Journal of Traumatic Stress
December 2016, 29, 556–562
Exploring Reliability and Validity of the Deployment Risk and
Resilience Inventory-2 Among a Nonclinical Sample of Discharged
Soldiers Following Mandatory Military Service
Hagai Maoz,1,2 Yiftach Goldwin,1 Yael Doreen Lewis,1,2 and Yuval Bloch1,2
1
The Emotion-Cognition Research Center, Shalvata Mental Health Care Center, Hod-Hasharon, Israel
2
Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
The Deployment Risk and Resilience Inventory (DRRI) is a widely used questionnaire assessing deployment-related risk and resilience
factors among war veterans. Its successor, the DRRI-2, has only been validated and used among veterans deployed for overseas military
missions, but because many countries still enforce compulsory military service, validating it among nonclinical samples of healthy
discharged soldiers following mandatory service is also a necessity. In the current study, a sample of 101 discharged Israeli soldiers
(39 males, 62 females; mean time since discharge 13.92, SD = 9.09 years) completed the DRRI-2. There were 52 participants who
completed the questionnaire at a second time point (mean time between assessments 19.02, SD = 6.21 days). Both physical and mental
health status were examined, as well as symptomatology of depression, anxiety, and posttraumatic stress disorder. Cronbach’s αs for
all latent variables in the inventory ranged from .47 to .95. The DRRI-2 risk factors were negatively associated with psychological
functioning, whereas resilience factors were positively associated with better self-reported mental health. Test-retest reliability coefficients
were generally high (Pearson correlations were .61 to .94, all p values < .01). Our study provides evidence for the reliability and validity
of the DRRI-2 in assessing salient deployment experiences among a nonclinical sample following mandatory military service.
Evidence shows that objective and subjective aspects of various military experiences may have a long-term negative impact
on physical and psychological functioning (D. King, King, &
Vogt, 2003). Among the most-examined objective deployment
risk factors is combat exposure, which is associated with
several psychological problems, including posttraumatic stress
disorder (PTSD; Kulka et al., 1990), depression (Sharkansky
et al., 2000), and substance abuse (Boscarino, 1981), as well
as physical problems such as pain (Schnurr & Spiro III, 1999).
Although other factors such as the deployed soldiers’ concerns
about family and relationship disruptions have not traditionally
received much attention in the field, studies suggest that they
may also have a negative impact on mental health, especially
for women (L. A. King, King, Vogt, Knight, & Samper, 2006;
Vogt et al., 2011).
Beyond objective aspects of the military experience, there
is also considerable evidence that subjective aspects—most
notably perceived threat—are associated with PTSD symptom
severity (D. W. King, King, Foy, Keane, & Fairbank, 1999).
Finally, significant experiences that occur before and soon after
deployment are also associated with postdeployment functioning. Among predeployment risk factors, early childhood family
environment (D. W. King, King, & Foy, 1996) and exposure to
stressful events (D. W. King et al., 1996) are both associated
with negative mental health outcomes. Among postdeployment
risk factors, the way in which the veteran is received home
after his or her military service—a form of social support—is
positively associated with overall adjustment among both
combat (Fontana & Rosenheck, 1994) and peacekeeping
(Bolton, Litz, Glenn, Orsillo, & Roemer, 2002) veterans.
Postdeployment stressful or traumatic events are negatively
associated with psychological adjustment (Green, Grace,
Lindy, Gleser, & Leonard, 1990; D. W. King et al., 1999).
The Deployment Risk and Resilience Inventory (DRRI) is
a questionnaire used to assess deployment-related risk and
resilience factors among war veterans (D. King et al., 2003; L.
A. King et al., 2006). The DRRI aims to measure psychosocial
risk and resilience factors for the postdeployment health and
well-being of war veterans. The original DRRI was developed
following the first U.S. Gulf War. The authors created the
DRRI-2 to cover a variety of deployment circumstances, which
Correspondence concerning this article should be addressed to Hagai Maoz,
The Emotion-Cognition Research Center, Shalvata Mental Health Center, HodHasharon, 45100, Israel. E-mail: hagaima@clalit.org.il
C 2016 The Authors. International Society for Traumatic Stress Studies published by The International Society for Traumatic Stress Studies. View this
article online at wileyonlinelibrary.com
DOI: 10.1002/jts.22135
This is an open access article under the terms of the Creative Commons
Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use
is non-commercial and no modifications or adaptations are made.
556
557
DRRI-2 for Discharged Soldiers After Mandatory Service
broadened the assessment of family factors throughout predeployment, deployment, and postdeployment periods and shortened the scales. To date, the DRRI-2 has only been validated
and used among groups of veterans returning from overseas
missions (e.g., Operation Enduring Freedom/Operation Iraqi
Freedom). In addition, most studies using the DRRI-2 have
focused on veterans who utilize mental health services (i.e., for
the treatment of PTSD and other trauma-related conditions)
and not on nonclinical samples (Vogt et al., 2013).
Many countries, for instance, Israel, Thailand, South Korea,
and various European countries still enforce mandatory
military service among their citizens. According to the media,
at least 67 countries currently conscript draftees and in
33 countries the duration of this military service is 18 months
or more (https://www.cia.gov/library/publications/the-worldfactbook/fields/2024.html). Even though it is now much more
common than in the past for women to serve in the military
worldwide, only four countries (i.e., Cuba, Israel, North Korea,
and Norway) require them to serve. Compulsory service differs,
depending on the country, both in terms of length of service
and type of mission. In Israel for example, men must serve for
3 years, and women for 2 years. Army service includes training,
routine security tasks sometimes conducted in high-friction
areas, and active combat duty during periods of great tension
and conflict. Obviously, not all soldiers are combat soldiers,
and a large percentage of them take part in technical and
clerical work away from conflict zones. In addition, differences
may also exist in terms of the nature of the psychosocial impact
on risk and resilience factors between veterans deployed
voluntarily for distant peace-seeking missions and soldiers
drafted for mandatory military service in their own countries.
Other differences between types of service include monetary
compensation, of which soldiers in Israel and other countries
receive little if any, for the period of compulsory service. On the
other hand, in contrast to deployed soldiers on distant peaceseeking missions, soldiers in countries that enforce mandatory
service probably have the benefit of high levels of public support. In addition, in many cases these soldiers return home once
every few weeks, and some of them even return home daily.
The aim of the current study was to validate the use of the
DRRI-2 among a nonclinical sample of discharged soldiers following mandatory military service. Conducting this validation
will contribute evidence to the use of the DRRI-2 in future
studies of the impact of mandatory military service on different
psychological functions and psychopathology. Based on previous studies, we predicted that there would be high internal
consistency (α ࣙ .7) for each of the DRRI-2 subscales. Also,
test-retest reliability was expected to be high (α ࣙ .7). We
hypothesized that emotional distress would be positively correlated with subscales containing risk factors, and negatively
correlated with measures of resilience (hypothesized effect
size ࣙ .25). In addition, we hypothesized that physical health
would not be correlated with risk and resilience factors as
measured by the DRRI-2.
Method
Participants and Procedure
The study protocol was approved by the Institutional Review
Board of the Shalvata Mental Health Center in Hod-Hasharon,
Israel. We followed standard procedures for translating
measurement instruments. Our first step was translating the
English version of the DRRI-2 to Hebrew; this was done by
group of professional translators. In the next step, another
group of translators (none of whom were involved in the first
step) back-translated the instrument into English. After that,
two bilingual psychologists resolved discrepancies between
the original and the back-translated English versions and made
the appropriate changes to the Hebrew version. Finally, a small
focus group of army veterans (n = 13) read through the Hebrew
version and checked the appropriateness of terms and items
for Israeli subjects. Only four items needed to be rephrased.
The final Hebrew version of the DRRI-2 had the exact same
number of scales and items as the original DRRI-2. All scales
retained the same response format and scoring scheme.
The sample consisted of individuals employed by the
Shalvata Mental Health Center and Tel Aviv University
who had previously completed their full army service in
the Israel Defense Forces (IDF). All participants were
Hebrew-speaking. The sample was a convenience sample of
individuals without clinical problems related to their service
in the IDF. We did not exclude participants with specific
psychopathologies (e.g., major depressive episode, PTSD).
Participants were contacted by e-mail to voluntarily participate
in the study and were asked to answer the questionnaires
anonymously using a digitally secured system that also
enabled them to sign a consent form electronically. The
outreach included 196 employees (including physicians,
therapists, researchers, administrative assistants, and others).
There were 101 participants (39 males and 62 females) who
replied. The mean age of the participants was 34.30 years
(SD = 8.71), and the mean time since discharge was 13.92 years
(SD = 9.09).
All 101 automatically received a shorter questionnaire
(Time 2) within 2 weeks of completing the first questionnaire.
Of those, 52 participated at Time 2. All participants were White;
55 were married, 41 were single, and 5 divorced. Income was
distributed as 32 above average, 41 average (9,767 NIS [new
Israeli shekel] according to the Central Bureau of Statistics in
Israel), and 28 below average. Combat had been the assignment for 27, combat support for 25, and rear echelon for 49.
This distribution appeared to reflect the distribution for the IDF
at large. The average time elapsed between the completion of
the Time 1 questionnaire and the Time 2 questionnaire was
19.02 days (SD = 6.21) and ranged between 14 and 32 days.
The 52 who completed the retest did not differ significantly
from those who did not (n = 49) in age, sex, depression, anxiety, or PTSD symptoms. Participants were not reimbursed for
their participation.
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
558
Maoz et al.
Measures
Pre-, peri-, and postservice experiences that might function
as risk or resilience factors were measured by the DRRI-2
(Vogt et al., 2013). Psychometric studies conducted with U.S.
Gulf War I and OEF/IOF veterans have provided evidence for
the high internal consistency, reliability, and validity of the
DRRI-2 (Vogt et al., 2013). Given the possible changes made
to their assignments in terms of location and mission during the
period of their service, we asked participants in this study to
base their answers on their most stressful experience or period of
service.
The DRRI-2 contains 17 scales; each scale includes 8–
18 items (overall 210 items). No item is used in more than
one scale. The Prior Stressors scale assesses exposure to stressful or traumatic life events prior to deployment and the Childhood Family Functioning scale assesses early childhood family
cohesion, accord, and closeness. The Preparedness scale assesses the extent to which the individual perceives that he or
she was prepared for deployment. The Difficult Living and
Working Environment scale assesses the individual’s exposure
to repeated or daily irritations and pressures in war or terror
zones. The Concerns about Life and Family Disruption scale
assesses the extent to which the individual worries that deployment will negatively affect important life domains (e.g., safety
of the family, relationships with spouse and children). The Deployment Social Support scale assesses the extent of assistance
and encouragement available to the individual from the military in general and from his or her unit leaders and comrades
in particular. The General Harassment scale assesses exposure
to harassment that is nonsexual, but instead occurs as a result
of the individual’s social status (e.g., inappropriate conduct toward a member of a cultural minority). The Sexual Harassment
scale assesses exposure to unwanted sexual contact or verbal
conduct of a sexual nature from other military members or
civilians in a war or terror zone. The Perceived Threat scale
assesses the extent to which the individual fears for his or her
safety and well-being in the war or terror zone. The Combat
Experiences scale assesses exposure to stereotypical warfare
experiences. The Aftermath of Battle scale assesses exposure
to various consequences of combat. The Nuclear, Biological,
and Chemical (NBC) Exposure scale assesses endorsed exposure to an array of NBC agents that the individual believes he or
she has encountered while serving in a war or terror zone. The
Post-Deployment Social Support scale assesses the extent to
which family, friends, coworkers, employers, and community
provided emotional and instrumental support to the individual
after he or she returned from deployment. The Post-Deployment
Stressors scale assesses exposure to discrete stressful life events
after deployment.
We measured depression with the Beck Depression Inventory
(BDI; Beck, Ward, & Mendelson, 1961), a 21-item, self-report
instrument that has been found to correlate well with clinical
ratings of depression (r = .72; Beck, Steer, & Carbin, 1988).
The mean BDI score was 5.99 (SD = 5.19) with high internal
Table 1
Social, Physical, and Mental Health Status at Time 1
Variable
M
SD
Range
BDI
BAI
PSS-SR
SF 12a
Physical health
Mental health
5.99
5.73
2.74
5.19
7.49
5.62
1–30
0–49
0–45
48.35
54.68
10.20
4.90
16.90–60.80
38.30–64.80
Note. N = 101. BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory; PSS-SR = PTSD Symptom Scale Self-Report; SF-12 = Short-Form Health
Survey.
a Transformed scores.
consistency (α = .82). These BDI scores indicate low levels of
depression in the sample.
We measured anxiety with the Beck Anxiety Inventory (BAI;
Beck et al., 1988), a 21-item, self-report instrument that has
been found to be highly correlated with other well-accepted
measures of anxiety (Beck et al., 1988). The mean BAI score
was 5.73 (SD = 7.49) with high internal consistency (α =
.91). These BAI scores indicate low levels of anxiety in the
sample. We measured PTSD symptoms with the self-report
version of the PTSD Symptom Scale Self-Report (PSS-SR;
Foa, Riggs, Dancu, & Rothbaum, 1993), a 17-item, self-report
instrument that assesses symptoms over the course of the last
month. It has been found to be highly correlated with one of
the most widely accepted structured interviews for PTSD, the
Clinician-Administered PTSD Scale (r = .93; Foa et al., 1993).
Again, we asked participants to base their answers on their most
stressful experience or period of service. In general, people in
the sample did not report significant PTSD symptomatology;
the mean score on the PSS-SR was 2.74 (SD = 5.62). Only one
participant had PSS-SR > 13 representing a possible diagnosis
of PTSD. In this sample, PSS-SR demonstrated high internal
consistency (α = .93).
We measured functional health status with the Short-Form
Health Survey (SF-12) Version 2 (Ware, Kosinski, TurnerBowker, & Gandek, 2002), a 12-item, self-report instrument.
The SF-12 provides eight indices of functional health status:
physical functioning; limitations due to physical problems; social functioning; bodily pain; general mental health; and limitations due to emotional problems, vitality, and general health
perceptions. The SF-12 has shown good reliability and validity
(Ware et al., 2002). Scores on physical and mental health status are reported in Table 1. The mean physical health score on
the SF-12 was 48.35 (M = 48.35, SD = 10.20), and the mean
mental health score was 54.68 (M = 54.68, SD = 4.90). These
scores represent generally good physical and mental health for
the mean age of the study group (Ware et al., 2002).
Data Analysis
We conducted analyses with SPSS Version 20.0. All tests were
two-tailed, with α < .05. Because there was very little missing
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
559
DRRI-2 for Discharged Soldiers After Mandatory Service
Table 2
Characteristics of DRRI-2 Scales at Two Time Points
Time 1 (N = 101)
Variable
Time 2 (n = 52)
n items
M
SD
Range
α
M
SD
Range
α
rtt
t
15
12
14
17
13
13
12
10
8
12
8
8
15
14
14
10
12
1.34
43.70
27.66
21.23
15.29
3.59
15.56
36.99
33.61
44.48
4.77
.79
23.97
1.91
2.10
42.0
51.7
1.41
11.41
9.88
7.58
4.63
4.63
5.72
9.04
6.90
9.90
4.67
1.80
5.88
1.74
1.87
5.91
8.62
0–6
18–60
14–54
17–64
13–41
0–26
12–36
10–50
11–40
17–60
0–20
0–13
15–45
0–8
0–7
27–50
24–60
.47
.95
.91
.91
.87
.83
.85
.93
.95
.94
.89
.70
.78
.54
.62
.85
.95
1.18
43.47
21.49
18.83
13.92
1.72
14.32
38.64
34.16
44.95
3.69
.46
23.67
1.51
1.82
43.92
52.00
1.45
11.59
7.96
3.33
1.64
2.31
3.91
7.52
7.33
9.55
3.44
1.48
6.34
1.23
1.80
5.32
8.65
0–7
25–60
14–42
17–28
12–18
0–8
12–27
17–50
10–40
23–59
0–14
0–8
15–46
0–4
0–8
31–50
27–60
.33
.96
.90
.82
.87
.69
.72
.88
.96
.93
.88
.74
.85
.21
.63
.84
.95
.76
.86
.91
.94
.84
.61
.88
.64
.82
.80
.64
.84
.73
.73
.76
.61
.70
−0.64
0.59
2.64*
1.67
2.51*
2.33*
0.64
−0.22
−0.80
0.58
0.42
1.25
0.07
0.33
−0.16
−0.28
0.92
Prior stressors
Childhood family functioning
Difficult living conditions
Combat experiences
Aftermath of battle
NBC exposure
Perceived threat
Preparedness
Deployment support
Unit social support
General harassment
Sexual harassment
Concerns about life & family
Family stressors
PD stressors
PD social support
PD family functioning
Note. NBC = nuclear, biological, and chemical; PD = postdeployment.
*p ࣘ .05.
data, no data-imputation procedures were used. Internal consistency estimates of reliability, in the form of Cronbach’s α and
Kuder-Richardson 20 coefficient α, were computed for each
of the 17 DRRI-2 scales. Linear associations between deployment risk and resilience factors, physical and/or mental health,
and social desirability were examined by computing Pearson
product-moment correlations. We used the Box-Cox normality plot to correct distribution of skewed measures (BDI, BAI,
and PSS-SR scores; Box & Cox, 1964). Adjustments for multiple tests were performed using the false discovery rate (FDR;
Benjamini & Hochberg, 1995). Test-retest reliability for each
of the scales, in the form of Pearson correlations between Time
1 and Time 2 scores, were also computed.
Results
Scores of the DRRI-2 measures are presented in Table 2. Scores
for prior stressors and difficult living conditions seemed slightly
lower than those reported among U.S. and Canadian male samples in earlier studies (Fikretoglu, Brunet, Poundja, Guay, &
Pedlar, 2006; Vogt, Smith, King, & King, 2012). Scores on
general harassment and sexual harassment items appeared to
be lower than among samples in previous studies. In addition,
scores for NBC exposure and perceived threat also appeared
lower in the current study than among the U.S. and Canadian
samples. This result is probably a reflection of the difference
between the samples: Although the American and Canadian
samples were composed of veterans returning from voluntary
military missions in faraway locations and treated in outpatient
mental health facilities, the current sample was composed of
healthy civilians.
Estimates of internal consistency and test-retest reliability
for each of the DRRI-2 subscales are reported in Table 2. For
Time 1, coefficient αs for the DRRI averaged .82 and ranged
from α = .47 to α = .95. Twelve of the 17 αs were over α = .80,
and 11 were α = .85 or above. The low estimates of internal
consistency for prior stressors (α = .47) and postdeployment
stressors (α = .62) are reasonable given that the discrete stressor
events that these scales measure are not expected to function as
covariants (Cohen, Cohen, Teresi, Marchi, & Velez, 1990). The
estimate of internal consistency for sexual harassment (α = .70)
was similar to that found in previously published reports (Vogt
et al., 2013). Estimates of test-retest reliability in the form of
Pearson product-moment correlations ranged from r = .61 to
r = .94 for each of the 17 scales (all p values were < .001).
The lowest test-retest estimates were for NBC exposure and
for two scales that measured discrete stressors (preparedness
and postdeployment social support). Estimates of test-retest
reliability between Time 1 and Time 2 were remarkably good.
Paired t tests showed no significant differences in mean scores
between T1 and T2 on all scales except the difficult living
conditions, aftermath of battle, and NBC exposure (Table 2).
Pearson correlations between DRRI-2 scales and physical
health and mental health are reported in Table 3. After adjusting
the results for multiple tests using FDR, most of the correlations
remained significant.
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
560
Maoz et al.
Table 3
Correlations of DRRI-2 Subscales With Physical and Mental Health Outcomes
Variable
Prior stressors
Childhood family functioning
Difficult living conditions
Combat experiences
Aftermath of battle
NBC exposure
Perceived threat
Preparedness
Deployment support
Unit social support
General harassment
Sexual harassment
Concerns about life & family
Family stressors
PD stressors
PD social support
PD family functioning
PCS
MCS
BDI
BAI
PSS-SR
.06
.01
.18
.24
.18
.06
.20§
.02
.02
.08
.02
.07
.25*
.11
−.07
.00
−.06
−.15
.30**
−.23
-.11
−.09
−.11
−.28**
.26*
.18
.30**
−.25*
.03
−.19
−.31**
−.26**
.21
.52**
.16
−.30**
.19
.05
.06
.11
.12
−.26**
−.18
−.37**
.34**
.02
.07
.25*
.37**
−.16
−.46**
.07
−.24*
.06
−.16
−.12
−.03
.15
−.23
−.05
−.31**
.26**
−.02
.04
.37**
.18
−.12
−.26**
.24*
−.40**
.12
.00
−.02
−.05
.03
−.31**
−.21
−.44**
.43**
.04
.08
.36**
.38**
−.24
−.43**
Note. N = 101. NBC = nuclear, biological, and chemical; PD = postdeployment; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory; PSS-SR = PTSD
Symptom Scale Self-Report; SF-12 = Short-Form Health Survey; PCS = Physical Health Composite Scale; MCS = Mental Health Composite Scale.
* p < .05. ** p < .01. False discovery rate cutoff point ± .25.
A comparison of the correlations that reached significance reveals that associations between deployment risk and resilience
factors and mental health outcomes were stronger than those between risk and resilience factors and physical health outcomes,
as would be expected given the psychosocial nature of deployment risk and resilience factors. Among predeployment and
deployment risk factors, both childhood family functioning and
difficult living conditions had small-to-moderate significant associations with mental health outcomes. Poor childhood family
functioning was also associated with more depressive, anxious,
and posttraumatic symptomatology. Of the more interpersonal
risk and resilience factors operating during deployment (general harassment, sexual harassment, and deployment and unit
social support), general harassment showed positive associations with depression, anxiety, and PTSD symptoms, whereas
unit social support showed a negative association with all of
these outcomes. As would be expected, interpersonal factors
were not associated with physical health outcomes. Preparedness was also moderately associated with depressive, anxious,
and posttraumatic symptoms. Family support during deployment was associated with higher resilience to mental health
symptoms. Finally, postdeployment risk and resilience factors
were moderately associated with mental health outcomes.
Postdeployment stressors showed small but significant associations with most domains of mental health. The absence of
family support and multiple family stressors were the strongest
factors associated with depression, anxiety, and posttraumatic
symptoms.
Discussion
The objectives of this study were to validate the DRRI-2 using
a healthy nonclinical sample of discharged soldiers following
mandatory military service and to assess the relationship between various deployment risk and resilience factors and psychological and physical functioning. Our sample differed from
previous samples that have been used to validate the DRRI and
DRRI-2 in several ways. First, most participants did not suffer
from any major psychopathologies and their physical health
was good; these are both important points given that we aimed
to validate the inventory among a nonclinical sample in the
aftermath of compulsory military service. Second, most participants in the current sample were not exposed to specific
life-threatening trauma. Third, our sample included a high percentage of women, important in that women’s military service
is becoming more and more common, and women as a group
are at a greater risk for PTSD.
The psychometric evidence for use of the Hebrew DRRI-2
among the nonclinical sample is promising; internal consistency and test-retest reliability coefficients were all quite high
and similar to previous reports (Vogt et al., 2013), suggesting
that the DRRI-2 can reliably assess salient deployment risk
and resilience factors among nonclinical groups comprised of
civilians in the aftermath of their mandatory military service.
In addition, support for the validity of the DRRI-2 has been
enhanced by the observed associations between the DRRI-2
scales and psychological health. For example, resilience factors
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
561
DRRI-2 for Discharged Soldiers After Mandatory Service
like better childhood functioning and unit social support were
associated with higher MCS scores and lower BDI, BAI, and
PSS-SR scores. Risk factors, however, like family stressors and
general harassment were associated with lower MCS scores
and higher BDI, BAI, and PSS-SR scores. Differences found
using paired t tests comparing T1 and T2 are probably related
to recall bias and the time lapse (Eisenhower, Mathiowetz, &
Morganstein, 2004).
Our analysis showed quite predictable associations between
background factors of childhood family functioning and postdeployment mental symptomatology. This association is not
necessarily related to the individual’s military service itself. The
relationship between objective dimensions of the deployment
experience and postdeployment psychological functioning can
best be seen in the significant associations between items such
as childhood family functioning and preparedness and the three
domains of psychological functioning (depression, anxiety,
and PTSD). The relationship between subjective dimensions of
the deployment experience and postdeployment psychological
functioning can best be seen in the significant, positive associations between perceived threat, unit social support, general
harassment, and family stressors and depression, anxiety,
and PTSD. These findings are in accordance with previous
studies showing a correlation between subjective experiences
such as threat appraisal and PTSD (Franz et al., 2013; Pinto,
Henriques, Jongenelen, Carvalho, & Maia, 2015). Together,
these findings highlight the importance of the role played by
subjective dimensions of the deployment experience in overall psychological functioning (D. W. King et al., 1999). The
relationship between postdeployment environment and psychological functioning can be seen in the significant associations
between postdeployment family functioning and mental health
outcomes and the significant positive associations between
postdeployment stressors and mental health outcomes. These
interesting findings are consistent with the existing literature
which shows that support from family and friends is negatively
correlated with posttraumatic cognitions (which are positively
associated with PTSD), and low family support and less
cohesion in families are associated with higher rates of PTSD
among veterans (Tsai, Harpaz-Rotem, Pietrzak, & Southwick,
2012; Woodward et al., 2015; Wright, Kelsall, Sim, Clarke,
& Creamer, 2013). Together these findings highlight both the
potential reactivating effects of additional stressors and the potential protective role of social support. As would be expected,
few deployment experiences were shown to be associated with
better physical health status. This finding resembles findings
from reports on other military samples (Fikretoglu et al., 2006;
D. King et al., 2003), and seems probable, given the psychosocial nature of the experiences assessed. It is worth mentioning
that in general, the correlations found in our study between
DRRI-2 scales concerning war experiences and mental health
symptoms are slightly weaker that those reported by Vogt
et al. (2012) in their original sample. Yet, correlations between
factors reflecting psychosocial experiences (e.g., unit social
support and family stressors) were found similarly significant
(Vogt et al., 2012). This probably reflects between-samples
differences in the nature of the military service as mentioned
above.
In interpreting our results, some limitations should be noted.
First, our study design was cross-sectional, which precludes
drawing conclusions about causality. Second, participants were
asked to recall deployment experiences many years after they
took place; the accuracy of such retrospective reports can be
affected by attribution biases and difficulty in recalling events.
Third, because most participants were healthy, the data were
not normally distributed and we had to transform it for statistical purposes—hence reduce the power of the validation of
the DRRI-2 as a screening tool. Fourth, only about 50% of the
sample completed the Time 2 assessment. This is most likely
due to the fact that the sample was a random convenient sample dependent on good will (participants were not reimbursed
and had no direct benefit from their participation in the study).
There were no differences, however, in BDI, BAI, and PSS-SR
scores between those who did and those who did not complete
the second assessment. Fifth, as a result of the nature and purpose of the study, the participants were all gainfully employed
native Israelis who spoke fluent Hebrew, characteristics which
limit the generalizability of the study regarding other groups
such as immigrants or the unemployed. Finally, the DRRI-2 is
not an exhaustive measure of deployment experiences. It does
not measure certain salient aspects of deployment experiences,
especially in the context of peacekeeping missions and certain
types of training that are characteristic of the IDF.
In conclusion, our study provided evidence for the reliability
and validity of the DRRI-2 in assessing deployment experiences
among a nonclinical sample of discharged soldiers following
compulsory military service. Deployment experiences should
be routinely assessed in studies assessing the influence of life
experiences on mental health.
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