Objective-To develop and evaluate a Critical Warzone Experiences (CWE) scale, a brief measure of warzone experiences associated with the development of posttraumatic stress disorder (PTSD), anxiety, and depression.Method-The psychometric properties of the CWE were evaluated across three independent samples of Iraq/Afghanistan veterans (combined N = 392).Results-Despite its brevity (7 items), the CWE exhibited good internal consistency (average α = .83), good temporal stability (1-year test-retest reliability = .73), and a clear unidimensional factor structure in Study 1. Study 2 confirmed the CWE's factor structure through confirmatory factor analysis, and structural equation modeling demonstrated a strong association between the CWE and post-deployment mental health, β = .49, p < .001. Study 3 provided further support for the validity of the CWE by demonstrating that it was associated with PTSD diagnosis, clinicianrated PTSD symptom severity, and global functional impairment in an independent sample of Iraq/Afghanistan veterans (average validity coefficient = .59). 1Correspondence concerning this article should be sent to: Dr. Nathan A. Kimbrel, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705. Phone: (919) 286-0411, ext. 6759. Nathan.Kimbrel@va.gov. U.S. Department of Veterans Affairs VA Author ManuscriptVA Author Manuscript VA Author ManuscriptConclusion-While replication of these findings in more diverse samples is needed, the preliminary evidence from these studies indicates that the CWE is a brief, reliable, and valid measure of critical warzone experiences among Iraq/Afghanistan war veterans.In the aftermath of the Vietnam War, researchers began to intensively study the manner in which combat experiences might contribute to posttraumatic stress disorder (PTSD) and other types of mental health problems. As a result, several measures of combat exposure were created, including the widely-used 7-item Combat Exposure Scale (CES; Keane et a., 1989), which was validated with Vietnam veterans. More recently, considerably longer measures of combat exposure and other types of deployment experiences (e.g., post-battle experiences) have been developed, including the U.S. Army and Marine Corps Mental Health Advisory Team's Combat Experiences Scale (MHAT-CES).The MHAT-CES has been used in numerous studies of Iraq/Afghanistan veterans (e.g., Booth-Kewley, Larson, Highfill-McRoy, Garland, & Gaskin, 2010;Castro, Bienvenu, Hufmann, & Adler, 2000;Hoge et al., 2004;Hoge, Milliken, Auchterlonie, & Hoge, 2007;Meyer et al., 2013;Morissette et al., 2011;Wright, Cabrera, Eckford, Adler, & Bliese, 2012), including Hoge and colleagues ' (2004) seminal study on mental health problems among Iraq/Afghanistan veterans. Despite the widespread use of the MHAT-CES in published studies of Iraq/Afghanistan veterans, there has been significant variability in the manner in which this measure has been administered. Whereas some studies used versions of the MHAT-CES that contained as many as 44 items and...

Serious mental illness diagnosis does not appear to be associated with adverse transplantation outcomes over the first 3 years; however, a potentially diverging survival curve may portend higher mortality at 5 years.

War veterans are at increased risk for chronic pain and co-occurring neurobehavioral problems, including posttraumatic stress disorder (PTSD), depression, alcohol-related problems, and mild traumatic brain injury (mTBI). Each condition is associated with disability, particularly when co-occurring. Pain acceptance is a strong predictor of lower levels of disability in chronic pain. This study examined whether acceptance of pain predicted current and future disability beyond the effects of these co-occurring conditions in war veterans. Eighty trauma-exposed veterans with chronic pain completed a PTSD diagnostic interview, clinician-administered mTBI screening, and self-report measures of disability, pain acceptance, depression, and alcohol use. Hierarchical regression models showed pain acceptance to be incrementally associated with disability after accounting for symptoms of PTSD, depression, alcohol-related problems, and mTBI (total adjusted R2=.57, p<.001, ΔR2=.03, p=.02). At 1-year follow-up, the total variance in disability accounted for by the model decreased (total adjusted R2 =.29, p<.001), whereas the unique contribution of pain acceptance increased (ΔR2=.07, p=.008). Pain acceptance remained significantly associated with 1-year disability when pain severity was included in the model. Future research should evaluate treatments that address chronic pain acceptance and co-occurring conditions to promote functional recovery in the context of polytrauma in war veterans.