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Screening for public safety positions (e.g., police officers, fire fighters, military service members) is a difficult and challenging task. Notably, the military has been widely criticized because of the general lack of an empirically based system or program for mental health screening. The purpose of the present study is to describe the use of statistical prediction rules for this task. Prediction rules were derived and validated using U.S. Air Force (USAF) recruits in basic military training (N = 50,322). Items from the Lackland Behavioral Questionnaire were used as predictors. General attrition (discharge for any reason before completing term of service) and disciplinary offenses (including criminal charges) were used as outcomes. For trainees in the top 2% or 1% of the general attrition prediction rule, 63% and 68% were discharged before they completed their first 4 years. The base rate was 25%. Similarly, for trainees in the top 2% or 1% of the disciplinary offenses prediction rule, 35% and 39% had a significant disciplinary offense over the following 4 years. The base rate was 15.5%. The results suggest that we may be able to use biographical data inventories and statistical prediction rules to identify a small percentage of trainees in public safety fields with significant mental health or behavioral histories who are at elevated risk for general attrition and disciplinary offenses. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Although previous research has indicated an elevated prevalence of posttraumatic stress disorder (PTSD) and other mental health problems among veterans of Operations Iraqi Freedom and Enduring Freedom following deployment, most of this research has been cross-sectional and has focused on a limited range of military groups and outcome criteria. This investigation was a longitudinal study of U.S. Air Force security forces assigned to a year-long high-threat ground mission in Iraq to determine the degree to which airmen's emotional and behavioral health and committed relationships were adversely impacted by an extended deployment to a warzone. Participants were a cohort of 164 security forces airmen tasked to a 365-day deployment to train Iraqi police. Airmen completed study measures both prior to and 6-9 months following deployment. Rates of deterioration in individual and interpersonal adjustment were both significant and medium to large in magnitude of effect, d = 0.43 to 0.90. Results suggest that the negative effects of deployment are related to levels of traumatic experiences and do not spontaneously remit within the first 6-9 months following return from deployment-particularly among those service members having relatively lower levels of social support. [ABSTRACT FROM AUTHOR]

Few studies have evaluated the effectiveness of mental health treatments for the combat stress reactions of military service members treated in deployed locations. The present pilot investigation is the first report on the effectiveness of a Combat Stress Control (CSC) unit treatment for deployed service members. Thirty-eight United States military personnel (33 men and 5 women) completed a 2-day CSC unit program at Balad Air Base, Iraq. The program included individual and group treatments to reduce the symptoms of combat operational stress reactions and to improve coping strategies, stress management skills, and interpersonal relationships. Measures used included the Outcome Questionnaire-45 (OQ-45) and the Posttraumatic Stress Disorder Checklist-Military version (PCL-M). The study found significant decreases on the OQ-45 and the PCL-M. These results provide preliminary data to support the use of CSC units to treat combat operational stress reactions in the field. [ABSTRACT FROM AUTHOR]

PURPOSE. We review the role of military mental health professionals in consulting with inpatient medical patients and staff at a combat hospital and aeromedical evacuation staging facility in Iraq. CONCLUSIONS. Behavioral health consultation with medical and surgical patients during hospitalization and prior to aeromedical evacuation can help identify patients with combat stress exposure that may require future mental health follow-up. PRACTICE IMPLICATIONS. Extensive use of civilian mental health practitioners including nurse psychotherapists and psychiatric nurse practitioners will be needed to provide psychiatric care for the large number of U.S. veterans who return from deployment with combat stress related disorders. [ABSTRACT FROM AUTHOR]

Results are presented for the largest study (N = 53,692) ever conducted on the 25-item Connor-Davidson Resilience Scale (CD-RISC), a popular measure of resilience. We examined the internal consistency of the CD-RISC items and associated mean resilience levels within a sample of enlisted basic trainees in the United States Air Force. In addition, the predictive validity of the CD-RISC Total Score was examined for real-life military outcomes, including attrition from service and mental health diagnosis. The CD-RISC items demonstrated strong internal consistency. Item-level examinations of scores revealed that most trainees reported relatively high resilience. Results indicated that resilience measured at the beginning of military service is a significant predictor of (a) attrition from service and (b) obtaining a mental health diagnosis within 6 months of entry. Implications and future directions are discussed. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Active-duty military personnel face deterrents to seeking outpatient mental health treatment despite the high prevalence of posttraumatic stress disorder (PTSD) in this population. The Behavioral Health Consultation (BHC) model may be the answer for those presenting subthreshold PTSD symptoms, at high risk for PTSD due to their occupation, not interested in outpatient mental health treatment, or unable to seek such treatment due to occupational limitations. Three empirically based interventions that have been effective in managing symptoms of PTSD are summarized and then integrated into the established BHC model as suggested treatments for managing PTSD symptoms in an integrated primary care setting. Pilot data and recommendations for future research and practice are provided. [ABSTRACT FROM AUTHOR]