The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Army or the Department of Defense.
An Examination of the Diagnostic Efficiency of Post-Deployment Mental Health Screens
Article first published online: 19 JUL 2012
© 2012 Wiley Periodicals, Inc.
Journal of Clinical Psychology
Volume 68, Issue 12, pages 1253–1265, December 2012
How to Cite
Skopp, N. A., Swanson, R., Luxton, D. D., Reger, M. A., Trofimovich, L., First, M., Maxwell, J. and Gahm, G. A. (2012), An Examination of the Diagnostic Efficiency of Post-Deployment Mental Health Screens. J. Clin. Psychol., 68: 1253–1265. doi: 10.1002/jclp.21887
The authors extend appreciation to Dr. H. Quigg Davis, Dr. Michael Jones, and Dr. Gary Southwell of the Madigan Healthcare System for their support of this research.
- Issue published online: 9 NOV 2012
- Article first published online: 19 JUL 2012
- Post-deployment screening; PDHRA;
- diagnostic efficiency;
- alcohol abuse;
To conduct a blinded study to examine the diagnostic efficiency of the Department of Defense (DoD) Post-Deployment Health Reassessment (PDHRA) screens for major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and alcohol abuse.
Participants were 148 post-deployed soldiers who were completing the PDHRA protocol. Soldiers’ mean age was 27.7 (standard deviation = 6.6) years, and 89.0% were male. Mental health professionals blinded to the PDHRA screening results administered the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition directly after the PDHRA assessment protocol.
All screens exhibited excellent negative predictive power. Sensitivity metrics were lower, consistent with the relatively low base rates observed for MDD (10.1%), PTSD (8.8%), and alcohol abuse (5.4%). Metrics obtained for the PTSD screen were consistent with previous research with a similar base rate. A two-item screen containing PTSD reexperiencing and hyperarousal symptom items revealed excellent psychometric properties (sensitivity = .92; specificity = .79). The alcohol abuse screen yielded high sensitivity (.86), but very poor precision; these metrics were somewhat improved when the screen was reduced to a single item.
The PDHRA MDD, PTSD, and alcohol abuse screens appear to be functioning well in accurately ruling out these diagnoses, consistent with a population-level screening program. Cross validation of the current results is indicated. Additional refinement may yield more sensitive screening measures within constraints imposed by the low base rates in a typically healthy population.