Psychometrics of Behavioral Health Screening Scales in Military Contexts

Abstract

A major task for military and civilian mental health practitioners is to screen United States service members/military personnel for an array of mental health problems (e.g., depression, alcohol abuse, suicidal ideation, posttraumatic stress disorder [PTSD]) before further assessment leading to diagnosis of mental disorders. During the assessment of such mental health problems, screening scales should be not only reliable and valid, but also have clinical utility in the military context. Busy clinicians may not have enough time to determine which screening scales meet minimal psychometric standards and proven clinical utility with predeployment or postdeployment soldiers on active duty. A sample of screening scales was identified during a thorough review of the peer-reviewed psychometric literature, textbooks on psychometrics, and the American Psychological Association PsycINFO database. Selection criteria (e.g., acceptable psychometric properties, previously used in the military context) resulted in the identification of 7 core (first-order description) screening scales recommended in the assessment of mental health problems within the military context. Core scales were organized across 4 clinical domains: general mental health functioning (e.g., Behavior and Symptom Identification Scale [BASIS]), self-harm and risk-taking behaviors (e.g., Suicide Intent Scale [SIS]), assessment of PTSD (e.g., PTSD Checklist [PCL]) and Anger Reactions (e.g., Dimension of Anger Reaction Scale [DAR]), and assessment of substance abuse/dependence (e.g., Alcohol Use Disorders Identification Test -AUDIT). For each core scale, alternative scales were also selected using similar selection criteria. Implications of the study findings for the practice of military and civilian psychologists in the Department of Defense (DoD) are discussed.