Low validity of self-report in identifying recent mental health diagnosis among U.S. service members completing Pre-Deployment Health Assessment (PreDHA) and deployed to Afghanistan, 2007: a retrospective cohort study

Nevin, Remington L.
January 2009
BMC Public Health;2009, Vol. 9, p376
Academic Journal
Background: Since 1998, the U.S. Armed Forces has used the mandatory Pre-Deployment Health Assessment (PreDHA) screening questionnaire as a means of assessing the health and suitability of U.S. service members for deployment. Limited data exists to quantify the validity of the self-reported PreDHA. This study was conducted to assess the validity of self-reporting in PreDHA to identify deployed service members who have had a recent mental health disorder diagnosis. Methods: A retrospective cohort study was conducted on 15,195 U.S. service members deployed in support of combat and reconstruction operations in Afghanistan. The Defense Medical Surveillance System (DMSS), the DoD's longitudinal medical surveillance database, was queried to identify cases among the cohort with a recent diagnosis of a pertinent mental health disorder and to obtain those subjects' responses to the PreDHA. Results: Of the study cohort, 11,179 (73.6%) subjects had a PreDHA available within the DMSS at the time of analysis. A total of 615 subjects (4.0%) had one or more mental health disorder diagnoses during the pre-deployment period. Out the 615 subjects with diagnosed mental health disorders, 465 had a PreDHA. Among these, only 224, not quite half, answered in the affirmative to the PreDHA question: "During the past year, have you sought counseling or care for your mental health?" Conclusion: This study demonstrates that the self-reported PreDHA has low validity for identifying service members with diagnosed mental health disorders. The development of electronic decision-support systems which automatically screen electronic health records to identify high-risk service members may prove a valuable component of improved pre-deployment screening processes.


Related Articles

  • Suicidal and Homicidal Soldiers in Deployment Environments. Hill, Jeffrey V.; Johnson, Robert C.; Barton, Richard A. // Military Medicine;Mar2006, Vol. 171 Issue 3, p228 

    Suicidal and homicidal soldiers present one of the most frequent and challenging scenarios for deployed mental health providers. A chart review of 425 deployed soldiers seen for mental health reasons found that 127 (nearly 30%) had considered killing themselves and 67 (nearly 16%) had considered...

  • Combat Duty in Iraq and Afghanistan, Mental Health Problems and Barriers to Care. Hoge, Charles W.; Castro, Carl A.; Messer, Stephen C.; McGurk, Dennis; Cotting, Dave I.; Koffman, Robert L. // U.S. Army Medical Department Journal;2008, p7 

    BACKGROUND The current combat operations in Iraq and Afghanistan have involved US military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health of members of the armed services who have participated in these operations and to...

  • Mental Health Professionals Find Fewer Problems Than Expected in Desert Storm. Gunby, Phil // JAMA: Journal of the American Medical Association;2/6/91, Vol. 265 Issue 5, p559 

    Reports on the mental health of U.S. soldiers participating in the 1991 Operation Desert Storm. Mental health screening of the soldiers; Factors that influence the good mental health of the soldiers; Changes in combat psychiatry.

  • Acute military psychiatric casualties from the war in Iraq. Turner, Mark A.; Kiernan, Mathew D.; McKechanie, Andrew G.; Finch, Peter J. C.; McManus, Frank B.; Neal, Leigh A. // British Journal of Psychiatry;Jun2005, Vol. 186, p476 

    Background The view that most military personnel evacuated from war zones are suffering from combat stress reactions, or are otherwise traumatised by the horrors of war, has an impact on all aspects of military psychiatry. Aims To delineate the reasons for psychiatric aeromedical evacuation from...

  • Validation of the Deployment Risk and Resilience Inventory in French-Canadian Veterans: Findings on the Relation Between Deployment Experiences and Postdeployment Health. Fikretoglu, Deniz; Brunet, Alain; Poundja, Joaquin; Guay, St�phane; David Pedlar // Canadian Journal of Psychiatry;Oct2006, Vol. 51 Issue 12, p755 

    Objectives: This study had a twofold purpose: to validate the French-Canadian version of a measure of deployment risk and resilience factors and to examine the relation between deployment risk and resilience factors and postdeployment functioning. Method: Canadian veterans at an outpatient...

  • WOUNDS THAT DON'T BLEED. Zabriskie, Phil // Time;11/29/2004, Vol. 164 Issue 22, p40 

    Looks at the severe stress American troops are under in Iraq. How the men and women are under fire from the moment they arrive to the moment they leave; Uncertainty of knowing where attacks will come from; Comments from Navy Captain Bill Nash, a psychiatrist who heads the Marines' Operational...

  • Mental Health Care Provision in the U.K. Armed Forces. Pinder, Richard J.; Fear, Nicola T.; Wessely, Simon; Reid, Geoffrey E.; Greenberg, Neil // Military Medicine;Oct2010, Vol. 175 Issue 10, p805 

    Like the United States, the United Kingdom (U.K.) population expresses ongoing interest in the mental health of their nation's armed forces and veterans. Current U.K. military mental health research efforts center on the work of military anti civilian academics based at King's College London....

  • Coming Home. Kiser, Kim // Minnesota Medicine;Dec2007, Vol. 90 Issue 12, p10 

    The article focuses on the role of physicians in understanding the physical and mental health of returning soldiers in the U.S. It discusses the complexities faced by attending physicians and how they could help manage the transitional problems of returning soldiers. It also presents several...

  • Cohort Profile Update: The China Jintan Child Cohort Study. Jianghong Liu; Siyuan Cao; Zehang Chen; Raine, Adrian; Hanlon, Alexandra; Yuexian Ai; Guoping Zhou; Chonghuai Yan; Leung, Patrick W.; McCauley, Linda; Pinto-Martin, Jennifer; Liu, Jianghong; Cao, Siyuan; Chen, Zehang; Ai, Yuexian; Zhou, Guoping; Yan, Chonghuai; Jintan Cohort Study Group // International Journal of Epidemiology;Oct2015, Vol. 44 Issue 5, p1548 

    The China Jintan Child Cohort study began in 2004 with 1656 pre-school participants and a research focus on studying the impact of environmental exposures, such as lead, on children's neurobehavioural outcomes. This population cohort now includes around 1000 of the original participants, who...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics