Development and validation of a brief warfare exposure measure among U.S. Iraq and Afghanistan war veterans: the deployment risk and resilience inventory-2 warfare exposure-short form (drri-2 we-sf)

Abstract: [Correction Notice: An Erratum for this article was reported online in Psychological Trauma: Theory, Research, Practice, and Policy on Jun 30 2022 (see record 2022-76274-001). In the original article, the following acknowledgment of funding was missing from the title page author note: “This material was based upon work supported by the United States Department of Veterans Affairs (VA), Veterans Health Administration, Patient Care Services, Health Outcomes Military Exposures Epidemiology Program as well as two VA Health Services Research and Development Service Grants “Validation of Modified DRRI Scales in a National Sample of OEF/OIF Veterans” (Project DHI 09-086, Dawne Vogt, Principal Investigator) and “Work and Family Functioning in Women Veterans: Implications for VA Service Use” (Project IIR 12-345, Dawne Vogt and Brian N. Smith, Principal Investigators).” All versions of this article have been corrected.] Objective: It is important to assess warfare experiences beyond direct combat exposure, as these exposures can negatively impact military veterans’ health. Although two validated scales from the Deployment Risk and Resilience Inventory-2 [DRRI-2] together capture a broad range of stressful warfare experiences, the length of this combined measure (30 items) is prohibitively long for some settings. Therefore, the goal of this project was to develop and validate a short form Warfare Exposure measure (DRRI-2-WE-SF). Method: U.S. veterans deployed for the wars in Iraq and Afghanistan completed questionnaires across 2 studies (study 1, N = 1046; study 2, N = 7141) to develop and validate the DRRI-2 WE-SF. Results: Study 1 involved developing the DRRI-2 WE-SF, a 9-item self-report instrument with strong internal consistency (α = .86) and large correlations with the full Warfare Exposure measure (r = .97). In study 2, the DRRI-2 WE-SF again demonstrated high levels of reliability and validity and evidenced high levels of classification accuracy (89.7% correct classification) and significant time savings (all ts > 39; all ps < .05) in comparison to the full measure. Conclusions: The DRRI-2 WE-SF is a psychometrically sound measure of direct exposures to warfare and its consequences. This measure of proximal warfare exposure retains the strong properties of the full measure while significantly reducing completion time. These properties make the DRRI-2 WE-SF a useful tool for efficiently evaluating proximal warfare exposure among individuals who have served in both combat and noncombat roles. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Read the full article
Report a problem with this article

Related articles

  • More for Researchers

    The impact of exposure to morally injurious events on posttraumatic stress symptoms among Israeli combat Veterans: a longitudinal moderated mediation model of moral injury outcomes and dispositional forgiveness

    Abstract: Background: Exposure to potentially morally injurious events (PMIEs) during military service can lead to moral injury (MI) outcomes and posttraumatic stress symptoms (PTSS). This longitudinal study examined the relationships between PMIE exposure, MI outcomes, and PTSS among Israeli combat veterans, and the potential protective role of dispositional forgiveness in these associations. Method: Participants were 169 Israeli combat veterans who participated in a six-year longitudinal study with four measurement points (T1: 12 months before enlistment, T2: Six months following enlistment- pre-deployment, T3: 18 months following enlistment- post-deployment, and T4: 28 months following discharge). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures (T2-T4) between 2019-2024. Results: Approximately 36% of participants reported exposure to PMIEs during service, with 13% exceeding the clinical threshold for probable PTSD at T4. PMIE-Betrayal at T3 was positively associated with MI outcomes of shame and trust violation at T4. The indirect effect of PMIEs on PTSS through MI outcome-Shame depended on forgiveness levels. Among veterans with low forgiveness, higher exposure to PMIE-Betrayal was associated with increased MI shame, which was linked to more severe PTSS. Conversely, for those with high forgiveness, exposure to PMIE-Self and Other was associated with decreased MI shame and subsequently reduced PTSS. Conclusion: Dispositional forgiveness moderates the relationship between PMIE exposure and MI outcomes, particularly shame, which mediates the development of PTSS. These findings highlight forgiveness as a potential target for intervention in treating moral injury and preventing PTSS among combat veterans.