Hoge, Charles, Carl A. Castro, Article Critique

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12). Greater frequency and intensity of combat experiences in Iraq was seen as the reason for the discrepancy.

The research was conducted through the auspices of the U.S. military and the response rate was 98%. Unit leaders assembled the soldiers and the investigators then briefed them and obtained their written consent. It should be noted that the researchers were themselves military personnel and thus were likely relatable figures for the study's members, and could 'speak the language' of the subjects (Hoge 2004, p.8). Major depression and generalized anxiety were measured with the use of a patient health questionnaire developed for a general population group while the presence or absence of PTSD was evaluated with the use of the 17-item National Center for PTSD Checklist of the Department of Veterans Affairs. Thus the instruments combined both civilian and military psychological inventories. The relatively brief survey took 45 minutes to complete and focused on current symptoms. There were also two questions regarding alcohol 'misuse' and questions about the severity of stress, emotional problems, and family problems experienced by the respondents. Participants were then asked whether they were interested in receiving help and asked about their past use of mental health services and perceived barriers to treatment such as stigmatization.

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Overall, it was found that 9% of soldiers were deemed to be at risk for mental disorders before combat deployment, and as many as 11% to 17% were at risk for such disorders 3 to 4 months after their return. Only 38% to 45% indicated an interest in receiving mental health services, and only 23% to 40% reported having received professional help in the past year (Hoge 2004, p.12).

Results between the different groups were surprisingly similar, despite the demographic discrepancies between the units. The rate of mental health complaints was only slightly lower for officers. The investigators granted that a cross-sectional approach is somewhat less accurate than a longitudinal approach. However, given the similarities between the Army and Marine units, and the units deployed to Afghanistan and Iraq, overall the conclusion that a more aggressive means of helping returning veterans seemed supported. Furthermore, the fact that logistics prevented the survey from being administered to the most severely injured veterans suggested that its findings were relatively conservative (Hoge 2004, p.14). The authors recommended making screening for PTSD and major depression routine in primary care setting, and making greater efforts to destigmatize the solicitation of mental health services (Hoge 2004, p.15).

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