Mindfulness-based Writing Expression Training Among Military Personnel

The Perceived Stress Scale (PSS) is used to measure the participants' perceived stress levels over the previous month. This scale contains 14 items, including 7 measuring loss of control and 7 measuring perceived tension, with responses ranging from 0 (never) to 4 (always). Notably, items 4, 5, 6, 7, 9, 10, and 13 are scored in reverse order. The total scores ranged between 0 and 56, with higher scores indicating increased levels of stress.

The Cognitive Flexibility Inventory (CFI) is used to measure participants' cognitive flexibility levels. It contains 20 items, which include 10 for control ability and 10 for alternatives, with responses ranging from 1 (strongly disagree) to 7 (completely agree). Importantly, items 2, 4, 7, 9, 11 and 17 are scored in reverse order. The total scores ranged between 20 and 140, with higher scores indicating higher cognitive flexibility levels.

The anxiety levels of active-duty military personnel The participants' anxiety is measured by the Generalized Anxiety Disorder Scale (GAD-7). It is a measure used to assess the severity of symptoms of generalized anxiety disorder. This scale contains 7 items, the scores for each item, on the GAD range from 0 (not at all) to 3 (nearly every day), and the total score ranges from 0 to 21. A higher total score indicates a higher level of anxiety. GAD-7 score > 14 has been shown to indicate severe anxiety .

The Patient Health Questionnaire (PHQ-9) is used to assess depression severity among military personnel. The scale contains 9 items. The response options for each item, of the PHQ-9 range from 0 (not at all) to 3 (nearly every day). The total PHQ-9 score ranges from 0 to 27. A higher total score indicates a higher level of depression.

The Posttraumatic Growth Inventory (PTGI) is used to determine the positive changes that occur as a result of the traumatic events experienced by military personnel. Participants are asked to rate the degree to which they have experienced the change described by each item. The scale consists of 21 items in total and uses a 6-point Likert-type response scale ranging from 0 (almost never) to 5 (almost always). The total score ranges from 0 to 105, and the higher the score is, the greater the level of posttraumatic growth.