Relationships Between Sleepiness, Mood, and Neurocognitive Performance in Military Personnel

Psychometric properties of the 10-item Connor-Davidson Resilience Scale in Chinese military personnel

Background

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a widely used assessment of resilience. However, psychometric properties of the Chinese version of CD-RISC-10 have not been well investigated in a Chinese military personnel sample.

Methods

A total of 3,129 Chinese military personnel completed the CD-RISC-10, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Among them, 528 recruits completed the CD-RISC-10, SAS, and SDS again after 3-month basic military training (BMT). Meanwhile, the commanding officers were asked to rate recruits' training performance on the training performance rating scale for recruits (TPRS). Confirmatory factor analysis (CFA) was implemented to examine the single-factor model of the CD-RISC-10, and multigroup CFA was conducted to test measurement invariance across military rank (officers vs. enlisted), gender (male vs. female), and time (before and after 3-month BMT). Internal consistency was evaluated using Cronbach's α and McDonald's ω, and test-retest reliability was tested using the intra-class correlation coefficient (ICC). The criterion-related validity of CD-RISC was evaluated using Pearson's correlation analysis between the CD-RISC-10 total score and SAS scores, SDS scores, and training performance ratings.

Results

The single-factor model of the CD-RISC-10 showed adequate fit (CFI = 0.955-0.970, TLI = 0.943-0.962, RMSEA = 0.059-0.072) in all examined subsamples (male, female, officer, and enlisted), and strict invariance was also supported across military rank, gender, and time (ΔCFI ≤ 0.001, ΔTLI ≤ 0.005, ΔRMSEA ≤ 0.006). The CD-RISC-10 showed good internal consistency in all subsamples (Cronbach's α of > 0.93 and McDonald's ω of > 0.93) and good test-retest reliability (ICC = 0.88). Moreover, concurrent and predictive validity with the SAS and SDS scores were good (r = -0.68 to -0.49, p < 0.001). The resilience level of recruits at the beginning of BMT was significantly associated with training performance rated by supervisors after training (r = 0.29, p < 0.001).

Conclusion

The psychometric evidence reported in this study suggests that the CD-RISC-10 is a reliable and valid assessment of resilience and a potential predictor for mental health and military performance in Chinese military personnel.

Sleep and PTSD in the Military Forces: A Reciprocal Relationship and a Psychiatric Approach

Sleep disturbances are well-recognised symptoms of Post-Traumatic Stress Disorder (PTSD). This review updates knowledge regarding the relationship between sleep during deployment, combat-related trauma, and PTSD in military personnel, from which the importance of restorative sleep results. The description of the characteristics of sleep in military forces with the considerable roles of the operational and training contexts highlights the important consequences of degraded sleep. Indeed, a lot of data suggest a dynamic link between sleep and the onset and chronicity of PTSD. We propose a reciprocal relationship model with strategies strongly recommended or already adopted by the military to promote restorative sleep before and after combat exposure. Among the alterations in a variety of sleep architecture and sleep patterns described in PTSD, the physiological hypothesis of REM sleep fragmentation in the development of PTSD symptoms may be important because REM sleep is generally associated with emotional memory. Finally, we address clinical and research perspectives that could be used to detect or restore sleep continuity before and during military deployment to possibly alleviate nightmares and insomnia related to combat exposure and PTSD occurrence and improve our understanding of sleep in PTSD.

The Effects of Major Depressive Disorder on the Sequential Organization of Information Processing Stages: An Event-Related Potential Study

The adverse effects of depression on patients’ life have been reported but information about its effects on the sequential organization of the information processing stages remains poorly understood as previous studies focused only on distinct stages. This study adds to existing knowledge by examining the effect of major depressive disorder (MDD) on the sequential organization of information processing, executive and community functioning. Fifty-seven participants with 19 participants each for first episode depression (FMDD), recurrent episodes depression (RMDD), and healthy controls (HCs) participated in this study. They completed assessments on executive and community functioning measures, and choice reaction time task (CRTT) for the event-related potential (ERP) data. Findings revealed no significant between-group difference in executive functioning but participants with depression (FMDD and RMDD) were found to be more depressed, with FMDD participants having worse community functioning skills compared with HCs. There was no significant between-group main effect on behavioral data. ERP data showed significantly less positive-going P3b among RMDD participants compared with HCs. FMDD participants used a different information processing strategy at P1, while HCs and RMDD participants used a different processing strategy at N2b compared with the other group(s), respectively. The results suggest the use of multifaceted assessment to get a holistic view of the health status of people with MDD in order to inform clinicians on the appropriate interventional strategies needed for the patient.