Despite the broad literature base on factor analysis best practices, research seeking to evaluate a measure's psychometric properties frequently fails to consider or follow these recommendations. This leads to incorrect factor structures, numerous and often overly complex competing factor models and, perhaps most harmful, biased model results. Our goal is to demonstrate a practical and actionable process for factor analysis through (a) an overview of six statistical and psychometric issues and approaches to be aware of, investigate, and report when engaging in factor structure validation, along with a flowchart for recommended procedures to understand latent factor structures; (b) demonstrating these issues to provide a summary of the updated Posttraumatic Stress Disorder Checklist (PCL-5) factor models and a rationale for validation; and (c) conducting a comprehensive statistical and psychometric validation of the PCL-5 factor structure to demonstrate all the issues we described earlier. Considering previous research, the PCL-5 was evaluated using a sample of 1,403 U.S. Air Force remotely piloted aircraft operators with high levels of battlefield exposure. Previously proposed PCL-5 factor structures were not supported by the data, but instead a bifactor model is arguably more statistically appropriate.

A B S T R A C TRemotely piloted aircraft (RPA), commonly referred to as "drones," have emerged over the past decade as an innovative warfighting tool. Given there is a paucity of empirical research assessing drone operators, the purpose of this study was to assess for the prevalence of PTSD symptoms among this cohort. Of the 1084 United States Air Force (USAF) drone operators that participated, a total of 4.3% endorsed a pattern of symptoms of moderate to extreme level of severity meeting criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders-4th edition. The incidence of PTSD among USAF drone operators in this study was lower than rates of PTSD (10-18%) among military personnel returning from deployment but higher than incidence rates (less than 1%) of USAF drone operators reported in electronic medical records. Although low PTSD rates may be promising, limitations to this study are discussed.

Recently, there has been a growing trend in the professional literature to address the question: “In what ways should spiritual interventions be used in counseling, with which clients, and under which circumstances?” However, few therapists have received training and supervised experience in incorporating spiritual interventions into their work. This article briefly addresses the purpose and prevalence of Christian spiritual interventions and proposes a series of progressive legal and ethical decision-making steps to improve therapists' skills in incorporating such interventions into psychotherapy. The initial steps include an assessment of the therapist's role, the setting of therapy, and the presenting problem of the client. Additional steps include obtaining informed consent, evaluating a therapist's competency, maintaining professional and scientific responsibility, respecting the client's religious values, documenting the use of spiritual interventions, making appropriate financial arrangements, and promoting the welfare of the client.

Among U.S. Air Force remotely piloted aircraft, the MQ-1 Predator and MQ-9 Reaper have emerged as critical assets to intelligence, surveillance, reconnaissance, and close air support operations. The effective selection of Predator/Reaper pilot training candidates for such aircraft is essential to successful training and operational performance. However, a profile of "the right stuff" (i.e., cognitive aptitudes, personality traits, and motivation) guiding aeromedical flight screening and selection processes for such pilots does not exist. This study addresses the gap in the literature by formulating such a profile based upon the input of line commanders and subject matter experts (SMEs). A total of 82 SMEs provided input on the psychological attributes perceived as critical to acquisition of Predator/Reaper pilot skills, as well as adaptation to the operational environment. The researchers analyzed, organized, and integrated the results of SME interviews in to a theoretical, multidimensional profile, which serves as a communication tool between aeromedical leadership and line commanders regarding psychological attributes that should be considered prior to a Predator/Reaper pilot training applicant entering the career field. The profile may also guide aeromedical and personnel assessment and selection procedures, as well as waiver evaluations to reduce attrition, and improve retention in such a high-demand, high-operational aviation career field. 15. SUBJECT TERMS Remotely piloted aircraft, pilot selection, cognitive aptitude, critical psychological attributes 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT SAR 18. NUMBER OF PAGES 43 19a. NAME OF RESPONSIBLE PERSON

This report is published in the interest of scientific and technical information exchange, and its publication does not constitute the Government's approval or disapproval of its ideas or findings.