Longitudinal mental health screening results among postdeployed U.S. soldiers preparing to deploy again.

Mental health concerns have been documented in soldiers postdeployed from Iraq or Afghanistan, but information is limited regarding individuals directed to deploy again. Routine screening assessed symptoms of posttraumatic stress disorder, depression, anxiety, panic, and hazardous alcohol consumption among 443 soldiers after returning from deployment and again before the next deployment. Initial rates for meeting screening criteria were under 9% with most around 5%. The average number of symptoms reported for depression, anxiety, and alcohol consumption decreased from first to second screening, as did the percentage of participants who met screening criteria for hazardous alcohol consumption. No change was observed on other screening measures. The findings suggest that mental health symptoms remain stable or decline for soldiers repeating deployment.

Soldier evaluation of the virtual reality Iraq.

Repeated combat deployments to Iraq and Afghanistan are resulting in increased rates of posttraumatic stress disorder (PTSD) among military personnel. Although exposure therapy is an effective treatment for this disorder, some personnel do not significantly respond to treatment, possibly due to poor activation of the trauma memory or a lack of emotional engagement during therapy. In addition, some service members do not seek mental healthcare due to treatment stigma. Researchers recently developed a virtual reality (VR) Iraq to attempt to improve activation of the traumatic memory during exposure therapy and to provide a treatment approach that may be more appealing to some service members, relative to traditional face-to-face talk therapy. Initial validation of the application requires an assessment of how well it represents the experiences of previously deployed service members. This study evaluated the realism of the VR Iraq application according to the subjective evaluation of 93 U.S. Army soldiers who returned from Iraq in the last year. Those screening negative for PTSD used and evaluated a VR tactical convoy and a VR dismounted patrol in a simulated Middle Eastern city. Results indicated that 86% of soldiers rated the overall realism of the VR convoy as ranging from adequate to excellent. Eighty-two percent of soldiers reported adequate-to-excellent overall realism of the city environment. Results provide evidence that the VR Iraq presents a realistic context in which VR exposure therapy can be conducted. However, clinical trials are needed to assess the efficacy of VR exposure therapy for Iraq veterans with PTSD.

Association between number of deployments to Iraq and mental health screening outcomes in US Army soldiers.

OBJECTIVE: High rates of mental health concerns have been documented in US Army soldiers deployed in support of Operation Iraqi Freedom. The goal of this study was to compare the postdeployment mental health screening results of US Army soldiers with 1 or 2 deployments to Iraq. METHOD: Routine mental health screening data collected from September 7, 2005, to April 27, 2007, in the Soldier Wellness Assessment Program were compared between soldiers evaluated after their first or second deployment to Iraq (n=1322). Standardized measures (Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, Primary Care Posttraumatic Stress Disorder Screen, Alcohol Use Disorders Identification Test) were used to screen for posttraumatic stress disorder (PTSD), panic, other anxiety, major depression, other depression, and hazardous alcohol consumption 90 to 180 days after the soldiers returned from Iraq. RESULTS: There was a significant association between number of deployments and mental health screening results such that soldiers with 2 deployments showed greater odds of screening positive for PTSD (odds ratio [OR]=1.64, P=.001). Similar results were observed when the analyses were repeated utilizing a more conservative cut-point for PTSD (OR=1.60, P=.001). After adjustment for demographic characteristics, the results were unchanged. There was no association between the number of deployments and other mental health screening results. CONCLUSIONS: These results provide preliminary evidence that multiple deployments to Iraq may be a risk factor for PTSD. However, these cross-sectional data require replication in a longitudinal study.