Abstract

BackgroundThe care of traumatized children would benefit significantly from accurate predictive models for Posttraumatic Stress Disorder (PTSD), using information available around the time of trauma. Machine Learning (ML) computational methods have yielded strong results in recent applications across many diseases and data types, yet they have not been previously applied to childhood PTSD. Since these methods have not been applied to this complex and debilitating disorder, there is a great deal that remains to be learned about their application. The first step is to prove the concept: Can ML methods – as applied in other fields – produce predictive classification models for childhood PTSD? Additionally, we seek to determine if specific variables can be identified – from the aforementioned predictive classification models - with putative causal relations to PTSD.MethodsML predictive classification methods – with causal discovery feature selection – were applied to a data set of 163 children hospitalized with an injury and PTSD was determined three months after hospital discharge. At the time of hospitalization, 105 risk factor variables were collected spanning a range of biopsychosocial domains.ResultsSeven percent of subjects had a high level of PTSD symptoms. A predictive classification model was discovered with significant predictive accuracy. A predictive model constructed based on subsets of potentially causally relevant features achieves similar predictivity compared to the best predictive model constructed with all variables. Causal Discovery feature selection methods identified 58 variables of which 10 were identified as most stable.ConclusionsIn this first proof-of-concept application of ML methods to predict childhood Posttraumatic Stress we were able to determine both predictive classification models for childhood PTSD and identify several causal variables. This set of techniques has great potential for enhancing the methodological toolkit in the field and future studies should seek to replicate, refine, and extend the results produced in this study.

Highlights

  • The care of traumatized children would benefit significantly from accurate predictive models for Posttraumatic Stress Disorder (PTSD), using information available around the time of trauma

  • The extant research literature has been unsuccessful in reliably identifying a set of risk factors for PTSD common to all traumatized children or specific sets of risk factors that may allow the individualized treatment of a child based on their risk [10, 11]

  • The current study addresses two broad hypotheses: Hypothesis 1: Machine Learning (ML) methods can identify an accurate and reliable predictive classification model for childhood PTSD, from variables measured around the time of trauma

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Summary

Introduction

The care of traumatized children would benefit significantly from accurate predictive models for Posttraumatic Stress Disorder (PTSD), using information available around the time of trauma. More than 20% of children in the United States will experience a traumatic event before they are 16 years old [1, 2] Of those who experienced a trauma, between 10 and 40% [3,4,5] will develop Posttraumatic Stress Disorder (PTSD) [6], a disorder that results in significant functional impairment and may have deleterious consequences for brain development [7,8,9]. The extant research literature has been unsuccessful in reliably identifying a set of risk factors for PTSD common to all traumatized children or specific sets of risk factors that may allow the individualized treatment of a child based on their risk [10, 11]

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