Relationship Between Spiritual Well-being and Post-traumatic Stress Disorder Symptoms in United States Air Force Remotely Piloted Aircraft and Intelligence Personnel.

BACKGROUND: Remotely piloted aircraft (RPA) are in frequent use by the U.S. Air Force to engage in combat operations from remote locations. RPA operations involve remote killing, which can lead to significant emotional responses. This study addresses a gap in research by examining the association of existential and spiritual health with post-traumatic stress disorder (PTSD) symptoms in RPA and intelligence personnel. METHODS: Three hundred and five U.S. Air Force RPA and intelligence personnel completed the Spiritual Well-Being Scale (SWBS) and PTSD Checklist-Military Version. Correlational analyses were used to examine the association between SWBS score and PTSD symptoms. FINDINGS: There was a negative correlation between the SWBS and PTSD Checklist-Military Version scores (Pearson correlation coefficient = -0.49, p < 0.0001). Higher spiritual and existential well-being were associated with lower PTSD symptoms. Further, spiritual and existential scores in this sample were comparable with a number of SWBS norms, suggesting that levels of existential distress may not be high among remote warfare operators. DISCUSSION: In this sample of U.S. Air Force personnel involved in remote warfare, higher spiritual and existential well-being were associated with less endorsement of mental health symptoms on a PTSD symptom measure. Additionally, levels of spiritual and existential well-being in this sample were comparable with norms used in a number of samples within the general population. Although there are ongoing concerns regarding the psychological impact remote warfare has on RPA operators, the bulk of current research has indicated that operational stressors such as workload, rotating shifts, organizational and leadership concerns, and balancing work and domestic tasks rather than the job duties themselves (i.e., involvement in killing) likely contribute more to reported emotional distress levels.

White Matter Integrity in High-Altitude Pilots Exposed to Hypobaria.

INTRODUCTION: Nonhypoxic hypobaric (low atmospheric pressure) occupational exposure, such as experienced by U.S. Air Force U-2 pilots and safety personnel operating inside altitude chambers, is associated with increased subcortical white matter hyperintensity (WMH) burden. The pathophysiological mechanisms underlying this discrete WMH change remain unknown. The objectives of this study were to demonstrate that occupational exposure to nonhypoxic hypobaria is associated with altered white matter integrity as quantified by fractional anisotropy (FA) measured using diffusion tensor imaging and relate these findings to WMH burden and neurocognitive ability. METHODS: There were 102 U-2 pilots and 114 age- and gender-controlled, health-matched controls who underwent magnetic resonance imaging. All pilots performed neurocognitive assessment. Whole-brain and tract-wise average FA values were compared between pilots and controls, followed by comparison within pilots separated into high and low WMH burden groups. Neurocognitive measurements were used to help interpret group difference in FA values. RESULTS: Pilots had significantly lower average FA values than controls (0.489/0.500, respectively). Regionally, pilots had higher FA values in the fronto-occipital tract where FA values positively correlated with visual-spatial performance scores (0.603/0.586, respectively). There was a trend for high burden pilots to have lower FA values than low burden pilots. DISCUSSION: Nonhypoxic hypobaric exposure is associated with significantly lower average FA in young, healthy U-2 pilots. This suggests that recurrent hypobaric exposure causes diffuse axonal injury in addition to focal white matter changes.McGuire SA, Boone GRE, Sherman PM, Tate DF, Wood JD, Patel B, Eskandar G, Wijtenburg SA, Rowland LM, Clarke GD, Grogan PM, Sladky JH, Kochunov PV. White matter integrity in high-altitude pilots exposed to hypobaria. Aerosp Med Hum Perform. 2016; 87(12):983-988.