Identification of and At-Risk Interventions for Pre-Deployment Psychophysiologic Predictors of Post-Deployment Mental Health Outcomes.

摘要

The primary objectives of this proposal are to develop objective pre- deployment predictors of PTSD and test two pre-deployment resiliency interventions. Objective predictors are as follows: (1) physiologic reactivity to combat-related virtual reality environments and white noise startle, and (2) cognitive bias assessment. We also will test two pre-deployment resiliency interventions: (1) video game-based heart rate variability biofeedback training, and (2) computerized cognitive bias training. Objective assessment and training measures are more reliably measured and could be early indicators of resilience/vulnerability. We will collect pre-deployment physiologic reactivity and cognitive bias data from Army National Guard and/or Reserve members within 12 months of OIF/OEF deployment. We plan to consent up to 600 soldiers to complete 500 pre-deployment assessments. Subjects will be randomized to one of three groups: heart rate variability biofeedback training, cognitive bias training, or no additional training. Follow-up data will be collected at 3- and 12-months post-deployment. Using the pre-deployment data, we found significant correlations in the expected directions between the cognitive bias assessment (sensitivity and response bias) and the Post-Traumatic Cognitions Inventory, Connor-Davidson Resilience Scale, Brief Symptom Inventory, and PTSD Checklist Avoidance Cluster. These findings provide evidence to support the validation of the cognitive bias assessment used in this study. We also found significant correlations between pre-deployment heart rate variability measures and self- report symptom measures among younger soldiers (age age < 30 years) which differed by prior combat deployment status. For example, among younger soldiers with no prior combat deployment there was a significant correlation between high frequency power (a measure of parasympathetic tone) and the Conner-Davidson Resilience Scale.