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A prediction model for differential resilience to the effects of combat-related stressors in US army soldiers.

Kessler RC, Bossarte RM, Hwang I, Luedtke A, Naifeh JA, Nock MK, Petukhova M, Sadikova E, Sampson NA, Sverdrup E, Zubizarreta JR, Wager S, Wagner J, Stein MB, Ursano RJ. A prediction model for differential resilience to the effects of combat-related stressors in US army soldiers. International Journal of Methods in Psychiatric Research. 2024 Dec 1; 33(4):e70006.

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Abstract:

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.




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