A computer program for processing impedance cardiographic data: Improving accuracy through user-interactive software

This report contains the source code and documentation for a computer program used to process impedance cardiography data. The cardiodynamic measures derived from impedance cardiography are ventricular stroke column, cardiac output, cardiac index and Heather index. The program digitizes data collected from the Minnesota Impedance Cardiograph, Electrocardiography (ECG), and respiratory cycles and then stores these data on hard disk. It computes the cardiodynamic functions using interactive graphics and stores the means and standard deviations of each 15-sec data epoch on floppy disk. This software was designed on a Digital PRO380 microcomputer and used version 2.0 of P/OS, with (minimally) a 4-channel 16-bit analog/digital (A/D) converter. Applications software is written in FORTRAN 77, and uses Digital's Pro-Tool Kit Real Time Interface Library, CORE Graphic Library, and laboratory routines. Source code can be readily modified to accommodate alternative detection, A/D conversion and interactive graphics. The object code utilizing overlays and multitasking has a maximum of 50 Kbytes

Design of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi‐component epidemiological and neurobiological study designed to generate actionable evidence‐based recommendations to reduce US Army suicides and increase basic knowledge about the determinants of suicidality. This report presents an overview of the designs of the six components of the Army STARRS. These include: an integrated analysis of the Historical Administrative Data Study (HADS) designed to provide data on significant administrative predictors of suicides among the more than 1.6 million soldiers on active duty in 2004–2009; retrospective case‐control studies of suicide attempts and fatalities; separate large‐scale cross‐sectional studies of new soldiers (i.e. those just beginning Basic Combat Training [BCT], who completed self‐administered questionnaires [SAQs] and neurocognitive tests and provided blood samples) and soldiers exclusive of those in BCT (who completed SAQs); a pre‐post deployment study of soldiers in three Brigade Combat Teams about to deploy to Afghanistan (who completed SAQs and provided blood samples) followed multiple times after returning from deployment; and a platform for following up Army STARRS participants who have returned to civilian life. Department of Defense/Army administrative data records are linked with SAQ data to examine prospective associations between self‐reports and subsequent suicidality. The presentation closes with a discussion of the methodological advantages of cross‐component coordination. Copyright © 2013 John Wiley & Sons, Ltd .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102177/1/mpr1401.pd

Neurocognitive Function and Suicide in U.S. Army Soldiers

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138894/1/sltb12307_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138894/2/sltb12307.pd

Field procedures in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi‐component epidemiological and neurobiological study of unprecedented size and complexity designed to generate actionable evidence‐based recommendations to reduce US Army suicides and increase basic knowledge about determinants of suicidality by carrying out coordinated component studies. A number of major logistical challenges were faced in implementing these studies. The current report presents an overview of the approaches taken to meet these challenges, with a special focus on the field procedures used to implement the component studies. As detailed in the paper, these challenges were addressed at the onset of the initiative by establishing an Executive Committee, a Data Coordination Center (the Survey Research Center [SRC] at the University of Michigan), and study‐specific design and analysis teams that worked with staff on instrumentation and field procedures. SRC staff, in turn, worked with the Office of the Deputy Under Secretary of the Army (ODUSA) and local Army Points of Contact (POCs) to address logistical issues and facilitate data collection. These structures, coupled with careful fieldworker training, supervision, and piloting, contributed to the major Army STARRS data collection efforts having higher response rates than previous large‐scale studies of comparable military samples. Copyright © 2013 John Wiley & Sons, Ltd .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102238/1/mpr1400.pd

Response bias, weighting adjustments, and design effects in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi‐component epidemiological and neurobiological study designed to generate actionable recommendations to reduce US Army suicides and increase knowledge about determinants of suicidality. Three Army STARRS component studies are large‐scale surveys: one of new soldiers prior to beginning Basic Combat Training (BCT; n  = 50,765 completed self‐administered questionnaires); another of other soldiers exclusive of those in BCT ( n  = 35,372); and a third of three Brigade Combat Teams about to deploy to Afghanistan who are being followed multiple times after returning from deployment ( n  = 9421). Although the response rates in these surveys are quite good (72.0–90.8%), questions can be raised about sample biases in estimating prevalence of mental disorders and suicidality, the main outcomes of the surveys based on evidence that people in the general population with mental disorders are under‐represented in community surveys. This paper presents the results of analyses designed to determine whether such bias exists in the Army STARRS surveys and, if so, to develop weights to correct for these biases. Data are also presented on sample inefficiencies introduced by weighting and sample clustering and on analyses of the trade‐off between bias and efficiency in weight trimming. Copyright © 2013 John Wiley & Sons, Ltd .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102203/1/mpr1399.pd

Lifetime Prevalence Of Dsm‐Iv Mental Disorders Among New Soldiers In The U.S. Army: Results From The Army Study To Assess Risk And Resilience In Servicemembers (Army Starrs)

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110630/1/da22316.pd

Clinical reappraisal of the Composite International Diagnostic Interview Screening Scales (CIDI‐SC) in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

A clinical reappraisal study was carried out in conjunction with the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) All‐Army Study (AAS) to evaluate concordance of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) diagnoses based on the Composite International Diagnostic Interview Screening Scales (CIDI‐SC) and post‐traumatic stress disorder (PTSD) checklist (PCL) with diagnoses based on independent clinical reappraisal interviews (Structured Clinical Interview for DSM‐IV [SCID]). Diagnoses included: lifetime mania/hypomania, panic disorder, and intermittent explosive disorder; six‐month adult attention‐deficit/hyperactivity disorder; and 30‐day major depressive episode, generalized anxiety disorder, PTSD, and substance (alcohol or drug) use disorder (abuse or dependence). The sample ( n  = 460) was weighted for over‐sampling CIDI‐SC/PCL screened positives. Diagnostic thresholds were set to equalize false positives and false negatives. Good individual‐level concordance was found between CIDI‐SC/PCL and SCID diagnoses at these thresholds (area under curve [AUC] = 0.69–0.79). AUC was considerably higher for continuous than dichotomous screening scale scores (AUC = 0.80–0.90), arguing for substantive analyses using not only dichotomous case designations but also continuous measures of predicted probabilities of clinical diagnoses. Copyright © 2013 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102145/1/mpr1398.pd

Genomewide association studies of suicide attempts in US soldiers

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139960/1/ajmgb32594.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139960/2/ajmgb32594_am.pd

Mental Disorders, Comorbidity, and Pre‐enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/115994/1/sltb12153.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/115994/2/sltb12153_am.pd

PTSD-8: A Short PTSD Inventory

Traumatic events pose great challenges on mental health services in scarcity of specialist trauma clinicians and services. Simple short screening instruments for detecting adverse psychological responses are needed. Several brief screening instruments have been developed. However, some are limited, especially in relation to reflecting the posttraumatic stress disorder (PTSD) diagnosis. Recently, several studies have challenged pre-existing ideas about PTSD’s latent structure. Factor analytic research currently supports two four factor models. One particular model contains a dysphoria factor which has been associated with depression and anxiety. The symptoms in this factor have been hailed as less specific to PTSD. The scope of this article is therefore to present a short screening instrument, based on this research; Posttraumatic Stress Disorder (PTSD) – 8 items. The PTSD-8 is shown to have good psychometric properties in three independent samples of whiplash patients (n=1710), rape victims (n=305), and disaster victims (n=516). Good test-rest reliability is also shown in a pilot study of young adults from families with alcohol problems (n=56)