Publication: 2019 Dec 07.
DOI: 10.1016/j.jpsychires.2019.12.003
Abstrakt: Background: Deployment-related experiences might be risk factors for soldier suicides, in which case identification of vulnerable soldiers before deployment could inform preventive efforts. We investigated this possibility by using pre-deployment survey and administrative data in a sample of US Army soldiers to develop a risk model for suicide attempt (SA) during and shortly after deployment.
Methods: Data came from the Army Study to Assess Risk and Resilience in Servicemembers Pre-Post Deployment Survey (PPDS). Soldiers completed a baseline survey shortly before deploying to Afghanistan in 2011-2012. Survey measures were used to predict SAs, defined using administrative and subsequent survey data, through 30 months after deployment. Models were built using penalized regression and ensemble machine learning methods.
Results: Significant pre-deployment risk factors were history of traumatic brain injury, 9 + mental health treatment visits in the 12 months before deployment, young age, female, previously married, and low relationship quality. Cross-validated AUC of the best penalized and ensemble models were .75-.77. 21.3-40.4% of SAs occurred among the 5-10% of soldiers with highest predicted risk and positive predictive value (PPV) among these high-risk soldiers was 4.4-5.7%.
Conclusions: SA can be predicted significantly from pre-deployment data, but intervention planning needs to take PPV into consideration.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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