title: Postdeployment Battlemind training for the U.K. armed forces: a cluster randomized controlled trial.
abstract: OBJECTIVE
  Combat exposure can increase the risk of subsequent psychological ill-health in armed forces (AF) personnel. A U.S. postdeployment psycho-educational intervention, Battlemind, showed a beneficial effect on mental health in U.S. military personnel exposed to high combat levels. We evaluated the effectiveness of an anglicized version of postdeployment Battlemind.
  
  
  METHODS
  Battlemind was adapted for the United Kingdom. The main amendments were to sections about carrying weapons, driving, and alcohol misuse. The anglicized Battlemind was compared with the U.K. standard postdeployment brief in a cluster randomized controlled trial. At baseline, 2,443 U.K. AF personnel returning from Afghanistan via Cyprus completed questionnaires about their combat experiences and mental health. Of these, 1,616 (66%) completed 6-month follow-up questionnaires. We used the Posttraumatic Stress Disorder Checklist (PCL-C) to measure probable posttraumatic stress disorder and the General Health Questionnaire (GHQ-12) to measure common mental disorders. Secondary outcomes included alcohol misuse, assessed with the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking. Mixed-effects models were used to account for possible cluster effects.
  
  
  RESULTS
  We did not find a difference in mental health or overall AUDIT score. Those who received Battlemind versus the standard brief were less likely to report binge drinking, although the effect size was small (adjusted odds ratio = 0.73, 95% CI [0.58, 0.92]).
  
  
  CONCLUSIONS
  The anglicized Battlemind did not improve mental health but had a modest impact on the reporting of binge drinking. Alcohol misuse is problematic in military populations; therefore, an intervention that reduces binge drinking may be helpful.
authors.affiliation: Academic Centre for Defence Mental Health, King's College London, London, United Kingdom.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mulligan
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Fear
authors.forename: Norman
authors.initials: N
authors.lastname: Jones
authors.forename: Helen
authors.initials: H
authors.lastname: Alvarez
authors.forename: Lisa
authors.initials: L
authors.lastname: Hull
authors.forename: Ulrike
authors.initials: U
authors.lastname: Naumann
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.forename: Neil
authors.initials: N
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom