Hardiness Predicts Post-Traumatic Growth and Well-Being in Severely Wounded Servicemen and Their Spouses.

INTRODUCTION: Thousands of military personnel have suffered severe wounds and traumatic amputations in recent overseas conflicts. They face multiple surgeries and long, painful rehabilitation. Despite the tremendous stress for these servicemen and families, many appear to cope quite well and even thrive despite their devastating wounds. Hardiness is a world view or mindset marked by high levels of commitment and engagement in the world, a strong sense of control, and the tendency to see change as a challenge and opportunity to learn and improve. Previous research has shown that military personnel high in hardiness are at lower risk for post-traumatic stress disorder, depression, and other psychiatric symptoms following combat exposure. This study evaluated the impact of personality hardiness on post-traumatic growth (PTG) and psychological well-being in severely wounded service members and their spouses. MATERIALS AND METHODS: Male volunteers were surveyed while in hospital for severe battle wounds including loss of limbs. All were married, and all spouses also agreed to participate. Participants (N = 44) completed measures of hardiness, PTG, well-being, and neuroticism, and answered a question regarding potential benefits of their experience. RESULTS: Hierarchical multiple regression showed that hardiness significantly predicted both PTG and well-being, while controlling for age, education, family income, and neuroticism. Both service members and spouses indicated they experienced benefits in the following areas: strengthened family ties and connections; greater appreciation for and perspective on life; new career and educational opportunities; stronger, more resilient as a person; and formed new relationships, friends, and connections. CONCLUSION: These results suggest that seriously wounded military members and their spouses who are high in hardiness are more likely to experience PTG and psychological well-being following extremely stressful experiences. Hardiness entails positive reframing of negative experiences as opportunities and challenges to overcome, and taking action to solve problems. Training programs to increase hardiness attitudes and related coping skills may thus be beneficial in facilitating healthy adaptation for severely injured patients.

Coping with recruiter stress: Hardiness, performance and well-being in US Army recruiters.

Recruiting for military service can be a highly stressful job, but it is one that is essential for success in the all-volunteer force. Military recruiters face a number of job stressors, including pressure to meet monthly production quotas, long work hours and time away from family. They also work in relative isolation, with limited work social support networks. These factors make recruiters vulnerable to burnout and early attrition. The present study examines psychological hardiness and active, problem focused coping as potential stress resilience resources in US Army recruiters. In a stratified random sample of N = 817 recruiters, hardiness was found to predict supervisor-rated performance and psychological well-being. Hardiness also interacted with problem focused coping to predict psychological well-being, suggesting a mediating role for coping. These results can be applied to help improve policy for selecting and training military recruiters.

Total force fitness: the military family fitness model.

The military lifestyle can create formidable challenges for military families. This article describes the Military Family Fitness Model (MFFM), a comprehensive model aimed at enhancing family fitness and resilience across the life span. This model is intended for use by Service members, their families, leaders, and health care providers but also has broader applications for all families. The MFFM has three core components: (1) family demands, (2) resources (including individual resources, family resources, and external resources), and (3) family outcomes (including related metrics). The MFFM proposes that resources from the individual, family, and external areas promote fitness, bolster resilience, and foster well-being for the family. The MFFM highlights each resource level for the purpose of improving family fitness and resilience over time. The MFFM both builds on existing family strengths and encourages the development of new family strengths through resource-acquiring behaviors. The purpose of this article is to (1) expand the military's Total Force Fitness (TFF) intent as it relates to families and (2) offer a family fitness model. This article will summarize relevant evidence, provide supportive theory, describe the model, and proffer metrics that support the dimensions of this model.

Total Force Fitness in units part 1: military demand-resource model.

The military unit is a critical center of gravity in the military's efforts to enhance resilience and the health of the force. The purpose of this article is to augment the military's Total Force Fitness (TFF) guidance with a framework of TFF in units. The framework is based on a Military Demand-Resource model that highlights the dynamic interactions across demands, resources, and outcomes. A joint team of subject-matter experts identified key variables representing unit fitness demands, resources, and outcomes. The resulting framework informs and supports leaders, support agencies, and enterprise efforts to strengthen TFF in units by (1) identifying TFF unit variables aligned with current evidence and operational practices, (2) standardizing communication about TFF in units across the Department of Defense enterprise in a variety of military organizational contexts, (3) improving current resources including evidence-based actions for leaders, (4) identifying and addressing of gaps, and (5) directing future research for enhancing TFF in units. These goals are intended to inform and enhance Service efforts to develop Service-specific TFF models, as well as provide the conceptual foundation for a follow-on article about TFF metrics for units.

Consensus recommendations for common data elements for operational stress research and surveillance: report of a federal interagency working group.

Empirical studies and surveillance projects increasingly assess and address potentially adverse psychological health outcomes from the stress of military operations, but no standards yet exist for common concept definitions, variable categories, and measures. This article reports the consensus recommendations of the federal interagency Operational Stress Working Group for common data elements to be used in future operational stress research and surveillance with the goal of improving comparability across studies. Operational stress encompasses more than just combat; it occurs everywhere service members and their families live and work. Posttraumatic stress is not the only adverse mental or behavioral health outcome of importance. The Operational Stress Working Group contends that a primary goal of operational stress research and surveillance is to promote prevention of adverse mental and behavioral outcomes, especially by recognizing the preclinical and subclinical states of distress and dysfunction that portend a risk for failure of role performance or future mental disorders. Recommendations for data elements are divided into 3 tiers: core, supplemental, and emerging, including variable domains and specific measures for assessing operational stressor exposures, stress outcomes, moderating factors, and mediating processes. Attention is drawn to the emerging construct of stress injury as a generic term for subclinical operational stress, and to emerging data elements addressing biological, psychological, and spiritual mediators of risk. Methodologies are needed for identifying preclinical and subclinical states of distress or dysfunction that are markers of risk for failure of role performance and future clinical mental disorders, so that targeted prevention interventions can be developed and evaluated.

The LIFE program: a wellness approach to weight loss.

The LIFE (lifestyle change, individual readiness, fitness excellence, eating healthy) wellness program was an intensive, out-patient, healthy lifestyle change program with participants from the Army, Navy, Air Force, and Marine Corps. Our objective was to describe the LIFE program and to present before and after test results for this 1-year program. Fifty-three participants completed the 5-day intensive outpatient and 1-year follow-up program and maintained average weight losses of >10 pounds and 14 pounds for men and women, respectively. Most of the weight loss occurred by 6 months. Participants who completed the program also showed increases in healthy eating attitudes, well-being, and overall quality of life. The LIFE change model has implications for improved service retention, health, and overall quality of life or patient evidence that matters (POEMS). The program is both portable and flexible and can be tailored to the demands of the dynamic military environment.

Traumatic stress disorders following first-trimester spontaneous abortion.

Provide counsel and support to women after a spontaneous abortion. Research indicates that many women will talk with their physician about their emotional distress and that physicians provide good information after the spontaneous abortion. Evaluate women for acute stress disorder (ASD) after a spontaneous abortion. Research found that women reporting physical, emotional, or sexual abuse are more likely to experience ASD. Patients should be assessed for post-traumatic stress disorder in follow-up visits 1 month after the initial visit. Research has found that up to 25% of women meet criteria for PTSD 1 month post the spontaneous abortion and 7% met criteria at 4 months. Physicians should refer women who are experiencing traumatic stress to a behavioral health professional.