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The concept of resilience is embedded within military culture and professional identity. To date, temporal changes in individuals' perceptions of their own resilience have not been systematically assessed in highstakes occupational contexts, like the military. The current study examined change in selfreported resilience over time by: (1) examining the longitudinal measurement invariance of the Brief Resilience Scale (BRS); (2) assessing the longitudinal pattern of resilience across a combat deployment cycle; and (3) examining predictors of postdeployment resilience and change in resilience scores across time. U.S. Army soldiers assigned to a combat brigade completed a survey at four time points over the course of a deployment cycle: (a) prior to deployment to Afghanistan; (b) during deployment; (c) immediately following return to home station; and (d) approximately 2-3 months thereafter. The longitudinal measurement invariance of the BRS was established. Growth curve modeling indicated that, on average, self-reported resilience decreased across the deployment cycle, but there was considerable individual variation in the rate of change. Of note, loneliness, as measured during deployment, predicted the rate of change in self-reported resilience over time. Results have implications for the longitudinal analysis of resilience and for the development of interventions with military personnel.
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Personal Militar , Resiliencia Psicológica , Humanos , Personal Militar/psicología , Masculino , Adulto , Femenino , Estudios Longitudinales , Adulto Joven , Despliegue Militar/psicología , Campaña Afgana 2001- , Estados UnidosRESUMEN
BACKGROUND: For decades confirmatory factor analysis (CFA) has been the preeminent method to study the underlying structure of posttraumatic stress disorder (PTSD); however, methodological limitations of CFA have led to the emergence of other analytic approaches. In particular, network analysis has become a gold standard to investigate the structure and relationships between PTSD symptoms. A key methodological limitation, however, which has significant clinical implications, is the lack of data on the potential impact of item order effects on the conclusions reached through network analyses. METHODS: The current study, involving a large sample (N = 5055) of active duty army soldiers following deployment to Iraq, assessed the vulnerability of network analyses and prevalence rate to item order effects. This was done by comparing symptom networks of the DSM-IV PTSD checklist items to these same items distributed in random order. Half of the participants rated their symptoms on traditionally ordered items and half the participants rated the same items, but in random order and interspersed between items from other validated scales. Differences in prevalence rate and network composition were examined. RESULTS: The prevalence rate differed between the ordered and random item samples. Network analyses using the ordered survey closely replicated the conclusions reached in the existing network analyses literature. However, in the random item survey, network composition differed considerably. CONCLUSION: Order effects appear to have a significant impact on conclusions reached from PTSD network analysis. Prevalence rates were also impacted by order effects. These findings have important diagnostic and clinical treatment implications.
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Personal Militar , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/epidemiología , Formación de Concepto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Análisis FactorialRESUMEN
This study assessed changes in measures of personality traits across a 12-month combat deployment in a sample of conventional US Army soldiers. Results revealed Impulsive Sensation-Seeking (ImpSS) and Sociability (Sy) decreased significantly, whereas Neuroticism-Anxiety (N-Anx) increased. Changes in ImpSS scores were mainly attributed to age, but were inversely related to increases in traumatic stress symptoms. Combat exposure, concussion, age, education, and changes in traumatic stress scores all independently contributed to changes in N-Anx scores. Changes in Sy were not associated with any of the data available from pre-deployment or deployment measures. Changes in Aggression-hostility (Agg-Hos) and Activity (Act) across the deployment were not significant. The findings suggest significant variability in the stability of personality traits when exposed to combat stress and injury while deployed, which may be influenced by factors such as age and education.
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The suicide rate within the military continues to rise. New approaches for prevention are needed which capitalize on existing strengths, are scalable at multiple levels, and promote mental fortitude. Healthy eating (HE) and physical activity (PA) represent scalable practices and methods for promoting mental health and protective factors within the military. A cross-sectional sample of N = 1019 active-duty Soldiers completed self-report measures of HE, PA, major depressive disorder (MDD) symptoms, generalized anxiety disorder (GAD) symptoms, and suicidal ideation (SI). Moderated mediation analyses using bootstrapping techniques were used to determine if HE and PA interact to relate to lower SI through reduced psychological health (PH) symptoms. Results indicated an indirect effect of HE on presence versus absence of past month SI through GAD symptoms at moderate-to-high levels of cardiovascular PA. A similar pattern was demonstrated for strength training PA where HE had an indirect effect on past month SI through GAD symptoms at only high levels of strength training PA. HE was indirectly related to lower MDD symptoms at all levels of cardiovascular PA and moderate to high levels of strength training PA. Study limitations and implications for secondary suicide prevention strategies within the military are discussed.
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The Interpersonal Theory of Suicide posits that two unmet interpersonal needs, thwarted belongingness and perceived burdensomeness, interact to predict suicide desire. These two constructs are frequently assessed using the 15-item Interpersonal Needs Questionnaire (INQ-15); however, this measure has never been validated in military service members. The current study analyzed the psychometric properties of the INQ-15 in a sample of (N = 1096) military personnel stationed overseas. Results indicated that the two-factor model of the INQ-15 had a poor model fit in this population; however, a bifactor model with two specific factors representing TB and PB demonstrated good fit. As seen in previous research, perceived burdensomeness was more strongly related to suicidal ideation severity than thwarted belongingness. Implications and future directions for research are discussed.
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Rates of suicide in the US Army continue to rise, and by some accounts exceed the general population. This increase has renewed efforts to identify protective factors that may inform novel suicide prevention strategies. Previous research has demonstrated that a sense of purpose in life and perceived cohesion with military peers are related to a reduction in the severity of suicidal ideation (SI). Additionally, research in military samples supports decreased SI in Soldiers who endorse that their leaders convey a sense of purpose and meaning in their shared mission. However, no work has investigated whether these leadership styles relate to a sense of felt purpose and perceived cohesion in Soldiers and thus the indirect effect of these leadership styles on SI. Active duty Army Soldiers (n = 1,160) completed self-report measures of purpose in life (PiL), perceived cohesion, ethical leadership, loneliness, and SI. Indirect effect analyses were conducted to determine how leadership behaviors indirectly relate to SI through PiL and perceived cohesion. Indirect effect analyses revealed that ethical leadership had an indirect effect on reduced SI through increased PiL. In the same parallel indirect effect analysis, ethical leadership was related to less SI through increased perceived cohesion and decreased loneliness sequentially. Enhanced leadership training that effectively increases Soldier purpose may be an important primary prevention tool to mitigate the effect of suicide risk factors. This primary prevention strategy may help augment existing suicide surveillance and clinical prevention efforts to reduce Soldier risk for suicide.
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OBJECTIVE: To evaluate trends in the extant literature on mild traumatic brain injury (mTBI) in military service members and veterans using network analysis based on a comprehensive search of original, peer-reviewed research articles involving human participants published between January 1, 2010, and December 31, 2019. Specifically, we employed network analysis to evaluate associations in the following areas: (1) peer-reviewed journals, (2) authors, (3) organizations/institutions, and (4) relevant key words. PARTICIPANTS: Included studies were published in peer-reviewed journals available on Web of Science database, using US military service members or veterans. DESIGN: Bibliometric network analytical review. MAIN MEASURES: Outcomes for each analysis included number of articles, citations, total link strength, and clusters. RESULTS: The top publishing journals were (1) Journal of Head Trauma and Rehabilitation, (2) Military Medicine, (3) Brain Injury, (4) Journal of Neurotrauma, and (5) Journal of Rehabilitation Research and Development. The top publishing authors were (1) French, (2) Lange, (3) Cooper, (4) Vanderploeg, and (5) Brickell. The top research institutions were (1) Defense and Veterans Brain Injury Center, (2) Uniformed Services University of the Health Sciences, (3) University of California San Diego, (4) Walter Reed National Military Medical Center, and (5) Boston University. The top co-occurring key words in this analysis were (1) posttraumatic stress disorder (PTSD), (2) persistent postconcussion symptoms (PPCS), (3) blast injury, (4) postconcussion syndrome (PCS), and (5) Alzheimer's disease. CONCLUSIONS: The results of this network analysis indicate a clear focus on veteran health, as well as investigations on chronic effects of mTBI. Research in civilian mTBI indicates that delaying treatment for symptoms and impairments related to mTBI may not be the most precise treatment strategy. Increasing the number of early, active, and targeted treatment trials in military personnel could translate to meaningful improvements in clinical practices for managing mTBI in this population.
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Conmoción Encefálica , Personal Militar , Síndrome Posconmocional , Trastornos por Estrés Postraumático , Veteranos , Conmoción Encefálica/diagnóstico , HumanosRESUMEN
Adverse childhood experiences (ACEs) can have long-term impacts on a person's mental health, which extend into adulthood. There is a high prevalence of ACEs among service members. Further, service members also report frequently experiencing disrupted sleep. We hypothesized that disrupted sleep may serve a mechanistic function connecting ACEs to functional impairment and poorer mental health. In a cross-sectional sample (n = 759), we found evidence for an indirect effect of ACEs on mental health outcomes through disrupted sleep. In a different sample using two time-points (n = 410), we found evidence for an indirect effect of ACEs on changes in mental health outcomes and functional impairment during a reset period, through changes in disrupted sleep during the same period. Implications, limitations and future research directions are discussed.
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Experiencias Adversas de la Infancia/psicología , Trastornos Mentales/etiología , Salud Mental/normas , Trastornos del Sueño-Vigilia/etiología , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Personal Militar , Prevalencia , Estados Unidos , Adulto JovenRESUMEN
Recurrent concussions increase risk for persistent post-concussion symptoms, and may lead to chronic neurocognitive deficits. Little is known about the molecular pathways that contribute to persistent concussion symptoms. We hypothesized that salivary measurement of microribonucleic acids (miRNAs), a class of epitranscriptional molecules implicated in concussion pathophysiology, would provide insights about the molecular cascade resulting from recurrent concussions. This hypothesis was tested in a case-control study involving 13 former professional football athletes with a history of recurrent concussion, and 18 age/sex-matched peers. Molecules of interest were further validated in a cross-sectional study of 310 younger individuals with a history of no concussion (n = 230), a single concussion (n = 56), or recurrent concussions (n = 24). There was no difference in neurocognitive performance between the former professional athletes and their peers, or among younger individuals with varying concussion exposures. However, younger individuals without prior concussion outperformed peers with prior concussion on three balance assessments. Twenty salivary miRNAs differed (adj. p < 0.05) between former professional athletes and their peers. Two of these (miR-28-3p and miR-339-3p) demonstrated relationships (p < 0.05) with the number of prior concussions reported by younger individuals. miR-28-3p and miR-339-5p may play a role in the pathophysiologic mechanism involved in cumulative concussion effects.
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Biomarcadores/metabolismo , Conmoción Encefálica/genética , MicroARNs/genética , Saliva/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Atletas/estadística & datos numéricos , Estudios de Casos y Controles , Niño , Estudios Transversales , Fútbol Americano , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Primary Objective: To assess a rapid concussion screening tool in Service members participating in combatives (mixed martial arts; MMA) training school.Research Design: This prospective study included baseline and either post-training or post-injury assessments.Methods and Procedures: Baseline (N = 152) and post-assessments (n = 129) of Service members included symptom reporting and the King-Devick (KD) oculomotor test.Outcomes and Results: Headache, balance problems, and dizziness were the most severe concussive symptoms. KD scores for those who sustained a concussion (n = 31) were significantly worse compared to baseline, but not for participants who finished the course with no concussion (n = 98). For concussed, 74.2% had scores that were worse from baseline (slower) compared to 39.8% of the post-training group. KD scores were worse 34.4% more in individuals who sustained a concussion compared to those who did not. However, there was poor discriminant ability of the KD test (AUC = .60, sensitivity/specificity) to distinguish between concussed and non-concussed participants.Conclusions: The KD test should not be used in isolation as a sideline or field concussion assessment during training scenarios. Rather, it has potential utility for evaluating individual cases to supplement decision making when an established baseline is available.
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Conmoción Encefálica/diagnóstico , Artes Marciales/lesiones , Tamizaje Masivo/normas , Personal Militar , Examen Neurológico/normas , Desempeño Psicomotor/fisiología , Adulto , Conmoción Encefálica/fisiopatología , Conmoción Encefálica/psicología , Femenino , Humanos , Masculino , Artes Marciales/psicología , Tamizaje Masivo/métodos , Personal Militar/psicología , Examen Neurológico/métodos , Estudios ProspectivosRESUMEN
Brain connectivity studies report group differences in pairwise connection strengths. While informative, such results are difficult to interpret since our understanding of the brain relies on region-based properties, rather than on connection information. Given that large disruptions in the brain are often caused by a few pivotal sources, we propose a novel framework to identify the sources of functional disruption from effective connectivity networks. Our approach integrates static and time-varying effective connectivity modeling in a probabilistic framework, to identify aberrant foci and the corresponding aberrant connectomics network. Using resting-state fMRI, we illustrate the utility of this novel approach in U.S. Army soldiers (N = 87) with posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI) and combat controls. Additionally, we employed machine-learning classification to identify those significant connectivity features that possessed high predictive ability. We identified three disrupted foci (middle frontal gyrus [MFG], insula, hippocampus), and an aberrant prefrontal-subcortical-parietal network of information flow. We found the MFG to be the pivotal focus of network disruption, with aberrant strength and temporal-variability of effective connectivity to the insula, amygdala and hippocampus. These connectivities also possessed high predictive ability (giving a classification accuracy of 81%); and they exhibited significant associations with symptom severity and neurocognitive functioning. In summary, dysregulation originating in the MFG caused elevated and temporally less-variable connectivity in subcortical regions, followed by a similar effect on parietal memory-related regions. This mechanism likely contributes to the reduced control over traumatic memories leading to re-experiencing, hyperarousal and flashbacks observed in soldiers with PTSD and mTBI. Hum Brain Mapp 39:264-287, 2018. © 2017 Wiley Periodicals, Inc.
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Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Vías Nerviosas/diagnóstico por imagen , Vías Nerviosas/fisiopatología , Trastornos por Estrés Postraumático/diagnóstico por imagen , Trastornos por Estrés Postraumático/fisiopatología , Adolescente , Adulto , Conectoma/métodos , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Personal Militar , Escalas de Valoración Psiquiátrica , Descanso , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Máquina de Vectores de Soporte , Estados Unidos , Exposición a la Guerra , Adulto JovenRESUMEN
OBJECTIVES: Military service members risk acquiring posttraumatic stress disorder (PTSD) and mild-traumatic brain injury (mTBI), with high comorbidity. Owing to overlapping symptomatology in chronic mTBI or postconcussion syndrome (PCS) and PTSD, it is difficult to assess the etiology of a patient's condition without objective measures. Using resting-state functional MRI in a novel framework, we tested the hypothesis that their neural signatures are characterized by functionally hyperconnected brain regions which are less variable over time. Additionally, we predicted that such connectivities possessed the highest ability in predicting the diagnostic membership of a novel subject (top-predictors) in addition to being statistically significant. METHODS: U.S. Army Soldiers (N = 87) with PTSD and comorbid PCS + PTSD were recruited along with combat controls. Static and dynamic functional connectivities were evaluated. Group differences were obtained in accordance with our hypothesis. Machine learning classification (MLC) was employed to determine top predictors. RESULTS: From whole-brain connectivity, we identified the hippocampus-striatum connectivity to be significantly altered in accordance with our hypothesis. Diffusion tractography revealed compromised white-matter integrity between aforementioned regions only in the PCS + PTSD group, suggesting a structural etiology for the PCS + PTSD group rather than being an extreme subset of PTSD. Employing MLC, connectivities provided worst-case accuracy of 84% (9% more than psychological measures). Additionally, the hippocampus-striatum connectivities were found to be top predictors and thus a potential biomarker of PTSD/mTBI. CONCLUSIONS: PTSD/mTBI are associated with hippocampal-striatal hyperconnectivity from which it is difficult to disengage, leading to a habit-like response toward episodic traumatic memories, which fits well with behavioral manifestations of combat-related PTSD/mTBI. Hum Brain Mapp 38:2843-2864, 2017. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Conmoción Encefálica/diagnóstico por imagen , Mapeo Encefálico , Hipocampo/diagnóstico por imagen , Hipocampo/patología , Trastornos por Estrés Postraumático/diagnóstico por imagen , Adolescente , Adulto , Conmoción Encefálica/patología , Imagen de Difusión Tensora , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Personal Militar , Análisis Multivariante , Vías Nerviosas/diagnóstico por imagen , Escalas de Valoración Psiquiátrica , Trastornos por Estrés Postraumático/patología , Índices de Gravedad del Trauma , Estados Unidos , Adulto JovenRESUMEN
PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p < 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p > 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.
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Conmoción Encefálica/diagnóstico , Disfunción Cognitiva/diagnóstico , Personal Militar/psicología , Adulto , Conmoción Encefálica/psicología , Disfunción Cognitiva/etiología , Disfunción Cognitiva/psicología , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Estándares de Referencia , Valores de ReferenciaRESUMEN
Human performance optimization (HPO) is defined as "the process of applying knowledge, skills and emerging technologies to improve and preserve the capabilities of military members, and organizations to execute essential tasks." The lack of consensus for operationally relevant and standardized metrics that meet joint military requirements has been identified as the single most important gap for research and application of HPO. In 2013, the Consortium for Health and Military Performance hosted a meeting to develop a toolkit of standardized HPO metrics for use in military and civilian research, and potentially for field applications by commanders, units, and organizations. Performance was considered from a holistic perspective as being influenced by various behaviors and barriers. To accomplish the goal of developing a standardized toolkit, key metrics were identified and evaluated across a spectrum of domains that contribute to HPO: physical performance, nutritional status, psychological status, cognitive performance, environmental challenges, sleep, and pain. These domains were chosen based on relevant data with regard to performance enhancers and degraders. The specific objectives at this meeting were to (a) identify and evaluate current metrics for assessing human performance within selected domains; (b) prioritize metrics within each domain to establish a human performance assessment toolkit; and (c) identify scientific gaps and the needed research to more effectively assess human performance across domains. This article provides of a summary of 150 total HPO metrics across multiple domains that can be used as a starting point-the beginning of an HPO toolkit: physical fitness (29 metrics), nutrition (24 metrics), psychological status (36 metrics), cognitive performance (35 metrics), environment (12 metrics), sleep (9 metrics), and pain (5 metrics). These metrics can be particularly valuable as the military emphasizes a renewed interest in Human Dimension efforts, and leverages science, resources, programs, and policies to optimize the performance capacities of all Service members.
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Indicadores de Salud , Personal Militar , Análisis y Desempeño de Tareas , Cognición , Consenso , Humanos , Salud Mental , Estado Nutricional , Dolor , Aptitud Física , SueñoRESUMEN
Problematic alcohol use is a serious threat to the behavioral health of active-duty Service Members (ADSM), resulting in numerous calls from governmental agencies to better understand mechanistic factors contributing to alcohol misuse within the military. Alcohol use motives are reliable predictors of alcohol-related behaviors and are considered malleable targets for prevention and intervention efforts. However, empirical research indicates that drinking motives vary across contextually distinct populations. Although some research has been conducted among veteran and reservist populations, limited work has been specifically focused on ADSM and no research has evaluated motives and alcohol metrics among ADSM based on military rank. Participants for the current study included 682 ADSM recruited from a large military installation in the U.S. Structural equation modeling evaluated associations between four drinking motives (i.e., enhancement, social, conformity, coping) and three alcohol misuse metrics (i.e., alcohol frequency, binge frequency, alcohol problems). Three models were evaluated: one full (combined) model and two separate models based on military rank - junior enlisted (i.e., E1-E4) and non-commissioned officers (NCOs) (i.e., E5-E9). Results for junior enlisted ADSM indicated that coping and enhancement motives were most strongly associated with all alcohol misuse metrics. However, among NCOs, results indicated that alcohol problems were only associated with coping motives. Notably, results also indicated that alcohol use motives accounted for substantively more variance across all alcohol-related metrics among NCOs. Findings generally support extant military-related literature indicating use of alcohol for coping (e.g., with anxiety) as the motivation most consistently associated with increased alcohol misuse. However, novel findings highlight enhancement motives - using alcohol to attain some positive internal reward - as another, often stronger, motivation impacting alcohol use outcomes. Further, findings highlight notable distinctions between alcohol use motives (i.e., coping vs. enhancement) and the impact of alcohol use motives (i.e., effect size) on alcohol metrics between junior enlisted and NCOs.
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Trastornos Relacionados con Alcohol , Alcoholismo , Consumo Excesivo de Bebidas Alcohólicas , Personal Militar , Humanos , Motivación , Consumo de Bebidas Alcohólicas/epidemiología , Alcoholismo/epidemiología , Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Adaptación Psicológica , Trastornos Relacionados con Alcohol/epidemiologíaRESUMEN
Functional connectivity (FC) obtained from resting-state functional magnetic resonance imaging has been integrated with machine learning algorithms to deliver consistent and reliable brain disease classification outcomes. However, in classical learning procedures, custom-built specialized feature selection techniques are typically used to filter out uninformative features from FC patterns to generalize efficiently on the datasets. The ability of convolutional neural networks (CNN) and other deep learning models to extract informative features from data with grid structure (such as images) has led to the surge in popularity of these techniques. However, the designs of many existing CNN models still fail to exploit the relationships between entities of graph-structure data (such as networks). Therefore, graph convolution network (GCN) has been suggested as a means for uncovering the intricate structure of brain network data, which has the potential to substantially improve classification accuracy. Furthermore, overfitting in classifiers can be largely attributed to the limited number of available training samples. Recently, the generative adversarial network (GAN) has been widely used in the medical field for its generative aspect that can generate synthesis images to cope with the problems of data scarcity and patient privacy. In our previous work, GCN and GAN have been designed to investigate FC patterns to perform diagnosis tasks, and their effectiveness has been tested on the ABIDE-I dataset. In this paper, the models will be further applied to FC data derived from more public datasets (ADHD, ABIDE-II, and ADNI) and our in-house dataset (PTSD) to justify their generalization on all types of data. The results of a number of experiments show the powerful characteristic of GAN to mimic FC data to achieve high performance in disease prediction. When employing GAN for data augmentation, the diagnostic accuracy across ADHD-200, ABIDE-II, and ADNI datasets surpasses that of other machine learning models, including results achieved with BrainNetCNN. Specifically, in ADHD, the accuracy increased from 67.74% to 73.96% with GAN, in ABIDE-II from 70.36% to 77.40%, and in ADNI, reaching 52.84% and 88.56% for multiclass and binary classification, respectively. GCN also obtains decent results, with the best accuracy in ADHD datasets at 71.38% for multinomial and 75% for binary classification, respectively, and the second-best accuracy in the ABIDE-II dataset (72.28% and 75.16%, respectively). Both GAN and GCN achieved the highest accuracy for the PTSD dataset, reaching 97.76%. However, there are still some limitations that can be improved. Both methods have many opportunities for the prediction and diagnosis of diseases.
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OBJECTIVE: To explore the cross-sectional relationships between blood eicosapentaenoic acid + docosahexaenoic acid (HSOmega-3 Index(®)) and sleep disorders, depression, anxiety, and neurocognitive performance in Servicemembers deployed to Iraq. METHODS: Servicemembers with mild-to-moderate depression by the Patient Health Questionnarie-9 from two US military camps were invited to participate in this study. A battery of validated psychosocial (Pittsburgh Sleep Quality Index, and Zung Depression, Zung Anxiety, Epworth Sleepiness, and Combat Experiences scales) and computerized neurocognitive tests were completed by each participant. Five neurocognitive domain scores were calculated--Processing Speed, Complex Attention, Reaction Time, Cognitive Flexibility (CF), and Executive Function (EF). A drop of blood was also collected on an anti-oxidant-treated filter paper card and sent for HS-Omega-3 Index(®) analysis. An analysis of variance contrast was used to test for linear trends between quartiles of the HS-Omega-3 Index(®) for both EF and CF. RESULTS: The mean HS-Omega-3 Index(®) was 3.5 ± 0.7% (n = 78). The HS-Omega-3 Index(®) was not significantly associated with scores for anxiety, depression, or sleep, whether assessed as continuous or dichotomous variables, but was directly associated with CF and EF (P < 0.02 and 0.01, respectively), especially in the 81% who reported poor sleep quality. In those with poor sleep quality (n = 63), EF and CF were higher (P = 0.005) in subjects with Omega-3 levels above versus below the mean. CONCLUSION: Optimal neurocognitive performance is essential during deployment. Our finding that EF and CF were positively related to HS-Omega-3 Index(®) suggests that improving omega-3 status through an increase in omega-3 intake may improve neurocognitive performance and confer an element of resilience to poor sleep.
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Atención/efectos de los fármacos , Ácidos Docosahexaenoicos/sangre , Ácido Eicosapentaenoico/sangre , Eritrocitos/química , Tiempo de Reacción/efectos de los fármacos , Adulto , Ansiedad/tratamiento farmacológico , Estudios Transversales , Depresión/tratamiento farmacológico , Función Ejecutiva/efectos de los fármacos , Femenino , Humanos , Guerra de Irak 2003-2011 , Masculino , Persona de Mediana Edad , Personal Militar , Pruebas Neuropsicológicas , Trastornos del Sueño-Vigilia/tratamiento farmacológico , Encuestas y Cuestionarios , Estados Unidos , Adulto JovenRESUMEN
Subjective well-being is a positive psychological construct that has important implications for the U.S. Military's goal to develop service members' strengths and support their overall thriving and downstream resilience. Despite this, the concept of well-being has not been well studied in military populations who have unique work demands, stressors, and autonomy/agency in daily life compared to civilians. To address this shortcoming in the literature, the present study assessed Ryff's measures of psychological well-being (PWB) in 1,333 U.S. service members prior to the deployments in the Middle East. Various methods attempting to validate the theoretical model purported by Ryff were unsuccessful, and exploratory factor analyses did not result in a novel model for this population. Future research should continue to evaluate proposed models of soldier well-being and propose novel theories, as well as measures, to assess this important construct. Implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Personal Militar , Humanos , Personal Militar/psicología , Bienestar PsicológicoRESUMEN
BACKGROUND: Recognizing sport-related concussion (SRC) is challenging and relies heavily on subjective symptom reports. An objective, biological marker could improve recognition and understanding of SRC. There is emerging evidence that salivary micro-ribonucleic acids (miRNAs) may serve as biomarkers of concussion; however, it remains unclear whether concussion-related miRNAs are impacted by exercise. We sought to determine whether 40 miRNAs previously implicated in concussion pathophysiology were affected by participation in a variety of contact and non-contact sports. Our goal was to refine a miRNA-based tool capable of identifying athletes with SRC without the confounding effects of exercise. METHODS: This case-control study harmonized data from concussed and non-concussed athletes recruited across 10 sites. Levels of salivary miRNAs within 455 samples from 314 individuals were measured with RNA sequencing. Within-subjects testing was used to identify and exclude miRNAs that changed with either (a) a single episode of exercise (166 samples from 83 individuals) or (b) season-long participation in contact sports (212 samples from 106 individuals). The miRNAs that were not impacted by exercise were interrogated for SRC diagnostic utility using logistic regression (172 samples from 75 concussed and 97 non-concussed individuals). RESULTS: Two miRNAs (miR-532-5p and miR-182-5p) decreased (adjusted p < 0.05) after a single episode of exercise, and 1 miRNA (miR-4510) increased only after contact sports participation. Twenty-three miRNAs changed at the end of a contact sports season. Two of these miRNAs (miR-26b-3p and miR-29c-3p) were associated (R > 0.50; adjusted p < 0.05) with the number of head impacts sustained in a single football practice. Among the 15 miRNAs not confounded by exercise or season-long contact sports participation, 11 demonstrated a significant difference (adjusted p < 0.05) between concussed and non-concussed participants, and 6 displayed moderate ability (area under curve > 0.70) to identify concussion. A single ratio (miR-27a-5p/miR-30a-3p) displayed the highest accuracy (AUCâ¯=â¯0.810, sensitivityâ¯=â¯82.4%, specificityâ¯=â¯73.3%) for differentiating concussed and non-concussed participants. Accuracy did not differ between participants with SRC and non-SRC (zâ¯=â¯0.5, pâ¯=â¯0.60). CONCLUSION: Salivary miRNA levels may accurately identify SRC when not confounded by exercise. Refinement of this approach in a large cohort of athletes could eventually lead to a non-invasive, sideline adjunct for SRC assessment.
Asunto(s)
Conmoción Encefálica , Fútbol Americano , MicroARNs , Humanos , Saliva , Estudios de Casos y Controles , Conmoción Encefálica/diagnóstico , BiomarcadoresRESUMEN
BACKGROUND: Military personnel must maintain physical performance despite exposure to operational stressors such as sleep loss, caloric restriction and high cognitive load. Habitual sleep and specific sleep features are positively associated with fitness and may contribute to physical performance in operational settings. Further, by affecting muscle recovery, sleep may contribute to the ability to maintain performance across multiple days of exposure to operational stressors. OBJECTIVES: We examined the role of individual differences in baseline sleep on baseline physical performance and on change in physical performance throughout exposure to simulated military operational stress (SMOS). METHODS: Military personnel (36 male, 9 female, 26.3 ± 5.3 years) completed a 5-day SMOS protocol during which they completed a tactical mobility test daily. Sleep questionnaires were administered at intake and sleep was monitored each night with polysomnography. Lasso regressions were used to identify meaningful predictors of physical performance at baseline and of change in physical performance across SMOS. RESULTS: Better aerobic fitness, lower daytime sleepiness (Epworth Sleepiness Scale), and lower absolute slow wave activity (0.5-4 Hz) predicted better physical performance at baseline (66.1% of variance explained), but did not relate to changes in performance. CONCLUSIONS: Collectively, higher daytime sleepiness and slow wave activity may reflect more chronic exposure to insufficient sleep and higher baseline sleep drive, which in turn led to compromised physical performance. The findings suggest that low self-report sleepiness and low objective slow wave activity may reflect two quantifiable markers of healthy sleep behaviors that have implications for operational performance.