Research on the mental health of the UK armed forces on deployment which doesn't really say a lot because of serious methological flaws but is interesting anyway

There's a new paper on the armed forces and mental health.

Mental health of UK military personnel while on deployment in Iraq
Mulligan, K et al. 2010, BJPsych (to be published on Monday but the
embargo's been lifted).

Here's the interesting thing. Their levels of distress, according to
this study, is barely above the level of the general population. The
Adult Psychiatric MorbidtySurvey uses GHQ-12 as well if I remember
right. It comes up with a figure of about 17% of people suffering
signifcant distress. In this study personnel on deployment had a level
lof 21%.

I'm just flicking through the paper. It says a score of 4 or more on
GHQ-12 represented a case to be counted. My memory isn't great but I
thought it was scores of 8 or more that represented a proper case. I
think that's what's used in the APMS but I really can't remember. If
it's true then this would inflate the effects.

The subjects weren't random. Reasons are given however my concern is
base commanders selected the subject group. Their selection could have
been biased.

But the biggest problem I feel is attributional style and the prevailing
feminist epistomology of mental health which means measures of
self-reported pschological distress may be biased. Most of the subjects
will be of the traditional male psychological stereotype (irrespective
of gender). Their self-report of distress just like physical pain will
be much lower. The authors note the stigma in the armed forces but
there's also the problem of recognition of distress and resilience to
distress. While there are objective measures of physical pain there are
no objective measures of psychological pain.

This makes the results questionable. The results are still interesting
though.

"
Those who scored above the cut-off on the GHQ–12 were more
likely to be younger, female, in the army and of junior rather than
of senior or officer rank (online Table DS1). Stronger unit
cohesion, better perceived leadership and receipt of a predeployment
stress brief were associated with a lower likelihood
of scoring above the GHQ–12 cut-off. There was no relationship
between GHQ–12 outcome and reservist status or deployment
factors such as location in theatre or combat exposure.
"

And

"
Although there are reasons for hypothesising that, on the one
hand deployed service personnel might experience better mental
health than those not deployed, for example due to the 'healthy
worker effect' but on the other hand worse mental health due
to increased exposure to stressors, this survey found that in
practice, there seemed to be little overall effect of deployment
on mental health. It may be that the positive and negative
aspects of deployment are equally balanced. Another possible
explanation is that Operation TELIC 13 was a low operational
intensity environment, which is often characteristic of a military
operation coming towards its end. This explanation is supported
by the most recent annual US survey of personnel deployed to
Iraq, the Mental Health Advisory Team (MHAT) VI, which has
reported the lowest rate of psychological problems since 2004.
"