How Much Distress Is Too Much on Deployed Operations? Validation of the Kessler Psychological Distress Scale (K10) for Application in Military Operational Settings

The aim of this study was threefold: (a) to assess the factor structure of the Kessler Psychological Distress Scale (K10) to determine whether interpreting the scale as a single dimensional measure of psychological distress is justified in military operational setting; (b) to validate the K10 for mental health surveillance in operational settings against self-reported occupational impairment; (c) to evaluate whether the K10 has better discriminatory power than de facto standards for mental health surveillance on deployment, namely the Patient Health Questionnaire and the Posttraumatic Stress Disorder Checklist, Civilian version. A convenience sample of Canadian Armed Forces personnel serving in Afghanistan (N = 1,264) completed self-report measures of psychological distress and occupational impairment. On examination of 6 competing models, the authors determined that interpreting the K10 as a measure of unspecified psychological distress is justified. Using receiver operating characteristic (ROC) curve analysis, they identified new cutoff values for dichotomous and polychotomous scoring methods. After comparing the area beneath the ROC curves for each of the 3 mental health surveillance questionnaires, the authors determined that all measures perform well as predictors of self-rated occupational impairment, with values ranging from .86 to .90. These results highlight the importance of cross-setting validation and demonstrate that validating psychological screening questionnaires against self-report measures of occupational impairment can be a useful strategy for understanding the manifestation of psychological distress on deployed military operations.     

Methylphenidate improves some but not all measures of ATTENTION,as measured by the TEA-Ch in medication-naïve children with ADHD

The Test of Everyday Attention for Children (TEA-Ch) is a reliable neuropsychological assessment of attention control in children. Methylphenidate (MPH) is an effective treatment to improve attentional difficulties in children with attention deficit/hyperactivity disorder (ADHD). Previous studies investigating the effects of MPH on attention performance of children with ADHD have produced mixed results and prior MPH usage may have confounded these results. No previous study has tested the effects of MPH on the entire TEA-Ch battery. This study investigated the effects of MPH on attention performance using the entire TEA-Ch in 51 medication-naïve children with ADHD compared with 35 nonmedicated typically developing children. All children were tested at baseline and after 6 weeks: The children with ADHD were medication-naïve at baseline, received MPH for 6 weeks and were tested whilst on medication at the second testing session. A beneficial effect of MPH administration was found on at least one subtest of each of the three forms of attention (selective, sustained, and attentional control) assessed by the TEA-Ch, independent of practice effects. MPH aided performance on the TEA-Ch tasks that were inherently nonarousing and that might require top-down control of attention. It is recommended that the TEA-Ch measures—Sky Search Count (selective attention),Score! (sustained attention), Creature Counting Time Taken for older children (attentional control), and Same Worlds (attentional control) be prioritized for use in future pharmacological studies using MPH.