Predicting Substance Use among Military Veterans with a Positive MST Screen: A Machine Learning Approach

项目总结/摘要 军事性创伤（MST）是一个严重和普遍的问题，在军事人口，影响 大约16%的军人和退伍军人[1]。物质使用不成比例地影响个人 有MST病史有MST病史的人（与没有MST病史的人相比）滥用药物的可能性是其他人的两倍。 [2-4]。军事样本中的物质使用与全球范围内更高的负面后果率有关。 几个域（例如，健康、职业、法律的[5，6]），包括死亡（例如，过量用药[7]、交通事故 [8]，自杀[7，8]）。此外，虽然在有MST病史的个体中研究不足，但阴性 物质使用的结果已被证明在创伤暴露人群中更为严重，包括 更严重的临床表现和更差的治疗预后[9，10]。这些发现强调， 必须澄清MST与军人群体中药物使用之间的关系。 尽管军事人口中药物使用的临床相关性和公共卫生意义， 这一领域的研究几乎完全依赖于横截面设计。而且绝大多数 这方面的研究采用传统的统计方法，其范围和能力有限。 这些局限性具有重要的临床意义，因为它们限制了我们指定确切性质的能力， MST和物质使用之间关系的方向性，从而影响研究结果的翻译方式 进行预防和干预。拟议的研究旨在通过利用 陆军STARRS部署前/部署后研究，一个大型的前瞻性军事数据集：（1）阐明方向性 使用纵向数据集确定MST与物质使用之间的关系，以及（2）采用机器学习 方法来开发一种算法，以优化检测的物质使用的军事人员的历史， MST。这些发现将有助于阐明这一高风险群体中物质使用的病因，以及 为临床应用提供了一个预测模型，以更好地瞄准该人群中的高危个体。 这项研究项目将在罗得岛大学心理学系进行， 该机构具有悠久的历史，致力于健康行为研究和方法。申请人 将有机会获得赞助商和顾问的专业知识，在MST，物质使用，先进的方法， 和统计分析，这将有助于她的职业目标，以发展增加的知识和熟练程度 在（a）性创伤（例如，（B）赠款/手稿开发;（c） 统计和方法能力（即，机器学习）;以及（d）大数据。 拟议的项目采用了及时和创新的方法来推进科学之间的关系MST 以及军事人员的药物使用解决这一人群中的物质使用问题是改善 我们国家退伍军人的健康，并与国家药物滥用研究所的使命保持一致。

Project Summary/Abstract Military sexual trauma (MST) is a serious and pervasive problem among military populations, affecting approximately 16% of military personnel and veterans [1]. Substance use disproportionately affects individuals with a history of MST. Individuals with (vs. without) a history of MST are twice as likely to misuse substances [2-4]. Substance use among military samples has been linked to higher rates of negative consequences across several domains (e.g., health, occupational, legal [5, 6]), including death (e.g., overdose [7], traffic accidents [8], suicide [7, 8]). Further, while understudied among individuals with a history of MST in particular, negative substance use outcomes have been shown to be more severe among trauma-exposed populations, including more severe clinical presentations and poorer treatment prognosis [9, 10]. These findings emphasize the importance of clarifying the association between MST and substance use among military populations. Despite the clinical relevance and public health significance of substance use among military populations, research in this area has relied almost exclusively on cross-sectional designs. Moreover, the vast majority of studies in this area have utilized traditional statistical methods, which are limited in scope and capabilities. These limitations have important clinical implications, as they restrict our ability to specify the exact nature and directionality of the relationship between MST and substance use, thereby affecting how findings are translated into prevention and intervention efforts. The proposed research aims to fill these critical gaps by utilizing the Army STARRS pre/post-deployment study, a large, prospective military dataset to: (1) explicate the directional relation between MST and substance use using a longitudinal dataset, and (2) employ machine learning methods to develop an algorithm to optimize detection of substance use in military personnel with a history of MST. These findings will assist in elucidating the etiology of substance use among this high-risk group, as well as provide a prediction model for clinical use to better target at-risk individuals in this population. This research project will take place within the Department of Psychology at the University of Rhode Island; an institution with a strong history and commitment to health behavior research and methodology. The applicant will have access to sponsors and consultants with expertise in MST, substance use, advanced methodology, and statistical analysis that will facilitate her career objectives to develop increased knowledge and proficiency in (a) sexual trauma (e.g., MST) and substance use in military veterans; (b) grant/manuscript development; (c) statistical and methodological capabilities (i.e., machine learning); and (d) big data. The proposed project uses a timely and innovative approach to advance science on the relation between MST and substance use in military personnel. Addressing substance use in this population is necessary to improve the health of our nation's veterans, and aligns with the mission of the National Institute on Drug Abuse.