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1.
Medicine (Baltimore) ; 99(3): e18746, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011456

RESUMO

Converging evidence reveals the negative interpretation bias in anxiety. Given that anxiety is a severe psychological problem among Chinese military personnel, the present study examined whether high trait anxiety military personnel showed negative interpretation bias in real-world situations and whether their interpretations were influenced by self-relevance.The sample included 24 high trait anxiety (H-TA) and 22 low trait anxiety (L-TA) Chinese military servicemen. Participants completed 20 open-ended ambiguous scenarios by deciding how much they believed in the positive and negative ending of each sentence. The 20 scenarios were designed according to real life in military and half of them were self-relevant and the others were non-self-relevant.A 2(group) ×2(self-relevance) ANOVA of positive and negative endings revealed that compared to L-TA, H-TA believed more in negative continuations and less in positive continuations. Moderate correlations were found between samples' believes in positive and negative endings and their trait anxiety scores. Military personnel showed more positive interpretation biases in non-self-relevant scenarios than in self-relevant scenarios.These findings are the first to show interpretation bias in military situations, and interventional strategies to modify servicemen's interpretation bias could be designed according to military situations.


Assuntos
Transtornos de Ansiedade/psicologia , Militares/psicologia , Adaptação Psicológica , Adolescente , Adulto , China , Humanos , Masculino , Testes Neuropsicológicos , Repressão Psicológica
2.
J Consult Clin Psychol ; 88(2): 137-148, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31894995

RESUMO

OBJECTIVE: This research evaluates changes in perceived military and civilian drinking norms as mechanisms of the effects of a motivational enhancement therapy (MET) intervention on changes in alcohol consumption among active-duty military personnel with a substance use disorder. We also evaluate the value of providing tolerance and family history risk-related personalized feedback by testing whether those receiving feedback indicating higher risk reduce their drinking more than those receiving feedback indicating lower risk or receiving no feedback. METHOD: Participants (N = 242; Mage = 28 years; 92% male; 59% Caucasian) completed a baseline questionnaire and were randomly assigned to a MET or educational control condition. Both conditions were single session and took place over the telephone. Outcomes were assessed 3 and 6 months later. The study was preregistered at ClinicalTrials.gov (NCT01128140). RESULTS: We found evidence that reductions in perceived norms for other military personnel, but not for civilians, mediated intervention efficacy on reductions in alcohol use. Further, the MET intervention was successful at reducing drinking among soldiers who reported higher levels of baseline tolerance and family history risk, but not succuessful at reducing drinking among those who reported low or medium levels of risk. CONCLUSIONS: Systematic evaluation of whether and how individual intervention components contribute to efficacy is a promising approach for refining and improving interventions. This research suggests that MET interventions may wish to target focal perceived norms and provides support for discussion of feedback indicating elevated risks due to tolerance and family history. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Alcoolismo/terapia , Retroalimentação Psicológica , Militares/psicologia , Entrevista Motivacional , Adulto , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Normas Sociais , Inquéritos e Questionários , Telefone , Resultado do Tratamento , Adulto Jovem
3.
JAMA Netw Open ; 3(1): e1919935, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31995212

RESUMO

Importance: Understanding suicide ideation (SI) during combat deployment can inform prevention and treatment during and after deployment. Objective: To examine associations of sociodemographic characteristics, lifetime and past-year stressors, and mental disorders with 30-day SI among a representative sample of US Army soldiers deployed in Afghanistan. Design, Setting, and Participants: In this survey study, soldiers deployed to Afghanistan completed self-administered questionnaires in July 2012. The sample was weighted to represent all 87 032 soldiers serving in Afghanistan. Prevalence of lifetime, past-year, and 30-day SI and mental disorders was determined. Logistic regression analyses examined risk factors associated with SI. Data analyses for this study were conducted between August 2018 and August 2019. Main Outcomes and Measures: Suicide ideation, lifetime and 12-month stressors, and mental disorders were assessed with questionnaires. Administrative records identified sociodemographic characteristics and suicide attempts. Results: A total of 3957 soldiers (3473 [weighted 87.5%] male; 2135 [weighted 52.6%] aged ≤29 years) completed self-administered questionnaires during their deployment in Afghanistan. Lifetime, past-year, and 30-day SI prevalence estimates were 11.7%, 3.0%, and 1.9%, respectively. Among soldiers with SI, 44.2% had major depressive disorder (MDD) and 19.3% had posttraumatic stress disorder in the past 30-day period. A series of analyses of the 23 grouped variables potentially associated with SI resulted in a final model of sex; race/ethnicity; lifetime noncombat trauma; past 12-month relationship problems, legal problems, and death or illness of a friend or family member; and MDD. In this final multivariable model, white race/ethnicity (odds ratio [OR], 3.1 [95% CI, 1.8-5.1]), lifetime noncombat trauma (OR, 2.1 [95% CI, 1.1-4.0]), and MDD (past 30 days: OR, 31.8 [95% CI, 15.0-67.7]; before past 30 days: OR, 4.9 [95% CI, 2.5-9.6]) were associated with SI. Among the 85 soldiers with past 30-day SI, from survey administration through 12 months after returning from deployment, 6% (5 participants) had a documented suicide attempt vs 0.14% (6 participants) of the 3872 soldiers without SI. Conclusions and Relevance: This study suggests that major depressive disorder and noncombat trauma are important factors in identifying SI risk during combat deployment.


Assuntos
Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Suicídio/psicologia , Adaptação Psicológica , Adulto , Campanha Afegã de 2001- , Fatores Etários , Feminino , Humanos , Masculino , Militares/estatística & dados numéricos , Resiliência Psicológica , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Suicídio/estatística & dados numéricos , Adulto Jovem
4.
Cyberpsychol Behav Soc Netw ; 22(12): 761-765, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31841649

RESUMO

Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are highly prevalent, and frequently comorbid, among active and retired military service members. Both TBI and PTSD may contribute to impaired cognitive function, but it remains insufficiently clear what the relative impact of each is on overall cognition and whether multiple TBIs may further impair cognitive function. To understand the relative impact of TBI and symptoms of PTSD on cognitive function we examined data from 326 active or retired military service members, or dependents, either with or without a history of TBI, using questionnaires and the NIH Toolbox Cognitive Battery (NIH-TB), a brief iPad-based assessment that measures the cognitive domains most important to daily functioning. The NIH-TB was developed for use as a "common currency" among research studies, and was more recently adapted to the iPad for ease of use. To our knowledge, this is the first report of its application to evaluate the relative impact of TBI and PTSD. Our results indicate that cognitive function remains largely intact after multiple TBIs if symptoms of PTSD are not evident, and that measures of literacy and overall intelligence are relatively impervious to both TBI and PTSD. When cognitive impairment is observed after TBI, it is predominantly associated with the presence of significant symptoms of PTSD in most domains. However, TBI alone may impair some aspects of executive function. These findings need to be validated in other populations.


Assuntos
Lesões Encefálicas Traumáticas/psicologia , Cognição , Disfunção Cognitiva/psicologia , Militares/psicologia , Doenças Profissionais/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Disfunção Cognitiva/diagnóstico , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Doenças Profissionais/diagnóstico , Inquéritos e Questionários
5.
J Music Ther ; 56(4): 315-347, 2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31696919

RESUMO

Music therapy treatment is increasingly being used to promote health, enhance quality of life, and improve functioning in military personnel, but evidence on the use of music interventions with military service members is still emerging. The purpose of this scoping review was to synthesize the available literature regarding music therapy treatment with military personnel by identifying the types of information available, key characteristics, and gaps in the knowledge base. The review was completed using the methodological framework proposed by Arksey and O'Malley. A total of 27 publications met the criteria for review. The results included anecdotal reports, white papers/ briefs, case studies, historical reviews, clinical program descriptions, and research studies. Both active duty and veteran service members were represented in the literature, and post-traumatic stress disorder and traumatic brain injury were the most commonly listed conditions among those served. Music therapy services were offered in both group and individual formats, and drumming was the most common music intervention cited. Most publications accurately represented music therapy, and the historical reviews highlighted the connection between the development of the field of music therapy and the use of music with military personnel. Several gaps were identified, including a lack of specificity in reporting, low levels of evidence, and limited inclusion of women service members.


Assuntos
Militares/psicologia , Musicoterapia , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/terapia , Feminino , Humanos
6.
BMC Public Health ; 19(1): 1517, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718613

RESUMO

BACKGROUND: The health and well-being of military spouses directly contribute to a robust military force by enabling the spouse to better support the active duty member's career. In order to understand the overall health and well-being of military spouses, we assessed health indicators among military spouses using the Healthy People 2020 framework and examined associations of these health indicators with military experiences and psychosocial factors. METHODS: Using data from the Millennium Cohort Family Study, a U.S. Department of Defense-sponsored survey of 9872 spouses of service members with 2-5 years of military service, we examined attainment of Healthy People 2020 goals for spouses and service members, including healthy weight, exercise, sleep, and alcohol and tobacco use. Multivariable logistic regression models assessed associations of spouse health indicators with stressful military life experiences and social support, adjusting for demographics and military descriptors. The spousal survey was administered nationwide in 2011. RESULTS: The majority of military spouses met each health goal assessed. However, less than half met the healthy weight and the strength training goals. Reporting greater perceived family support from the military was associated with better behavioral health outcomes, while having no one to turn to for support was associated with poorer outcomes. Using the Healthy People 2020 objectives as a framework for identifying key health behaviors and benchmarks, this study identified factors, including military-specific experiences, that may contribute to physical health behaviors and outcomes among military spouses. With respect to demographic characteristics, the findings are consistent with other literature that women are more likely to refrain from risky substance use and that greater education is associated with better overall health outcomes. CONCLUSIONS: Findings suggest that enhanced social and military support and tailored programming for military spouses may improve health outcomes and contribute to the well-being of military couples. Such programming could also bolster force readiness and retention.


Assuntos
Comportamentos Relacionados com a Saúde , Nível de Saúde , Estilo de Vida , Militares , Apoio Social , Cônjuges , Adolescente , Adulto , Peso Corporal , Estudos de Coortes , Escolaridade , Características da Família , Feminino , Humanos , Modelos Logísticos , Masculino , Militares/psicologia , Projetos de Pesquisa , Treinamento de Resistência , Fatores Sexuais , Cônjuges/psicologia , Transtornos Relacionados ao Uso de Substâncias , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
7.
BMC Psychol ; 7(1): 75, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775853

RESUMO

BACKGROUND: Previous studies have found that perceptions of mental health related stigma can negatively impact help-seeking, particularly in military samples. Moreover, perceptions of stigma and barriers to care can vary between individuals with different psychiatric disorders. The aim of this study was to examine whether perceptions of stigma and barriers to care differed in a UK military sample between those with and without a current likely mental health diagnosis. METHOD: Structured telephone interviews were carried out with 1432 service personnel and veterans who reported recent subjective mental ill health in the last 3 years. Participants completed self-reported measures relating to perceived stigma, barriers to care and psychological wellbeing. RESULTS: Those meeting criteria for probable common mental disorders (CMD) and PTSD were significantly more likely to report concerns relating to perceived and internalised stigma and barriers to care compared to participants without a likely mental disorder. Compared to individuals with likely CMD and alcohol misuse, those with probable PTSD reported higher levels of stigma-related concerns and barriers to care - although this difference was not significantly different. CONCLUSIONS: These results indicate that perceptions of stigma continue to exist in UK serving personnel and military veterans with current probable mental disorders. Efforts to address particular concerns (e.g. being seen as weak; difficulty accessing appointments) may be worthwhile and, ultimately, lead to improvements in military personnel and veteran wellbeing.


Assuntos
Autoavaliação Diagnóstica , Transtornos Mentais/psicologia , Militares/psicologia , Estigma Social , Veteranos/psicologia , Adulto , Mecanismos de Defesa , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Serviços de Saúde Mental , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/psicologia , Reino Unido , Adulto Jovem
8.
Behav Ther ; 50(6): 1053-1062, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31735241

RESUMO

Trauma-related cognitions about the self and the world have been identified as a mediator of posttraumatic stress disorder (PTSD) change during prolonged exposure (PE) therapy. However, the extent to which negative cognitions mediate PTSD change in other PTSD treatments is unclear. In addition, previous studies have not tested alternate mediators of PTSD change during PE. In a sample of 216 treatment-seeking active-duty military personnel with PTSD, the present study examined the specificity of the negative cognition mediation effect in both PE and present-centered therapy (PCT). In addition, we examined another possible mediator, cognitive emotion regulation. Lagged mediational analyses indicated that negative cognitions about the self and world and the unhelpful cognitive emotion regulation strategy of catastrophizing each significantly mediated change in PTSD from baseline to 6-month follow-up. In a combined model, the mediating effect of catastrophizing was greater than negative cognitions about the world, and similar to negative cognitions about the self. Moderated mediation analyses revealed that the effect of catastrophizing was greater in PE than in PCT. Findings show that trauma-related cognitions and, to a greater degree, the emotion regulation strategy catastrophizing, both mediate PTSD change. Further research is needed to determine whether these mediating variables represent mechanisms of therapeutic change.


Assuntos
Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Cognição , Feminino , Humanos , Terapia Implosiva , Masculino , Pessoa de Meia-Idade
9.
BMC Public Health ; 19(1): 1394, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660935

RESUMO

BACKGROUND: Alcohol misuse is an important contributor to sexual acquisition and transmission of HIV in military communities. This cross-sectional study quantified the prevalence of probable problematic alcohol use among male service members in the Armed Forces of the Democratic Republic of the Congo (FARDC), identified associated factors, and investigated associations of alcohol misuse with risky sexual behaviors. METHODS: Participants included 2549 active duty male soldiers ≥ 18 years old. Data were collected via computer-assisted personal-interview from October 2013-April 2014. The Alcohol Use Disorders Identification Test (AUDIT) was used to identify probable problematic alcohol use (AUDIT score ≥ 8) compared to no/low-risk alcohol use (AUDIT score ≤ 7). Bivariate logistic regressions were used to identify factors associated with probable problematic alcohol use. Several multivariable logistic regressions (adjusted for age, marital status, education level) were used to examine associations of probable problematic alcohol use with risky sexual behaviors. Tests were two sided; statistical significance was defined as p < 0.05. RESULTS: Fifteen percent of men screened positive for probable problematic alcohol use. The odds of probable problematic alcohol use were elevated among men who were single and living with a partner (OR = 1.66; 95% CI = 1.24-2.21), ranked as a non-commissioned officer [NCO] (OR = 1.40; 95% CI = 1.10-1.77), and in the 30-39 and 40-49 age groups (OR 30-39 age group = 2.17; 95% CI = 1.56-3.02; OR 40-49 age group = 1.79; 95% CI = 1.26-2.55). Probable problematic alcohol use was associated with increased odds of having sex with a sex worker (SW), having multiple sexual partners, and participating in transactional sex (aOR sex with a SW = 2.36; 95% CI = 1.78-3.13; aOR multiple sexual partners = 2.08; 95% CI = 1.66-2.60; aOR transactional sex = 1.99; 95% CI = 1.59-2.50). CONCLUSIONS: Results emphasize the need to address alcohol use in the FARDC and integrate alcohol abuse education into HIV prevention programs among male service members. Alcohol abuse prevention efforts should target men who are 30-49 years of age, unmarried, and ranked as a NCO. Messages and interventions to reduce alcohol misuse in relation to risky sexual behaviors are needed.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Militares/psicologia , Assunção de Riscos , Comportamento Sexual/psicologia , Adolescente , Adulto , Estudos Transversais , República Democrática do Congo/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Prevalência , Adulto Jovem
10.
Psychiatry ; 82(3): 240-255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31566520

RESUMO

Objective: During the wars in Afghanistan and Iraq, suicidal behaviors increased among U.S. Army soldiers. Although Reserve Component (RC) soldiers (National Guard and Army Reserve) comprise approximately one third of those deployed in support of the wars, few studies have examined suicidal behaviors among these "citizen-soldiers". The objective of this study is to examine suicide attempt risk factors and timing among RC enlisted soldiers. Methods: This longitudinal, retrospective cohort study used individual-level person-month records from Army and Department of Defense administrative data systems to examine socio-demographic, service-related, and mental health predictors of medically documented suicide attempts among enlisted RC soldiers during deployment from 2004-2009. Data were analyzed using discrete-time survival models. Results: A total of 230 enlisted RC soldiers attempted suicide. Overall, the in-theater suicide attempt rate among RC soldiers was 81/100,000 person-years. Risk was highest in the fifth month of deployment (13.8 per 100,000 person-months). Suicide attempts were more likely among soldiers who were women (adjusted odds ratio, aOR = 2.5 [95% CI: 1.8-3.5]), less than high school educated (aOR = 1.8 [95% CI: 1.3-2.5]), in their first 2 years of service (aOR = 2.0 [95% CI: 1.2-3.4]), were currently married (aOR = 2.0 [95% CI: 1.5-2.7]), and had received a mental health diagnosis in the previous month (aOR = 24.7 [95% CI: 17.4-35.0]). Conclusions: Being female, early in service and currently married are associated with increased odds of suicide attempt in RC soldiers. Risk of suicide attempt was greatest at mid deployment. These predictors and the timing of suicide attempt for RC soldiers in-theater are largely consistent with those of deployed Active Component (Regular) soldiers. Results also reinforce and replicate the findings among Active Component soldiers related to the importance of a recent mental health diagnosis and the mid-deployment as a period of enhanced risk.


Assuntos
Campanha Afegã de 2001- , Guerra do Iraque 2003-2011 , Militares/psicologia , Resiliência Psicológica , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Adulto Jovem
11.
BMC Musculoskelet Disord ; 20(1): 444, 2019 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-31604450

RESUMO

BACKGROUND: Musculoskeletal disorders (MSD) are common among soldiers and constitute the most common reason for discontinuing military service within different military populations worldwide. The aims of this study were to investigate the prevalence of musculoskeletal disorders in two cohorts, 10 years apart, in the Swedish Armed Forces, to explore differences between these cohorts and to determine associated factors with MSD. METHOD: Comparative cross-sectional study. Participants were recruited from the Swedish Armed Forces, i.e. soldiers preparing for international missions in 2002 and 2012. A total of 961 soldiers, 7% women, participated in the study. Data were collected using the Musculoskeletal Screening Protocol (MSP), which includes questions regarding prevalence of MSD in ten anatomical locations (neck, upper back, low back, shoulders, elbow, hand, hip, knee, lower limb and foot). An additional five questions concern perceived self-rated health, i.e. how the respondent perceives their own physical body, mental health, social environment, physical environment and work ability. RESULTS: Over a ten-year period, both point prevalence and one-year prevalence of MSD in any body part increased significantly, with point prevalence increasing from 7.1 to 35.2% (p < 0.001) and one-year prevalence from 27.9 to 67.9% (p < 0.001). The knee was the most common anatomic location for MSD in both cohorts. Across each anatomical location (neck, upper back, low back, shoulders, elbow, hand, hip, knee, lower leg and foot), both point prevalence (p < 0.039) and one-year prevalence (p < 0.005) increased significantly from 2002 to 2012. Most soldiers reported good to excellent perceived health, i.e. self-perception of their physical body, mental health, physical and social environments, and work ability. The odds of reporting one-year prevalence of MSD in any body part was 5.28 times higher for soldiers in Cohort 2012, 1.91 times higher in age group 31-40 and 2.84 times higher in age group 41 and above. CONCLUSIONS: The prevalence of MSD increased remarkably over a ten-year period among Swedish soldiers preparing for international missions. With increasing age as one risk factor, systematic monitoring of MSD throughout the soldiers' careers and implementation of targeted primary-to-tertiary preventive programs are thus important.


Assuntos
Militares/estatística & dados numéricos , Missionários/estatística & dados numéricos , Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Masculino , Militares/psicologia , Missionários/psicologia , Doenças Musculoesqueléticas/prevenção & controle , Doenças Musculoesqueléticas/psicologia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/psicologia , Prevalência , Fatores de Risco , Autoimagem , Inquéritos e Questionários/estatística & dados numéricos , Suécia/epidemiologia , Adulto Jovem
12.
BMC Womens Health ; 19(1): 119, 2019 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623632

RESUMO

BACKGROUND: Substantial research has found that women assess their health as poor relative to men, but the reasons for this are not fully understood. Military women are characterised by good health and the ability to work in an archetypically male culture. Thus, studies on the gender pattern of self-reported health in military personnel could generate hypotheses for future research on the possible associations between gender and health. However, such studies are rare and limited to a few countries. The aim of this study was to examine self-reported physical and mental health in Norwegian military women. METHODS: We compared responses on self-reported health of 1068 active duty military women in Norway to those of active duty military men (n = 8100). Further, we compared the military women to civilian women working in the Norwegian Armed Forces (n = 1081). Participants were stratified into three age groups: 20-29; 30-39; and 40-60 years. We used Pearson Chi-square tests, Students t-tests and regression models to assess differences between the groups. RESULTS: The military women in our study reported physical illness and injuries equal to those of military men, but more military women used pain relieving and psychotropic drugs. More military women aged 20-29 and 30-39 years reported mental health issues than military men of the same age. In the age group 30-39 years, twice as many military women assessed their health as poor compared to military men. In the age group 40-60 years, more military women than men reported musculoskeletal pain. Military women used less smokeless tobacco than military men, but there were few differences in alcohol consumption and smoking. Military women appeared to be more physically healthy than civilian women, but we found few differences in mental health between these two groups. CONCLUSION: Most military women reported physical symptoms equal to those of military men, but there were differences between the genders in mental health and drug use. More favourable health compared to civilian women was most evident in the youngest age group and did not apply to mental health.


Assuntos
Autoavaliação Diagnóstica , Militares/psicologia , Grupos Populacionais/psicologia , Fatores Sexuais , Adulto , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Análise de Regressão , Autorrelato , Adulto Jovem
13.
Int J Occup Med Environ Health ; 32(5): 653-662, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31511703

RESUMO

OBJECTIVES: The study analyzed the effectiveness of military pilots' behavior under the influence of false horizon illusion - a false perception of the real horizon. It was assumed that visual illusion tends to cause spatial disorientation (SD). The question was asked which orientation of the sloping cloud (right/left) would have a bigger impact on SD. The effectiveness of the flight profile performance under the influence of visual illusion was analyzed in the context of the field dependence (FD), field independence (FI) or field intermediate dependence (FINT) of perception, the effectiveness of attention and operational memory. MATERIAL AND METHODS: The study covered 66 pilots. A flight simulator was used as a measure of effectiveness in performing the flight profile in spatial disorientation conditions. The effectiveness of attention and working memory was diagnosed using 4 computer tasks. RESULTS: It was revealed that the right sloping cloud (compared to the left sloping cloud) had a greater impact on military pilots' behavior. The cognitive style distinguishes the accuracy of the flight profile performance from the inclined cloud pointing to the right. The comparisons showed significant differences between the FI and FD pilot groups. All the pilots demonstrated the right-sided asymmetry of the flight rate. While performing tasks on the simulator, the FI pilots were characterized by a more stable rate than the FINT pilots. CONCLUSIONS: A general conclusion is that the "correct falling cloud" had a greater impact on pilots' behavior. The presented results confirm the hypothesis that susceptibility to visual illusions is significantly increased in the pilots characterized by field dependence while the pilots with the FINT style of perception are characterized by a greater variability of the flight rate. Int J Occup Med Environ Health. 2019;32(5):653-62.


Assuntos
Cognição , Ilusões/psicologia , Pilotos/psicologia , Adulto , Medicina Aeroespacial , Simulação por Computador , Humanos , Memória de Curto Prazo , Militares/psicologia , Orientação Espacial , Campos Visuais
14.
J Consult Clin Psychol ; 87(11): 1019-1029, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31556650

RESUMO

OBJECTIVE: We evaluated patterns and predictors of change from three efficacy trials of trauma-focused cognitive-behavioral treatments (TF-CBT) among service members (N = 702; mean age = 32.88; 89.4% male; 79.8% non-Hispanic/Latino). Rates of clinically significant change were also compared with other trials. METHOD: The trials were conducted in the same setting with identical measures. The primary outcome was symptom severity scores on the PTSD Symptom Scale-Interview Version (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993). RESULTS: Symptom change was best explained by baseline scores and individual slopes. TF-CBT was not associated with better slope change relative to Present-Centered Therapy, a comparison arm in 2 trials. Lower baseline scores (ß = .33, p < .01) and higher ratings of treatment credibility (ß = -.22, p < .01) and expectancy for change (ß = -.16, p < .01) were associated with greater symptom change. Older service members also responded less well to treatment (ß = .09, p < .05). Based on the Jacobson and Truax (1991) metric for clinically significant change, 31% of trial participants either recovered or improved. CONCLUSIONS: Clinicians should individually tailor treatment for service members with high baseline symptoms, older patients, and those with low levels of credibility and expectancy for change. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Conflitos Armados/psicologia , Terapia Cognitivo-Comportamental/métodos , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Feminino , Humanos , Masculino , Resultado do Tratamento , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-31489903

RESUMO

Psychiatric hospitalization for a suicide attempt (SA), rather than suicide ideation (SI) alone, is a stronger risk indicator for eventual suicide death. Yet, little is known about demographic and clinical characteristics differentiating those admitted for SA versus SI. Understanding these differences has implications for assessment and treatment. A retrospective review of electronic medical records (EMRs) was performed on service members (n = 955) admitted for SA or SI at the Walter Reed Army Medical Center between 2001-2006. Service members hospitalized for SA were younger compared to those hospitalized for SI. The proportion of women admitted for SA was significantly higher than those admitted for SI whereas their male counterparts showed the opposite pattern. Patients admitted for SA, versus SI, had significantly higher prevalence of adjustment disorder with mixed disturbance of emotion and conduct (MDEC), personality disorder not otherwise specified (PDNOS), and borderline personality disorder (BPD). Patients admitted for SI had significantly higher prevalence of adjustment disorder with depressed mood and deferred Axis II diagnosis, compared to those admitted for SA. There were no significant between-group differences in the average or median number of documented prior suicide attempts. Findings highlight the need for more standardized assessment, diagnostic decision-making, and documentation practices for all patients.


Assuntos
Hospitalização , Militares/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Transtornos da Personalidade , Prevalência , Estudos Retrospectivos , Adulto Jovem
16.
Georgian Med News ; (292-293): 108-112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31560674

RESUMO

The article reviews the theoretical and methodological basis of specialized assistance to participants in military actions. The essence of specialized assistance and its features in conditions of geopolitical conflicts reveal it to be a social phenomenon and a system of medical support in our country and in world practice. The state of specialized assistance to participants of an antiterrorist operation and members of their families were investigated, as well as the peculiarities of practical actions to ensure it with institutions of different levels. Some features of state regulation of the processes of social rehabilitation and re-socialization of combatants were analysed.


Assuntos
Assistência à Saúde , Militares/psicologia , Política , Guerra , Humanos , Apoio Social
17.
Psychol Assess ; 31(11): 1340-1356, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31380697

RESUMO

Prior studies raise questions about whether persistent postconcussive symptoms (PCS) are differentiable from mental health sequelae of traumatic brain injury (TBI). To investigate whether PCS represented a distinct symptom domain, we evaluated the structure of post-concussive and psychological symptoms using data from The Army STARRS Pre/Post Deployment Study, a panel survey of three U.S. Army Brigade Combat Teams that deployed to Afghanistan. Data from 1229 participants who sustained probable TBI during deployment completed ratings of past-30-day post-concussive, posttraumatic stress, and depressive symptoms three months after their return. Exploratory factor analysis (EFA; n = 300) and confirmatory factor analysis (CFA; n = 929) of symptom ratings were performed in independent subsamples. EFA suggested a model with 3 correlated factors resembling PCS, posttraumatic stress, and depression. CFA confirmed adequate fit of the 3-factor model (CFI = .964, RMSEA = .073 [.070, .075]), contingent upon allowing theoretically defensible cross-loadings. Bifactor CFA indicated that variance in all symptoms was explained by a general factor (λ = .36-.93), but also provided evidence of domain factors defined by (a) reexperiencing/hyperarousal, (b) cognitive/somatic symptoms, and (c) depressed mood/anhedonia. Soldiers with more severe TBI had higher cognitive/somatic scores, whereas soldiers with more deployment stress had higher general and reexperiencing/hyperarousal scores. Thus, variance in PCS is attributable to both a specific cognitive/somatic symptom factor and a general factor that also explains variance in posttraumatic stress and depression. Measurement of specific domains representing cognitive/somatic symptoms, reexperiencing/hyperarousal, and depressed mood/anhedonia may help clarify the relative severity of PCS, posttraumatic stress, and depression among individuals with recent TBI. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Masculino , Síndrome Pós-Concussão/complicações , Síndrome Pós-Concussão/psicologia , Estados Unidos , Adulto Jovem
18.
Sleep Health ; 5(6): 651-657, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31377248

RESUMO

OBJECTIVES: The current study sought to characterize the sleep problems of soldiers entering Basic Combat Training and to identify the link between sleep problems and subsequent performance, psychological distress, anger reactions, and attention. DESIGN: Soldiers were surveyed at 4 time points throughout the standard 10 weeks of Basic Combat Training. Surveys were administered at weeks 1, 3, 6, and 9. Sleep problems were identified as either present or absent at each time point using a sleep problem screening questionnaire. Four sleep patterns were identified and then used to evaluate outcomes throughout training (n = 1577). RESULTS: When compared to those who never had a sleep problem ("healthy "; 60.6%), those who recovered from their initial sleep problem ("recovered"; 12.8%) started training with higher psychological distress and anger reactions and lower attention but steadily improved throughout training. Those who developed a sleep problem during training ("new onset"; 20.0%) and those who had a sleep problem throughout training ("chronic"; 6.6%) also started off significantly worse than the healthy group. The new-onset and chronic groups saw slower psychological distress improvement and a decline in attention throughout the course compared to the healthy group. The chronic group also significantly increased their anger reactions throughout training compared to the healthy group. CONCLUSION: Sleep problems during Basic Combat Training may be an indicator for difficulties managing entry into the military. These findings highlight the importance of improving sleep health for soldiers throughout Basic Combat Training and for others with similar training in high-risk occupations.


Assuntos
Militares/educação , Militares/psicologia , Desempenho Físico Funcional , Transtornos do Sono-Vigília/psicologia , Ensino , Adolescente , Adulto , Ira , Atenção/fisiologia , Feminino , Humanos , Masculino , Militares/estatística & dados numéricos , Medição de Risco , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-31412599

RESUMO

Although work fatigue represents an important issue among military personnel in combat settings, little attention has been paid to work fatigue in the non-deployed setting. This issue was addressed by (a) validating the Three-Dimensional Work Fatigue Inventory (3D-WFI) among non-deployed military personnel, (b) assessing the prevalence of work fatigue in a non-deployed setting, and (c) exploring several potential predictors and outcomes of work fatigue in this setting. Data came from a large national probability sample (N = 1375) of non-deployed Royal Canadian Air Force military personnel. Results demonstrated that the 3D-WFI provided a psychometrically sound assessment of physical, mental, and emotional work fatigue among military personnel, which was invariant across sex, age, military component, and military role. All three types of work fatigue were highly prevalent among military personnel in a non-deployed setting. In terms of predictors, job demands were positively associated, and distributive justice, perceived organizational support, physical activity and sleep quality were negatively associated with each type of work fatigue, whereas role ambiguity was positively associated with mental and emotional work fatigue, and interpersonal justice was negatively associated with physical and emotional fatigue. Abusive supervision and sleep quantity were unrelated to work fatigue. In terms of outcomes, the three types of fatigue were positively associated with workplace cognitive failures and work-to-family conflict. In contrast, mental and emotional work fatigue were negatively related to military morale and positively associated with turnover intentions. This study demonstrates that work fatigue is a critical issue among military personnel in non-deployed settings, and an essential issue for military policy development.


Assuntos
Fadiga/psicologia , Militares/psicologia , Saúde do Trabalhador , Adulto , Esgotamento Profissional , Canadá , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Psicometria , Local de Trabalho/psicologia
20.
Psychiatry ; 82(3): 256-271, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385751

RESUMO

Background: Little is known about gender differences in mental health, related help-seeking behavior and social support in UK military personnel. Methods: 1714 UK military serving personnel and ex-service veterans were randomly selected if, in a cohort study, they endorsed experiencing a subjective stress, emotional, alcohol or mental health problem in the previous three years. Following exclusions, the final sample size was 1448 (participation rate 84.5%; women n = 219). Structured telephone interviews assessed anxiety, depression, PTSD symptoms, alcohol use, help-seeking and social support occurring both currently and in the past three years. Outcomes were assessed using weighted unadjusted and adjusted logistic regression analyses. Results: Mental health problems assessed at interview were broadly similar for men and women; for both genders, levels of social support were high. One-fifth of respondents screened positive for probable mental disorder or alcohol misuse; although rates of mental disorder symptoms did not differ by gender, women were significantly less likely than men to report alcohol misuse. Women were significantly more likely to have sought help from formal medical sources but significantly less likely to access informal support such as friends, family or unit welfare sources; reasons for seeking formal medical support were similar for men and women except for problem recognition and acting on advice from others, which were both significantly more common among women. Conclusion: For military personnel with a history of mental ill-health, women should make greater use of informal support networks while for men, engagement with formal medical help sources should be encouraged.


Assuntos
Comportamento de Busca de Ajuda , Transtornos Mentais/psicologia , Militares/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Apoio Social , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Fatores Sexuais , Reino Unido/epidemiologia , Veteranos/psicologia , Adulto Jovem
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