Steele Nicole M, Fogarty Gerard J
Joint Health Command, Australian Government Department of Defence, CP3-7-156, Campbell Park Offices, Canberra, ACT, Australia, 2600.
Australian Centre for Sustainable Business and Development, University of Southern Queensland, Toowoomba, QLD, Australia, 4350.
Mil Med. 2017 Mar;182(3):e1628-e1633. doi: 10.7205/MILMED-D-16-00187.
Mental health screens are designed to detect individuals at risk of psychological disorders. In the military setting of this study, these disorders were post-traumatic stress disorder (PTSD) and alcohol use. This study extends the literature on deployment-related mental health screening by including measures of sleep difficulties and anger as predictors of postdeployment PTSD and alcohol abuse. Evidence that measures of anger and sleep difficulties contribute incremental validity to the prediction of postdeployment mental health problems, including substance abuse, would be helpful in designing interventions to assist the rehabilitation of returning personnel.
A test battery containing the PTSD Checklist-Civilian (PCL-C) to screen for PTSD, the Kessler 10 to screen for psychological distress, a Sleep Difficulties scale, an exposure to trauma scale, and an anger scale was administered to 212 personnel nearing completion of a deployment to the Middle East. A second battery containing the PCL-C, the Kessler 10, and a measure of alcohol consumption (Alcohol Use Disorders Identification Test [AUDIT]) was administered to the same personnel 3 to 6 months after return to Australia. Hierarchical regression analyses assessed the predictive validity of measures of psychological distress (anxiety and depression), PTSD symptomatology, sleep disturbance, and anger in relation to postdeployment measures of PTSD symptomatology and alcohol use.
Time 1 measures predicted 24.4% of the variance in postdeployment PCL-C scores and 13.1% of the variance in AUDIT scores, with the Sleep Difficulties scale contributing to the prediction of the PCL-C score and the anger scale helping to predict AUDIT scores.
On the basis of these findings, we recommend the inclusion of improved measures of both anger and sleep difficulties in end-of-deployment mental health screens. A less behaviorally specific and more wide-ranging anger scale is recommended for future studies that aim to evaluate the role of anger in screening batteries. Our findings suggest that the Sleep Difficulties scale used in this study would be a worthwhile addition to mental health screening because it is moderately correlated with both Time 1 and Time 2 measures of PTSD symptomatology and psychological distress. Furthermore, there is minimal stigma associated with the experience of sleep difficulties.
心理健康筛查旨在检测有心理障碍风险的个体。在本研究的军事背景下，这些障碍为创伤后应激障碍（PTSD）和酒精使用问题。本研究通过纳入睡眠困难和愤怒程度的测量指标作为部署后PTSD和酒精滥用的预测因素，扩展了与部署相关的心理健康筛查的文献。有证据表明，愤怒程度和睡眠困难的测量指标对部署后心理健康问题（包括药物滥用）的预测具有增量效度，这将有助于设计干预措施，以协助归国人员的康复。
对212名即将完成中东部署的人员进行了一组测试，其中包括用于筛查PTSD的PTSD检查表-平民版（PCL-C）、用于筛查心理困扰的凯斯勒10项量表、睡眠困难量表、创伤暴露量表和愤怒量表。在这些人员返回澳大利亚3至6个月后，对他们进行了第二组测试，包括PCL-C、凯斯勒10项量表和一项酒精消费量测量指标（酒精使用障碍识别测试[AUDIT]）。分层回归分析评估了心理困扰（焦虑和抑郁）、PTSD症状、睡眠障碍和愤怒程度的测量指标与部署后PTSD症状和酒精使用测量指标之间的预测效度。
第一次测试的测量指标预测了部署后PCL-C分数方差的24.4%和AUDIT分数方差的13.1%，睡眠困难量表有助于预测PCL-C分数，愤怒量表有助于预测AUDIT分数。
基于这些发现，我们建议在部署结束时的心理健康筛查中纳入改进后的愤怒程度和睡眠困难测量指标。对于未来旨在评估愤怒在筛查量表中作用的研究，建议使用一个行为特异性较低、范围更广的愤怒量表。我们的研究结果表明，本研究中使用的睡眠困难量表将是心理健康筛查中一个有价值的补充，因为它与PTSD症状和心理困扰的第一次和第二次测量指标均具有中度相关性。此外，睡眠困难体验相关的污名化程度极低。
