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1.
Psychol Med ; 53(5): 2031-2040, 2023 04.
Article in English | MEDLINE | ID: mdl-34802475

ABSTRACT

BACKGROUND: Problematic anger is frequently reported by soldiers who have deployed to combat zones. However, evidence is lacking with respect to how anger changes over a deployment cycle, and which factors prospectively influence change in anger among combat-deployed soldiers. METHODS: Reports of problematic anger were obtained from 7298 US Army soldiers who deployed to Afghanistan in 2012. A series of mixed-effects growth models estimated linear trajectories of anger over a period of 1-2 months before deployment to 9 months post-deployment, and evaluated the effects of pre-deployment factors (prior deployments and perceived resilience) on average levels and growth of problematic anger. RESULTS: A model with random intercepts and slopes provided the best fit, indicating heterogeneity in soldiers' levels and trajectories of anger. First-time deployers reported the lowest anger overall, but the most growth in anger over time. Soldiers with multiple prior deployments displayed the highest anger overall, which remained relatively stable over time. Higher pre-deployment resilience was associated with lower reports of anger, but its protective effect diminished over time. First- and second-time deployers reporting low resilience displayed different anger trajectories (stable v. decreasing, respectively). CONCLUSIONS: Change in anger from pre- to post-deployment varies based on pre-deployment factors. The observed differences in anger trajectories suggest that efforts to detect and reduce problematic anger should be tailored for first-time v. repeat deployers. Ongoing screening is needed even for soldiers reporting high resilience before deployment, as the protective effect of pre-deployment resilience on anger erodes over time.


Subject(s)
Military Personnel , Stress Disorders, Post-Traumatic , Humans , Anger , Longitudinal Studies
2.
Psychol Med ; 52(1): 121-131, 2022 01.
Article in English | MEDLINE | ID: mdl-32517825

ABSTRACT

BACKGROUND: Unit cohesion may protect service member mental health by mitigating effects of combat exposure; however, questions remain about the origins of potential stress-buffering effects. We examined buffering effects associated with two forms of unit cohesion (peer-oriented horizontal cohesion and subordinate-leader vertical cohesion) defined as either individual-level or aggregated unit-level variables. METHODS: Longitudinal survey data from US Army soldiers who deployed to Afghanistan in 2012 were analyzed using mixed-effects regression. Models evaluated individual- and unit-level interaction effects of combat exposure and cohesion during deployment on symptoms of post-traumatic stress disorder (PTSD), depression, and suicidal ideation reported at 3 months post-deployment (model n's = 6684 to 6826). Given the small effective sample size (k = 89), the significance of unit-level interactions was evaluated at a 90% confidence level. RESULTS: At the individual-level, buffering effects of horizontal cohesion were found for PTSD symptoms [B = -0.11, 95% CI (-0.18 to -0.04), p < 0.01] and depressive symptoms [B = -0.06, 95% CI (-0.10 to -0.01), p < 0.05]; while a buffering effect of vertical cohesion was observed for PTSD symptoms only [B = -0.03, 95% CI (-0.06 to -0.0001), p < 0.05]. At the unit-level, buffering effects of horizontal (but not vertical) cohesion were observed for PTSD symptoms [B = -0.91, 90% CI (-1.70 to -0.11), p = 0.06], depressive symptoms [B = -0.83, 90% CI (-1.24 to -0.41), p < 0.01], and suicidal ideation [B = -0.32, 90% CI (-0.62 to -0.01), p = 0.08]. CONCLUSIONS: Policies and interventions that enhance horizontal cohesion may protect combat-exposed units against post-deployment mental health problems. Efforts to support individual soldiers who report low levels of horizontal or vertical cohesion may also yield mental health benefits.


Subject(s)
Military Personnel , Stress Disorders, Post-Traumatic , Humans , Military Personnel/psychology , Mental Health , Afghan Campaign 2001- , Stress Disorders, Post-Traumatic/psychology , Suicidal Ideation , Risk Factors
3.
Depress Anxiety ; 36(6): 511-521, 2019 06.
Article in English | MEDLINE | ID: mdl-30694009

ABSTRACT

BACKGROUND: Prior investigations have found negative associations between military unit cohesion and posttraumatic stress disorder (PTSD); however, most relied on cross-sectional data and few examined relationships of unit cohesion to other mental disorders. This study evaluates prospective associations of perceived unit cohesion with a range of mental health outcomes following combat deployment. METHODS: U.S. Army soldiers were surveyed approximately 1-2 months before deployment to Afghanistan (T0); and 1 month (T1), 3 months (T2), and 9 months (T3) after return from deployment. Logistic regression was performed to estimate associations of perceived unit cohesion at T0 with risk of PTSD, major depressive episode (MDE), generalized anxiety disorder (GAD), alcohol or substance use disorder (AUD/SUD), and suicidal ideation at T2 or T3 among soldiers who completed all study assessments (N = 4,645). Models were adjusted for sociodemographic and Army service characteristics, predeployment history of the index outcome, and deployment stress exposure. RESULTS: Higher perceived unit cohesion at T0 was associated with lower risk of PTSD, MDE, GAD, AUD/SUD, and suicidal ideation at T2 or T3 (AORs = 0.72 to 0.85 per standard score increase in unit cohesion; P-values < 0.05). Models of incidence of mental disorders and suicidal ideation among soldiers without these problems predeployment yielded similar results, except that perceived unit cohesion was not associated with incident AUD/SUD. CONCLUSIONS: Soldiers who reported strong unit cohesion before deployment had lower risk of postdeployment mental disorders and suicidal ideation. Awareness of associations of perceived unit cohesion with postdeployment mental health may facilitate targeting of prevention programs.


Subject(s)
Mental Disorders/epidemiology , Mental Disorders/psychology , Mental Health , Military Personnel/psychology , Adult , Afghan Campaign 2001- , Alcoholism/epidemiology , Alcoholism/psychology , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , Cross-Sectional Studies , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Female , Health Surveys , Humans , Logistic Models , Male , Prospective Studies , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Suicidal Ideation
4.
J Trauma Stress ; 32(5): 791-798, 2019 10.
Article in English | MEDLINE | ID: mdl-31461560

ABSTRACT

Although initial findings indicated that threat-related attention bias variability (ABV), an index designed to capture dynamic shifts in threat-related attention over time, was positively correlated with the severity of posttraumatic stress disorder (PTSD) symptoms, a recent study relying on simulated data has raised questions regarding the validity and empirical utility of ABV. Specifically, the simulations suggested that core features of reaction time data distinct from threat-related attention bias, such as the reaction time standard deviation and mean, could explicate the reported elevated ABV among samples with PTSD. In the present study, we evaluated these suggestions in 95 PTSD-diagnosed participants. The results showed that ABV significantly and uniquely predicted PTSD symptom severity beyond the predictive value of core reaction time features, ΔR2 = .05-.23. Some of the predictions stemming from the simulated results were replicated, whereas others were not. Contrary to the conclusion drawn from the simulated data, the results from the current study suggest that ABV is a valid and replicable correlate of PTSD symptom severity.


Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) La validez de los índices de variabilidad del sesgo de atención para la investigación del TEPT: Evidencia sobre los datos de los pacientes VALIDEZ DE LA VARIABILIDAD DEL SESGO ATENCIONAL EN EL TEPT Aunque los hallazgos iniciales indicaron que la variabilidad del sesgo de atención (ABV en su sigla en inglés) relacionada con la amenaza, un índice diseñado para capturar cambios dinámicos en la atención relacionada con la amenaza a lo largo del tiempo, que se correlacionó positivamente con la gravedad de los síntomas del trastorno de estrés postraumático (TEPT), un estudio reciente basado en datos simulados ha planteado preguntas sobre la validez y la utilidad empírica del ABV. Específicamente, las simulaciones sugirieron que las características centrales de los datos del tiempo de reacción distintas del sesgo de atención relacionado con la amenaza, como la desviación estándar y la media del tiempo de reacción, podrían explicar el aumento del ABV reportado entre las muestras con el TEPT. En el presente estudio, evaluamos estas sugerencias en 95 participantes con diagnóstico del TEPT. Los resultados mostraron que ABV predijo de manera significativa y única la gravedad de los síntomas del TEPT más allá del valor predictivo de las características centrales del tiempo de reacción, ΔR2 = .05 - .23. Algunas de las predicciones derivadas de los resultados simulados se replicaron, mientras que otras no. Contrariamente a la conclusión extraída de los datos simulados, los resultados del estudio actual sugieren que la ABV es un correlato válido y replicable de la gravedad de los síntomas del TEPT.


Subject(s)
Attention , Severity of Illness Index , Stress Disorders, Post-Traumatic/psychology , Adult , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Reaction Time , Reproducibility of Results , Symptom Assessment , Young Adult
5.
Depress Anxiety ; 35(11): 1073-1080, 2018 11.
Article in English | MEDLINE | ID: mdl-30102442

ABSTRACT

BACKGROUND: Preventing suicides, mental disorders, and noncombat-related interpersonal violence during deployment are priorities of the US Army. We used predeployment survey and administrative data to develop actuarial models to identify soldiers at high risk of these outcomes during combat deployment. METHODS: The models were developed in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) Pre-Post Deployment Study, a panel study of soldiers deployed to Afghanistan in 2012-2013. Soldiers completed self-administered questionnaires before deployment and one (T1), three (T2), and nine months (T3) after deployment, and consented to administrative data linkage. Seven during-deployment outcomes were operationalized using the postdeployment surveys. Two overlapping samples were used because some outcomes were assessed at T1 (n = 7,048) and others at T2-T3 (n = 7,081). Ensemble machine learning was used to develop a model for each outcome from 273 predeployment predictors, which were compared to simple logistic regression models. RESULTS: The relative improvement in area under the receiver operating characteristic curve (AUC) obtained by machine learning compared to the logistic models ranged from 1.11 (major depression) to 1.83 (suicidality).The best-performing machine learning models were for major depression (AUC = 0.88), suicidality (0.86), and generalized anxiety disorder (0.85). Roughly 40% of these outcomes occurred among the 5% of soldiers with highest predicted risk. CONCLUSIONS: Actuarial models could be used to identify high risk soldiers either for exclusion from deployment or preventive interventions. However, the ultimate value of this approach depends on the associated costs, competing risks (e.g. stigma), and the effectiveness to-be-determined interventions.


Subject(s)
Machine Learning , Mental Disorders/epidemiology , Military Personnel/statistics & numerical data , Models, Theoretical , Resilience, Psychological , Risk Assessment/methods , Suicide/statistics & numerical data , Violence/statistics & numerical data , Adult , Afghanistan , Female , Humans , Male
6.
Am J Public Health ; 107(5): 732-739, 2017 05.
Article in English | MEDLINE | ID: mdl-28323466

ABSTRACT

OBJECTIVES: To examine associations of administratively recorded sexual assault victimization during military service with subsequent mental health and negative career outcomes among US Army women controlling for nonrandom victimization exposure. METHODS: We used data from the Army Study to Assess Risk and Resilience in Servicemembers to apply propensity score methods to match all 4238 female Regular Army soldiers with administratively recorded sexual assault victimization during 2004 to 2009 to 5 controls per case with similar composite victimization risk. We examined associations of this victimization measure with administratively recorded mental health treatment, suicide attempt, and Army career outcomes over the subsequent 12 months by using survival analysis for dichotomous outcomes and conditional generalized linear models for continuous outcomes. RESULTS: Women with administratively recorded sexual assault had significantly elevated odds ratios (ORs) of subsequent mental health treatment (any, OR = 2.5; 95% confidence interval [CI] = 2.4, 2.6; specialty, OR = 3.1; 95% CI = 2.9, 3.3; inpatient, OR = 2.8; 95% CI = 2.5, 3.1), posttraumatic stress disorder treatment (any, OR = 6.3; 95% CI = 5.7, 6.9; specialty, OR = 7.7; 95% CI = 6.8, 8.6; inpatient, OR = 6.8; 95% CI = 5.4, 8.6), suicide attempt (OR = 3.0; 95% CI = 2.5, 3.6), demotion (OR = 2.1; 95% CI = 1.9, 2.3), and attrition (OR = 1.2; 95% CI = 1.1, 1.2). CONCLUSIONS: Sexual assault victimization is associated with considerable suffering and likely decreased force readiness.


Subject(s)
Crime Victims/psychology , Mental Disorders/epidemiology , Military Personnel/psychology , Sex Offenses/psychology , Sex Offenses/statistics & numerical data , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data , Adult , Female , Humans , Propensity Score , Risk Factors , United States/epidemiology
7.
J Trauma Stress ; 30(5): 491-501, 2017 10.
Article in English | MEDLINE | ID: mdl-29078001

ABSTRACT

The present research examined selected coping strategies as moderators of the relationship between combat exposure and posttraumatic stress disorder (PTSD) symptoms among service members who were deployed to Iraq (N = 2,023) and Afghanistan (N = 1,023). A three-factor model of coping was confirmed for both military operations: positive emotion-focused, self-blame, and prayer/spirituality. Positive emotion-focused coping was inversely associated with PTSD symptoms (r = -.14) and buffered service members from the negative effects of combat exposure in both Iraq (r2 = .01) and Afghanistan (r2 = .02). Self-blame coping was positively associated with PTSD symptoms in both samples (Iraq, r = .36; Afghanistan, r = .29) but only magnified the relationship between combat exposure and PTSD symptoms among service members in Iraq (r2 = .01) . These findings were replicated when controlling for unit cohesion and symptoms of depression. Prayer/spirituality coping was not significantly associated with PTSD symptoms, regardless of combat exposure. Discussion focuses on how specific positive emotion-focused coping strategies may be helpful for military personnel in combat operations given the uncontrollable and chaotic nature of the environment. Implications include providing training for deploying personnel that covers the use of these positive emotion-focused coping strategies and the potential problems with self-blame. Such training may also be suitable for other high-risk occupations in which employees face uncontrollable situations.


Subject(s)
Adaptation, Psychological , Military Personnel/psychology , Stress Disorders, Post-Traumatic/psychology , War Exposure , Adolescent , Adult , Afghan Campaign 2001- , Cross-Sectional Studies , Depression/diagnosis , Depression/psychology , Factor Analysis, Statistical , Humans , Iraq War, 2003-2011 , Psychiatric Status Rating Scales , Resilience, Psychological , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/therapy , Surveys and Questionnaires , United States , Young Adult
8.
Cogn Emot ; 31(7): 1453-1464, 2017 11.
Article in English | MEDLINE | ID: mdl-27653208

ABSTRACT

This study explored attention and interpretation biases in processing facial expressions as correlates of theoretically distinct self-reported anger experience, expression, and control. Non-selected undergraduate students (N = 101) completed cognitive tasks measuring attention bias, interpretation bias, and Spielberger's State-Trait Anger Expression Inventory (STAXI-2). Attention bias toward angry faces was associated with higher trait anger and anger expression and with lower anger control-in and anger control-out. The propensity to quickly interpret ambiguous faces as angry was associated with greater anger expression and its subcomponent of anger expression-out and with lower anger control-out. Interactions between attention and interpretation biases did not contribute to the prediction of any anger component suggesting that attention and interpretation biases may function as distinct mechanisms. Theoretical and possible clinical implications are discussed.


Subject(s)
Anger , Attention , Facial Expression , Adult , Cognition , Female , Humans , Linear Models , Male , Young Adult
9.
Br J Psychiatry ; 204(3): 200-7, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24434071

ABSTRACT

BACKGROUND: Research of military personnel who deployed to the conflicts in Iraq or Afghanistan has suggested that there are differences in mental health outcomes between UK and US military personnel. AIMS: To compare the prevalence of post-traumatic stress disorder (PTSD), hazardous alcohol consumption, aggressive behaviour and multiple physical symptoms in US and UK military personnel deployed to Iraq. METHOD: Data were from one US (n = 1560) and one UK (n = 313) study of post-deployment military health of army personnel who had deployed to Iraq during 2007-2008. Analyses were stratified by high- and low-combat exposure. RESULTS: Significant differences in combat exposure and sociodemographics were observed between US and UK personnel; controlling for these variables accounted for the difference in prevalence of PTSD, but not in the total symptom level scores. Levels of hazardous alcohol consumption (low-combat exposure: odds ratio (OR) = 0.13, 95% CI 0.07-0.21; high-combat exposure: OR = 0.23, 95% CI 0.14-0.39) and aggression (low-combat exposure: OR = 0.36, 95% CI 0.19-0.68) were significantly lower in US compared with UK personnel. There was no difference in multiple physical symptoms. CONCLUSIONS: Differences in self-reported combat exposures explain most of the differences in reported prevalence of PTSD. Adjusting for self-reported combat exposures and sociodemographics did not explain differences in hazardous alcohol consumption or aggression.


Subject(s)
Aggression , Alcohol Drinking/epidemiology , Iraq War, 2003-2011 , Military Personnel/psychology , Stress Disorders, Post-Traumatic/epidemiology , Adolescent , Adult , Combat Disorders/epidemiology , Female , Humans , Male , Prevalence , United Kingdom/epidemiology , United States/epidemiology , Young Adult
10.
Depress Anxiety ; 31(2): 124-9, 2014 Feb.
Article in English | MEDLINE | ID: mdl-23959788

ABSTRACT

BACKGROUND: Recent studies suggest that assessment of threat-related attention bias may be useful in identifying soldiers at risk for clinical symptoms. The present study assessed the degree to which soldiers experienced combat events and showed attentional threat avoidance affected their reported levels of post-traumatic stress disorder (PTSD) and anxiety symptoms. METHODS: Four months after a combat deployment to Iraq, 63 US soldiers completed a survey assessing combat exposures and clinical symptoms as well as a dot-probe task assessing threat-related attention bias. RESULTS: Significant three-way interactions regressing threat reaction times (RTs), neutral RTs, and combat exposure on PTSD and anxiety symptoms were observed. Specifically, soldiers with high levels of combat exposure, who were more likely to demonstrate attentional bias away from threat, were also more symptomatic. CONCLUSION: These results demonstrate the potential of threat-related attention bias as a behavioral marker of PTSD and anxiety symptoms in a high-risk military occupational context.


Subject(s)
Anxiety/psychology , Attention , Combat Disorders/psychology , Iraq War, 2003-2011 , Military Personnel/psychology , Stress Disorders, Post-Traumatic/psychology , Adult , Anxiety/complications , Combat Disorders/complications , Female , Humans , Male , Military Personnel/statistics & numerical data , Reaction Time/physiology , Stress Disorders, Post-Traumatic/complications , Young Adult
11.
Psychol Methods ; 2024 Apr 22.
Article in English | MEDLINE | ID: mdl-38647484

ABSTRACT

Dishop (see record 2022-78260-001) identifies the consensus emergence model (CEM) as a useful tool for future research on emergence but argues that autoregressive models with positive autoregressive effects are an important alternative data-generating mechanism that researchers need to rule out. Here, we acknowledge that alternative data-generating mechanisms are possibility for most, if not all, nonexperimental designs and appreciate Dishop's attempts to identify cases where the CEM could provide misleading results. However, in a series of independent simulations, we were unable to replicate two of three key analyses, and the results for the third analysis did not support the earlier conclusions. The discrepancies appear to originate from Dishop's simulation code and what appear to be inconsistent model specifications that neither simulate the models described in the article nor include notable positive autoregressive effects. We contribute to the wider literature by suggesting four key criteria that researchers can apply to evaluate the possibility of alternative data-generating mechanisms: Theory, parameter recovery, fit to real data, and context. Applied to autoregressive effects and emergence data, these criteria reveal that (a) theory in psychology would generally suggest negative instead of positive autoregressive effects for behavior, (b) it is challenging to recover true autoregressive parameters from simulated data, and (c) that real data sets across a number of different contexts show little to no evidence for autoregressive effects. Instead, our analyses suggest that CEM results are congruent with the temporal changes occurring within groups and that autoregressive effects do not lead to spurious CEM results. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

12.
J Nerv Ment Dis ; 201(4): 259-65, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23538969

ABSTRACT

Research involving military service members has shown a strong relationship between combat experiences and increased risk for posttraumatic stress disorder (PTSD) and other mental health problems. Comparatively little research has examined the relationship between combat experiences, PTSD, aggression, and unethical conduct on the battlefield, although news stories sometimes suggest links between unethical conduct and disorders such as PTSD. This study systematically examined whether unethical conduct is a proxy for aggression and whether specific combat experiences and PTSD are independently associated with unethical behavior. The results of this study indicate that aggression (ß = 0.30) and specific combat experiences (particularly, witnessing war atrocities [ß = 0.14] and fighting [ß = 0.13]) are much more strongly associated with unethical conduct than is PTSD (ß = 0.04).


Subject(s)
Aggression/ethics , Aggression/psychology , Codes of Ethics , Combat Disorders/psychology , Iraq War, 2003-2011 , Military Personnel/psychology , Military Personnel/statistics & numerical data , Stress Disorders, Post-Traumatic/psychology , Violence/ethics , Violence/psychology , Adolescent , Adult , Afghan Campaign 2001- , Combat Disorders/diagnosis , Combat Disorders/epidemiology , Cross-Sectional Studies , Female , Health Surveys , Humans , Male , Middle Aged , Risk Factors , Statistics as Topic , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , United States , Violence/statistics & numerical data , Young Adult
13.
J Trauma Stress ; 26(1): 94-101, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23371305

ABSTRACT

We examined morale as a moderator of the relationship between combat exposure and posttraumatic stress disorder (PTSD) symptoms in a longitudinal study of U.S. soldiers who had participated in a deployment to Iraq. Soldiers (N = 636) completed assessments at 4 (Time 1) and 10 (Time 2) months following their combat deployment. Combat exposure (both breadth and perceived stressfulness), morale, and PTSD symptoms were assessed at Time 1, and PTSD symptoms were assessed again at Time 2. Results of multivariate multiple regressions revealed that morale at Time 1 interacted with both the breadth and stressfulness of combat exposure to predict PTSD symptoms at both Time 1 and Time 2, even when partialling out the effect of unit support. The slope of the given combat exposure and PTSD symptoms relationship was weaker when reports of morale were higher (with the effect size of the interaction ranging from .01 to .04). The results suggest that morale may buffer soldiers from the negative consequences of combat stressors.


Subject(s)
Combat Disorders/diagnosis , Combat Disorders/psychology , Iraq War, 2003-2011 , Morale , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Veterans/psychology , Adaptation, Psychological , Adult , Female , Humans , Life Change Events , Longitudinal Studies , Male , Personality Assessment , Social Support , Stress, Psychological/complications , Surveys and Questionnaires
14.
Psychol Serv ; 2023 Aug 17.
Article in English | MEDLINE | ID: mdl-37589687

ABSTRACT

As part of an Army pilot program, mandatory annual wellness checks were initiated to introduce individuals to counseling and to support psychological resilience and thriving. The program was evaluated using a cross-sectional survey completed by 7,831 soldiers. Findings revealed that about half of soldiers who reported a wellness check rated the check at least moderately helpful in their professional and personal lives. Participants receiving a wellness check reported being more likely to report willingness to seek help if they were to have mental health problems and to report higher levels of resilience and thriving even after controlling for rank, age, education, months in the unit, and trait negative affect. Participants were also less likely to report stigma-related concerns compared to those who had not received a wellness check. Consistent with theory on the common factors in counseling and the contextual model of psychotherapy (Laska et al., 2014), feeling listened to and learning new skills partially mediated the association between perceived wellness check usefulness and study outcomes, although acquiring a new perspective about problems did not. While not a randomized trial, this evaluation suggests that wellness checks are associated with programmatic goals: improved attitudes toward care seeking, resilience, and thriving. Future work should consider ways to ensure counselors address therapeutic common factors and should use a randomized, longitudinal design. Study findings have implications for implementing programs like wellness checks for military personnel and others working in high-stress occupations like first responders. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

15.
J Affect Disord ; 340: 535-541, 2023 11 01.
Article in English | MEDLINE | ID: mdl-37553016

ABSTRACT

BACKGROUND: Many servicemembers experience difficulties transitioning from military to civilian life. We examined whether changes in mental health observed during active duty were associated with indices of post-military adjustment. METHODS: Survey data from the multi-wave Army STARRS Pre/Post Deployment Study (PPDS; conducted 2012-2014) were linked to follow-up data from wave 1 of the STARRS Longitudinal Study (STARRS-LS1; conducted 2016-2018). Empirical Bayes estimates of intercepts and slopes of posttraumatic stress, problematic anger, and depressive symptoms during the PPDS were extracted from mixed-effects growth models and evaluated as predictors of life stress among 1080 participants who had separated or retired from the Army at STARRS-LS1; and of job satisfaction among 586 veterans who were employed at STARRS-LS1. RESULTS: Higher average levels and larger increases in posttraumatic stress, anger, and depression over the deployment period were each associated with increased stress and (in the case of anger and depression) reduced job satisfaction. Posttraumatic stress and anger slopes were associated with overall stress (b = 5.60, p < 0.01 and b = 15.64, p = 0.04, respectively) and relationship stress (b = 5.50, p = 0.01 and b = 22.86, p = 0.01, respectively) beyond the average levels of those symptoms. LIMITATIONS: Some transition-related difficulties may have resolved before outcome assessment; some measures were not previously validated. CONCLUSIONS: Larger increases in posttraumatic stress and anger over a deployment period were associated with increased stress after leaving the Army, even after controlling for average symptom levels during the same period. Monitoring changes in mental health during active duty may help identify personnel who need additional support to facilitate the military-to-civilian transition.


Subject(s)
Military Personnel , Stress Disorders, Post-Traumatic , Humans , Longitudinal Studies , Mental Health , Bayes Theorem , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Military Personnel/psychology
16.
J Trauma Stress ; 25(4): 376-83, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22833447

ABSTRACT

Military personnel report significant and increasing mental health problems in the months following return from combat. Nevertheless, studies have not assessed the impact of mental health training with this at-risk population. The present study evaluated the efficacy of a prototype mental health training module designed for U.S. soldiers 3-6 months after returning from combat; the module was a component of the Battlemind Training system. Soldiers (N = 1,645) were randomly assigned by platoon to 1 hour of training or a survey-only control group. Baseline surveys were conducted immediately before training; a training satisfaction survey was administered immediately after training, and a follow-up survey was administered 6 months later. Immediate postsession surveys were conducted with 681 subjects, and follow-up surveys were conducted with 542 soldiers. The Battlemind Training module received positive ratings from participants, and those who received it reported significantly better adjustment in terms of posttraumatic stress disorder symptoms, depression, and life satisfaction at follow-up compared to those in the survey-only control group. Changes in attitudes about the stigma of seeking mental health care were found immediately posttraining, but not at follow-up. The findings demonstrate that brief mental health training can be effective in reducing mental health systems with at-risk occupational groups.


Subject(s)
Life Change Events , Mental Disorders/prevention & control , Mental Health/education , Military Personnel/education , Military Personnel/psychology , Adaptation, Psychological , Adolescent , Adult , Attitude to Health , Female , Humans , Iraq War, 2003-2011 , Male , Patient Acceptance of Health Care , Patient Satisfaction , Social Stigma , United States , Young Adult
17.
J Trauma Stress ; 25(3): 307-14, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22729980

ABSTRACT

Benefit finding, described as one's ability to find benefits from stressful situations, has been hypothesized as a buffer against the negative effects of stress on mental health outcomes. Nonetheless, many have questioned the buffering potential of benefit finding in the face of prolonged and excessive stress such as is found in the combat environment. This study suggests that the length of a combat deployment and benefit finding may impact the relationship between combat exposure and posttraumatic stress disorder (PTSD) symptoms. Surveys were distributed to U.S. enlisted soldiers (n = 1,917), officers, and warrant officers (n = 163) of various combat and combat support units deployed to Iraq. A significant 3-way interaction (sr(2) = .004, p < .05) revealed that benefit finding buffered soldiers from increased PTSD symptoms under high levels of combat exposure early in the deployment, but not in later months. These results indicate that although benefit finding may be a useful coping approach during the early phases of deployment, prolonged exposure to stress may diminish a soldier's ability to use benefit finding as a method for coping.


Subject(s)
Adaptation, Psychological , Iraq War, 2003-2011 , Military Personnel/psychology , Adolescent , Adult , Combat Disorders , Female , Health Surveys , Humans , Male , Regression Analysis , Stress Disorders, Post-Traumatic/psychology , United States , Young Adult
18.
Mil Med ; 177(10): 1169-77, 2012 Oct.
Article in English | MEDLINE | ID: mdl-23113443

ABSTRACT

OBJECTIVE: This study examined 2003-2009 trends in three marital functioning indicators: marital quality, infidelity, and separation/divorce intent, and in marital dissolution rates among U.S. soldiers. METHODS: Marital functioning trends were examined with cross-sectional postdeployment sample data collected under the Land Combat Study from married, male, enlisted soldiers who had deployed to Iraq or Afghanistan (n = 5,928). Marital dissolution rates were examined with population data (n = 1,895,571). The relationships between time (measured by year) and all study variables were analyzed with chi2 tests of association, analysis of variance, and logistic regression analyses adjusting for combat exposure, mental and physical health, and demographic variables. RESULTS: Marital quality has declined, and reports of past-year infidelity and separation/divorce intent have increased between 2003 and 2009. However, no increases were observed in marital dissolution rates. CONCLUSIONS: The results indicate that more proximal indicators of marital functioning such as decreased marital quality, infidelity, and separation/divorce intent may better illustrate the strain that increased deployment tempo exerts on marital relationships. The findings provide a better understanding of how Army marriages have been affected by the wars, and suggest that further inquiry is needed on military marriages.


Subject(s)
Afghan Campaign 2001- , Iraq War, 2003-2011 , Marriage , Military Personnel , Adolescent , Adult , Cross-Sectional Studies , Divorce/statistics & numerical data , Humans , Logistic Models , Male , Mental Health , United States , Young Adult
19.
J Appl Psychol ; 107(2): 319-327, 2022 Feb.
Article in English | MEDLINE | ID: mdl-33856825

ABSTRACT

Previous research has established the role of positive emotional cultures such as companionate love and joy in predicting team performance. Building on this work, the present study analyzes the role of positive emotional culture variables as predictors of resilient performance by examining patterns of objective team performance in U.S. Army tank crews over time. We also broaden the emotional culture domain by investigating an action-oriented positive emotional culture of optimism and a negative emotional culture of anger. During a high-stakes international military training exercise, 55 U.S. Army tank crews (N = 175) completed a pre-qualification performance event, a final qualification performance event, and surveys at baseline and after both events. The positive emotional culture of optimism predicted a pattern of resilient performance defined as a rebound from poor pre-qualification performance. Emotional cultures of joy and optimism also directly predicted final performance, but neither the emotional culture of companionate love, nor the emotional culture of anger was a significant predictor. Results demonstrate the distinct nature of each of these emotional culture variables, and show that these variables differ from group trait affectivity and cohesion. Teams with a strong emotional culture of optimism were better positioned to rebound in the face of poor performance, suggesting that organizations that promote an optimistic culture develop more resilient teams. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Emotions , Optimism , Anger , Exercise , Humans , Surveys and Questionnaires
20.
J Nerv Ment Dis ; 199(3): 199-202, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21346492

ABSTRACT

This study investigates whether modifying the instructions of the Posttraumatic Stress Disorder Checklist (PCL) for military survey research changes posttraumatic stress disorder (PTSD) symptom reporting or prevalence. The sample consisted of 1691 soldiers who were randomly assigned to complete 1 of 3 versions of the PCL, which differed only in the wording of the instructions. Group differences in demographic variables, combat exposure, mean PTSD symptoms, and PTSD prevalence estimates were examined. Results showed that there were no statistically significant differences in the outcomes across the PCL versions. The findings indicate that researchers may make modifications to the PCL instructions to meet research needs without affecting PTSD symptom reporting or prevalence estimates.


Subject(s)
Checklist , Military Personnel/psychology , Stress Disorders, Post-Traumatic/diagnosis , Adolescent , Adult , Analysis of Variance , Checklist/methods , Checklist/standards , Chi-Square Distribution , Female , Humans , Male , Military Personnel/statistics & numerical data , Prevalence , Risk Factors , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Young Adult
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