Identifying probable post-traumatic stress disorder: applying supervised machine learning to data from a UK military cohort

Abstract Background: Early identification of probable post-traumatic stress disorder (PTSD) can lead to early intervention and treatment. Aims: This study aimed to evaluate supervised machine learning (ML) classifiers for the identification of probable PTSD in those who are serving, or have recently served in the United Kingdom (UK) Armed Forces. Methods: Supervised ML classification techniques were applied to a military cohort of 13,690 serving and ex-serving UK Armed Forces personnel to identify probable PTSD based on self-reported service exposures and a range of validated self-report measures. Data were collected between 2004 and 2009. Results: The predictive performance of supervised ML classifiers to detect cases of probable PTSD were encouraging when compared to a validated measure, demonstrating a capability of supervised ML to detect the cases of probable PTSD. It was possible to identify which variables contributed to the performance, including alcohol misuse, gender and deployment status. A satisfactory sensitivity was obtained across a range of supervised ML classifiers, but sensitivity was low, indicating a potential for false negative diagnoses. Conclusions: Detection of probable PTSD based on self-reported measurement data is feasible, may greatly reduce the burden on public health and improve operational efficiencies by enabling early intervention, before manifestation of symptoms.

[1]  Tola Bayisa,et al.  The prevalence of common mental disorders among healthcare professionals during the COVID-19 pandemic at a tertiary Hospital in Addis Ababa, Ethiopia , 2021, Journal of Affective Disorders Reports.

[2]  D. Murphy,et al.  Describing the profile of a population of UK veterans seeking support for mental health difficulties , 2019, Journal of mental health.

[3]  Moi Hoon Yap,et al.  Automated Analysis and Quantification of Human Mobility Using a Depth Sensor , 2017, IEEE Journal of Biomedical and Health Informatics.

[4]  Pat and Lisa Sue Armed Forces Covenant , 2015 .

[5]  S. Wessely,et al.  Alcohol misuse in the United Kingdom Armed Forces: A longitudinal study. , 2015, Drug and alcohol dependence.

[6]  J. Beckham,et al.  The Relationship Between Posttraumatic Stress Symptoms and Physical Health in a Survey of U.S. Veterans of the Iraq and Afghanistan Era. , 2015, Psychosomatics.

[7]  A. Statnikov,et al.  Early identification of posttraumatic stress following military deployment: Application of machine learning methods to a prospective study of Danish soldiers. , 2015, Journal of affective disorders.

[8]  Carmen C. Y. Poon,et al.  Big Data for Health , 2015, IEEE Journal of Biomedical and Health Informatics.

[9]  C. Nievergelt,et al.  Diagnostic Utility of the Posttraumatic Stress Disorder (PTSD) Checklist for Identifying Full and Partial PTSD in Active-Duty Military , 2015, Assessment.

[10]  D. Murphy,et al.  PTSD, stigma and barriers to help-seeking within the UK Armed Forces , 2014, Journal of the Royal Army Medical Corps.

[11]  R. Kessler,et al.  How well can post‐traumatic stress disorder be predicted from pre‐trauma risk factors? An exploratory study in the WHO World Mental Health Surveys , 2014, World psychiatry : official journal of the World Psychiatric Association.

[12]  S. Schneeweiss Learning from big health care data. , 2014, The New England journal of medicine.

[13]  Richard Dobson,et al.  A comparison of machine learning methods for classification using simulation with multiple real data examples from mental health studies , 2013, Statistical methods in medical research.

[14]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[15]  Bruce Guthrie,et al.  The effect of physical multimorbidity, mental health conditions and socioeconomic deprivation on unplanned admissions to hospital: a retrospective cohort study , 2013, Canadian Medical Association Journal.

[16]  N. Fear,et al.  What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else? , 2012, Psychological Medicine.

[17]  S. Wessely,et al.  Does anonymity increase the reporting of mental health symptoms? , 2012, BMC Public Health.

[18]  Laura Goodwin,et al.  Predicting persistent posttraumatic stress disorder (PTSD) in UK military personnel who served in Iraq: a longitudinal study. , 2012, Journal of psychiatric research.

[19]  J. Ainsworth,et al.  Intelligent real-time therapy: Harnessing the power of machine learning to optimise the delivery of momentary cognitive–behavioural interventions , 2012, Journal of mental health.

[20]  J. Kenardy,et al.  Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury , 2011, PAIN.

[21]  S. Wessely,et al.  The acceptability of 'Trauma Risk Management' within the UK Armed Forces. , 2011, Occupational medicine.

[22]  P. Calhoun,et al.  The diagnostic accuracy of the PTSD checklist: a critical review. , 2010, Clinical psychology review.

[23]  Christopher Dandeker,et al.  What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study , 2010, The Lancet.

[24]  C. Hoge,et al.  Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war. , 2010, Drug and alcohol dependence.

[25]  J. Suvisaari,et al.  Prevalence and correlates of alcohol and other substance use disorders in young adulthood: A population-based study , 2009, BMC psychiatry.

[26]  S. Ishikawa,et al.  Human activity recognition: Various paradigms , 2008, 2008 International Conference on Control, Automation and Systems.

[27]  T. Wells,et al.  Alcohol use and alcohol-related problems before and after military combat deployment. , 2008, JAMA.

[28]  J. Eriksson,et al.  Depressive symptoms in adults separated from their parents as children: a natural experiment during World War II. , 2007, American journal of epidemiology.

[29]  M. Hotopf,et al.  Mental health consequences of overstretch in the UK armed forces: first phase of a cohort study , 2007, BMJ : British Medical Journal.

[30]  M. O'Donnell,et al.  PTSD symptom trajectories: from early to chronic response. , 2007, Behaviour research and therapy.

[31]  Christopher Dandeker,et al.  The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study , 2006, The Lancet.

[32]  S. Wessely,et al.  What happens to British veterans when they leave the armed forces? , 2005, European journal of public health.

[33]  C. Hoge,et al.  Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. , 2004, The New England journal of medicine.

[34]  D. Erickson,et al.  The Course of PTSD Symptoms Among Gulf War Veterans: A Growth Mixture Modeling Approach , 2004, Journal of traumatic stress.

[35]  R. Kerns,et al.  An examination of the relationship between chronic pain and post-traumatic stress disorder. , 2003, Journal of rehabilitation research and development.

[36]  R. Bryant Early predictors of posttraumatic stress disorder , 2003, Biological Psychiatry.

[37]  Jinbo Bi,et al.  Dimensionality Reduction via Sparse Support Vector Machines , 2003, J. Mach. Learn. Res..

[38]  O. Gureje,et al.  The validity of two versions of the GHQ in the WHO study of mental illness in general health care , 1997, Psychological Medicine.

[39]  Leo Breiman,et al.  Bagging Predictors , 1996, Machine Learning.

[40]  E. Blanchard,et al.  Psychometric properties of the PTSD Checklist (PCL). , 1996, Behaviour research and therapy.

[41]  Corinna Cortes,et al.  Support-Vector Networks , 1995, Machine Learning.

[42]  O. Aasland,et al.  Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. , 1993, Addiction.

[43]  Jon Louis Bentley,et al.  An Algorithm for Finding Best Matches in Logarithmic Expected Time , 1977, TOMS.

[44]  M. Stone Cross‐Validatory Choice and Assessment of Statistical Predictions , 1976 .

[45]  Arthur L. Samuel,et al.  Some Studies in Machine Learning Using the Game of Checkers , 1967, IBM J. Res. Dev..

[46]  Howard Rosenbaum,et al.  Effects of reading proficiency on embedded stem priming in primary school children , 2021 .

[47]  V. Persico Big Data for Health , 2019, Encyclopedia of Big Data Technologies.

[48]  L. Goodwin,et al.  Stigma as a barrier to seeking health care among military personnel with mental health problems. , 2015, Epidemiologic reviews.

[49]  L. Goodwin,et al.  Factors affecting help seeking for mental health problems after deployment to Iraq and Afghanistan. , 2014, Psychiatric services.

[50]  Ingmar Nitze,et al.  COMPARISON OF MACHINE LEARNING ALGORITHMS RANDOM FOREST, ARTIFICIAL NEURAL NETWORK AND SUPPORT VECTOR MACHINE TO MAXIMUM LIKELIHOOD FOR SUPERVISED CROP TYPE CLASSIFICATION , 2012 .

[51]  Kathleen M. Carley,et al.  Conditional random fields for entity extraction and ontological text coding , 2008 .

[52]  Kenneth J Sher,et al.  The development of alcohol use disorders. , 2005, Annual review of clinical psychology.

[53]  Isabelle Guyon,et al.  An Introduction to Variable and Feature Selection , 2003, J. Mach. Learn. Res..

[54]  Trevor Hastie,et al.  Imputing Missing Data for Gene Expression Arrays , 2001 .

[55]  L. Breiman Random Forests , 2001, Machine Learning.

[56]  John R. Koza,et al.  Automated Design of Both the Topology and Sizing of Analog Electrical Circuits Using Genetic Programming , 1996 .

[57]  W S McCulloch,et al.  A logical calculus of the ideas immanent in nervous activity , 1990, The Philosophy of Artificial Intelligence.