Development of the combat distress scale of the Combat Experiences Questionnaire (CEQ)

Background Military combat exposure can be perceived as a great threat to the integrity of soldiers. However, no available assessment tools evaluate the degree of emotional distress that results from the exposure to various combat scenarios. This paper presents the second independent section of the Combat Exposure Questionnaire, the Combat Distress Scale (CEQ B). This questionnaire assesses Veterans׳ subjective emotional distress that is due to objective and typical military combat scenarios during war. Methods A sample of 708 Portuguese Overseas War Veterans participated. The scale structure of the CEQ B was analyzed with a Rasch Model, and the internal consistency and convergent validity of the scale were studied. The temporal reliability was calculated in a subgroup of 112 participants. Two samples of war Veterans with and without war-related Post-Traumatic Stress Disorder (N=40 and N=47, respectively) were used to explore the scale׳s discriminant validity. Results Overall, the CEQ B showed an acceptable fit to the data, excellent internal consistency, high temporal stability, adequate convergent validity and suitable discriminant validity. Limitations This study used a population of male war Veterans that did not equally represent genders or the full adult age span, which may hinder the generalization of the results. Conclusion The findings indicated that the CEQ B is valid, reliable and supported by convergent and discriminant data. This lends confidence in the use of the measure as an assessment of the subjective emotional distress resulting from exposure to military combat scenarios in clinical and research settings.