The Nature of Combat Stress Development During Military Operations and Psychotherapy in Extreme Situations.

ABSTRACT: The purpose of the research work is the theoretical and empirical analysis of the study of the nature of combat stress in military personnel and the assessment of psychotherapeutic methods of providing psychological assistance in extreme situations. The authors used the following methods to achieve this goal: method of analysis and synthesis, hermeneutic method, testing method, comparative method, and generalization method. The results of the research work have revealed the meaning of traumatic stress, psychological trauma, and combat mental trauma, and explained the concept of combat stress and the dynamics of its growth. The findings identified the factors of posttraumatic stress syndrome and its prevalence, tracked down the dynamics of psychoemotional disorders, and revealed the importance of military psychological selection and determination of combat readiness. The authors established the main tasks of a staff psychologist in working with military personnel, conducted an empirical study of the nature of combat stress in the military, observed main psychotherapeutic tools for the prevention of negative mental states in combat conditions, and investigated self-regulation techniques of emotional, physical, and mental health. The practical significance of the scientific work lies in the modern coverage of the phenomenon of combat stress and the classification of effective psychotherapeutic methods that will ensure the sustainable psychological preparation of the soldiers for extreme situations.

Acupuncture for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial.

Importance: Current interventions for posttraumatic stress disorder (PTSD) are efficacious, yet effectiveness may be limited by adverse effects and high withdrawal rates. Acupuncture is an emerging intervention with positive preliminary data for PTSD. Objective: To compare verum acupuncture with sham acupuncture (minimal needling) on clinical and physiological outcomes. Design, Setting, and Participants: This was a 2-arm, parallel-group, prospective blinded randomized clinical trial hypothesizing superiority of verum to sham acupuncture. The study was conducted at a single outpatient-based site, the Tibor Rubin VA Medical Center in Long Beach, California, with recruitment from April 2018 to May 2022, followed by a 15-week treatment period. Following exclusion for characteristics that are known PTSD treatment confounds, might affect biological assessment, indicate past nonadherence or treatment resistance, or indicate risk of harm, 93 treatment-seeking combat veterans with PTSD aged 18 to 55 years were allocated to group by adaptive randomization and 71 participants completed the intervention protocols. Interventions: Verum and sham were provided as 1-hour sessions, twice weekly, and participants were given 15 weeks to complete up to 24 sessions. Main Outcomes and Measures: The primary outcome was pretreatment to posttreatment change in PTSD symptom severity on the Clinician-Administered PTSD Scale-5 (CAPS-5). The secondary outcome was pretreatment to posttreatment change in fear-conditioned extinction, assessed by fear-potentiated startle response. Outcomes were assessed at pretreatment, midtreatment, and posttreatment. General linear models comparing within- and between-group were analyzed in both intention-to-treat (ITT) and treatment-completed models. Results: A total of 85 male and 8 female veterans (mean [SD] age, 39.2 [8.5] years) were randomized. There was a large treatment effect of verum (Cohen d, 1.17), a moderate effect of sham (d, 0.67), and a moderate between-group effect favoring verum (mean [SD] Δ, 7.1 [11.8]; t90 = 2.87, d, 0.63; P = .005) in the intention-to-treat analysis. The effect pattern was similar in the treatment-completed analysis: verum d, 1.53; sham d, 0.86; between-group mean (SD) Δ, 7.4 (11.7); t69 = 2.64; d, 0.63; P = .01). There was a significant pretreatment to posttreatment reduction of fear-potentiated startle during extinction (ie, better fear extinction) in the verum but not the sham group and a significant correlation (r = 0.31) between symptom reduction and fear extinction. Withdrawal rates were low. Conclusions and Relevance: The acupuncture intervention used in this study was clinically efficacious and favorably affected the psychobiology of PTSD in combat veterans. These data build on extant literature and suggest that clinical implementation of acupuncture for PTSD, along with further research about comparative efficacy, durability, and mechanisms of effects, is warranted. Trial Registration: ClinicalTrials.gov Identifier: NCT02869646.

Outcome metrics utilized in evaluations of programs and interventions for combat and operational stress: A review of psychometric properties.

The Department of Defense has mandated combat and operational stress control (COSC) efforts for the Services since 1999. Although several COSC-related programs have been implemented, few have undergone evaluation, and no standardized metrics have been established to assess their effectiveness and utility. The purpose of this review was to characterize the content and psychometrics of measures that have been utilized as outcome metrics in evaluations of COSC-related programs and interventions. Systematic literature searches were conducted for publications that: a) evaluated at least one measure from U.S. service members who participated in a program or intervention to prevent or reduce the adverse effects of combat and operational stress; and b) reported U.S. data on the internal consistency, test-retest reliability, convergent validity, and sensitivity/specificity of the identified measures. This process identified 15 measures for which psychometric properties were reviewed for acceptability based on recommended criteria. Identified measures varied from well-validated measures to newer instruments for which more data is needed on one or more of the target psychometric properties. Aside from internal consistency, psychometric data from U.S. military samples were sparse. Results further suggested that some measures might have reduced sensitivity in service members under certain conditions, such as large-scale screening. Additional studies are needed to validate COSC-relevant measures in service members. Future evaluations of programs and interventions for combat and operational stress should select measures that will increase the consistency of the literature, allow comparisons across studies, and ensure alignment with the objectives of identified programs.

trazos para una metodología que permita comprender las razones de éxito y fracaso regional del control territorial de las farc-ep / features for a methodology which allows the understanding of the reasons of the regional success and failure behind the territorial control of farc-ep: the perspective of the qualitative comparative analysis (csqca)

El siguiente artículo recoge la propuesta metodológica de una investigación que se formuló con el propósito de dar cuenta de las razones que explican la diferente presencia que, a nivel territorial, expresan las Farc al término del periodo 1998-2010, tiempo en que la estrategia contrainsurgente del estado colombiano si bien logró desplazar a esta guerrilla de algunas regiones del país, en otras no lo consiguió. La perspectiva metodológica aquí planteada propone una estrategia analítica para identificar, definir y comprender las causas de la diversidad regional de la geografía de la guerra en Colombia. Tal estrategia se enfocó desde una óptica comparada a partir de un modelo desarrollado por la ciencia política denominado Conjunto de Variables para el Análisis Comparativo Cualitativo (csQCA en sus siglas en inglés, crips set of Qualitative Comprative Analysis).

The following article contains the methodological proposal of a piece of research that was carried out in order to give an account of the reasons which explain the different presence that, at the territorial level, the FARC express, at the end of the 1998 – 2010 period. That was a time in which the counterinsurgency strategy of the Colombian State even though it managed to move the guerrillas in some regions of the country, in others did not. The methodological perspective, which is posed here, proposes an analytical strategy to identify, to define, and to understand the causes of the regional diversity of the geography of the war in Colombia. Such a strategy has shifted from a comparative perspective based on a model developed by the political science called Set of Variables for Qualitative Comparative Analysis (csQCA in its acronym in English, crips set of Qualitative Comparative Analysis).

Bombardeio estratégico: aspecto psicológico / Firstly

Inicialmente foi comentado sobre a política de guerra quanto ao impacto psicológico sofrido por populações inimigas, ao serem bombardeadas por via aérea, onde foi citado o bombardeio de Hirochima das principais cidades européias na II Grande Guerra. Por fim, é demonstrado que esses estudos sobre bombardeio aéreo em populações metropolitanas abate o moral, facilitando o final do conflito, e que esta não é só uma questão do poderio militar material, existem as sequelas psicológicas dos povos em guerra, as quais podem ser essenciais na definição política do conflito