International survey of military mental health professionals

This paper reports on data from a survey of international military mental health professionals. In a series of open-ended questions, respondents were asked to describe their country in terms of the field of military psychology, the role of mental health professionals on deployment, the degree to which the field of mental health is accepted in the military, and their contact with their international counterparts. The survey was mailed to 44 different countries from July 1995 through July 1996. The data are based on 30 individual responses from 23 different countries. Cultural differences included the role of psychologists in the military and on deployment, the degree of professional isolation, and specific services provided by psychologists. Cultural similarities included the ambivalent response to the mental health field by military leaders, the use of psychology as a prevention tool, and the degree of interest in international contact and exchange. The discussion focuses on three obstacles to the acceptance of the mental health field and possible avenues for greater exchange of information among military professionals working in psychology-related fields.

Psychological intervention with military personnel in Rwanda

The Canadian Forces have deployed on humanitarian, peacekeeping, and peacemaking operations frequently throughout the 1990s. The circumstances that many Canadian soldiers have found themselves in while deployed have been grim. They have been witness to countless unspeakable acts and carry the burden of their experiences with them. As a result of their operational deployment, many soldiers develop stress reactions that interfere with their daily social functioning. This article reviews the psychological support provided to Canadian soldiers deployed to Rwanda in 1994. The primary intervention known as "debriefing" is also elaborated upon.

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In the First World War representatives of the university discipline of psychology took the opportunity to apply their expertise in the armed forces. The initial undertakings in the German Empire and in the USA show some similarities and marked disparities. A comparison of events and circumstances in these principal belligerent states is linked with a sketch of their importance for the further development of psychology as an academic specialty and an emerging profession.

Mental health officers' causal explanations of combat stress reaction

This study examined causal attributions for combat stress reaction (CSR) among 117 Israel Defense Forces (IDF) mental health officers. The impact of case characteristics (the level of objective stress in the situation, reaction of others in the same situation, soldier's previous functioning, and type of symptomatology) and respondent characteristics (professional affiliation, therapeutic orientation) on these attributions was also examined. Results show that mental health officers view CSR primarily as a response to external circumstances; it is not generally seen as resulting from personality traits or intrapsychic processes. Findings also indicate that causal attributions were influenced at least to some degree by the clinicians' professional affiliation, their therapeutic orientation, and their knowledge of the casualty's prior functioning.

On being informed you are HIV positive: experiences of Navy service members

This study addressed the experience of being told that one has become infected with the human immunodeficiency virus (HIV) while serving in the United States Navy. Responses to a questionnaire, administered to 150 HIV-positive service members, indicated that feelings of fear, shock, disbelief, and embarrassment were experienced by study participants upon learning of their HIV-positive status. The manner in which their HIV diagnosis was disclosed was generally viewed in favorable terms and more so in recent years relative to the earliest days of the Navy's HIV program. Having a medical officer as a disclosing official was associated with more negative experiences than was the case for other categories of disclosing officials. Lastly, post-disclosure events were often excessively stressful, and no improvement in this regard over 6 years of the Navy's HIV program was evident.

Prevention and management of panic in personnel facing a chemical threat--lessons from the Gulf War

During the Gulf War a number of subjects presented with panic, hyperventilation, and inability to wear respirators when chemical alarms were sounded, despite a perceived real chemical threat. Twenty-five such sufferers were seen at the Psychiatric Department of 33 General (Surgical) Hospital. This paper considers the aetiology of such responses, describes a mode of treatment which can be used in the threat situation, and considers issues of future training.

Israel defence forces experiences with treatment of POWs and families: an innovative multifaceted treatment model

This paper attempts to provide an integrative, multifaceted treatment approach for the surviving POW and his family. The model takes into account the individual, family, interpersonal, and community effects of captivity from the time of captivity until 1 year later. Ramifications of this model are discussed.

Success rate analysis of Navy SERGRAD flight training

SERGRADS are selectively retained graduates of Naval Flight Training who become flight instructors during their first tour as Naval Aviators. A perception exists that SERGRADS have more difficulties than newly designated pilots during subsequent training in the Fleet Replacement Squadrons (FRS). A preliminary inquiry at the F/A-18 FRS revealed that former SERGRADS appear to experience a higher rate of failure on their initial carrier qualification attempt during FRS training. This study examined the SERGRAD experience and compared their performance to trainees from other sources. Although significant differences were found between groups for Fleet Replacement Squadron flight grades and Training Command composite grades, no significant differences were found between the groups for Training Command carrier qualification grades or Fleet Replacement Squadron carrier qualification. Thus, the data do not support the hypothesis that SERGRADS have more problems or are poorer aviators than F/A-18 students from other sources.

Flight psychology at Sheppard Air Force Base

Flight psychology is the application of psychological principles to the unique environment of the aviator in order to enhance training, flight safety, and mission accomplishment. At Sheppard Air Force Base, TX, flight psychology is a cooperative effort between a clinical psychologist and the aeromedical services, with the former acting as a consultant to the latter. The primary focus of the flight psychology program is stress management, including managing the stress response of airsickness, for students in the Euro-NATO Joint Jet Pilot Training (ENJJPT) program. Psychological assessments of flying personnel, air traffic controllers, and individuals being considered for special duties constitute a valuable contribution to aeromedical services. We present clinical vignettes to illustrate the interaction of the flight psychologist and aeromedical services, and the effect on flying training and flight safety.

Training success in U.S. Navy special forces

Several aspects of success in an intensive military training experience on a select group of military trainees were studied. The primary dependent variables were differences in questionnaire scores between graduates and those who drop, and questionnaire score changes from pretest to posttest in graduates. A total of 336 trainees at the U.S. Navy 's Basic Underwater Demolition/SEALS (BUD/S) training school were tested at the beginning of their training period; 6 months later, all successful trainees were retested on graduation. The total sample was divided into two groups for replication. Results indicated that graduates differed consistently from drops on the Estimation scale of the Physical Estimation and Attraction Scale (PEAS), and four scales on the Hogan Personality Inventory (HPI); graduates showed consistent posttest changes in the Estimation scale, three out of six scales on the Profile of Mood States (POMS), plus four scales on the HPI. Differences between graduates and drops suggested that some aspects of the PEAS and HPI could be used as a screening device in order to reduce attrition. Posttest changes on the PEAS, POMS, and HPI in Graduates were in part consistent with previous work and in part somewhat new, indicating both general and unique features of the BUD/S training experience.

Motivational factors that affect the retention of reserve nurses in eight aeromedical evacuation flights

The purpose of the study was to identify the motivational factors which contribute to the retention of reserve flight nurses in aeromedical evacuation flights. Almost all units experience some difficulty in retaining nurses, and with the reserve program becoming increasingly complex, this problem is likely to become more severe. The motivation maintenance theory developed by Frederich Herzberg contends that two sets of factors can impinge on job satisfaction. Hygiene factors such as salary and working conditions can lead to job dissatisfaction. Motivators, such as job content and professional achievement are job satisfaction factors. A convenience sample of 69 reserve flight nurses from 8 flights was utilized in the survey approach. Participants filled out a Demographic Questionnaire, and a Reserve Flight Nurse Satisfaction Questionnaire. The results confirmed the proposed hypotheses in that not only were the nurses able to identify motivational factors, but that these factors had more impact on job satisfaction than did the hygiene factors.

The healthy motivation to fly: no psychiatric diagnosis

Aircrew mission effectiveness may uniquely be influenced by subtle psychological factors not ordinarily brought to the attention of psychiatrists. Pilots tend to be bright, articulate, and anxious to resume their aviation duties when grounded. However, these patients are usually well defended, and rarely psychologically attuned or introspective. Greater insight into what constitutes the normal, healthy motivation to fly will help those who make judgments regarding the return of grounded aviators to flying duty. A review of associated birth order, personality theory, industrial and business psychology, aerospace, and psychoanalytic literature is presented. Highlighted are the difficulties inherent in examining the motivation of a healthy, well-defended population. Our conclusion: an examiner's countertransferential feelings are the best available tool for measurement of healthy motivation.

The role of proximity, immediacy, and expectancy in frontline treatment of combat stress reaction among Israelis in the Lebanon War

The authors examined the effectiveness of the prevailing treatment doctrine stressing the principles of proximity, immediacy, and expectancy for combat stress reaction among Israeli soldiers in the Lebanon War. Two treatment outcomes were measured: return to military unit and presence of posttraumatic stress disorder. All three treatment principles were associated with a higher rate of return to the military unit. The beneficial effect of frontline treatment was also evidenced by lower rates of posttraumatic stress disorder. The authors suggest that these principles can also be effective in treating other forms of posttraumatic stress disorder.

The USAF pilot selection and classification research program

A multi-year research program to improve the selection of pilot trainees and the classification of student pilots for either fighter or heavy aircraft training is described. A battery of experimental tests measuring psychomotor skills, personality traits, and cognitive abilities is being given via computer prior to training. The subjects' performance in training and operational flying is then tracked and analyzed. The preliminary results and future directions of this ongoing program are discussed.

The military performance of soldiers in sustained operations

Two 9-d tactical defensive exercises were carried out. The first assessed and compared the performance of three platoons of infantry scheduled for either 0, 1.5, or 3 h of sleep in every 24 h, and the second determined whether soldiers are likely to remain militarily effective during a period of partial sleep loss following a period with no scheduled sleep at all. To this end, 10 infantry soldiers were scheduled for 4 h of sleep in every 24 for a 6-d period following a 3.75-d period without any scheduled sleep. Performance, physical fitness, and mood were assessed throughout both exercises. Results indicated that the effects of sleep loss are psychological rather than physiological; soldiers are likely to be militarily ineffective after 48-72 h without sleep; and a small amount of recovery sleep relative to the amount lost has very beneficial effects.

Homosexual men and women who served their country

The present work examines the effectiveness of United States military policies in excluding homosexual men and women from the armed forces by comparing percentages of homosexuals who have served in the armed forces with matched samples of heterosexuals. Interview data on 1,456 respondents from 1969 and 1970 are reported. The data show that homosexual and heterosexual men seem equally likely to have served in the military, while lesbians were more likely than heterosexual women to have served. The data also indicate that the policies of excluding homosexuals from the services are ineffective. The explanation for this may be that many homosexuals may not be aware of their homosexuality at time of entry into the service, and, hence, cannot readily be identified either by themselves or others. It is also suggested that certain draft criteria have in fact increased the percentages of homosexuals serving in the military.

Psychiatric assessment of female fliers at the U.S. Air Force School of Aerospace Medicine (USAFSAM)

There were 17 female fliers referred for evaluation to the Neuropsychiatry Branch, Clinical Sciences Division, of the USAF School of Aerospace Medicine, Brooks AFB, TX, between October 1976 and September 1982: five primarily for emotional reasons; seven primarily for somatic disorders and only secondarily for emotional symptoms; two for entry to the Airsickness Rehabilitation/Treatment protocol; and three for routine evaluation in preparation for possible future space flight. This number is too small for any sort of statistical analysis, but one emerging theme has clinical importance. A significant number of male fliers tend to see these female fliers in stereotyped roles--mother, potential sexual partner, little sister, daughter--and then respond to the assigned role rather than to a real person. Whether a woman accepts this projected role as egosyntonic or rejects it as egosyntonic, its existence may affect her real-life role. For example, one woman pilot reported that her instructors seemed to make allowances for her sex by expecting less of her than they did of her male colleagues, "carrying" her along as if she were a little sister. While such role-casting may be carried on subconsciously, its behavioral manifestations are real and may have the potential for affecting flight safety. This study represents an initial approach to the data in this area, and is intended to alert flight surgeons to the implications of such role-casting in the flight environment.

Stress reactions among participants in mass casualty simulations

Specific stress reactions have been observed in health care providers involved in disaster relief and mass casualty care. To determine whether similar stress reactions occurred in mass casualty simulations, we observed the participants in five large military mass casualty simulations. Using a framework of specific questions, descriptive data were obtained using direct observation and discussion with participants by faculty present to evaluate the exercise. Observations revealed that stress reactions occurred consistently during these mass casualty simulations, and these reactions resembled those seen in health care workers involved in actual mass casualty care. Application of this information to disaster medicine training for emergency physicians is discussed.