Correlates and consequences of morale versus depression under stressful conditions

National Guard Deployment in Support of COVID-19: Psychological and Behavioral Health

INTRODUCTION

The National Guard (NG) served as a critical component of the USA's response to the Coronavirus Disease 2019 (COVID-19) pandemic, while concurrently managing their personal responses to the pandemic. Determining whether the activation of NG service members in response to the COVID-19 pandemic was associated with a greater psychological strain can identify NG's needs for mental health support.

MATERIALS AND METHODS

We surveyed 3993 NG unit (NGU) service members (75% Army NG, 79% enlisted, 52% 30-49 years old, and 81% males) during the COVID-19 pandemic, with surveys administered between August and November 2020. Almost half (46%) of NGU service members reported being activated in response to COVID-19 (mean activation length = 18.6 weeks). Activated service members completed the survey approximately 2 to 3 months post-activation. Surveys assessed demographics, service-related characteristics, unit cohesion and positive leadership skills (leadership), and COVID-19 activation, and outcomes including probable post-traumatic stress disorder (PTSD), clinically significant anxiety and depression, and anger. Descriptive and logistic regression analyses were conducted. The study was approved by the Institutional Review Board of the Uniformed Services University of the Health Sciences in Bethesda, MD.

RESULTS

In all, 9.7% met the criteria for probable PTSD, 7.6% reported clinically significant anxiety and depression, and 13.2% reported feeling angry/anger outbursts. Multivariate logistic regression analyses, adjusting for demographic and service-related characteristics, indicated that COVID-19 activation was not associated with a greater risk of PTSD, anxiety and depression, or anger. Regardless of activation status, NGU service members with low levels of unit cohesion and leadership were more likely to report PTSD and anger, and low levels of unit cohesion were associated with clinically significant anxiety and depression.

CONCLUSIONS

COVID-19 activation did not increase the risk of mental health difficulties among NGU service members. However, low levels of unit cohesion were associated with the risk of PTSD, anxiety and depression, and anger, and low levels of leadership were associated with the risk of PTSD and anger. The results suggest a resilient psychological response to COVID-19 activation and the potential for strengthening all NG service members through enhancing unit cohesion and leadership support. Future research on specific activation exposures, including the type of work tasks in which service members are engaged, particularly those associated with high-stress work conditions, is needed to help better understand their activation experience and how it may influence post-activation responses.

Assessing the dimensionality and construct validity of the military stigma scale across current service members

US service members are at elevated risk for distress and suicidal behavior, compared to the general US population. However, despite the availability of evidence-based treatments, only 40% of Service members in need of mental health care seek help. One potential reason for the lower use of services is that service members experience stigma or concerns that the act of seeking mental health care from a mental health provider carries a mark of disgrace. The Military Stigma Scale (MSS) was designed to assess two theoretical dimensions of help-seeking stigma (public and self), specifically among service members. The goal of the current study was to further examine the validity of the MSS among 347 active duty service members. Examination of unidimensional, two-factor, and bifactor models revealed that a bifactor model, with a general (overall stigma), two specific factors (public and self-stigma), and one method factor (accounting for negatively worded items) provided the best fit to the data. Ancillary reliability analyses also supported the MSS measuring a broad stigma factor associated with seeking mental health care in the military. Subsequent model analyses showed that the MSS was associated with other stigma-related constructs. Overall, findings suggest that the MSS is a reliable and validated scale that can be used to assess military help-seeking stigma and to evaluate results of programs designed to reduce stigma.

Role of Self-Control and Self-Construal in the Army Morale and Suicidal Ideation of Chinese Military Cadets

The current study investigated the relationship between army morale and suicidal ideation in Chinese military cadets, including the mediating role of self-control and the moderating role of self-construal. A total of 1124 male navy cadets participated in the study, completing a series of questionnaires. The results revealed the following: (1) army morale could negatively predict suicidal ideation; (2) the negative predictive effect of army morale on suicidal ideation could be partially mediated by self-control; and (3) self-construal moderated the predictive effect of army morale on suicidal ideation among navy cadets. Finally, the current study suggested that building some relevant assessment, diagnostic, and training programs may help build army morale and further prevent suicidal ideation in the military context.

Physical Injuries, Treatment-Seeking, and Perceived Barriers to Treatment in U.S. Army Drill Sergeants

INTRODUCTION

Drill sergeants work under mentally and physically challenging conditions. The current study examined self-reported rates of physical injuries in drill sergeants; rates of treatment-seeking for injuries; perceived barriers toward treatment-seeking; and associated demographic and environmental factors.

MATERIALS AND METHODS

Drill sergeants from across all Army basic training locations completed self-report surveys from September to November of 2018. In total, 726 drill sergeants were included in analyses. Drill sergeants indicated whether they had acquired an injury during their time in the drill sergeant role and whether they had sought treatment for all such injuries. Furthermore, drill sergeants rated their agreement with a number of possible perceived barriers to treatment-seeking for physical injuries. Regression models examining each phenomenon included hours of sleep obtained per day; general- and health-specific leadership behaviors of the company command teams; unit cohesion; time as a drill sergeant; duty location; gender; military operational specialty; years in the military; previous combat deployments; and route of assignment. The study was approved by the Walter Reed Army Institute of Research Institutional Review Board.

RESULTS

In total, 38% of respondents reported acquiring an injury during their time as drill sergeants. Of those who had acquired an injury, 61% reported seeking medical help for all injuries acquired. Injuries were more likely in females (49%) than in males (34%) and less likely in drill sergeants reporting at least 6 hours of sleep (27%) versus those reporting 5 hours (40%) and 4 hours or less (43%). Reported comparisons were significant after controlling for demographic and environmental variables in regression models. The most strongly endorsed perceived barriers to treatment-seeking were "Seeking help would place too much burden on the other drill sergeants" (69%) and "Seeking help would interfere with my ability to train the recruits" (60%). Both of these perceived barriers were significantly associated with reduced treatment-seeking in injured drill sergeants, after controlling for demographic and environmental variables.

CONCLUSIONS

This study is the first to examine injury occurrence, treatment-seeking, and perceived barriers to treatment-seeking in U.S. Army drill sergeants. Building on previous studies that showed the negative effects of sleep deprivation on the safety and behavioral health of drill sergeants, the current study gives further evidence of the negative effects of such sleep deprivation, this time in the domain of physical injuries. The results suggest that pursuing strategies that allow for healthier sleep duration may contribute to injury reduction.

Prevalence and prediction of PTSD and depression in mothers of children surviving a motor vehicle crash

Introduction: Few studies have examined the psychopathological consequences for parents of children who were survivors of a motor vehicle crash (MVC). This study assessed the impact of dissociation and peritraumatic distress on the severity of PTSD and post-traumatic major depressive episode (MDE) symptoms in mothers during the first years after the MVC and the role that cortisol response might play in this association. Methods: 125 mothers were included. Peritraumatic distress and dissociation were assessed. Morning salivary cortisol was tested at the baseline. Participants were assessed for a probable diagnosis of PTSD and MDE at 5 weeks, 6 months and 12 months. Results: At 5 weeks, 12 (13.6%) mothers exhibited probable PTSD. During the first year, the PCL score was higher when the (i) Peritraumatic Distress Inventory (PDI) score increased and (ii) the Peritraumatic Dissociation Experience Questionnaire (PDEQ) score increased. Cortisol levels were lower when the PDI score increased. Conclusion: This is the first study to assess the mothers of MVC survivors for one year following the trauma. We confirm that peritraumatic responses are useful for predicting the severity of PTSD symptoms. These results could encourage the implementation of follow-up programmes not only for survivors but also for their mothers. HIGHLIGHTS Mothers of children involved in motor vehicle accident are at risk for developing PTSD.Peritraumatic responses (distress and dissociation) are associated to the severity of PTSD symptoms.Low salivary cortisol levels were associated with high peritraumatic distress.

US Army Drill Sergeants: Stressors, Behavioral Health, and Mitigating Factors

INTRODUCTION

The role of the drill sergeant is one of the most challenging within the US Army, involving unusually long hours and little time off, for a minimum of 2 years. The current study sought to examine the behavioral health of this population and identify risk factors that might be addressed by policy changes.

MATERIALS AND METHODS

In total, 856 drill sergeants across all Army basic training sites completed surveys from September to November of 2018. Drill sergeants identified factors that had caused stress or worry during their assignment. Rates were measured for behavioral health outcomes including depression, insomnia, anxiety, burnout, functional impairment, alcohol misuse, aggression, and low morale. Potential risk and resilience factors included time as a drill sergeant, sleep, route of assignment, general leadership, health-promoting leadership, and drill sergeant camaraderie. The study was approved by the Walter Reed Army Institute of Research Institutional Review Board.

RESULTS

The most commonly experienced stressors were finding time to exercise, lack of sleep, and long work hours. Percentages of drill sergeants meeting behavioral health screening criteria were 19% for depression, 27% for moderate-to-severe insomnia, 14% for generalized anxiety disorder, 48% for high burnout, 32% for functional impairment, 35% for moderate alcohol misuse, 32% for off-duty aggression, and 25% for low morale. Rates for most outcomes were associated with time spent as a drill sergeant, with behavioral health issues peaking during 13-18 months. Poorer outcomes were also associated with fewer hours of sleep and initial unhappiness regarding involuntary assignment to the role of drill sergeant, while better outcomes were associated with higher ratings of general leadership, health-promoting leadership, and drill sergeant camaraderie.

CONCLUSIONS

This study is the first to examine behavioral health and morale of drill sergeants and to identify risk and resilience factors. Suggestions for policy changes include increasing the number of drill sergeants to decrease workload and allow sufficient time for recovery and sleep.

Meaningful military engagement among male and female post-9/11 veterans: An examination of correlates and implications for resilience

OBJECTIVE

Post-9/11 military deployment is commonly reported as stressful and is often followed by psychological distress after returning home. Yet veterans also frequently report experiencing meaningful military engagement (MME) that may buffer detrimental effects of military stressors. Focusing on the under-investigated topic of association of MME with post-deployment psychological adjustment, this study tests gender differences in MME and post-deployment outcomes.

METHOD

This cross-sectional study examined the relationship of MME with deployment stressors, subsequent psychological distress (posttraumatic stress symptoms (PTSS) and depression), and gender among 850 recent-era U.S. veterans (41.4% female).

RESULTS

On average, both male and female veterans reported high MME. Greater MME was associated with less PTSS and depression following combat and general harassment, and more depression after sexual harassment. For men only, MME associated with less PTSS after sexual harassment.

CONCLUSIONS

MME is high among post-9/11 veterans, but its stress-buffering effects depend on gender and specific stressor exposure.

Military suicide prevention: The importance of leadership behaviors as an upstream suicide prevention target

OBJECTIVE

To evaluate the longitudinal relationships between unit cohesion, Army leader behaviors, and subordinate suicidal/death ideation. Recent cross-sectional research indicates that subordinates who perceive that their leaders instill a sense of purpose regarding military service demonstrate less frequent suicidal ideation.

METHOD

Five hundred fifty-nine soldiers completed self-report measures of perceptions of leadership behaviors, unit cohesion, and suicidal/death ideation during deployment as well as one and three months following deployment. Latent change score modeling was conducted to evaluate the course and direction of study variables as well as the relationship between them.

RESULTS

Although lower levels of suicidal/death ideation were related to leader-provided purpose, leader-provided meaning, and unit cohesion at baseline, only leader-provided purpose and unit cohesion prospectively predicted changes in suicidal/death ideation.

CONCLUSIONS

Consistent with the goal of military leadership to augment effective clinical interventions that reduce suicide risk, prevention programs that reach a broader population of personnel should be considered. Enhanced leadership training may be an important primary prevention tool to reduce suicide risk that warrants further research.

Military occupation as a moderator between combat exposure and posttraumatic stress disorder symptoms in US Army personnel

Military occupational designations are standardized classifications that help define and convey a service member's expected duties and responsibilities. The present study examined how occupational designation was related to adverse combat-reactions, specifically posttraumatic stress disorder (PTSD). It was hypothesized that at comparable levels of combat, non-combat units would display greater symptomology than combat units. The study sample consisted of 785 combat-deployed, active-duty enlisted US Army personnel. Participants were administered self-report questionnaires, including the Combat Experiences Scale and PTSD Checklist for DSM-5. Occupation was coded using the three-branch system (i.e., Operations, Support, & Force Sustainment). Hierarchical multiple linear regression (MLR) was run to examine the effect of occupation, combat, and unit cohesion on PTSD symptoms. Operations units reported the highest frequency of combat exposure; however, Force Sustainment units displayed the highest PTSD symptoms. In MLR analysis, there was a significant interaction between Force Sustainment units and combat exposure (β = 0.10, p = .019), that was not observed in Operations or Support units. These findings demonstrate that PTSD symptom intensity is not solely a function of combat exposure, and that non-combat units may react differently when exposed to elevated levels of combat.

The Buffering Effect of Relationships on Combat Exposure, Military Performance, and Mental Health of U.S. Military Soldiers: A Vantage Point for CFTs

This study examined the role of cumulative combat experiences with regard to military performance and conduct and mental health among a sample of young soldiers from the Army STARRS dataset (N = 5,283). Higher levels of cumulative combat experiences were directly related to poorer performance and conduct and a greater likelihood of anxiety, depression, and post-traumatic stress disorder (PTSD). Military performance and conduct served as a linking mechanism between combat experiences and mental health. Using moderated mediation structural equation modeling, relationship disruptions were found to exacerbate the adverse effects of combat experiences; conversely, unit cohesion buffered the impact of combat experiences. Implications for military helping professionals include identifying leverage points for intervention, particularly strengthening the social connections of service members within and outside the military.

An effective suicide prevention program in the Israeli Defense Forces: A cohort study

Objective

To evaluate the effectiveness of the IDF Suicide Prevention Program, implemented since 2006.

Design

Quasi-experimental (before and after) cohort study.

Participants

Two cohorts of IDF mandatory service soldiers: the first inducted prior to (1992–2005, n = 766,107) and the second subsequent to (2006–2012, n = 405,252) the launching of the intervention program.

Exposure

The IDF Suicide Prevention Program is a population-based program, incorporating: reducing weapon availability, de-stigmatizing help-seeking behavior, integrating mental health officers into service units, and training commanders and soldiers to recognize suicide risk factors and warning signs.

Main outcome measure

Suicide rate and time to suicide in cohorts before and after exposure to the Suicide Prevention Program.

Results

Trend analysis showed lower suicide rates in the cohort after intervention. The hazard ratio for the intervention effect on time to suicide was 0.44 (95% CI = 0.34–0.56, P < .001) among males. Lower risk was associated with: male gender; born in Israel; higher socio-economic status; higher intelligence score; and serving in a combat unit (HR = 0.43: 95% CI = 0.33–0.55).

Conclusions

There was a 57% decrease in the suicide rate following the administration of the IDF Suicide Prevention Program. The effect of the intervention appears to be related to use of a weapon, and being able to benefit from improved help-seeking and de-stigmatization. Future efforts should seek to extend the program's prevention reach to other demographic groups of soldiers. The success of the IDF program may inform suicide prevention in other military organizations and in the civilian sector.

Military Mental Health Personnel Deployment Survey: A Secondary Analysis

INTRODUCTION

Military mental health personnel (MMHP) have increasingly engaged in deployment-related roles in closer proximity to combat environments. Although studies examining deployment-related outcomes among military health care personnel have found combat exposure (CE) positively related to psychological problems, no studies of MMHP have investigated CE or its association with psychological outcomes. This study seeks to provide descriptive data on CE and perceived impacts associated with deployment, as well as explore how CE, perceptions of preparedness for deployment, difficulties during deployment (DDD), and meaningful work during deployment relate to appraisal of problems after deployment (ie, sleep problems, interpersonal withdrawal, depressive symptoms, and work problems).

MATERIALS AND METHODS

Archival postdeployment survey data from 113 U.S. Air Force MMHP previously deployed to Iraq or Afghanistan were utilized to determine descriptive statistics on CE and other factors. Additionally, hierarchical linear regression was utilized to test relationships between CE, DDD, preparation for deployment, and meaningful work with reports of sleep problems, interpersonal withdrawal, work problems, and depression symptoms. The study was approved by the Institutional Review Board of the U.S. Air Force Academy.

RESULTS

MMHP reported an average of 1.58 (standard deviation = 1.03) combat-related events and DDD included: (1) being away from family/close friends (62%), (2) uncertain redeployment date (35%), (3) difficulty adapting to a new situation (35%), and (4) working long hours (31%), with 66% endorsing two or more areas of difficulty. Most MMHP reported feeling prepared for deployment both professionally (91%) and personally (87%), as well as that their family was prepared (83%). Additionally, nearly all reported at least one meaningful work experience while deployed (96%) with positive impacts on their clients, being the most frequent (89%). Furthermore, CE predicted both sleep difficulties and interpersonal withdrawal. MMHP who perceived their deployment experience as difficult also had higher rates of postdeployment difficulties. Finally, we found no relationship between perceived deployment preparation and postdeployment outcomes.

CONCLUSIONS

This is the first study of MMHP reporting CE rates and examining relationships between perceived outcomes and CE, deployment preparation, difficulties during deployment, and meaningful work. The vast majority of MMHP were exposed to more than one combat-related event; however, this rate of CE appears lower than what has been reported among a similar sample of military health care personnel. Although CE predicted difficulties, appraisals of difficulties during deployment experience predicted the highest rates of postdeployment difficulties, accounting for nearly a quarter or more of the outcome variance. The lack of relationship between deployment preparation and meaningful work is inconsistent with prior research and may be because of the limited response range in our sample. Additionally, other methodological limitations include: (1) cross-sectional study design, (2) lack of validated measures, and (3) the long-term retrospective nature of the assessment. Future research should incorporate more rigorous methodologies and assess constructs absent in this archival data set. Despite these limitations, this study provides important preliminary data to support future research development and funding. Additionally, the results may be used to normalize associated impacts and promote help seeking among MMHP.

Leader provided purpose: Military leadership behavior and its association with suicidal ideation

Suicide in U.S. Army Soldiers is of major concern as it is estimated that over 100 Soldiers die by suicide each year. Examining risk and protective factors is essential to develop both an understanding of Soldier suicide as well as inform systemic interventions to reduce suicide. One potential systemic approach is to embed preventive mechanisms within the structure of the military rather than the typical administration of primary intervention through mandatory training. To examine potential mechanisms of leader-based interventions, several leadership behaviors were assessed in a cross-sectional sample of n = 1,096 active duty Soldiers. Soldiers completed self-report measures of interpersonal predictors of suicide, suicidal ideation (SI), leadership behaviors, and unit cohesion. Logistic regression was used to identify leadership behaviors related to SI. Only the leader behavior attempting to foster a sense of purpose predicted SI. Leader provided purpose (LPP) was then entered into indirect effect analyses to evaluate the mechanisms of this relationship. Analyses revealed that LPP predicted SI through unit cohesion, thwarted belongingness, and perceived burdensomeness. Results demonstrate that specific aspects of military leadership such as fostering Soldier purpose may enhance resilience and reduce risk for SI.

Work Fatigue in a Non-Deployed Military Setting: Assessment, Prevalence, Predictors, and Outcomes

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.

Opening the Black Box: A Multilevel Framework for Studying Group Processes

Over time, groups can change in at least two important ways. First, they can display different trajectories (e.g., increases or decreases) on constructs of interest. Second, the configuration of group members’ responses within a group can change, such that the members become more or less similar to each other. Psychologists have historically been interested in understanding changes in groups over time; however, there is currently no comprehensive quantitative framework for studying and modeling group processes over time. We present a multilevel framework for such research—the multilevel group-process framework (MGPF). The MGPF builds on a statistical approach developed to capture whether individual members of a group develop a shared climate over time, but we extend the core ideas in two important ways. First, we describe how researchers can gain insights into group phenomena such as group leniency, group learning, groupthink, group extremity, group forming, group freezing, and group adjourning through modeling change in latent mean levels and consensus. Second, we present a sequence of model-testing steps that enable researchers to systematically study and contrast different group processes. We describe how the MGPF can lead to novel research questions and illustrate its use in two example data sets.

A confirmatory factor analysis of the Utrecht Work Engagement Scale for Students in a Chinese sample

BACKGROUND

Educational institutions play an important role in encouraging students' engagement with course work. Educators are finding instruments to measure students' engagement in order to develop strategies to improve it. Little is known about the factor structure of the Utrecht Work Engagement Scale for Students among Chinese nursing students.

OBJECTIVES

The aim of this research was to examine the factor structure of the Utrecht Work Engagement Scale for Students via confirmatory factor analysis.

DESIGN AND METHODS

The study used a cross-sectional design. A sample of 480 students from a nursing school in one Chinese university completed the Utrecht Work Engagement Scale for Students. Factor analysis was used to analyze the resulting data.

RESULTS

The overall results of internal consistency reliability and confirmatory factor analysis provided evidence supporting the reliability and three-factor structure of the Utrecht Work Engagement Scale for Students. The total internal consistency reliability coefficients were 0.91. Model comparison tests indicated that an oblique factors model that permitted correlations between pairs of error terms fitted the data better than other first-order models. In addition, due to the three strongly intercorrelated factors, a second-order model was found to fit the data well, providing support for the factorial structure of the Utrecht Work Engagement Scale for Students.

CONCLUSIONS

The findings of confirmatory factor analysis provided evidence supporting the reliability and three-factor structure of the Utrecht Work Engagement Scale for Students when evaluated with a Chinese nursing student sample in this study. Thus, it is appropriate to use The Utrecht Work Engagement Scale for Students in for assessing the engagement among Chinese nursing students.

Resilience during war: Better unit cohesion and reductions in avoidant coping are associated with better mental health function after combat deployment

OBJECTIVE

The majority of individuals who endure traumatic events are resilient; however, we do not yet understand why some individuals are more resilient than others. We used data from a prospective longitudinal study Army National Guard and Reserve personnel to examine how unit cohesion (military-specific social support) and avoidant coping relate to resilience over the first year after return from deployment.

METHOD

Soldiers (N = 767) were assessed at 4 phases: predeployment (P1), immediately postdeployment (P2), 3 months' postdeployment (P3), and 1-year postdeployment (P4).

RESULTS

After controlling for predeployment avoidant coping and overall social support, higher unit cohesion was associated with a reduction in avoidant coping (from P1 to P3). This reduction in avoidant coping (from P1 to P3) mediated the relationship between unit cohesion (P2) and improvement in mental health function (from P1 to P3).

CONCLUSIONS

The results are consistent with the hypothesis that higher unit cohesion may mitigate increases in avoidant coping in military personnel after a combat deployment and in turn may improve mental health function. (PsycINFO Database Record

Ecological transcendence and ecological behavior: a test of the S-curve hypothesis

Purpose

Adopting a positive organizational scholarship perspective, this paper aims to examine dynamic effects of ecological transcendence on ecological behavior.

Design/methodology/approach

Based on 176 responses of employees from 46 organizations, the author found that both quadratic and cubic terms in the hierarchical regression equation were significant, evidence that ecological transcendence has an S-curve relationship with ecological behavior which suggests deficiency, goading and lulling effects.

Findings

The author finds a significant cubic term indicative of a signoidal relationship between ecological transcendence and ecological behavior.

Research limitations/implications

Implications for theory and practice are discussed. Given the growing interest in environmental sustainability, this study provides initial evidence of the dynamics of ecological behavior.

Practical implications

The study has implications for managing sustainability in organizations. Managers have empirical evidence of the dynamics which can serve as a basis for establishing mechanisms to goad growth and constraints to limit downturns.

Originality/value

The study is original in that it has not been published elsewhere except for presentation at a conference.

Unit cohesion, traumatic exposure and mental health of military personnel

BACKGROUND

The benefit of military unit cohesion to morale and psychological resilience is well established. But it remains unclear whether unit cohesion modifies the association between deployment-related traumatic exposure and mental health problems.

AIMS

To examine the association between unit cohesion, traumatic exposure and poor mental health [symptoms of post-traumatic stress disorder (PTSD), psychological distress and alcohol dependency] and assess whether the relationship between traumatic exposure and poor mental health differs by level of unit cohesion.

METHODS

A self-reported cross-sectional survey of Australian military personnel deployed to Iraq or Afghanistan between 2001 and 2009.

RESULTS

Among 11411 participants, those with low levels of unit cohesion had higher odds of PTSD symptoms [aOR (95% CI): 2.54 (1.88, 3.42)], very high psychological distress [aOR (95% CI): 4.28 (3.04, 6.02)] and a high level of alcohol problems [aOR (95% CI): 1.71 (1.32, 2.22)] compared with those reporting high unit cohesion on deployment. Higher exposure to traumatic events on deployment was associated with greater risk of PTSD symptoms, very high levels of psychological distress and high levels of alcohol problems in this cohort. However, there was no evidence of a statistically significant interaction between unit cohesion and traumatic exposures in influencing poor mental health.

CONCLUSIONS

Our findings suggest that both unit cohesion and traumatic exposure are independently associated with poor mental health. Efforts to improve military unit cohesion may help to improve the mental health resilience of military personnel, regardless of their level of traumatic exposure.

The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.

Team spirit makes the difference: the interactive effects of team work engagement and organizational constraints during a military operation on psychological outcomes afterwards

This article prospectively explores the effects of collective team work engagement and organizational constraints during military deployment on individual-level psychological outcomes afterwards. Participants were 971 Dutch peacekeepers within 93 teams who were deployed between the end of 2008 and beginning of 2010, for an average of 4 months, in the International Security Assistance Force. Surveys were administered 2 months into deployment and 6 months afterwards. Multi-level regression analyses demonstrated that team work engagement during deployment moderated the relation between organizational constraints and post-deployment fatigue symptoms. Team members reported less fatigue symptoms after deployment if they were part of highly engaged teams during deployment, particularly when concerns about organizational constraints during deployment were high. In contrast, low team work engagement was related to more fatigue symptoms, particularly when concerns about organizational constraints were high. Contrary to expectations, no effects for team work engagement or organizational constraints were found for post-traumatic growth. The present study highlights that investing in team work engagement is important for those working in highly demanding jobs.

Military Beliefs and PTSD in Active Duty U.S. Army Soldiers

Post-traumatic distress after military combat is a major cost of war. One under-investigated factor potentially associated with PTSD symptoms is specific beliefs about one's military service. This study examined post-deployment self-reports from 272 active-duty U.S. Army soldiers, to investigate potential associations between military-related PTSD symptom severity and three beliefs about the military: the importance and value ascribed to one's own work in the Army, to current military operations in Iraq and Afghanistan, and to military service in general. Higher scores on these three beliefs were negatively correlated with military-related PTSD symptom severity. However, in a combined regression model that controlled for recent combat exposure, only the belief about current military operations had a significant, unique association with PTSD symptom severity. That is, more positive beliefs about the value of operations in Iraq or Afghanistan were associated with lower PTSD symptoms.

Etiology of depression comorbidity in combat-related PTSD: a review of the literature

Posttraumatic stress disorder is often diagnosed with other mental health problems, particularly depression. Although PTSD comorbidity has been associated with more severe and chronic symptomology, relationships among commonly co-occurring disorders are not well understood. The purpose of this study was to review the literature regarding the development of depression comorbid with combat-related PTSD among military personnel. We summarize results of commonly tested hypotheses about the etiology of PTSD and depression comorbidity, including (1) causal hypotheses, (2) common factor hypotheses, and (3) potential confounds. Evidence suggests that PTSD may be a causal risk factor for subsequent depression; however, associations are likely complex, involving bidirectional causality, common risk factors, and common vulnerabilities. The unique nature of PTSD-depression comorbidity in the context of military deployment and combat exposure is emphasized. Implications of our results for clinical practice and future research are discussed.

Morale as a moderator of the combat exposure-PTSD symptom relationship

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.

Measuring Meaningful Work

Many people desire work that is meaningful. However, research in this area has attracted diverse ideas about meaningful work (MW), accompanied by an equally disparate collection of ways of assessing MW. To further advance study in this area, the authors propose a multidimensional model of work as a subjectively meaningful experience consisting of experiencing positive meaning in work, sensing that work is a key avenue for making meaning, and perceiving one’s work to benefit some greater good. The development of a scale to measure these dimensions is described, an initial appraisal of the reliability and construct validity of the instrument’s scores is reported using a sample of university employees ( N = 370) representing diverse occupations. MW scores correlated in predicted ways with work-related and general well-being indices, and accounted for unique variance beyond common predictors of job satisfaction, days reported absent from work, and life satisfaction. The authors discuss ways in which this conceptual model provides advantages to scholars, counselors, and organizations interested in fostering MW.

On the home front: stress for recently deployed Army couples

Military couples who have experienced deployment and reintegration in current U.S. military operations frequently experience stress regarding the dangers and effects of such experiences. The current study evaluated a sample of 300 couples with an active duty Army husband and civilian spouse who experienced a deployment within the year before the survey (conducted in 2007). Wives generally reported greater levels of emotional stress compared with husbands. Overall, higher levels of stress were found for couples who reported lower income and greater economic strain, perceive the need for more support and are unsure about how to get support, have more marital conflict, and are generally less satisfied with the Army and the current mission. Husband combat exposure was also associated with more stress for husbands and wives. Additionally, for wives, stress was related to greater child behavior problems and a sense of less Army concern for families. The results suggest areas of intervention with military couples to help them cope with the challenges of military life and deployment.

Is peacekeeping peaceful? A systematic review

OBJECTIVE

To systematically review the literature on the association between deployment to a peacekeeping mission and distress, mental disorders, and suicide.

METHODS

Peer-reviewed English publications were found through key word searches in MEDLINE, PsycINFO, Scopus, and Embase, and by contacting authors in the field. Sixty-eight articles were included in this review.

RESULTS

Some studies have found higher levels of postdeployment distress and posttraumatic stress disorder (PTSD) symptoms. Most studies have not shown an increased risk of suicide in former peacekeepers. Correlates of distress and PTSD symptoms included level of exposure to traumatic events during deployment, number of deployments, predeployment personality traits or disorder, and postdeployment stressors. Perceived meaningfulness of the mission, postdeployment social supports, and positive perception of homecoming were associated with lower likelihood of distress.

CONCLUSIONS

Most peacekeepers do not develop high levels of distress or symptoms of PTSD. As postdeployment distress is consistently shown to be associated with high levels of exposure to combat during deployment, targeted interventions for peacekeepers who have been exposed to high levels of combat should be considered.

Positive Organizational Scholarship

Positive organizational scholarship (POS) is considered an alternative approach to studying organizations; it is argued that POS plays a critical theory role in contemporary organizational scholarship. By using essays on critical theory in organizational science to consider POS research, and drawing from the principles of Gestalt psychology, it is argued that the important distinctions between POS and traditional organizational scholarship lie in POS's emphasis on positive processes, on value transparency, and on extending the range of what constitutes a positive organizational outcome. In doing so, it is concluded that the primary contribution of POS is that it offers an alternative to the deficit model that shapes the design and conduct of organizational research.