Adolescent Military Stress Measure (AMSM)

1. Abstract

The Adolescent Military Stress Measure (AMSM) is a specialized 21-item psychometric inventory developed by Tamika D. Gilreath and colleagues (2023) to assess unique, multidimensional stressors experienced by military-connected youth. Traditional adolescent stress inventories predominantly target normative civilian developmental challenges—such as academic pressure, general peer dynamics, and routine family conflict—frequently failing to capture the idiosyncratic, institutional, and environmental pressures characteristic of life within armed forces families. To resolve this measurement gap, the AMSM was constructed using qualitative insights from Life History Calendar (LHC) interviews, cognitive interviews, focus groups with military youth, and consultation with expert advisory boards. Psychometric evaluation demonstrates a robust four-factor latent structure comprising: (1) Relocation Stressors, (2) Ongoing Socioecological Stressors, (3) Deployment Stressors, and (4) Social Support Stressors. Administered via a dichotomous binary (“yes/no”) response format, the instrument yields both subscale composite scores and a total stress burden score, with social support items reverse-coded such that higher overall scores denote greater exposure to military-related strain. The AMSM exhibits commendable internal consistency across its full scale (standardized Cronbach’s $\alpha = 0.86$) and acceptable to good reliability across subscales ($\alpha = 0.69$ to $0.83$). Confirmatory factor analysis verified structural adequacy ($\mathrm{RMSEA} = 0.043$, $\mathrm{CFI} = 0.969$, $\mathrm{TLI} = 0.964$). Demonstrating strong convergent and criterion-related validity, structural equation modeling and logistic regressions show that each incremental stressor reported on the AMSM corresponds to statistically significant increases in clinical risk markers, including depressive affect (odds ratio $[\mathrm{OR}] = 1.07$) and suicidal ideation ($\mathrm{OR} = 1.06$), with ongoing socioecological stressors serving as a potent predictor of adolescent suicidality ($b = 0.67, p = 0.05$). The AMSM provides clinicians, school counselors, and military family researchers with an empirically validated, low-burden screening tool designed to facilitate targeted prevention and intervention strategies.

2. Keywords

Adolescent Military Stress Measure, AMSM, military-connected youth, military families, deployment stress, relocation stress, ongoing socioecological stressors, social support, adolescent mental health, suicidality, psychometrics, Life History Calendar.

3. Authors

The Adolescent Military Stress Measure was developed and psychometrically validated by a multidisciplinary team of behavioral scientists, social work scholars, and public health researchers:

• Tamika D. Gilreath, Ph.D. (Corresponding Author)
  ORCID: 0000-0001-9545-9153
  Affiliation: Department of Health & Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, Texas, United States.
  Email: [email protected]
  Mailing Address: 267 Gilchrist Building, 4243 TAMU, College Station, TX 77843-4243, USA.
• Kathrine Sullivan, Ph.D.
  Affiliation: Silver School of Social Work, New York University, New York, New York, United States.
• Francisco A. Montiel-Ishino, Ph.D.
  Affiliation: National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH), Bethesda, Maryland, United States.
• Titilayo Okoror, Ph.D.
  Affiliation: Department of Africana Studies, Binghamton University, State University of New York (SUNY), Binghamton, New York, United States.

4. Purpose

The primary purpose of the Adolescent Military Stress Measure (AMSM) is to provide an empirically grounded, developmentally sensitive, and contextually specific measurement tool capable of identifying, quantifying, and monitoring military-induced stressors among adolescents aged 12 to 18 years. While youth across all societal strata encounter universal developmental milestones—such as identity exploration, peer group formation, and academic transitions—adolescents embedded within military ecologies confront an atypical constellation of cumulative stressors. These include recurrent geographic relocations (often occurring every two to three years), prolonged parental separations during hazardous deployments, reintegration strains upon a parent’s return, altered family roles, parental service-related morbidity or psychological trauma (e.g., post-traumatic stress disorder, traumatic brain injury), and the systemic requirement to repeatedly reconstruct social networks in unfamiliar civilian or Department of Defense Education Activity (DoDEA) environments.

Prior to the introduction of the AMSM, researchers and mental health professionals working with military dependents relied largely on general life event checklists or generic adolescent stress questionnaires (such as the Adolescent Perceived Stress Scale or the Life Events Checklist). These standardized instruments exhibit notable measurement blind spots: they lack sensitivity to military jargon, fail to differentiate between wartime deployments and routine domestic field exercises, overlook the specific social isolation stemming from living off-base without military-informed peer groups, and neglect the systemic tension inherent to institutional military life. Consequently, studies utilizing generic metrics often underestimate the aggregate stress burden borne by military-connected youth or misclassify military-specific ecological adaptations as generalized behavioral maladjustment.

From an applied clinical perspective, the AMSM serves as a rapid screening instrument for school psychologists, Department of Defense clinicians, licensed clinical social workers, and community pediatricians. By delineating an adolescent’s vulnerability across distinct stress domains (such as ongoing socioecological friction versus acute deployment disruption), practitioners can formulate tailored psychosocial interventions. In research environments, the AMSM offers epidemiological utility, allowing investigators to model structural relationships between military institutional policies, localized community supports, familial stress transmission, and adolescent psychiatric outcomes—notably internalizing symptoms, externalizing behaviors, non-suicidal self-injury, and suicidal ideation.

5. Psychological Construct

The AMSM measures military-related stress, conceptualized as an overarching, multidimensional latent construct encompassing the subjective strain, disruption, and adaptive demands imposed upon youth by the operational, structural, and cultural realities of parental military service. Rather than treating military life as a uniform or monolithic risk factor, the AMSM disaggregates military-induced strain into four empirically derived dimensions:

1. Relocation Stressors

This subscale captures the disruptions associated with the permanent change of station (PCS) cycle inherent to military service. Geographic relocation forces adolescents to abandon established peer networks, academic cohorts, extracurricular activities, and community attachments. The cognitive and behavioral load of adjusting to divergent school curricula, navigating new institutional climates, encountering varying grading systems, and facing the stigma of being the perpetual “new kid” represents an acute ecological disruption. Relocation stress within the AMSM reflects both the cumulative frequency of moves and the immediate friction experienced during the transition phase.

2. Ongoing Socioecological Stressors

Operating continuously throughout an adolescent’s formative years, ongoing socioecological stressors represent distal and proximal systemic demands generated by military institutional culture. This dimension assesses chronic environmental friction, including the anxiety associated with parental rank hierarchies influencing social dynamics, living within high-surveillance military installations versus isolated civilian neighborhoods, navigating the threat of sudden parental redeployment, managing household responsibilities when one parent acts as a de facto single caregiver, and absorbing secondary traumatic stress linked to a parent’s physical or mental combat injuries.

3. Deployment Stressors

This dimension quantifies the direct acute and chronic strain precipitated by parental operational separation. Unlike civilian parental travel or divorce, military deployment introduces ambiguous loss, persistent anticipatory grief, and constant awareness of mortal danger. The subscale evaluates stress associated with communication blackouts, media exposure regarding overseas conflict zones, disrupted family routines, shifting parental discipline structures, and the complex renegotiation of roles during post-deployment reintegration, where returning service members may present with emotional numbing, hypervigilance, or altered relational dynamics.

4. Social Support Stressors

Social support operates both as a primary buffer against psychological decompensation and, when absent or compromised, as an independent source of severe stress. This subscale measures perceived deficits in empathetic, structural, and relational resources across the adolescent’s micro- and mesosystems. Items index feelings of social alienation from civilian peers who do not comprehend the nuances of military life, difficulty establishing deep, long-term friendships due to anticipatory departure anxiety, perceived lack of institutional support from community agencies or school counselors, and an inability to confide in family members who are already perceived as emotionally overburdened.

6. Theoretical Framework

The construction and validation of the AMSM are anchored in an integration of three foundational frameworks: Bronfenbrenner’s Bioecological Systems Theory, the Double ABCX Model of Family Stress and Adaptation (McCubbin & Patterson, 1983), and Lazarus and Folkman’s Transactional Model of Stress and Coping (1984).

Under Bronfenbrenner’s bioecological paradigm, human development is shaped by interactive, nested systems ranging from proximal microsystems (family, peer groups, school) to the overarching macrosystem (military culture, national defense policies). The AMSM explicitly accounts for the chronosystem—the dimension of time as it intersects with sociopolitical events, wartime eras, and developmental transitions. The military apparatus functions as an all-encompassing exosystem that directly dictates where the family lives, when parents depart, and the social structures available to the youth. The AMSM operationalizes how shifts in this military exosystem fundamentally reverberate through the adolescent’s microsystems, disrupting environmental stability and altering developmental trajectories.

Complementing this systemic framework, McCubbin and Patterson’s Double ABCX Model explicates family adaptation over time in response to cumulative stressors. In this formulation, the initial stressor event (Factor A, such as deployment) interacts with existing family resources (Factor B) and the subjective definition or cognitive appraisal assigned to the event (Factor C) to produce the crisis (Factor X). Over time, families experience “pile-up” (Factor aA)—the compounding of primary deployment stress with concurrent daily hassles, relocation demands, and secondary parental distress. The AMSM operationalizes this stress pile-up concept, capturing the intersecting burden of ecological disruptions that undermine an adolescent’s individual coping resources (Factor bB) and cognitive resilience (Factor cC), potentially culminating in maladaptation (Factor xX), such as depressive decompensation or suicidality.

Finally, Lazarus and Folkman’s Transactional Model provides the cognitive foundation for the AMSM’s binary response structure. Stress is conceptualized as a dynamic relationship between the individual and an environment evaluated as taxing or exceeding available resources. By measuring whether specific military conditions are endorsed as present and problematic, the AMSM reflects the outcome of primary cognitive appraisals (evaluating an event as harmful, threatening, or challenging) within an institutional ecology that circumscribes adolescent autonomy.

7. Validity

The psychometric evaluation of the AMSM demonstrated strong evidence of content, structural, convergent, and predictive criterion-related validity across diverse military-connected youth cohorts.

Content and Face Validity

Content validity was established through rigorous qualitative and cognitive pretesting protocols. Gilreath et al. (2023) initially generated a pool of 23 candidate items drawn directly from qualitative Life History Calendar (LHC) interviews and focus groups conducted with military-connected adolescents. Representative youth quotes were utilized to construct initial items, ensuring that the vernacular, phenomenological tone, and ecological challenges reflected authentic adolescent experiences. Subsequently, cognitive interviews were executed to evaluate item comprehension, semantic readability, and face validity. An advisory board comprising military family researchers, behavioral health clinicians, and youth advocates evaluated the preliminary inventory, ensuring exhaustive coverage of military-specific developmental stressors.

Structural and Construct Validity

Construct validity was confirmed using both exploratory factor analysis (EFA) across five independent, randomly selected subsets and subsequent confirmatory factor analysis (CFA). These analyses confirmed that the 21 retained items mapped reliably onto the hypothesized four-dimensional architecture: Relocation Stressors, Ongoing Socioecological Stressors, Deployment Stressors, and Social Support Stressors. Two items demonstrating insufficient factor saturation were removed, establishing structural parsimony.

Convergent and Predictive Validity

The convergent and predictive validity of the AMSM was established through structural equation modeling (SEM) and multivariate logistic regression analyses examining associations with established clinical endpoints of psychological distress. The total AMSM score demonstrated significant predictive validity relative to internalizing pathology: each additional military-related stressor endorsed on the AMSM was associated with a 7% increase in the odds of experiencing profound sadness and hopelessness ($\mathrm{OR} = 1.07$, $95%\text{ CI } [1.01, 1.12]$) and a 6% increase in the odds of reporting past-year suicidal ideation ($\mathrm{OR} = 1.06$, $95%\text{ CI } [1.03, 1.12]$).

Furthermore, structural equation models evaluating the unique contribution of specific subscales revealed that the Ongoing Socioecological Stressors dimension exerted a particularly powerful, direct effect on severe psychiatric vulnerability, significantly predicting suicidality ($b = 0.67, p = 0.05$). This finding underscores that chronic, systemic friction within military life poses an equal or greater psychological hazard than acute, discrete deployment cycles alone.

8. Reliability

The AMSM exhibits robust internal consistency across its full composite score and acceptable to good reliability across its individual subscales, establishing its stability for research and clinical screening.

In the primary validation study by Gilreath et al. (2023), the full-scale standardized Cronbach’s alpha coefficient was:

• Full-Scale AMSM (21 items): Standardized $\alpha = 0.86$, indicating high overall internal consistency without excessive item redundancy.

Subscale reliability coefficients demonstrated sound measurement properties given the brief nature of the subdimensions and the use of dichotomous item responses:

• Deployment Stressors Subscale: Standardized $\alpha = 0.83$, demonstrating excellent internal consistency for assessing parental operational absence and deployment-related fear.
• Relocation Stressors Subscale: Standardized $\alpha = 0.74$, reflecting satisfactory reliability in evaluating permanent changes of station and social disruption.
• Ongoing Socioecological Stressors Subscale: Standardized $\alpha = 0.73$, indicating acceptable internal consistency for chronic systemic and environmental pressures.
• Social Support Stressors Subscale: Standardized $\alpha = 0.69$, approaching the conventional $0.70$ threshold, considered acceptable for brief exploratory and screening subscales capturing complex relational dynamics.

9. Factor Analysis

The latent structure of the AMSM was delineated through a rigorous split-sample psychometric approach employing sequential Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).

Exploratory Factor Analysis (EFA)

Initial item selection began with 23 candidate items. To establish stability and avoid sample-dependent idiosyncrasies, EFA was conducted across five randomly generated split datasets. Across all iterations, principal axis factoring with oblique rotation yielded a stable four-factor solution with all retained factors displaying eigenvalues substantially greater than 1.0. During this phase, two items—specifically, “attending an off-base school” and “residing off-base”—demonstrated poor factor saturation, failing to achieve the pre-established retention criterion of a factor loading $ge 0.63$ on any single factor. These two items were systematically eliminated, reducing the instrument to a refined 21-item questionnaire.

Confirmatory Factor Analysis (CFA)

The four-factor structural model was subsequently tested using CFA on an independent verification sample of military-connected adolescents. Goodness-of-fit indices demonstrated an exceptional fit between the hypothesized multidimensional model and the observed empirical data:

• Root Mean Square Error of Approximation (RMSEA): $0.043$ ($90%\text{ CI } [0.035, 0.051]$), well below the stringent $0.05$ threshold indicative of close model fit.
• Comparative Fit Index (CFI): $0.969$, exceeding the conservative $0.95$ benchmark for exemplary incremental fit.
• Tucker-Lewis Index (TLI): $0.964$, indicating excellent structural specification relative to the null baseline model.

All standardized factor loadings for the 21 retained items were statistically significant ($p < 0.001$), confirming that the four latent dimensions—Relocation, Ongoing Socioecological, Deployment, and Social Support—provide a theoretically robust and mathematically sound representation of military-related adolescent stress.

10. Instrument / Measurement Tool

• Test Type: Original psychometric inventory / self-report psychological rating scale.
• Target Population: Military-connected youth aged 12 to 18 years residing in the United States (potentially applicable to youth aged 6–12 and young adults aged 18–29 in specialized clinical or academic contexts).
• Format: Structured self-report questionnaire comprising 21 items.
• Response Scale: Binary dichotomous format with forced-choice options: “Yes” or “No” for each item statement.
• Subscales (4 Dimensions):
  • Relocation Stressors
  • Ongoing Socioecological Stressors
  • Deployment Stressors
  • Social Support Stressors
• Scoring Protocol:
  • Affirmative responses indicating stress are scored as 1 point; negative responses are scored as 0 points.
  • Items indexing protective social support are reverse-coded prior to scale aggregation (such that a response indicating an absence of support receives 1 point, and the presence of support receives 0 points).
  • Subscale Scores: Computed by summing the affirmative (and reverse-coded) items within each respective domain.
  • Total AMSM Score: Calculated by summing all 21 items, yielding a continuous stress score ranging from 0 to 21, where higher values denote greater exposure to cumulative military-related stress.
• Administration Time: Approximately 5 to 10 minutes, making it suitable for high-volume clinical, educational, or epidemiological deployments.

11. Permissions & Fee and Test Year

• Year of Formal Publication: 2023.
• Copyright & Ownership: The Adolescent Military Stress Measure is copyrighted by Tamika D. Gilreath and co-authors, with publication rights licensed to Springer Nature in the Journal of Child and Family Studies.
• Fee: No licensing fee is required for non-commercial academic research, public school implementation, or non-profit clinical screening.
• Permissions & Access: Qualified researchers and clinical practitioners seeking to use, translate, or adapt the AMSM must contact the corresponding author directly:
  Dr. Tamika D. Gilreath
  Email: [email protected]
  Department of Health & Kinesiology, Texas A&M University.

12. References

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.

Gilreath, T. D., Sullivan, K., Montiel-Ishino, F. A., & Okoror, T. (2023). Development and validation of the AMSM for military-connected adolescents. Journal of Child and Family Studies, 32(10), 2931–2943. https://doi.org/10.1007/s10826-023-02661-6

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.

McCubbin, H. I., & Patterson, J. M. (1983). The family stress process: The Double ABCX model of adjustment and adaptation. Marriage & Family Review, 6(1–2), 7–37. https://doi.org/10.1300/J002v06n01_02

Sullivan, K., Gilreath, T. D., & Castro, C. A. (2020). Secondary traumatic stress and military-connected youth: A systematic review. Child and Adolescent Social Work Journal, 37(4), 385–398. https://doi.org/10.1007/s10560-020-00652-9

13. Items of the Scale