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The Mental Disability Military Assessment Tool: A Reliable Tool for Determining Disability in Veterans with Post-traumatic Stress Disorder

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Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose An assessment tool was developed to assess disability in veterans who suffer from post-traumatic stress disorder (PTSD) due to a military mission. The objective of this study was to determine the reliability, intra-rater and inter-rater variation of the Mental Disability Military (MDM) assessment tool. Methods Twenty-four assessment interviews of veterans with an insurance physician were videotaped. Each videotaped interview was assessed by a group of five independent raters on limitations of the veterans using the MDM assessment tool. After 2 months the raters repeated this procedure. Next the intra-rater and inter-rater variation was assessed with an adjusted version of AG09 computing weighted percentage agreement. Results The results of this study showed that both the intra-rater variation and inter-rater variation on the ten subcategories of the MDM assessment tool were small, with an agreement of 84–100 % within raters and 93–100 % between raters. Conclusions The MDM assessment tool proves to be a reliable instrument to measure PTSD limitations in functioning in Dutch military veterans who apply for disability compensation. Further research is needed to assess the validity of this instrument.

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References

  1. Horesh D, Solomon Z, Zerach G, Ein-Dor T. Delayed-onset PTSD among war veterans: the role of life events throughout the life cycle. Soc Psychiatry Psychiatr Epidemiol. 2011;46(9):863–70.

    Article  PubMed  Google Scholar 

  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington: APA; 2000 Text revision.

    Google Scholar 

  3. Mithoefer MC, Wagner MT, Mithoefer AT, Jerome L, Martin SF, Yazar-Klosinski B, et al. Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. J Psychopharmacol. 2013;27(1):28–39.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Perkonigg A, Kessler RC, Storz S, Wittchen H. Traumatic events and post-traumatic stress disorder in the community: prevalence, risk factors and comorbidity. Acta Psychiatr Scand. 2000;101(1):46–59.

    Article  CAS  PubMed  Google Scholar 

  5. Breslau N. The epidemiology of posttraumatic stress disorder: what is the extent of the problem? J Clin Psychiatry. 2001.

  6. Richardson LK, Frueh BC, Acierno R. Prevalence estimates of combat-related post-traumatic stress disorder: critical review. Aust N Z J Psychiatry. 2010;44(1):4–19.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Veteranen Instituut. Factsheet Posttraumatische Stress-Stoornis. 2007 December; tweede versie. (Veterans Institute. Factsheet Post Traumatic Stres Disorder. December 2007, the second version).

  8. McHugh PR, Treisman G. PTSD: a problematic diagnostic category. J Anxiety Disord. 2007;21(2):211–22.

    Article  PubMed  Google Scholar 

  9. Javidi H, Yadollahie M. Post-traumatic stress disorder. Int J Occup Environ Med. 2012;3(1).

  10. Resick PA, Bovin MJ, Calloway AL, Dick AM, King MW, Mitchell KS, et al. A critical evaluation of the complex PTSD literature: implications for DSM‐5. J Trauma Stress. 2012;25(3):241–51.

    Article  PubMed  Google Scholar 

  11. O’Brien LS. Traumatic events and mental health. Cambridge: Cambridge University; 1998.

    Book  Google Scholar 

  12. Klein S, Alexander DA. Epidemiology and presentation of post-traumatic disorders. Psychiatry. 2006;5(7):225–7.

    Article  Google Scholar 

  13. Neal LA, Green G, Turner MA. Post-traumatic stress and disability. Br J Psychiatry. 2004;184:247–50.

    Article  PubMed  Google Scholar 

  14. Tsai J, Rosenheck RA. Examination of Veterans Affairs disability compensation as a disincentive for employment in a population-based sample of Veterans under age 65. J Occup Rehabil. 2013;23(4):504–12.

    Article  PubMed  Google Scholar 

  15. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–63.

    Article  CAS  PubMed  Google Scholar 

  16. Seal KH, Bertenthal D, Miner CR, Sen S, Marmar C. Bringing the war back home: mental health disorders among 103–788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs Facilities. Arch Intern Med. 2007;167(5):476–82.

    Article  PubMed  Google Scholar 

  17. Frueh BC, Elhai JD, Gold PB, Monnier J, Magruder KM, Keane TM, et al. Disability compensation seeking among veterans evaluated for posttraumatic stress disorder. Psychiatr Serv. 2003;54(1):84–91.

    Article  PubMed  Google Scholar 

  18. Hathaway SR, McKinley JC. Manual for the Minnesota Multiphasic Personality Inventory (MMPI). New York: Psychological Corporation; 1943.

  19. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893.

    Article  CAS  PubMed  Google Scholar 

  20. Beck AT, Steer RA. BDI, Beck Depression Inventory: manual. New York: Psychological Corporation; 1987.

    Google Scholar 

  21. Keane TM, Caddell JM, Taylor KL. Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: three studies in reliability and validity. J Consult Clin Psychol. 1988;56(1):85.

    Article  CAS  PubMed  Google Scholar 

  22. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986;174(12):727–35.

    Article  CAS  PubMed  Google Scholar 

  23. Sheehan D, Harnett-Sheehan K, Raj B. The measurement of disability. Int Clin Psychopharmacol. 1996;11:89–95.

    Article  PubMed  Google Scholar 

  24. Frueh BC, Smith DW, Barker SE. Compensation seeking status and psychometric assessment of combat veterans seeking treatment for PTSD. J Trauma Stress. 1996;9(3):427–39.

    Article  CAS  PubMed  Google Scholar 

  25. Spanjer J, Krol B, Brouwer S, Popping R, Groothoff JW, Van der Klink JJ. Reliability and Validity of the Disability Assessment Structured Interview (DASI): a tool for assessing functional limitations in claimants. J Occup Rehabil. 2010;20(1):33–40.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Advies Commissie WPC-PIM. Schade in Schalen,- de psyche in beeld. Het vaststellen van de mate van psychische invaliditeit in het kader van de militaire pensioenvoorschriften. 2005. (Advisory Committee on WPC-PIM. To assess severity and limitations due to mental disorders in the context of military pension).

  27. VSNU. Gedragscode wetenschapsbeoefening. (Code of research behavior). Available at the website of the Association of Universities in The Netherlands. 2012. www.vsnu.nl.

  28. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20(1):37.

    Article  Google Scholar 

  29. Scott WA. Reliability of content analysis: the case of nominal scale coding. Public Opin Q.1955.

  30. Cicchetti DV, Feinstein AR. High agreement but low kappa: II. Resolving the paradoxes. J Clin Epidemiol. 1990;43(6):551–8.

    Article  CAS  PubMed  Google Scholar 

  31. Spanjer J, Krol B, Popping R, Groothoff JW, Brouwer S. Disability assessment interview: the role of detailed information on functioning in addition to medical history-taking. J Rehabil Med. 2009;41(4):267–72.

    Article  PubMed  Google Scholar 

  32. Popping R. Ag09 A computer program for interrater agreement for judgments. Soc Sci Comput Rev. 2010;28(3):391–6.

    Article  Google Scholar 

  33. Cicchetti DV. A new measure of agreement between rank ordered variables. Proceedings of the Annual Convention of the American Psychological Association: American Psychological Association; 1972.

  34. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.

    Article  CAS  PubMed  Google Scholar 

  35. Slebus FG, Kuijer PP, Willems JH, Frings-Dresen MH, Sluiter JK. Work ability assessment in prolonged depressive illness. Occup Med. 2010;60(4):307–9.

    Article  CAS  Google Scholar 

  36. Hendriks EJ, Brandsma JW, Heerkens YF, Oostendorp RA, Nelson RM. Intraobserver and interobserver reliability of assessments of impairments and disabilities. Phys Ther. 1997;77(10):1097–106.

    CAS  PubMed  Google Scholar 

  37. Rootmensen GN, van Keimpema AR, Jansen HM, de Haan RJ. Predictors of incorrect inhalation technique in patients with asthma or COPD: a study using a validated videotaped scoring method. J Aerosol Med Pulm Drug Deliv. 2010;23(5):323–8.

    Article  PubMed  Google Scholar 

  38. Toro B, Nester CJ, Farren PC. Inter- and intraobserver repeatability of the Salford Gait Tool: an observation-based clinical gait assessment tool. Arch Phys Med Rehabil. 2007;88(3):328–32.

    Article  PubMed  Google Scholar 

  39. Brouwer S, Dijkstra P, Gerrits E, Schellekens J, Groothoff J, Geertzen J, et al. Intra-en inter-beoordelaarsbetrouwbaarheid ‘FIS-Belastbaarheidspatroon’en ‘Functionele mogelijkhedenlijst’. (Intra- and interrater reliability ‘FIS capacity profile’ and ‘Functional ability list’.) TBV–Tijdschrift voor Bedrijfs-en Verzekeringsgeneeskunde. 2003;11(12):352–360.

  40. De Raad J, Mooren RJ, de Boer H. De incidentie van erkende, uitzendgerelateerde psychische klachten onder militairen bij pensioenkeuringen van 2008 tot en met 2010. TBV- Tijdschrift voor Bedrijfs-en Verzekeringsgeneeskunde 2012;20(6):261–265. (The incidence of RNLA-personnel, declared unfit for duty, due to psychiatric complaints, related to deployment on a mission between 2008 and 2010).

  41. Rondinelli RD, Genovese E, Brigham CR. Guides to the evaluation of permanent impairment. Chicago: American Medical Association; 2008.

    Google Scholar 

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Conflict of interest

Andrea S. Fokkens, Johan W. Groothoff, Jac J. L. van der Klink, Roel Popping, Roy E. Stewart, Lex van de Ven, Sandra Brouwer and Jolanda Tuinstra declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Applied Research in Care (FA12), University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands

    Andrea S. Fokkens & Jolanda Tuinstra

  2. Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Johan W. Groothoff, Jac J. L. van der Klink, Roy E. Stewart, Lex van de Ven & Sandra Brouwer

  3. Department of Sociology, University of Groningen, Groningen, The Netherlands

    Roel Popping

  4. Social Security Institute (UWV), Groningen, The Netherlands

    Lex van de Ven

Authors
  1. Andrea S. Fokkens
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  2. Johan W. Groothoff
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  3. Jac J. L. van der Klink
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  4. Roel Popping
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  5. Roy E. Stewart
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  6. Lex van de Ven
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  7. Sandra Brouwer
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Correspondence to Andrea S. Fokkens.

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Fokkens, A.S., Groothoff, J.W., van der Klink, J.J.L. et al. The Mental Disability Military Assessment Tool: A Reliable Tool for Determining Disability in Veterans with Post-traumatic Stress Disorder. J Occup Rehabil 25, 569–576 (2015). https://doi.org/10.1007/s10926-014-9563-0

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  • DOI: https://doi.org/10.1007/s10926-014-9563-0

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