Department of Psychology, Harvard University , Cambridge, MA, USA.
Department of Health Care Policy, Harvard Medical School , Boston, MA, USA.
Psychiatry. 2020 Fall;83(3):244-258. doi: 10.1080/00332747.2020.1794191.
: Rates of some psychological disorders are higher among enlisted U.S. military personnel than socio-demographically matched civilians. Indirect evidence suggests some internalizing and externalizing psychological problems among enlistees onset prior to enlistment. However, the consistency and strength of the associations between pre-enlistment psychological problems and enlistment over time is unknown. We address this uncertainty by examining whether internalizing and externalizing problems in high school predicted subsequent military enlistment using a large cohort-sequential panel study. : The Monitoring the Future study administered baseline surveys from 1989-2014 and biennial follow-up surveys two and four years later to national samples of high-school seniors (N = 20,823). Validated self-report scales assessed internalizing (depression, low self-esteem) and externalizing (risk-taking, school misbehavior, conduct disorder, interpersonal violence, alcohol, and drug use) problems in each survey. Follow-up surveys assessed military enlistment. Logistic regression models were used to estimate associations of problems scales with subsequent enlistment. : School misbehavior in 12 grade, and risk-taking in 12 grade and two years after graduation were associated with significantly elevated odds of enlistment at follow-up. Although modest, these associations were linear and invariant across respondent sex and baseline survey year. : School misbehavior and risk-taking predicted subsequent enlistment and there was no evidence of historical changes in these associations over the course of 25 years; these pre-enlistment psychological problems do not fully explain the high rates of psychological disorders among enlisted military personnel. Further research is needed to determine whether these predictors are associated with negative outcomes during or after military service.
美国军人中某些心理障碍的发病率高于社会人口统计学匹配的平民。间接证据表明，一些入伍者入伍前就出现了内化和外化的心理问题。然而，入伍前心理问题与入伍时间之间的关联的一致性和强度尚不清楚。我们通过检查高中生的内化和外化问题是否在高中时预测了随后的兵役，使用了一项大型队列序列面板研究来解决这一不确定性。
监测未来研究从 1989 年至 2014 年进行了基线调查，并在两年和四年后对全国高中生样本进行了两年一次的后续调查（N=20823）。经过验证的自我报告量表评估了每个调查中的内化（抑郁、低自尊）和外化（冒险、学校不良行为、行为障碍、人际暴力、酒精和药物使用）问题。后续调查评估了军事入伍情况。逻辑回归模型用于估计问题量表与随后入伍的关联。
12 年级的学校不良行为以及 12 年级和毕业后两年的冒险行为与随访时入伍的几率显著升高相关。尽管幅度较小，但这些关联是线性的，并且在受访者性别和基线调查年份之间保持不变。
学校不良行为和冒险行为预测了随后的入伍，而且在 25 年的时间里，这些关联没有证据表明历史上发生了变化；这些入伍前的心理问题并不能完全解释入伍军人中心理障碍的高发病率。需要进一步研究以确定这些预测因素是否与兵役期间或之后的负面结果有关。
