Service Era – Does it Matter for Assessment?

New Paper Alert!

Service era is a huge part of how military/Veterans identify themselves, and it varies during their wartime and homecoming experiences. When it comes to psychological assessment, the question is do these variations in experience become important considerations to ensure culturally competent and responsible assessment practices. This has been investigated a little, but the results have been interpreted as contradictory due to the overlap in (and inherent revisions between) the instruments compared.

A brief history: Glenn et al (2002) started asking this question with the MMPI-2. They compared response endorsement in a sample (Vietnam v Gulf 1) of those receiving PTSD Clinical Team (PCT) outpatient care and concluded that the wartime experience was different and important. Conversely, Ingram et al (2020) used the MMPI-2-RF in a nationally drawn PCT sample & found no differences (Vietnam v Gulf 1+2). I found Glenn’s differences may be a function of measure error & scale quality given the scale changes in the MMPI-2-RF. Why did I combine Gulf 1+2 given that they are considered different ears by the VA, you may ask? Because of how the data was gathered, service era was classified how it is reported within the electronic medical record system. A definite shortcoming when looking at eras. So studies on service era assessment have: (i) excluded Post-9/11 because of study age (Glenn) and (ii) Combined Gulf 1 and Post-9/11 (Gulf 2) into a single sample, despite the substantial variation in service experience

They have also only focused on the MMPI (2/2-RF). While popular, the PAI is equally widely used (Ingram et al., in press; Wright et al., 2017) and doesn’t have the same problem of scale version revisions as a potential explanation for findings (see Ingram et al, 2020) So what did we do about this shortage in the literature? We sampled Veterans from PTSD Treatment Teams (PCTs) and compared Vets from all three eras (Vietnam, Gulf, and Post-9/11) on the PAI, after controlling for Gender and Combat Exposure Severity. And what did we find?

These results are a (non-comprehensive) sample of the scales analyzed, differences interpreted were statistically important – and also clinically meaningful (i.e., greater than a medium effect / 5T points). We didn’t have item level data so couldn’t evaluate some aspects in question. Its important to note the high frequency of mean scores at or above T70, which is the PAI cut-score for clinical severity – a frequency more pronounced in Vietnam/Post-9/11.

Published by Dr. Ingram's Psychology Research Lab

I'm an assistant professor of counseling psychology at Texas Tech University and an active researcher of psychological assessment, veterans, and treatment engagement. I am also in private practice here in Lubbock Texas.

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