title: A noncognitive temperament test to predict risk of mental disorders and attrition in U.S. Army recruits.
abstract: U.S. military accession mental health screening includes cognitive testing and questions regarding the applicants' past mental health history. This process relies on applicants' knowledge of and willingness to disclose symptoms and conditions. Applicants have a strong incentive to appear qualified, which has resulted in a long history of frequent mental health conditions presenting during recruit training.
  
  
  OBJECTIVE
  To assess the predictive value of a pre-enlistment noncognitive temperament test score for risk of mental disorders and attrition in the first year of service.
  
  
  METHODS
  A retrospective cohort study was conducted on non-high school diploma U.S. Army active duty recruits who took the Assessment of Individual Motivation (AIM). Multivariate logistic regression models were used to determine associations between AIM score quintiles, mental disorders, and attrition.
  
  
  RESULTS
  AIM scorers in the lowest quintile were at increased risk for a mental disorder (OR, 1.44; 95% CI, 1.35-1.53) and of discharge (OR, 1.65; 95% CI, 1.44-1.68) compared to AIM scorers in the highest quintile, with significant linear trends for decreased risk with increasing AIM score.
  
  
  CONCLUSIONS
  AIM offers the potential to improve screening of military applicants and reduce mental disorders and attrition in new recruits beyond the current process.
authors.affiliation: Department of Epidemiology, Division of Preventive Medicine, Walter Reed Army Institute of Research, 503 Robert Grant Road, Silver Spring, MD 20910, USA.
authors.forename: Marlene E
authors.initials: ME
authors.lastname: Gubata
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Oetting
authors.forename: Natalya S
authors.initials: NS
authors.lastname: Weber
authors.forename: Xiaoshu
authors.initials: X
authors.lastname: Feng
authors.forename: David N
authors.initials: DN
authors.lastname: Cowan
authors.forename: David W
authors.initials: DW
authors.lastname: Niebuhr
mesh_terms: D000293:Adolescent; D000328:Adult; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008603:Mental Health; D008887:Military Medicine; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D053580:Muscle Strength; D010552:Personality Assessment / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D010560:Personnel Selection / Q000379:methods*; D010807:Physical Endurance; D010809:Physical Fitness; D011237:Predictive Value of Tests; D011594:Psychometrics; D012189:Retrospective Studies; D012307:Risk Factors; D013694:Temperament; D014481:United States / Q000453:epidemiology