Assessing psychological adjustment and cultural reintegration after military service: development and psychometric evaluation of the post-separation Military-Civilian Adjustment and Reintegration Measure (M-CARM)

Abstract

Background The transition out of military service and subsequent reintegration to civilian life has been established as a period associated with an increased risk of psychological adjustment difficulties, psychiatric disorders and suicide risk, yet no tool exists to measure cultural and psychological adjustment following permanent separation from the military. This study describes the two-phase mixed-methods development and validation of the self-report Military-Civilian Adjustment and Reintegration Measure (M-CARM). Methods In Phase I, four focus groups (n = 20) and semi-structured one-on-one interviews (n = 80) enabled thematic analysis and generation of 53 initial items that were reviewed by an expert multidisciplinary panel (n = 12) and piloted for clarity and relevance in an Australian service-veteran sample (n = 11). In Phase II, psychometric properties of the 47 items resulting from Phase I were evaluated with online assessment of a convenience sample of transitioned Australian Defence Force veterans (n = 725). Analyses included exploratory and confirmatory factor analyses, as well as evaluation of test-retest reliability, internal consistency, and convergent, divergent and discriminant validity. Results Exploratory factor analysis on a randomized split-half sample (n = 357), resulted in a 21-item, five-factor solution of Purpose and Connection, Help seeking, Beliefs about civilians, Resentment and regret, and Regimentation, explaining 53.22% of the variance. Confirmatory factor analysis (n = 368) verified this factor structure without modification (χ2 = 304.96, df = 160; CFI = .96, TLI = .94, NFI = .91, RMSEA = .05). Strong convergent, divergent and discriminant validity was demonstrated as M-CARM scores significantly correlated with related constructs assessed by standardised clinical measures as well as differentiated groups based on three binary reintegration items, with large effect sizes (d = > 1). Strong test-retest reliability for the total score (n = 186, r = .93) and excellent internal consistency (n = 725, a = .90) were also found. Conclusions Results provide promising evidence the M-CARM is a valid, reliable measure of psychological and cultural reintegration to civilian life, with potential for considerable clinical and research application.

Transition from military to civilian: Identity, social connectedness, and veteran wellbeing

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Rural former service members participate in meaningful occupations to ‘fill the void’ after military service

“…As demonstrated in prior research, finding connection and a new sense of purpose in life was critical to the participants' wellbeing and search for meaning after ending their military service (George & Park, 2016;Romaniuk et al, 2020). However, the meaning of participation in occupations such as sport and volunteer work can only be fully appreciated when consideration is given to the collective or community-based nature of these occupations within rural communities (Lyons et al, 2016).…”

Obtaining and retaining employment post military service: A qualitative analysis of challenges experienced by Australian veterans

“…The interviews were conducted as part of a larger study related to psychological adjustment, transition, and reintegration to civilian life (see Romaniuk et al., 2020). All participants were assigned a study identification number on enrollment.…”