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A brief intensive workshop on patient-centered communication tailored to the military screening context is feasible and may improve key outcomes.

Previous studies have found deployment to combat areas to be associated with an increased risk of post-traumatic stress disorder (PTSD), depression, and alcohol abuse, but many previous studies were limited by samples that were not representative of the deployed military as a whole. This study presents an overview of these three mental health problems associated with deployment among Air Force, Army, Marine Corp, and Navy service members returning from deployment to Iraq and Afghanistan between January 2007 and March 2008. With postdeployment health data on over 50,000 service men and women, including diagnostic information, we were able to estimate prevalence of those who screened positive for risk of each disorder in self-report data at two time points, as well as prevalence of diagnoses received during health care encounters within the military health care system. The prevalence ranges of the three disorders were consistent with previous studies using similar measures, but service members in the Navy had higher rates of screening positive for all three disorders and higher prevalence of depression and PTSD diagnoses compared to the other branches. Further, PTSD risk was higher for service members returning from Afghanistan compared to Iraq, in contrast to previous findings.

Laboratory investigations of cardiovascular reactivity to mental stress often ignore concomitant differences in cognitive, affective, and behavioral responses that are commonly observed among study participants. To provide a more systematic laboratory methodology to examine relations among cardiovascular, behavioral, and self-report measures of cognitive and affective responses to stress, we developed and tested a social confrontation procedure involving standardized interactions during two scenes. Results of three investigations are presented to illustrate the utility of the social confrontation procedure. In the first two studies, this multidimensional assessment strategy produced results which may foster research projects that bridge separate areas of psychological inquiry. In one application, persons with hypertensive parents, in contrast to persons with normotensive parents, exhibited characteristic negative behavioral responses during both interactions as well as the more commonly-observed exaggerated blood pressure reactions. In the other study, students from less functional families (regarding cohesion and adaptability) were shown to exhibit exaggerated blood pressure reactions in addition to their commonly-reported negative cognitive and behavioral coping styles. Finally, a third study examined how a simple instructional set regarding the expression or suppression of anger influenced participants' responses. Significant differences were observed across response domains, with anger expression resulting in a more intense response than anger suppression. In sum, the social confrontation procedure represents an important methodological development for exploring the relation between response domains, the relation between cardiovascular response to stress and psychosocial risk for cardiovascular disease, and the physiological and behavioral distinction between anger expression and anger suppression.