Page 38 - Journal of Special Operations Medicine - Summer 2014

data were missing for 24 (12.4%) participants. Race/ PTSD Symptoms
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ethnicity of the study sample was 77.3% white, 2.6% The PTSD Checklist Military Version was used to
African American, 2.1% Asian, 1.5% Native Ameri- measure PTSD symptom severity. The self-report ques-
can/Alaskan Native, 1.5% Native Hawaiian/Pacific Is- tionnaire contains 17 items that correspond to the DSM-
lander, and 2.1% other; 5.7% claimed an Hispanic or IV-TR criteria for a PTSD diagnosis on a scale ranging
Latino ethnicity. Age ranged from 21 to 48 years (mean from 1 (“not at all”) to 5 (“extremely”). Higher scores
30.38 years, SD 5.98 years). The majority (72.2%) was indicate more severe PTSD symptoms. Internal consis-
active duty; the remaining 27.8% were in the National tency in the current sample was α = .88.
Guard/Reserve. Participants had spent an average of
9.12 years (SD 6.02 years) in the military and on av- Unit Support
erage had deployed twice (mean 2.72 times, SD 1.78 The unit support subscale of the Deployment Risk and
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times). Only 3.1% of participants had never deployed. Resilience Inventory (DRRI) measures unit support
Rank distribution was 24.7% junior enlisted (E3-E4), both on a vertical level (i.e., unit support among com-
30.9% noncommissioned officers (E5-E6), 11.8% se- manding officers and subordinates) and the horizontal
nior noncommissioned officers (E7-E9), and 19.5% of- level (i.e., unit support among fellow team members).
ficers (O1-O5). Respondents indicate how much they agree with each of
12 items on a scale ranging from 1 (“strongly disagree”)
Procedures to 5 (“strongly agree”). Higher scores indicate greater
Participants were recruited voluntarily from seven Air perceived levels of support. Internal consistency in the
Force rescue squadrons. All PJs and CROs were eligi- current sample was α = .72.
ble for participation; there were no exclusion criteria.
Members of the research team visited each research site Combat Trauma Exposure
to provide information about the study to participants The Combat Experiences Scale (CES) of the DRRI was
and to answer any questions. Informed consent docu- used to measure intensity of combat trauma exposure.
ments were distributed to all personnel and reviewed The CES assesses the frequency with which respondents
without unit leadership present to minimize potential experienced combat trauma such as going on patrols,
coercion; personnel were informed that participation shooting or being fired on, and directly witnessing
was voluntary, that data would be stored external to someone being wounded or killed. The scale assesses the
the Air Force on a secured university database managed frequency of 24 combat experiences while deployed on
by one of the researchers (C.J.B.), and that identifiable a scale ranging from 1 (“never”) to 5 (“daily or almost
data would not be shared with Air Force leadership. daily”). Higher scores indicate more intense exposure to
Survey packets were then distributed to personnel who combat. Internal consistency in the current sample was
consented to participate. On completion, participants α = .90.
returned survey packets to research staff. Completed
survey packets were then hand-carried or mailed to Medical Trauma Exposure
the University of Utah for data entry by research assis- The Aftermath of Battle Scale (ABS) of the DRRI was
tants. Data were deidentified before analysis. Approval used to measure intensity of medical trauma exposure.
for the current study was obtained from the USAF In- The ABS assesses the frequency with which respondents
stitutional Review Board located at the Wilford Hall experienced traumas associated with the outcome or
Ambulatory Surgical Center, Lackland Air Force Base, consequences of battle such as seeing devastated com-
Texas. munities, injured or wounded personnel, dead bodies,
and handling human remains. The scale assesses the fre-
quency of 15 aftermath experiences while deployed on
Measures a scale ranging from 1 (“never”) to 5 (“daily or almost
daily”). Higher scores indicate more intense exposure
Depression to aftermath events. Internal consistency in the current
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The Patient Health Questionnaire-9 was used to mea- sample was α = .92.
sure depression symptom severity. This self-report ques-
tionnaire includes nine items that measure frequency of Data Analysis
depression symptoms on a scale that ranges from 0 (“not Frequency and descriptive analyses were conducted to
at all”) to 3 (“nearly every day”), consistent with Diag- determine combat exposure levels. Generalized linear
nostic and Statistical Manual of Mental Disorders, 4th regression with robust maximum likelihood estimation
Edition, Text Revision (DSM-IV-TR) diagnostic criteria was used to test the associations of unit support with
for major depressive disorder. Higher scores indicate PTSD and depression symptom severity. Although re-
more severe depression symptoms. Internal consistency gression analysis is similar to correlation analysis, the
(Cronbach α) in the current sample was .73. regression analysis provides additional information that

28 Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014