The purpose of the research was to assess the diagnostic efficiency of the Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) and the Posttraumatic Stress Disorder Checklist (PCL) as clinical screening tools for active duty soldiers recently returned from a combat deployment. A secondary goal was to examine the item-level characteristics of both the PC-PTSD and the PCL. A validation study conducted with a sample of 352 service members showed that both the PC-PTSD and PCL had good diagnostic efficiency. The overall diagnostic efficiency assessed by the area under the curve (AUC) was virtually the same for both the PC-PTSD and PCL. The most efficient cutoff values for the PC-PTSD were either 2 or 3 "yes" responses with the latter favoring specificity. For the PCL, the most efficient cutoff values were between 30 and 34, mirroring recommended PCL cutoff values from some studies in primary care settings. The examination of item characteristics suggested a 4-item PCL with an AUC virtually identical to that of the full PCL. Item analyses also identified that the most discriminate item in both scales pertained to symptoms of avoidance. Implications and limitations are discussed.
Researchers have found that there is an increase in mental heath problems as a result of military-related traumatic events, and such problems increase in the months following return from combat. Nevertheless, researchers have not assessed the impact of early intervention efforts with this at-risk population. In the present study, the authors compared different early interventions with 2,297 U.S. soldiers following a year-long deployment to Iraq. Platoons were randomly assigned to standard postdeployment stress education, Battlemind debriefing, and small and large group Battlemind training. Results from a 4-month follow-up with 1,060 participants showed those with high levels of combat exposure who received Battlemind debriefing reported fewer posttraumatic stress symptoms, depression symptoms, and sleep problems than those in stress education. Small group Battlemind training participants with high combat exposure reported fewer posttraumatic stress symptoms and sleep problems than stress education participants. Compared to stress education participants, large group Battlemind training participants with high combat exposure reported fewer posttraumatic stress symptoms and lower levels of stigma and, regardless of combat exposure, reported fewer depression symptoms. Findings demonstrate that brief early interventions have the potential to be effective with at-risk occupational groups.
This research explored the relationship between the meaningfulness of work, personality hardiness, and deriving long-term benefits from a stressful event. U.S. soldiers participating in a peacekeeping mission to Bosnia completed measures assessing the meaning of their work and personality hardiness midway through a 1-year deployment (mid-deployment) and completed a measure of deriving benefits from the deployment 4-5 months after it was over (postdeployment). Structural equation modeling revealed that personality hardiness was associated with being engaged in meaningful work during the deployment, which was strongly associated with deriving benefits from the deployment months after it was over. Enriching experiences were also associated with deriving benefits from the deployment. Discussion focuses on the linkages between personality processes, meaningful work, and deriving benefits from a stressful experience.
Stigma and organizational barriers have been identified as factors for why a small proportion of soldiers with psychological problems seek professional help. In this article, we examine the impact of negative attitudes toward treatment on treatment seeking among soldiers previously deployed to Afghanistan or Iraq (n = 2,623). We asked soldiers with psychological problems questions about stigma, organizational barriers, negative attitudes toward treatment, and whether they sought treatment for their psychological problems. We found that negative attitudes about treatment inversely predicted treatment seeking. These results provide a more comprehensive examination of reasons that soldiers do not seek needed treatment and highlight the need for policy aimed at reducing negative attitudes toward mental health treatment.
Results support the role of insomnia in the development of additional psychological problems and highlight the clinical implications for combat veterans, to include the importance of longitudinal assessment and monitoring of sleep disturbances, and the need for early intervention.
U.S. military forces are increasingly involved in a variety of multinational peacekeeping and humanitarian assistance missions. How well combat-trained units and soldiers adapt to these new roles will determine U.S. success in such operations, as well as the future health and readiness of the force. In preparing soldiers for such missions, it is critical that leaders and health care providers have a clear understanding of the nature of the stressors they are likely to encounter. This report summarizes findings from a longitudinal, descriptive case study of a U.S. Army medical unit performing a peacekeeping mission in the former Yugoslavia. The goal of the investigation was to identify key sources of stress and to delineate the effect of these stressors on the health, morale, and mental readiness of soldiers. Findings suggest a range of psychological stressors that varies somewhat across operational phases of a peacekeeping mission. Furthermore, the degree of stress experienced in various areas correlates significantly with depression, psychiatric symptoms, and low reported morale. The range of stressors is reduced and summarized in a conceptually derived model of five underlying dimensions of psychological stress salient to soldier adaptation in peacekeeping operations: isolation, ambiguity, powerlessness, boredom, and danger/threat. This model provides a useful heuristic for organizing thinking about stress in peacekeeping operations and leads to several recommendations for "countermeasures" that organizational leaders can take to maintain soldier psychological readiness during peacekeeping operations.
509 Army Soldiers (who had returned within the previous week from a 12-month deployment to Iraq) participated in a study to examine changes in psychological symptoms between homecoming and 120 days later. Rates of psychological symptoms were significantly higher at 120 days postdeployment than at immediate reintegration largely due to an increase in Soldiers who were initially nonsymptomatic but became symptomatic later.
The organizational justice literature has consistently documented substantial correlations between organizational justice and employee depression. Existing theoretical literature suggests this relationship occurs because perceptions of organizational (in)justice lead to subsequent psychological health problems. Building on recent research on the affective nature of justice perceptions, in the present research we broaden this perspective by arguing there are also theoretical arguments for a reverse effect whereby psychological health problems influence perceptions of organizational justice. To contrast both theoretical perspectives, we test longitudinal lagged effects between organizational justice perceptions (i.e., distributive justice, interactional justice, interpersonal justice, informational justice, and procedural justice) and employee depressive symptoms using structural equation modeling. Analyses of 3 samples from different military contexts (N₁ = 625, N₂ = 134, N₃ = 550) revealed evidence of depressive symptoms leading to subsequent organizational justice perceptions. In contrast, the opposite effects of organizational justice perceptions on depressive symptoms were not significant for any of the justice dimensions. The findings have broad implications for theoretical perspectives on psychological health and organizational justice perceptions.
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