National Center for PTSD and VA Boston Healthcare System, Boston, Massachusetts, USA.
Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
J Trauma Stress. 2017 Aug;30(4):362-371. doi: 10.1002/jts.22210. Epub 2017 Jul 25.
Suicide rates among recent veterans have led to interest in risk identification. Evidence of gender-and trauma-specific predictors of suicidal ideation necessitates the use of advanced computational methods capable of elucidating these important and complex associations. In this study, we used machine learning to examine gender-specific associations between predeployment and military factors, traumatic deployment experiences, and psychopathology and suicidal ideation (SI) in a national sample of veterans deployed during the Iraq and Afghanistan conflicts (n = 2,244). Classification, regression tree analyses, and random forests were used to identify associations with SI and determine their classification accuracy. Findings converged on several associations for men that included depression, posttraumatic stress disorder (PTSD), and somatic complaints. Sexual harassment during deployment emerged as a key factor that interacted with PTSD and depression and demonstrated a stronger association with SI among women. Classification accuracy for SI presence or absence was good based on the receiver operating characteristic area under the curve, men = .91, women = .92. The risk for SI was classifiable with good accuracy, with associations that varied by gender. The use of machine learning analyses allowed for the discovery of rich, nuanced results that should be replicated in other samples and may eventually be a basis for the development of gender-specific actuarial tools to assess SI risk among veterans.
最近退伍军人的自杀率引起了人们对风险识别的兴趣。有证据表明,性别和创伤特异性预测因素与自杀意念有关,这就需要使用能够阐明这些重要而复杂关联的先进计算方法。在这项研究中,我们使用机器学习技术研究了伊拉克和阿富汗冲突期间部署的退伍军人全国样本中, predeployment 和军事因素、创伤性部署经历以及精神病理学和自杀意念(SI)之间的性别特异性关联(n=2244)。分类回归树分析和随机森林用于识别与 SI 的关联,并确定其分类准确性。研究结果集中在与男性有关的几个关联上,包括抑郁、创伤后应激障碍(PTSD)和躯体抱怨。在部署期间的性骚扰被认为是一个关键因素,它与 PTSD 和抑郁相互作用,并且与女性的 SI 之间存在更强的关联。基于接收器工作特征曲线下的面积,男性 SI 存在或不存在的分类准确性较好,为.91,女性为.92。SI 的风险可以以良好的准确性进行分类,其关联因性别而异。机器学习分析的使用允许发现丰富而微妙的结果,这些结果应该在其他样本中复制,并且最终可能成为为退伍军人评估 SI 风险开发性别特异性精算工具的基础。