This study examined the validity of psychological measures used in screening for the U.S. Army with 885 soldiers before a 6-month peacekeeping rotation in Kosovo. Content validity and construct validity were assessed by evaluating the clinical domains, comparing clinician assessments of functioning, and assessing risk factors for screening positive. Construct validity and content validity were demonstrated. Risks, benefits, and future directions of the Army's psychological screening research program are discussed.
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[Show abstract][Hide abstract] ABSTRACT: Psychological screening can be conducted using global screens, single items, symptom-based scales, or composite measures. These four different approaches were evaluated against structured clinical interviews in studies with U.S. soldiers preparing to deploy and returning from combat operations in Iraq. Three samples (N = 337, N = 574, and N = 348) were screened to assess the effectiveness of a short global measure of distress, a single self-referral item, symptom-specific scales selected for the target population, and a composite instrument that included a combination of clinical domains. A composite screen with measures of posttraumatic stress, depression, and alcohol problems, along with a single self-referral item, performed most effectively.
[Show abstract][Hide abstract] ABSTRACT: We sought to evaluate outcomes of the Veterans Administration (VA) Afghan and Iraq Post-Deployment Screen for mental health symptoms.
Veterans Administration clinicians were encouraged to refer Iraq or Afghanistan veterans who screened positive for posttraumatic stress disorder, depression, or high-risk alcohol use to a VA mental health clinic. Multivariate methods were used to determine predictors of screening, the proportions who screened positive for particular mental health problems, and predictors of VA mental health clinic attendance.
Among 750 Iraq and Afghanistan veterans who were referred to a VA medical center and 5 associated community clinics, 338 underwent postdeployment screening; 233 (69%) screened positive for mental health problems. Having been seen in primary care (adjusted odd ratio [AOR]=13.3; 95% confidence interval [CI]=8.31, 21.3) and at a VA community clinic (AOR=3.28; 95% CI=2.03, 5.28) predicted screening. African American veterans were less likely to have been screened than were White veterans (AOR=0.45; 95% CI=0.22, 0.91). Of 233 veterans who screened positive, 170 (73%) completed a mental health follow-up visit.
A substantial proportion of veterans met screening criteria for co-occurring mental health problems, suggesting that the VA screens may help overcome a "don't ask, don't tell" climate that surrounds stigmatized mental illness. Based on data from 1 VA facility, VA postdeployment screening increases mental health clinic attendance among Iraq and Afghanistan veterans.
American Journal of Public Health 05/2008; 98(4):714-20. DOI:10.2105/AJPH.2007.115519 · 4.55 Impact Factor