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). 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. 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. 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.

中文翻译：

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评估服兵役后的心理调整和文化融合：分离后的军民调整和融合措施（M-CARM）的发展和心理计量评估

从服兵役过渡到随后重返平民生活的时期已确定为心理适应困难，精神疾病和自杀风险增加的风险，但目前尚无任何工具可用来永久性地与军队分离后衡量文化和心理适应的情况。这项研究描述了两阶段混合方法的发展和自我报告军民调整和重返社会措施（M-CARM）的验证。在第一阶段，四个焦点小组（n = 20）和半结构化一对一访谈（n = 80）可以进行主题分析并生成53个初始项目，这些项目由多学科专家小组（n = 12）进行了审查，在澳大利亚退役军人样本中进行了试点，以明确其相关性（n = 11）。在第二阶段 通过在线评估过渡的澳大利亚国防军退伍军人（n = 725）的便利样本，评估了第一阶段产生的47件物品的心理测量特性。分析包括探索性和确认性因素分析，以及重新测试信度，内部一致性以及趋同性，分歧性和判别性有效性的评估。探索性因素分析对一个随机的一半样本（n = 357）进行了分析，得出了21个项目的五因素解决方案，目的和联系，寻求帮助，对平民的信仰，怨恨和遗憾以及团伙，占53.22％方差。验证性因子分析（n = 368）验证了该因子结构，无需进行任何修改（χ2= 304.96，df = 160; CFI = .96，TLI = .94，NFI = .91，RMSEA = .05）。强收敛 M-CARM评分与通过标准化临床措施评估的相关构建体以及基于三个二元整合项的分化组显着相关，证明了不同和可区分的有效性，且效应量大（d => 1）。还发现总分的重测信度（n = 186，r = 0.93）和出色的内部一致性（n = 725，a = .90）。结果提供了有希望的证据，M-CARM是心理和文化重新融入平民生活的有效，可靠的方法，具有大量的临床和研究应用潜力。还发现总分的重测信度（n = 186，r = 0.93）和出色的内部一致性（n = 725，a = .90）。结果提供了有希望的证据，M-CARM是心理和文化重新融入平民生活的有效，可靠的方法，具有大量的临床和研究应用潜力。还发现总分的重测信度（n = 186，r = 0.93）和出色的内部一致性（n = 725，a = .90）。结果提供了有希望的证据，M-CARM是心理和文化重新融入平民生活的有效，可靠的方法，具有大量的临床和研究应用潜力。