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Using self-report surveys at the beginning of service to develop multi-outcome risk models for new soldiers in the U.S. Army.
Rosellini, A J; Stein, M B; Benedek, D M; Bliese, P D; Chiu, W T; Hwang, I; Monahan, J; Nock, M K; Petukhova, M V; Sampson, N A; Street, A E; Zaslavsky, A M; Ursano, R J; Kessler, R C.
Afiliación
  • Rosellini AJ; Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
  • Stein MB; Departments of Psychiatry and Family Medicine & Public Health,University of California San Diego,La Jolla, California,USA.
  • Benedek DM; Department of Psychiatry,Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine,Bethesda, MD,USA.
  • Bliese PD; Darla Moore School of Business,University of South Carolina,Columbia, South Carolina,USA.
  • Chiu WT; Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
  • Hwang I; Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
  • Monahan J; School of Law,University of Virginia,Charlottesville, VA,USA.
  • Nock MK; Department of Psychology,Harvard University,Cambridge, Massachusetts,USA.
  • Petukhova MV; Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
  • Sampson NA; Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
  • Street AE; National Center for PTSD, VA Boston Healthcare System,Boston, Massachusetts,USA.
  • Zaslavsky AM; Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
  • Ursano RJ; Department of Psychiatry,Center for the Study of Traumatic Stress, Uniformed Services University School of Medicine,Bethesda, MD,USA.
  • Kessler RC; Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
Psychol Med ; 47(13): 2275-2287, 2017 Oct.
Article en En | MEDLINE | ID: mdl-28374665
BACKGROUND: The U.S. Army uses universal preventives interventions for several negative outcomes (e.g. suicide, violence, sexual assault) with especially high risks in the early years of service. More intensive interventions exist, but would be cost-effective only if targeted at high-risk soldiers. We report results of efforts to develop models for such targeting from self-report surveys administered at the beginning of Army service. METHODS: 21 832 new soldiers completed a self-administered questionnaire (SAQ) in 2011-2012 and consented to link administrative data to SAQ responses. Penalized regression models were developed for 12 administratively-recorded outcomes occurring by December 2013: suicide attempt, mental hospitalization, positive drug test, traumatic brain injury (TBI), other severe injury, several types of violence perpetration and victimization, demotion, and attrition. RESULTS: The best-performing models were for TBI (AUC = 0.80), major physical violence perpetration (AUC = 0.78), sexual assault perpetration (AUC = 0.78), and suicide attempt (AUC = 0.74). Although predicted risk scores were significantly correlated across outcomes, prediction was not improved by including risk scores for other outcomes in models. Of particular note: 40.5% of suicide attempts occurred among the 10% of new soldiers with highest predicted risk, 57.2% of male sexual assault perpetrations among the 15% with highest predicted risk, and 35.5% of female sexual assault victimizations among the 10% with highest predicted risk. CONCLUSIONS: Data collected at the beginning of service in self-report surveys could be used to develop risk models that define small proportions of new soldiers accounting for high proportions of negative outcomes over the first few years of service.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delitos Sexuales / Intento de Suicidio / Encuestas Epidemiológicas / Modelos Estadísticos / Medición de Riesgo / Víctimas de Crimen / Autoinforme / Abuso Físico / Trastornos Mentales / Personal Militar Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Psychol Med Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delitos Sexuales / Intento de Suicidio / Encuestas Epidemiológicas / Modelos Estadísticos / Medición de Riesgo / Víctimas de Crimen / Autoinforme / Abuso Físico / Trastornos Mentales / Personal Militar Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Psychol Med Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido