Student Research: William Callis

MPH, , 2009
Faculty Advisor:

The Relationship between Self-Reported Morale and Post-Deployment Mental Illness: A Retrospective Cohort Time to Event Analysis


BACKGROUND: At Fort Lewis, Washington, the Soldier Wellness Assessment Program questionnaire (SWAP) is given 90 days following deployment. It is similar to a Post Deployment Health Re-Assessment (PDHRA),however the SWAP contains a set of questions defined as morale. These SWAP morale related questions ask the soldier about their feelings of importance of work, fellow soldier relationships and leadership climate. The fellow soldier relationship and leadership climate part of morale questions are similar to emotional/social support mentioned in previous studies. While morale related screening questions are asked in the SWAP, the association of soldier morale and post-deployment mental illness is not well understood. This proposed study is a logical next step of research because identification of an association between self reported morale and post-deployment mental illness could provide an alternative means of screening and be of great value.

METHODS: In this study, we will use a time-to-event retrospective analysis of data from a cohort of soldiers to examine potential relationships between self-reported morale and the incidence of post-deployment mental illness. The study population is Fort Lewis soldiers who returned in 2006 from deployment in Iraq or Afghanistan (2006 cohort). The Fort Lewis SWAP database will provide soldier responses to a questionnaire completed 90 days after return from deployment, including limited demographic information, traumatic exposure(s), and level of morale. The Fort Lewis Health Outcomes Management Metrics Section database will provide ICD-9 codes for mental health diagnoses occurring in the 2006 cohort as of September 2008. Survival analysis will be used to examine the incidence of selected mental illness diagnoses found department of defense wide within 20 months after completion of SWAP, compared to the level of morale.

RESULTS: We anticipate an increased incidence of mental health illness diagnoses with the self report of low morale.

CONCLUSIONS: The identification of a new screening marker by evaluating the relationship between morale level and the incidence of post deployment mental health illnesses could be of value to the Department of Defense.