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Trauma and Adversity Exposure - Military
Date of MHRP final approval:
Date of SC final approval:
About the Measure
Domain:
PTSD
Measure:
Definition:
Trauma and Adversity Exposure
A questionnaire to assess the participant’s exposure to potentially traumatic events
(PTEs).
This measure is used to document exposure to potentially traumatic events (PTEs) that
have sufficient characteristics (e.g., magnitude, proximity) to trigger a debilitating stress
reaction and also to adversity that may amplify impact or impede recovery. Exposure to
PTEs is associated with psychological and emotional distress, posttraumatic stress
disorder (PTSD), depression, and substance abuse and also with increased use of
health care services.
Purpose:
This measure includes two protocols. One protocol is used to screen the general
population for lifetime exposure to PTEs. Cumulative exposure is associated with
increased likelihood of developing PTSD after a new traumatic event. The other
protocol is used to screen military populations for exposure to PTEs in a warzone or
combat setting. Potentially traumatic exposures are common for military personnel in
combat.
About the Protocol
Description of
Protocol:
Selection
Rationale:
Specific
Instructions:
Protocol Text:
This protocol includes the following four self-reported, deployment-related subscales
from the Deployment Risk and Resilience Inventory-2 (DRRI-2): Difficult Living and
Working Environment (14 items); Combat Experiences (17 items); Aftermath of Battle
(13 items); and Perceived Threat (12 items). Items are rated on Likert-style scales and
added together to give a score for each scale.
The Deployment Risk and Resilience Inventory-2 (DRRI-2) is a self-administered,
widely-used, reliable, psychometrically sound instrument that captures deployment
and warzone experiences relevant to contemporary warfare (e.g., recent wars in Iraq
and Afghanistan) that have documented potential to affect the health and well-being of
military personnel and veterans.
The four subscales from the Deployment Risk and Resilience Inventory-2 (DRRI-2)
included here address exposure to potentially traumatic events experienced by
military service personnel. 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 [CAPS]—see PTSD Symptoms, Severity and
Diagnosis measure in the PhenX Toolkit).
For assessment of general (i.e., nonmilitary) potentially traumatic events, see the Life
Events Checklist for The Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (LEC-5) in the PhenX Toolkit here.
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.
Version 10 – 10/21/09
Trauma and Adversity Exposure - Military
Date of MHRP final approval:
Date of SC final approval:
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:
Version 10 – 10/21/09
Trauma and Adversity Exposure - Military
Date of MHRP final approval:
Date of SC final approval:
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).
Participant:
Source:
Language of
Source:
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.
Adults, ages 18 and older.
Vogt, D. S., Smith, B. N., King, L. A., King, D. W., Knight, J. A., & Vasterling, J. J.
(2013). Deployment Risk and Resilience Inventory-2 (DRRI-2): An updated tool for
assessing psychosocial risk and resilience factors among service members and
veterans (PDF). Journal of Traumatic Stress, 26, 710–717. Instrument available from
the National Center for PTSD at www.ptsd.va.gov.
English
Personnel and
Training Required:
Equipment Needs:
None
Protocol Type:
Requirements:
Self-administered questionnaire
None
Requirements category
Common Data
Elements:
General
References:
Required (Yes/No)
Major equipment
No
Specialized training
No
Specialized requirements for biospecimen
collection
Average time of greater than 15 minutes in an
unaffected individual
TBD by PhenX Staff
No
No
Kaloupek, D. G., Chard, K. M., Freed, M. C., Peterson, A. L., Riggs, D. S., Stein,
M. B., & Tuma, F. (2010). Common data elements for posttraumatic stress disorder
research. Archives of Physical Medicine and Rehabilitation, 91(11), 1684–1191.
King, L. A., King, D. W., Vogt, D. S., Knight, J. A., & Samper, R. E. (2006) Deployment
risk and resilience inventory: A collection of measures for studying deployment-related
experiences of military personnel and veterans. Military Psychology, 18, 89–120.
Vogt, D., Smith, B. N., King, D. W., & King, L. A. (2012). Manual for the Deployment
Risk and Resilience Inventory-2 (DRRI-2): A collection of measures for studying
deployment-related experiences of military veterans. Boston, MA: National Center for
PTSD. Available from the National Center for PTSD at www.ptsd.va.gov.
Version 10 – 10/21/09
Trauma and Adversity Exposure - Military
Date of MHRP final approval:
Date of SC final approval:
Vogt, D. S., Proctor, S. P., King, D. W., King, L. A., & Vasterling, J. J. (2008).
Validation of scales from the Deployment Risk and Resilience Inventory in a sample of
Operation Iraqi Freedom veterans. Assessment, 15(4), 391–403.
Additional Information About the Measure
Essential Data:
Related PhenX
Measures:
Derived Variables:
Current Age, Gender
Life Events, Exposure to Violence, Childhood Maltreatment, Perceived Stress,
PTSD Symptoms, Severity and Diagnosis
None
Keywords/Related
Concepts:
Trauma, Potentially traumatic event, Stress, Deployment stressor, Military adversity
Version 10 – 10/21/09