Combat Deployment Experiences and Soldier Mental Health: Examining the Factor Structure of a Combat Experiences Scale

Acceptance and commitment therapy for enhancing mental health in military personnel: A comprehensive review and meta-analysis

BACKGROUND

Military personnel frequently face unique psychological challenges due to high-stress environments, which increase the risk of mental health issues like anxiety and depression. Acceptance and commitment therapy (ACT) has shown potential in addressing these issues by enhancing psychological flexibility and resilience.

AIM

To systematically evaluate the effectiveness of ACT in improving the mental health of military personnel. Through a scoping review and meta-analysis, we quantitatively assess the impact of ACT on psychological outcomes, guiding future research and clinical practice.

METHODS

Relevant literature was searched systematically from database inception to June 30, 2023, across multiple databases, including PubMed, Web of Science, Cochrane Library, and Embase. The Joanna Briggs Institute's (JBI) scoping review guidelines were used as the methodological framework. Meta-analysis was performed using a random-effects model, and publication bias was assessed through Egger's regression test and Begg's funnel plot.

RESULTS

Twenty-six studies were included, highlighting the application of ACT in addressing PTSD, chronic pain, anxiety, and depression among military personnel. The meta-analysis of eight studies demonstrated a significant positive effect of ACT on mental health, with a pooled mean difference of -4.99 (95%CI: -6.53 to -3.45). Despite high heterogeneity (I² = 63%), sensitivity analyses confirmed the robustness of the findings.

CONCLUSION

This study underscores the potential of ACT as an effective intervention for improving the mental health of military personnel. Future research should focus on large-scale, multi-center RCTs to further validate these findings, particularly within diverse military populations.

Examining the association between aggression and suicide attempts among army soldiers

BACKGROUND

Suicide is a major concern among active-duty military personnel. Aggression represents a salient risk factor for suicide among civilians, yet is relatively understudied among military populations. Although several theories posit a relation between aggression and suicide with putative underlying mechanisms of social isolation, access to firearms, and alcohol use, researchers have yet to test these potential mediators. This study uses rich, longitudinal data from the Army Study to Assess Risk and Resilience (STARRS) Pre/Post Deployment Study (PPDS) to examine whether aggression longitudinally predicts suicide attempts and to identify mediators of this association.

METHODS

Army soldiers (N = 8483) completed assessments 1 month prior to deployment and 1, 2-3, and 9-12 months post-deployment. Participants reported on their physical and verbal aggression, suicide attempts, social network size, firearm ownership, and frequency of alcohol use.

RESULTS

As expected, pre-deployment aggression was significantly associated with suicide attempts at 12-months post-deployment even after controlling for lifetime suicide attempts. Social network size and alcohol use frequency mediated this association, but firearm ownership did not.

CONCLUSIONS

Findings further implicate aggression as an important suicide risk factor among military personnel and suggest that social isolation and alcohol use may partially account for this association.

Military-related stress, self-efficacy, and anxiety: Investigating the role of marital quality in military couples

This study utilizes a stress process framework in conjunction with a crossover perspective to conceptualize how stress, specifically military-related stress, manifests within individuals and couples. An actor-partner interdependence mediation modeling approach was used in a cross-sectional sample of 243 military couples to examine whether difficulties managing military-related stress may erode one's own self-efficacy and, in turn, contribute to greater anxiety (actor effects) and/or one's partner's self-efficacy and, in turn, anxiety (partner effects). Further, the potential moderating impact of marital quality was explicated in the model to understand if greater marital quality might buffer the impact of military-related stress. There was support for the stress process model primarily regarding actor effects; fewer partner effects emerged. One's own perceptions of military-related stress, specifically higher stress, were related to lower levels of their own self-efficacy, and, consequently, higher anxiety, but military-related stress did not directly affect the partner's self-efficacy or anxiety. Both service members' and civilian spouses' marital quality had ramifications for civilian spouses' self-efficacy, specifically a buffering effect; that was not the case regarding civilian spouse effects on the military member. Findings point to specific ways in which military stressors have implications for personal well-being, the role of a strong couple relationship in buffering stress, especially for civilian spouses, and concomitant leverage points for supporting both individual and couple well-being.