Psychometric evaluation of the Suicide Cognitions Scale-Revised (SCS-R).

The measurement of self-reported suicide risk can be complicated in medical settings due to patient apprehension about the potential consequences of self-disclosure. The Suicide Cognitions Scale (SCS) was designed to assess suicide risk by measuring a range of suicidogenic cognitions (e.g., hopelessness, perceived burdensomeness) collectively referred to as the suicidal belief system. The SCS's concurrent, known groups, and prospective validity for suicidal thoughts and behaviors have previously been supported. The present study examined the factor structure, known-groups, and concurrent validity of a revised, 16-item version of the SCS (SCS-R), which removed two items that explicitly used the word "suicide" and changed item scoring from a 1-5 to 0-4 scale, thereby improving the interpretation of scores. In a sample of 2,690 primary care patients presenting for routine medical care at one of six US military clinics, results of bifactor analysis supported the scale's unidimensionality. The SCS-R significantly differentiated participants with a history of suicide attempts and was significantly correlated with frequency of thoughts about death and self-harm during the previous 2 weeks. Results align with earlier research and provide psychometric support for the SCS-R.

Improving Suicide Risk Screening to Identify the Highest Risk Patients: Results From the PRImary Care Screening Methods (PRISM) Study.

PURPOSE: Over 95% of patients who screen positive on the Patient Health Questionnaire-9 (PHQ-9) suicide risk item do not attempt or die by suicide, which could lead to unnecessary treatment and/or misallocation of limited resources. The present study seeks to determine if suicide risk screening can be meaningfully improved to identify the highest-risk patients. METHODS: Patients eligible to receive medical treatment from the US Department of Defense medical system were recruited from 6 military primary care clinics located at 5 military installations around the United States. Patients completed self-report measures including the PHQ-9 and 16 items from the Suicide Cognitions Scale (SCS) during routine primary care clinic visits. Postbaseline suicidal behaviors (suicide attempts, interrupted attempts, and aborted attempts) were assessed by evaluators who were blind to screening results using the Self-Injurious Thoughts and Behaviors Interview. RESULTS: Among 2,744 patients, 13 (0.5%) engaged in suicidal behavior in the 30 days after screening and 28 (1.0%) displayed suicidal behavior in the 90 days after screening. Multiple SCS items differentiated patients with suicidal behavior less than 30 days after screening positive for suicide risk. Augmenting the PHQ-9 suicide risk item with SCS items improved the identification of patients who were most likely to have suicidal behavior within a month of screening positive without sacrificing sensitivity. CONCLUSION: Among primary care patients who screen positive for suicide risk on the PHQ-9, SCS items improved screening efficiency by identifying those patients who are most likely to engage in suicidal behavior within the next 30 days.

NICU Fathers: Improving the Quality of Paternal Support in the NICU.

BACKGROUND: Parental support in the neonatal intensive care unit (NICU) is critical; yet, the nursing staff may struggle to provide optimal support to NICU fathers. Generally, fathers are not viewed as equally competent caregivers when compared with mothers, and fathers often impart these beliefs on themselves. Increasing the nursing staff's knowledge and understanding of paternal support can change attitudes and foster positive behavior changes, enhancing the perception of support received by NICU fathers. PURPOSE: To implement a needs assessment and educational intervention for the nursing staff designed to increase the perception of nursing support received by NICU fathers. METHODS: The Nurse Parents Support Tool (NPST) was administered to the clinical nursing staff and fathers in a pre/posttest design comparing support given by nurses with the fathers' perception of received support. Data from the preintervention assessment was used to design an educational intervention on improving fathers' support. Following the intervention, a postintervention NPST was administered to fathers to determine whether there was an improvement in support perception. FINDINGS/RESULTS: Improvement in the NICU fathers' perception of nursing staff support was noted between father groups. In addition, the NPST can be used to assess paternal support needs and develop staff education. IMPLICATIONS FOR PRACTICE: Support provided to NICU fathers can enhance the father's perception of himself as an equal and competent caregiver, leading to improved father-infant bonding as the child ages. Educational interventions targeting father support should be a routine part of nursing staff training. IMPLICATIONS FOR RESEARCH: Future research should examine the long-term effects of early paternal support on psychosocial, cognitive, and developmental outcomes of NICU infants.

The Coping Self-Efficacy Scale: Psychometric properties in an outpatient sample of active duty military personnel.

Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.

Those who died very young-Inferences from δ15 N and δ13 C in bone collagen and the absence of a neonatal line in enamel related to the possible onset of breastfeeding.

OBJECTIVES: Stable isotope analysis has often been used in neonatal remains from archeological contexts to investigate the presence of a signal of breastfeeding and weaning in past populations. Tooth histology on the other hand might be used as an indicator of birth survival. This pilot study aimed to investigate the feasibility of using stable nitrogen (δ15 N) and carbon (δ13 C) isotope values from neonatal bone collagen to elucidate if values deviating from the adult female average could indicate breastfeeding and co-occur with the presence of a neonatal line (NNL). The combination of these independent indicators might be useful in clarifying the fate of individuals who died around birth. MATERIALS AND METHODS: Bone collagen from 21 archeological human and animal specimens was extracted and analyzed via mass-spectrometry for δ15 N and δ13 C. A verification of the stable isotope results was undertaken using tooth histology on three individuals who were investigated for the presence of a NNL as an indicator of live birth and short survival. RESULTS: The biological age of the human samples varied between 8.5 lunar months (Lm) and 2 postnatal months (Pm) of age. All except one individual exhibited elevated δ15 N values compared to the female average. The histological analyses revealed no NNL for this and two further individuals (n = 3). DISCUSSION: The results indicate that elevated nitrogen values of very young infants relative to a female average in archeological contexts are not necessarily associated with a breastfeeding onset signal, and therefore cannot be used exclusively as a proxy of birth survival. The elevation might be possible due to various reasons; one could be nutritional, in particular maternal stress during pregnancy or a metabolic disorder of mother and/or her child. In those cases, the evaluation of a NNL might reveal a false breastfeeding signal as seen for two individuals in our sample who have elevated nitrogen values despite the fact no NNL could be observed. Overall, our data support the growing awareness that bone collagen δ15 N values of neonates/infants should not be used as a proxy for breastfeeding or birth survival on its own.

Improving the Process of Enteral Nutrition Preparation With Milk Technicians: Perceptions of Cost, Time, and Quality.

BACKGROUND: Neonatal intensive care nurses have historically been responsible for preparing enteral feedings--a costly and time-consuming process that may require leaving the bedside. To address these concerns, the Milk Technician Program was implemented at a major military treatment facility. Milk technicians were specially trained and responsible for handling, storing, and preparing enteral feeds. PURPOSE: To determine effectiveness of the Milk Technician Program, changes in length of time required to first attain full feeds, cost of feeding preparation, adherence to feeding preparation procedures, and nurse and milk technician role variables were evaluated. METHODS: A pre-/postdesign was used to compare length of time to full enteral feedings and cost. A plan-do-study-act design was used to evaluate protocol adherence and to identify and evaluate nurse and milk technician role variables. Data were collected via surveys, direct observations, and retrospective chart reviews to determine the overall effectiveness of this intervention. RESULTS: The average time for extremely and very preterm infants (<28 to 31 weeks) to first reach full feeds decreased from 32 to 19 days, t (33.1) = 2.33, P = .026, d = 0.704. Estimated feeding preparation cost savings for all infants admitted to the unit was $767 per day. Observed milk technician adherence to preparation procedures was 95.5%. Most nurses reported that the program saved time (97%) and all milk technicians reported improved job satisfaction. Nurses expressed concerns about accuracy and safety of preparation. Milk technicians reported concerns with communication, supplies, and lack of perceived support. IMPLICATIONS FOR PRACTICE: Milk technicians offer significant benefit to infants and nurses in the neonatal intensive care unit, including reducing time for infants to reach full feeds, saving nurses' time, and reducing costs. IMPLICATIONS FOR RESEARCH: Further research is needed to identify ideal educational backgrounds for milk technicians and to directly measure the effect of milk technicians on hospital length of stay and infant growth parameters.

The developing juvenile ischium: macro-radiographic insights.

Despite the importance of the human pelvis as a weight-bearing structure, there is a paucity of literature that discusses the development of the juvenile innominate from a biomechanical perspective. This study aims to add to the limited body of literature pertaining to this topic through the qualitative analysis of the gross architecture of the human ischium during the juvenile period. Macro-radiographs of 55 human ischia ranging from 28 intra-uterine weeks to 14 years of age were examined using intensity-gradient color mapping to highlight changes in gross structural morphology with increasing age. A clear pattern of maturation was observed in the juvenile ischium with increasing age. The acetabular component and ramus of the ischium consistently displayed low bone intensity in the postnatal skeletal material. Conversely the posterior body of the ischium, and in particular the ischial spine and lesser sciatic notch, exhibited increasing bone intensity which first arose at 1-2 years of age and became more expansive in older cohorts. The intensity patterns observed within the developing juvenile ischium are indicative of the potential factors influencing the maturation of this skeletal element. While the low intensity acetabular fossa indicates a lack of significant biomechanical interactions, the posterior increase in bone intensity may be related to the load-bearing nature of the posterior ischium.

The vascular collar of the ilium: three-dimensional evaluation of the dominant nutrient foramen.

Nutrient arteries are the predominant blood supply to endochondral bones and are particularly important during the early stages of endochondral ossification and the active growth period. These nutrient vessels traverse the periosteal shell of a developing bone to invade the disintegrating cartilage matrix and bring about endochondral bone formation. This results in the formation of a nutrient foramen which is retained as the vascular conduit between the exterior and interior of the bone. This study examined the dominant nutrient foramen of the neonatal ilium using high resolution micro-computed (micro-CT) tomography. Three-dimensional reconstruction of micro-CT data consistently demonstrated the presence of a distinctive, yet poorly reported, collar of bone extending into the trabecular cavity beyond the endosteum. This study proposes that this collar of bone may have formed in response to osteogenic signaling from approximated arterial vasculature. Additionally, it is suggested that the formation of this collar may act as a protective mechanism to the dominant nutrient vessel and as a potential biomechanical anchor for surrounding trabeculae, aiding to increase the biomechanical competency around the area of the foramen. The documentation of this osteological structure is important from a clinical perspective to prevent the misinterpretation of fracturing and pathology on plain plate radiographs and clinical computed tomography scans.

External Validation and Updating of a Statistical Civilian-Based Suicide Risk Model in US Naval Primary Care.

Importance: Suicide remains an ongoing concern in the US military. Statistical models have not been broadly disseminated for US Navy service members. Objective: To externally validate and update a statistical suicide risk model initially developed in a civilian setting with an emphasis on primary care. Design, Setting, and Participants: This retrospective cohort study used data collected from 2007 through 2017 among active-duty US Navy service members. The external civilian model was applied to every visit at Naval Medical Center Portsmouth (NMCP), its NMCP Naval Branch Health Clinics (NBHCs), and TRICARE Prime Clinics (TPCs) that fall within the NMCP area. The model was retrained and recalibrated using visits to NBHCs and TPCs and updated using Department of Defense (DoD)-specific billing codes and demographic characteristics, including expanded race and ethnicity categories. Domain and temporal analyses were performed with bootstrap validation. Data analysis was performed from September 2020 to December 2022. Exposure: Visit to US NMCP. Main Outcomes and Measures: Recorded suicidal behavior on the day of or within 30 days of a visit. Performance was assessed using area under the receiver operating curve (AUROC), area under the precision recall curve (AUPRC), Brier score, and Spiegelhalter z-test statistic. Results: Of the 260 583 service members, 6529 (2.5%) had a recorded suicidal behavior, 206 412 (79.2%) were male; 104 835 (40.2%) were aged 20 to 24 years; and 9458 (3.6%) were Asian, 56 715 (21.8%) were Black or African American, and 158 277 (60.7%) were White. Applying the civilian-trained model resulted in an AUROC of 0.77 (95% CI, 0.74-0.79) and an AUPRC of 0.004 (95% CI, 0.003-0.005) at NBHCs with poor calibration (Spiegelhalter P < .001). Retraining the algorithm improved AUROC to 0.92 (95% CI, 0.91-0.93) and AUPRC to 0.66 (95% CI, 0.63-0.68). Number needed to screen in the top risk tiers was 366 for the external model and 200 for the retrained model; the lower number indicates better performance. Domain validation showed AUROC of 0.90 (95% CI, 0.90-0.91) and AUPRC of 0.01 (95% CI, 0.01-0.01), and temporal validation showed AUROC of 0.75 (95% CI, 0.72-0.78) and AUPRC of 0.003 (95% CI, 0.003-0.005). Conclusions and Relevance: In this cohort study of active-duty Navy service members, a civilian suicide attempt risk model was externally validated. Retraining and updating with DoD-specific variables improved performance. Domain and temporal validation results were similar to external validation, suggesting that implementing an external model in US Navy primary care clinics may bypass the need for costly internal development and expedite the automation of suicide prevention in these clinics.

Preferences in Information Processing: Understanding Suicidal Thoughts and Behaviors among Active Duty Military Service Members.

The present study examined Preferences in Information Processing (PIP), an emerging model of understanding suicidal thoughts and behaviors (STBs), in a clinical military sample for the first time. Constructs of need for affect (NFA; i.e., extent to which one engages or avoids emotional content) and need for cognition (NFC; i.e., extent of preference for and enjoyment of cognitive effort) are central individual differences of the PIP model hypothesized to be associated with STBs. Data (n = 200 active duty personnel) were drawn from medical records and self-report questionnaires from two outpatient treatment settings in a military hospital. Primary findings include: (1) moderate positive bivariate associations of NFA avoidance with mental health symptoms and lifetime STBs; (2) consistent patterns in which NFA approach buffers the negative associations of depression with life STBs, clinical suicide risk, perceived burdensomeness and thwarted belonging. Recommendations are offered for military suicide prevention, and future suicide theory testing.

A psychometric assessment of the Military Suicide Attitudes Questionnaire (MSAQ).

Suicide rates remain high among military populations. Stigmatizing beliefs about suicide contribute to the problem of heightened suicide risk as a deterrent for help-seeking. Measurement of military suicide stigma is therefore an important gap in the literature as a necessity toward the development of military suicide prevention programming. This paper assessed the factor structure, reliability, and validity of the Military Suicide Attitudes Questionnaire (MSAQ). Study 1 featured secondary analysis of a suicide risk dataset from active duty treatment-seeking military personnel (N = 200). Study 2 was a secondary analysis of a statewide assessment of Army National Guard service members' beliefs about mental health and suicide (N =1116). Factor analyses results collectively supported a four-factor Military Suicide Attitudes Questionnaire (MSAQ) structure: discomfort, unacceptability, support, and empathic views. Subscale reliabilities ranged from 0.77 to 0.83 across samples. Unacceptability and support displayed significant negative correlations with psychological distress. Men displayed more negative suicide-related beliefs compared to women counterparts. Discomfort and unacceptability beliefs displayed significant positive associations with perceived barriers to care. The final short version of the MSAQ is an efficient, multi-dimensional measure of military suicide-related beliefs. The instrument can be used for public health assessment and program evaluation in military settings.

Psychometric assessment of two suicide screeners when used under routine conditions in military outpatient treatment programs.

Suicide remains a pressing problem among active-duty military personnel. Recent Department of Veterans Affairs and Department of Defense suicide prevention practice guidelines highlight the need for further screening research. The present study assessed the psychometric properties of 2 common self-report suicide screening tools: the Suicidal Behaviors Questionnaire-Revised (SBQ-R) and the Columbia Suicide Severity Rating Scale (C-SSRS) ideation subscale. Data (n = 200 active-duty personnel) were drawn from medical records and self-report questionnaires from 2 outpatient treatment settings in a military hospital. Primary findings include: (a) confirmatory factor analytic support for the SBQ-R but not the self-report version of the C-SSRS ideation severity subscale; and (b) acceptable reliability for both the SBQ-R and C-SSRS ideation severity subscale. Recommendations are offered for military suicide screening practice and research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Military parents' perceptions of separation for their younger children.

ABSTRACT: Many studies are available in the literature considering effects of deployment on older school age and adolescent children, but less is known about the effects on younger children. The purpose of this study was to describe the experience of deployment/separation for military children aged 4-10 years from both the deployed parent and stay-at-home parent's experiences. Parents completed demographics followed by an interview to describe the child's reaction to separation. Thematic analysis was used to identify children's reactions and intervention strategies. Thirty-eight families, encompassing 57 children aged 4-10 who experienced a separation or deployment within the past 2 years participated. Interviews included 24 military members and 34 spouses (most frequently the mothers) completed the interview and research instruments. Interview data revealed a turbulent experience for families resulting from frequent and repeated separations. Parents actively employed strategies garnered from military-provided materials and informal interaction with other military parents. The different perspectives provided new insights as to the strategies military families find successful during separations and will be useful in providing anticipatory guidance.

Trauma Management Therapy and Prolonged Exposure Therapy for PTSD in an active duty sample: Design and methodology of a randomized clinical trial.

Posttraumatic stress disorder (PTSD) resulting from military service is a common, yet often chronic condition. Treatment outcome often is attenuated by programs that are (a) lengthy in nature and (b) constricted in their target outcomes. These limitations leave much of the emotional and behavioral impairment that accompanies PTSD unaddressed and/or unassessed. Typical PTSD treatment programs are 3-4 months in length, which is challenging for the pace of the nation's military. In this investigation, we will compare two treatments, Trauma Management Therapy (TMT) and Prolonged Exposure (PE), both redesigned to address the needs of active duty personnel (300 participants at 3 military installations). Specifically, we will compare the TMT Intensive Outpatient Program (IOP; 3 weeks) to PE's compressed (2 week) format. Both interventions will be compared to a standard course of PE (12 weeks). In addition to PTSD symptomatology, outcome measurement includes other aspects of psychopathology as well as changes in social, occupational, and familial impairment. Potential negative outcomes of massed treatment, such as increased suicidal ideation or increased alcohol use, will be assessed, as will genetic predictors of PTSD subtype and treatment outcome. This study will inform the delivery of care for military-related PTSD and particularly the use of intensive or compressed treatments for active duty personnel.

Development of the fetal ilium--challenging concepts of bipedality.

Macroradiographs of 30 human fetal and neonatal ilia were analysed to investigate the early pattern of trabecular bone organization prior to the influences of direct weight-bearing locomotion. Consistent and well-defined patterns of internal organization were identified within the fetal and neonatal ilium, which correspond with previously recognized regions that have been attributed directly to forces associated with bipedal locomotion. This study proposes that patterns previously attributed to weight-bearing locomotive responses are present in the earliest stages of the development of this bone. It is suggested that the rudimentary scaffold seen in the fetal and neonatal ilium could indicate a predetermined template upon which locomotive influences may be superimposed and perhaps reinforced at a later age. Alternatively, this early pattern may mimic the adult form due to the effects of in-utero limb movement activity even though it is not weight bearing. This is a preliminary study that will be supported in a further communication with three-dimensional micro-computed trabecular analysis.

Iliac cortical thickness in the neonate - the gradient effect.

Recent studies of the neonatal ilium are beginning to reveal that a recognizable structural patterning of trabecular bone is present in the absence of any direct stance-related weight transfer. However, little is known about the organization of compact bone in the ilium and the way in which it is laid down during the earliest stages of development. This study investigates cortical bone thickness across both gluteal and pelvic iliac shells in the human neonatal ilium. Measurements of specific regions of interest on the iliac cortices were recorded using reconstructed micro-computed tomography scans from 30 neonatal ilia. Analysis of gluteal and pelvic cortical thicknesses revealed a distinctive patterning consistent with the expected bone distribution achieved through early bone modelling and remodelling. The analysis of this pattern is important for understanding the relationship between trabecular bone patterning and cortical bone structure in the earliest stages of pelvic development prior to locomotive influences and its response to the specific functional forces acting during this period.

Anticipating bipedalism: trabecular organization in the newborn ilium.

Trabecular bone structural organization is considered to be predominantly influenced by localized temporal forces which act to maintain and remodel the trabecular architecture into a biomechanically optimal configuration. In the adult pelvis, the most significant remodelling forces are believed to be those generated during bipedal locomotion. However, during the fetal and neonatal period the pelvic complex is non-weight bearing and, as such, structural organization of iliac trabecular bone cannot reflect direct stance-related forces. In this study, micro-computed tomography scans from 28 neonatal ilia were analysed, using a whole bone approach, to investigate the trabecular characteristics present within specific volumes of interest relevant to density gradients highlighted in a previous radiographic study. Analysis of the structural indices bone volume fraction, trabecular thickness, trabecular spacing and trabecular number was carried out to quantitatively investigate structural composition. Quantification of the neonatal trabecular structure reinforced radiographic observations by highlighting regions of significant architectural form which grossly parallel architectural differences in the adult pattern but which have previously been attributed to stance-related forces. It is suggested that the seemingly organized rudimentary scaffold observed in the neonatal ilium may be attributable to other non-weight bearing anatomical interactions or even to a predetermined genetic blueprint. It must also be postulated that whilst the observed patterning may be indicative of a predetermined inherent template, early non-weight bearing and late stance-related locomotive influences may subsequently be superimposed upon this scaffolding and perhaps reinforced and likely remodelled at a later age. Ultimately, the analysis of this fundamental primary pattern has core implications for understanding the earliest changes in pelvic trabecular architecture and provides a baseline insight into future ontogenetic development and bipedal capabilities.

Recovery from Mild Traumatic Brain Injury Following Uncomplicated Mounted and Dismounted Blast: A Natural History Approach.

Objective: The purpose of this study is to utilize a natural history approach to describe and understand symptom recovery in personnel diagnosed with a blast-related mild traumatic brain injury (mTBI) resulting from an improvised explosive device blast. Participants and Design: The population included military personnel who experienced a blast mTBI while mounted (vehicle; n = 176) or dismounted (on foot; n = 37) (N = 213). Patients had no co-morbid psychiatric or muscle-skeletal issues and were treated within 72 h of injury. Prevalence and duration of self-reported symptoms were separately analyzed by injury context (mounted vs dismounted). Results: Headache was prominently reported in both mounted (85%) and dismounted (75%) populations. The mean time from injury to return to full duty was between 7.8 d (mounted) and 8.5 d (dismounted). The dismounted population reported visual changes that lasted 0.74 d longer. Conclusion: Our analysis implicates that headache is a common and acutely persistent symptom in mTBI regardless of injury context. Additionally, patients in mounted vs dismounted injury did not report significant differences in symptom prevalence. Although knowing the injury context (i.e., dismounted vs mounted) may be beneficial for providers to understand symptom presentations and deliver accurate anticipatory guidance for patients with blast-related mTBI, no significant differences were observed in this population. This may be due to the population characteristic as the trajectory of recovery may vary for patients who were not able to return to full duty within 30 d or required higher levels of care.

Applications of Transductive Spectral Clustering Methods in a Military Medical Concussion Database.

Traumatic brain injury (TBI) is one of the most common forms of neurotrauma that has affected more than 250,000 military service members over the last decade alone. While in battle, service members who experience TBI are at significant risk for the development of normal TBI symptoms, as well as risk for the development of psychological disorders such as Post-Traumatic Stress Disorder (PTSD). As such, these service members often require intense bouts of medication and therapy in order to resume full return-to-duty status. The primary aim of this study is to identify the relationship between the administration of specific medications and reductions in symptomology such as headaches, dizziness, or light-headedness. Service members diagnosed with mTBI and seen at the Concussion Restoration Care Center (CRCC) in Afghanistan were analyzed according to prescribed medications and symptomology. Here, we demonstrate that in such situations with sparse labels and small feature sets, classic analytic techniques such as logistic regression, support vector machines, naïve Bayes, random forest, decision trees, and k-nearest neighbor are not well suited for the prediction of outcomes. We attribute our findings to several issues inherent to this problem setting and discuss several advantages of spectral graph methods.

The role of resilience and social support in predicting postdeployment adjustment in otherwise healthy Navy personnel.

The purpose of this study was to determine if resilience, social support, and exposure to combat, stressful deployment environments, and additional stressful life events predicted short-term (12 months or less) postdeployment adjustment in a relatively healthy subset of Navy service members. One hundred and thirty-two service members between 3 and 6 months postdeployment completed anonymous surveys at a deployment health center. Service members with probable post-traumatic stress disorder and those who were at risk for harm to self or others were excluded. There was relatively low variance in exposure to combat, stressful deployment environments, and additional stressful life events for this convenience sample. Although the sample was a relatively healthy subset of service members and conclusions may not be generalizable to larger populations, 56% endorsed considerable adjustment difficulties. Results of logistic regression indicated that greater resilience, greater postdeployment social support, and less stressful deployment environments predicted greater postdeployment adjustment. Resilience and postdeployment social support remained significant predictors of postdeployment adjustment when controlling for covariates. Results also suggest that individual augmentee experience may be a protective factor against postdeployment adjustment difficulties-at least in otherwise healthy service members.