Protocol - Trauma and Adversity Exposure - Military

Summary of the DRRI-2:

This protocol includes the following four deployment-related subscales from the Deployment Risk and Resilience Inventory-2 (DRRI-2): Difficult Living and Working Environment; Combat Experiences; Aftermath of Battle; and Perceived Threat.

Difficult Living and Working Environment Scale

14 items from Section C: Deployment Environment, including:

• Climate
• Food quality
• Access to bathroom
• Adequate shelter
• Ability to rest
• Heavy gear

Scoring:

Each item is rated on a 5-point Likert scale (1 = Almost none of the time; 5 = Almost all of the time). Scores are summed across all items for a range of 14 to 70. Higher scores are indicative of more difficult living and working environment.

Combat Experiences Scale

17 items from Section D: Combat Experiences, including:

• Witnessed someone (from unit or civilians) wounded or killed
• Exposed to hostile or friendly fire
• Part of convoy that was attacked
• Injured in combat-related incident
• Fired weapon at enemy
• Searched for or disarmed enemy

Scoring:

Each item is rated on a 6-point Likert scale (1 = Never; 6 = Daily or almost daily). Scores are summed across all items for a range of 17 to 102. Higher scores are indicative of greater exposure to combat.

Aftermath of Battle Scale

13 items from Section E: Postbattle Experiences, including:

• Saw refugees
• Cared for injured/dying people
• Saw wounded or disfigured civilians
• Saw bodies of enemy
• Interacted with detainees
• Handled human remains

Scoring:

Each item is rated on a 6-point Likert scale (1 = Never; 6 = Daily or almost daily). Scores are summed across all items for a range of 17 to 102. Higher scores are indicative of greater exposure to the aftermath of combat.

Perceived Threat (Section G: Deployment Concerns)

12 items from Section G: Deployment Concerns, including:

• Concerned health might suffer from nuclear, biological, chemical, or infectious agent
• Danger of being wounded
• Thought would not survive
• Concerned about being taken hostage

Scoring:

Each item is rated on a 5-point Likert scale (1 = Strongly agree; 5 = Strongly disagree). Scores are summed across all items for a range of 12 to 60. Higher scores are indicative of more perceived threat.

Self-report of exposure to these events may facilitate identification of an index trauma for the assessment of PTSD symptoms (e.g., the Clinician Administered PTSD Scale or CAPS-see PTSD Symptoms, Severity and Diagnosis measure in the PhenX Toolkit).

Availability:

The Deployment Risk and Resilience Inventory-2 (DRRI-2) is available for download from the National Center for PTSD at www.ptsd.va.gov.