美国陆军士兵自我评估韧性的预测效度及其相关性。
Predictive validity and correlates of self-assessed resilience among U.S. Army soldiers.
机构信息
Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
出版信息
Depress Anxiety. 2018 Feb;35(2):122-131. doi: 10.1002/da.22694. Epub 2017 Nov 2.
BACKGROUND
Self-assessment of resilience could prove valuable to military and other organizations whose personnel confront foreseen stressors. We evaluated the validity of self-assessed resilience among U.S. Army soldiers, including whether predeployment perceived resilience predicted postdeployment emotional disorder.
METHODS
Resilience was assessed via self-administered questionnaire among new soldiers reporting for basic training (N = 35,807) and experienced soldiers preparing to deploy to Afghanistan (N = 8,558). Concurrent validity of self-assessed resilience was evaluated among recruits by estimating its association with past-month emotional disorder. Predictive validity was examined among 3,526 experienced soldiers with no lifetime emotional disorder predeployment. Predictive models estimated associations of predeployment resilience with incidence of emotional disorder through 9 months postdeployment and with marked improvement in coping at 3 months postdeployment. Weights-adjusted regression models incorporated stringent controls for risk factors.
RESULTS
Soldiers characterized themselves as very resilient on average [M = 14.34, SD = 4.20 (recruits); M = 14.75, SD = 4.31 (experienced soldiers); theoretical range = 0-20]. Demographic characteristics exhibited only modest associations with resilience, while severity of childhood maltreatment was negatively associated with resilience in both samples. Among recruits, resilience was inversely associated with past-month emotional disorder [adjusted odds ratio (AOR) = 0.65, 95% CI = 0.62-0.68, P < .0005 (per standard score increase)]. Among deployed soldiers, greater predeployment resilience was associated with decreased incidence of emotional disorder (AOR = 0.91; 95% CI = 0.84-0.98; P = .016) and increased odds of improved coping (AOR = 1.36; 95% CI = 1.24-1.49; P < .0005) postdeployment.
CONCLUSIONS
Findings supported validity of self-assessed resilience among soldiers, although its predictive effect on incidence of emotional disorder was modest. In conjunction with assessment of known risk factors, measurement of resilience could help predict adaptation to foreseen stressors like deployment.
背景
自我评估韧性可能对面临可预见压力源的军队和其他组织具有重要价值。我们评估了美国陆军士兵自我评估韧性的有效性，包括部署前感知的韧性是否预测部署后情绪障碍。
方法
新兵在接受基本训练时（N=35807）和经验丰富的士兵准备部署到阿富汗时（N=8558）通过自我管理问卷评估韧性。通过估计新兵中自我评估韧性与过去一个月情绪障碍的相关性来评估自我评估韧性的同时效度。在 3526 名没有预先存在的情绪障碍的经验丰富的士兵中，通过 9 个月的部署后评估前瞻性预测效力。通过 3 个月的部署后评估，预测模型评估了预先存在的韧性与情绪障碍的发生率之间的关联，以及应对能力的显著改善。加权回归模型包含了对风险因素的严格控制。
结果
士兵平均将自己描述为非常有韧性[新兵 M=14.34，SD=4.20（新兵）；经验丰富的士兵 M=14.75，SD=4.31（经验丰富的士兵）；理论范围 0-20]。人口统计学特征与韧性只有适度的相关性，而儿童期虐待的严重程度与两个样本中的韧性呈负相关。在新兵中，韧性与过去一个月的情绪障碍呈负相关[调整后的优势比（AOR）=0.65，95%置信区间（CI）=0.62-0.68，P<.0005（每标准分数增加）]。在部署的士兵中，较高的预先存在的韧性与情绪障碍发生率的降低相关（AOR=0.91；95%CI=0.84-0.98；P=0.016）和应对能力改善的可能性增加（AOR=1.36；95%CI=1.24-1.49；P<.0005）。
结论
研究结果支持了士兵自我评估韧性的有效性，尽管其对情绪障碍发生率的预测效果是适度的。与评估已知风险因素相结合，韧性的测量可能有助于预测对可预见的压力源（如部署）的适应。
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