Universitet Perceived danger during deployment

The potential stressors associated with military deployment are related to an increased risk of adverse mental health outcomes. Perceived exposure to combat has been found to be proportional to the severity of post-deployment posttraumatic stress disorder (PTSD). However, other perceived adversities during deployment, such as witnessing danger, distress, and hardship in the war zone, have been less systematically studied, but might play an equally substantial role for post-deployment mental health. The development and validation of scales that assess these related constructs are needed to distinguish their contribution to post-deployment risk of PTSD. We evaluated the validity of 10 items measuring perceived danger distributed to all deployed personnel with the Danish Defense since 1998. We hypothesize two scales: Exposure to Danger and Combat (EDC) and Witnessing Consequences of War (WCW). Two military cohorts deployed to Afghanistan in 2009 (Cohort 1, N = 276) and 2013 (Cohort 2, N = 273) were included. Questionnaire data was collected six months after homecoming, including deployment experiences and postdeployment reactions. We tested the construct validity of the 10 items of perceived danger with Rasch models (RM), focusing specifically on presence of subscales, and differential item functioning (DIF) across cohorts. We confirmed the existence of two separate subscales, EDCS and WCWS, both with adequate reliability. None of the subscales fitted a pure RM, but adequate fit was found for graphical log-linear RMs with evidence of DIF for the ECDS. However, adjusting the score to account for DIF had practically no effect, suggesting that the total non-adjusted mean score can be used in future cohort comparisons. Perceived exposure to combat and danger and witnessing consequences of war are related, but essentially distinct, concepts, each providing unique information about deployment adversities. Future studies should evaluate their shared and unique contribution to the risk of post-deployment PTSD. Los estresores potenciales asociados al despliegue militar se relacionan con un mayor riesgo de presentar eventos adversos en salud mental La percepción de exposición al combate ha resultado ser proporcional a la severidad del trastorno por estrés post-traumático (TEPT) posterior al despliegue militar. Sin embargo, otras adversidades percibidas durante el despliegue, tales como experimentar peligro, angustia, y dificultades en la zona de guerra, han sido menos sistemáticamente estudiadas, pero podrían jugar un rol sustancialmente equivalente para el impacto en la salud mental posterior al despliegue militar. Se requiere desarrollar y validar escalas que evalúen estos constructos relacionados para distinguir su contribución al riesgo de desarrollar TEPT posterior al despliegue. El objetivo es evaluar la validez de 10 ítems que miden el peligro percibido distribuido a todo el personal desplegado con la Defensa Danesa desde 1998. Se hipotetizan dos escalas; Exposición a Peligro y Combate (EDC) y Exposición a Consecuencias de Guerra (WCW). Se incluyó a dos cohortes militares, que se desplegaron en Afganistán el año 2009 (Cohorte 1, N=276), y el 2013 (Cohorte 2, N=273). Se recopiló datos a partir de cuestionarios seis meses después de regreso al país de origen, incluyendo experiencias dentro del despliegue y reacciones posteriores a éste. Se probó en las cohortes la validez de constructo de los 10 ítems de peligro percibido con modelos Rasch (RM), poniendo especial énfasis en la presencia de subescalas, e Ítem de funcionamiento diferencial (DIF). Se confirmó la existencia de dos subescalas separadas, EDC y WCW, ambas con fiabilidad adecuada. Ninguna de las subescales correspondía a un modelo Rasch puro, pero sí se encontró una relación adecuada para un modelo Rasch logarítmico-lineal con evidencia de DIF para EDC. No obstante, el ajustar el puntaje para explicar el IFD prácticamente no tuvo efectos, ARTICLE HISTORY Received 12 October 2017 Accepted 16 May 2018