Contextual Considerations: Service Era

Here is the first of the dives into posters presented this year at the Combat PTSD conference. Great work by Tristan and Ari on this one!

There is a history of research looking at the influence of Service Era on broadband personality assessment inventory instruments (Glenn et al., 2022 [MMPI-2]; Ingram et al., 2020a[MMPI-2-RF]; Ingram et al., 2021 [PAI]). All of this work has been conducted in a PTSD Clinical Team (PCT) and has found that, except for the MMPI-2-RF, there is notable influence by service era that warrants unique clinical interpretations – even after controlling for things like combat exposure and gender. This new research presented at the 2023 Combat PTSD Conference in San Antonio expands the existing literature in a few ways:

1. It offers the first examination of Service Era outside of PCTs, providing a test of generalizability of the MMPI-2-RF’s lack of influence by service Era.
2. It provides the first evaluation of service era influence after controlling for service connection status.
3. It helps contextualize a new VA clinic sample that has not yet been evaluated as part of nation-wide datapulls (see Ingram et al., 2019; 2020a, b; 2022 – each year links to a different paper from that research project)

The results are great news. Prior service era findings for the MMPI-2-RF (i.e., that it didn’t influence scale scores beyond other demographic data) were supported. It looks like good news for less biased assessment methods for the VA when using the RF. One thing that is important to note is that the significance of the covariates seems to follow a general pattern of endorsement consistent with internalizing pathology mainly. As we continue this work and evaluate the remaining substantive scales it will be interesting to see if those patterns emerge consistent with trauma-pathology – a notable possibility in my view of the literature of VA assessment trends.

Next time I have a few I’ll write about PTSD screening with the MMPI-2 Clinical Scales and Restructured Scales (Luke’s Poster, student poster award winner!)