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Bekesiene S, Smaliukienė R, Kanapeckaitė R. The Relationship between Psychological Hardiness and Military Performance by Reservists: A Moderation Effect of Perceived Stress and Resilience. Healthcare (Basel) 2023; 11:healthcare11091224. [PMID: 37174765 PMCID: PMC10178462 DOI: 10.3390/healthcare11091224] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
The purpose of this study is to evaluate the effect of hardiness on the perceived military performance of reservists, i.e., young people who have full-time jobs in a civilian sector and perform military training as a part of their civic duty. We proposed the conceptual model with conditional indirect effects of the hardiness on personal military performance, where mediated moderation effects are observed from personality traits and variables important for military service: team cohesion, perceived stress, and psychological resilience. The final dataset was comprised of 384 self-reported paper-pencil questionnaires filled out by reserve soldiers, and PROCESS Macro 3.5 Model 7 and Model 14 were used for the analysis. The results revealed that perceived stress (Model 1) and psychological resilience (Model 2) have a statistically significant moderate mediating effect on the interlink between hardiness and performance when personality traits and team cohesion are taken into consideration. The change in R2 is statistically significant and explains how perceived stress and psychological resilience affect individuals. When psychological hardiness is low, the level of perceived stress has a statistically significant moderating effect, i.e., it reduces the effect of hardiness on performance. When comparing the effects of perceived stress and psychological resilience, the latter has a stronger moderating effect on performance. Specifically, the moderating effect of resilience was more evident in Model 2 (66.9% variance, r = 0.818) for the military performance of the reservists than the perceived stress in Model 1 (52.5% variance, r = 0.724). This means that resilience increases the accountability of Model 2 compared to Model 1 by 14.4%. We conclude that resilience training could statistically significantly increase the military performance of reserve soldiers as a tactical population.
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Affiliation(s)
- Svajone Bekesiene
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania
| | - Rasa Smaliukienė
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania
| | - Rosita Kanapeckaitė
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania
- Institute of Psychology, Vilnius University, Universiteto g. 9/1, LT-01513 Vilnius, Lithuania
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Ledford A, Luning CR, Beckner M, Conkright W, Dixon D, Miles P, Martin B, Nindl B, Lynch S. Psychological and Physiological Changes during Basic, Underwater, Demolition/SEAL Training. Physiol Behav 2022; 257:113970. [PMID: 36179811 DOI: 10.1016/j.physbeh.2022.113970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
Abstract
This longitudinal study examines the growth of psychological characteristics and adaptation of physiological markers of stress during a six-month assessment and selection course for U.S. Navy SEALs. Resilience, hardiness, and grit instruments were used to evaluate the psychological characteristics. Blood samples were taken to determine physiological markers related to stress adaptation; specifically, evaluating DHEA, DHEA-to-cortisol ratio, BDNF, NPY, and cortisol. Data was collected at four timepoints throughout the assessment and selection course from 353 students over three classes. Results indicated that resilience and hardiness grow after an initial decline, DHEA and DHEA-to-cortisol increased suggesting physiological adaptation. However, psychological and physiological markers do not exhibit the same growth patterns for participants in the course. This study enhances the understanding of psychological growth and physiological adaptation in a high-stress environment over an extended duration.
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Affiliation(s)
- Andrew Ledford
- Department of Leadership, Ethics, and Law, United States Naval Academy.
| | | | | | - Will Conkright
- Deputy Chief, Nutrition Care Division, Madigan Army Medical Center
| | - Deirdre Dixon
- TECO Energy Center for Leadership, Sykes College of Business, The University of Tampa
| | | | - Brian Martin
- Neuromuscular Research Laboratory, University of Pittsburgh
| | - Brad Nindl
- Neuromuscular Research Laboratory, University of Pittsburgh
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Doody CB, Robertson L, Cox KM, Bogue J, Egan J, Sarma KM. Pre-deployment programmes for building resilience in military and frontline emergency service personnel. Cochrane Database Syst Rev 2021; 12:CD013242. [PMID: 34870330 PMCID: PMC8647095 DOI: 10.1002/14651858.cd013242.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Military personnel and frontline emergency workers may be exposed to events that have the potential to precipitate negative mental health outcomes such as depression, symptoms of post-traumatic stress and even post-traumatic stress disorder (PTSD). Programmes have been designed to build psychological resilience before staff are deployed into the field. This review presents a synthesis of the literature on these "pre-deployment resilience-building programmes". OBJECTIVES The objective of this review was to assess the effectiveness of programmes that seek to build resilience to potentially traumatic events among military and frontline emergency service personnel prior to their deployment. These resilience programmes were compared to other interventions, treatment as usual or no intervention. SEARCH METHODS Studies were identified through searches of electronic databases including Ovid MEDLINE, Embase, PsycINFO, Web of Science and Google Scholar. The initial search took place in January 2019, with an updated search completed at the end of September 2020. SELECTION CRITERIA Only studies that used a randomised controlled trial (RCT)/cluster-RCT methodology were included. The programmes being evaluated must have sought to build resilience prior to exposure to trauma. Study participants must have been 18 years or older and be military personnel or frontline emergency workers. DATA COLLECTION AND ANALYSIS Studies that met the inclusion criteria were assembled. Data extracted included methods, participants' details, intervention details, comparator details, and information on outcomes. The primary outcomes of interest were resilience, symptoms of post-traumatic stress and PTSD. Secondary outcomes of interest included acute stress disorder, depression, social support, coping skills, emotional flexibility, self-efficacy, social functioning, subjective levels of aggression, quality of sleep, quality of life and stress. Assessment of risk of bias was also completed. A total of 28 studies were included in a narrative synthesis of results. MAIN RESULTS All 28 included studies compared an experimental resilience building intervention versus a control or no intervention. There was a wide range of therapeutic modalities used, including cognitive behavioural therapy (CBT) informed programmes, biofeedback based programmes, stress-management programmes, mindfulness and relaxation programmes, neuropsychological-based programmes, and psychoeducational-informed programmes. The main outcomes are specified here, secondary outcomes such as depression, social support, coping skills, self-efficacy, subjective levels of aggression and stress are reported in text. No studies reported on the following pre-specified outcomes; acute stress disorder, emotional flexibility, social functioning, quality of sleep and quality of life. Resilience Eight studies reported resilience as an outcome. We narratively synthesised the data from these studies and our findings show that five of these interventions had success in building resilience in their respective samples. Two of the studies that reported significant results utilised a CBT approach to build resilience, while the other three successful programmes were mindfulness-based interventions. Symptoms of post-traumatic stress Our narrative synthesis of results included eight studies. Two of the eight studies produced significant reductions in symptoms of post traumatic stress compared to controls. These interventions used neuropsychological and biofeedback intervention models respectively. PTSD caseness Four studies reported PTSD caseness as an outcome. Our narrative synthesis of results suggests that evidence is mixed as to the effectiveness of these interventions in reducing clinical diagnosis of PTSD. One study of a neuropsychology-orientated Attention Bias Modification Training (AMBT) programme had success in reducing both symptoms of post-traumatic stress and numbers of participants receiving a diagnosis of PTSD. A stress-management programme reported that, when baseline differences in rates of pre-deployment mental health issues were controlled for, participants in the control condition were at 6.9 times the risk of a diagnosis of PTSD when compared to the intervention group. Given the diversity of intervention designs and theoretical orientations used (which included stress-management, neuropsychological and psychoeducational programmes), a definitive statement on the efficacy of pre-deployment programmes at reducing symptoms of post-traumatic stress and PTSD cannot be confidently offered. AUTHORS' CONCLUSIONS While a number of evaluations of relevant programmes have been published, the quality of these evaluations limits our ability to determine if resilience-building programmes 'work' in terms of preventing negative outcomes such as depression, symptoms of post-traumatic stress and diagnoses of PTSD. Based on our findings we recommend that future research should: a) report pre-/post-means and standard deviation scores for scales used within respective studies, b) take the form of large, RCTs with protocols published in advance, and c) seek to measure defined psychological facets such as resilience, PTSD and stress, and measure these concepts using established psychometric tools. This will provide more certainty in future assessments of the evidence base. From a clinical implications point of view, overall there is mixed evidence that the interventions included in this review are effective at safe guarding military personnel or frontline emergency workers from experiencing negative mental health outcomes, including PTSD, following exposure to potentially traumatic events. Based on this, practitioners seeking to build resilience in their personnel need to be aware of the limitations of the evidence base. Practitioners should have modest expectations in relation to the efficacy of resilience-building programmes as a prophylactic approach to employment-related critical incident traumas.
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Affiliation(s)
- Colm B Doody
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Lindsay Robertson
- Cochrane Common Mental Disorders, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Katie M Cox
- National University of Ireland Galway, Galway, Ireland
| | - John Bogue
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jonathan Egan
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Kiran M Sarma
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Abstract
OBJECTIVE Burnout is a costly problem, and it appears to be getting worse due to COVID-related stressors. It is thus important for organizations to find better tools to prevent and mitigate worker burnout. METHODS Conditional PROCESS path analysis was used to assess the relation of hardiness to burnout in a representative sample of U.S. workers, with sex and age as potential moderators. RESULTS Hardiness is associated with reduced burnout symptoms. Sex did not moderate this relation. A moderating effect for age was observed, with more burnout appearing in younger, less hardy workers. CONCLUSIONS Findings suggest hardiness operates similarly for men and women as a buffer against burnout, and that older workers are less vulnerable to burnout. Training programs to increase stress appraisals and coping skills used by more experienced, hardy workers may be beneficial in reducing burnout.
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Altınsoy F, Aypay A. A post-traumatic growth model: psychological hardiness, happiness-increasing strategies, and problem-focused coping. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02466-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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A Concept Analysis on Disaster Resilience in Rescue Workers: The Psychological Perspective. Disaster Med Public Health Prep 2021; 16:1682-1691. [PMID: 34286679 DOI: 10.1017/dmp.2021.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The term disaster resilience has not been well defined. The purpose of this article is to scrutinize the concept of disaster resilience in rescue workers. METHODS A systematic search was conducted of the PsychInfo, PubMed, ISI Web of Science, MEDLINE, CINAHL, Embase, and Scopus databases using the key terms. The framework from Walker and Avant was used to analyze the concept of disaster resilience. RESULTS A total of 26 papers was included in this analysis. The attributes of disaster resilience have been identified from the literature as including personality, perceived control, self-efficacy, coping strategies, and social support. The antecedents of disaster resilience are disastrous events and preparedness for disaster. The consequences of disaster resilience are psychological well-being, posttraumatic growth, and enhanced work engagement. CONCLUSION This concept analysis presents a definition of the concept of disaster resilience that could contribute to the development of a standardized screening or assessment tool and tailored training programs to strengthen disaster resilience among those who are willing to be deployed to engage in disaster rescue work and those who have been involved in such work.
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Bachem R, Zhou X, Levin Y, Solomon Z. Trajectories of depression in aging veterans and former prisoners-of-war: The role of social support and hardiness. J Clin Psychol 2021; 77:2203-2215. [PMID: 34000063 DOI: 10.1002/jclp.23168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Depression is a prevalent outcome of traumatic experiences, such as combat and war captivity. This study explores the heterogeneity of changes over time and assesses the contribution of trauma exposure (combat vs. war captivity), hardiness, and social support for depression trajectories. METHODS Two groups of Israeli veterans were assessed in 1991, 2003, 2008, and 2015: 149 former prisoners-of-war (ex-POWs) and 107 combat veterans. Protective factors were evaluated in 1991. Group-based trajectory modeling was conducted to identify latent trajectories of change. RESULTS Four trajectories of "resiliency" (62.8%), "delayed onset" (25.1%), "exacerbation" (6.2%), and "chronicity" (5.9%) were found. The majority of the resilient group were combat veterans whereas the clinical groups consisted primarily of ex-POWs. Lower hardiness and social support were related to more deleterious trajectories. CONCLUSIONS Spirals of loss involving hardiness and social support, normative experiences, and contextual factors may present explanations for the various depression trajectories.
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Affiliation(s)
- Rahel Bachem
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Xiao Zhou
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yafit Levin
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Zahava Solomon
- I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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The impact of psychological hardiness on soldiers’ engagement and general health: The mediating role of need satisfaction. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01371-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Prevalence of Low Back Pain and Relationship to Mental Health Symptoms and Quality of Life After a Deployment-related Lower Limb Amputation. Spine (Phila Pa 1976) 2020; 45:1368-1375. [PMID: 32576777 DOI: 10.1097/brs.0000000000003525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective, cross-sectional study. OBJECTIVE To assess the prevalence and association of low back pain (LBP) with psychosocial factors in Service members with amputations. SUMMARY OF BACKGROUND DATA LBP is a common secondary health condition after amputation with important implications related to function and quality of life. A growing body of evidence suggests that psychosocial factors influence LBP in patients without amputation. However, there is a dearth of information regarding the association of psychosocial factors and LBP after amputation. METHODS Seventy-nine individuals with lower limb amputations who were a part of the Wounded Warrior Recovery Project were included in the analysis. Data on posttraumatic stress disorder (PTSD), depression, and quality of life (QOL) were collected from the Wounded Warrior Recovery Project, while data on LBP and LBP chronicity were extracted from the Military Health System Data Repository. General linear models were utilized to analyze associations between LBP and psychosocial factors, while controlling for injury severity and time since amputation. RESULTS In individuals with amputations, 19.0% had acute LBP and 49.4% had recurrent LBP. Individuals with amputations and recurrent LBP reported higher PTSD symptom severity compared with those without LBP (B = 9.213, P < 0.05). More severe depression symptoms were observed in those with amputations and recurrent LBP compared with those without LBP (B = 5.626, P < 0.05). Among individuals with amputations, those with recurrent LBP reported lower QOL compared with those without LBP (B = -0.058, P < 0.05). There were no differences in PTSD, depression or QOL in those with amputations with and without acute LBP. CONCLUSIONS Presence of recurrent LBP after amputation appears to be associated with more severe PTSD and depression symptoms as well as lower QOL. Further research is needed to assess the efficacy of addressing psychosocial factors for improving pain and function in service members with amputations and LBP. LEVEL OF EVIDENCE 3.
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Kunzler AM, Helmreich I, König J, Chmitorz A, Wessa M, Binder H, Lieb K. Psychological interventions to foster resilience in healthcare students. Cochrane Database Syst Rev 2020; 7:CD013684. [PMID: 32691879 PMCID: PMC7388680 DOI: 10.1002/14651858.cd013684] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions, as distinct from medical care (e.g. psychology, physical therapy or social work students). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, waiting list, usual care, and active or attention control, in adults (18 years and older), who are healthcare students. Primary outcomes were resilience, anxiety, depression, stress or stress perception, and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 30 RCTs, of which 24 were set in high-income countries and six in (upper- to lower-) middle-income countries. Twenty-two studies focused solely on healthcare students (1315 participants; number randomised not specified for two studies), including both students in health professions delivering direct medical care and those in allied health professions, such as psychology and physical therapy. Half of the studies were conducted in a university or school setting, including nursing/midwifery students or medical students. Eight studies investigated mixed samples (1365 participants), with healthcare students and participants outside of a health professional study field. Participants mainly included women (63.3% to 67.3% in mixed samples) from young adulthood (mean age range, if reported: 19.5 to 26.83 years; 19.35 to 38.14 years in mixed samples). Seventeen of the studies investigated group interventions of high training intensity (11 studies; > 12 hours/sessions), that were delivered face-to-face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. universities, foundations), or a combination of various sources (four studies). Seven studies did not specify a potential funder, and three studies received no funding support. Risk of bias was high or unclear, with main flaws in performance, detection, attrition and reporting bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare students receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.43, 95% confidence interval (CI) 0.07 to 0.78; 9 studies, 561 participants), lower levels of anxiety (SMD -0.45, 95% CI -0.84 to -0.06; 7 studies, 362 participants), and lower levels of stress or stress perception (SMD -0.28, 95% CI -0.48 to -0.09; 7 studies, 420 participants). Effect sizes varied between small and moderate. There was little or no evidence of any effect of resilience training on depression (SMD -0.20, 95% CI -0.52 to 0.11; 6 studies, 332 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.15, 95% CI -0.14 to 0.43; 4 studies, 251 participants; very-low certainty evidence). Adverse effects were measured in four studies, but data were only reported for three of them. None of the three studies reported any adverse events occurring during the study (very-low certainty of evidence). AUTHORS' CONCLUSIONS For healthcare students, there is very-low certainty evidence for the effect of resilience training on resilience, anxiety, and stress or stress perception at post-intervention. The heterogeneous interventions, the paucity of short-, medium- or long-term data, and the geographical distribution restricted to high-income countries limit the generalisability of results. Conclusions should therefore be drawn cautiously. Since the findings suggest positive effects of resilience training for healthcare students with very-low certainty evidence, high-quality replications and improved study designs (e.g. a consensus on the definition of resilience, the assessment of individual stressor exposure, more attention controls, and longer follow-up periods) are clearly needed.
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Affiliation(s)
| | | | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Kunzler AM, Helmreich I, Chmitorz A, König J, Binder H, Wessa M, Lieb K. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev 2020; 7:CD012527. [PMID: 32627860 PMCID: PMC8121081 DOI: 10.1002/14651858.cd012527.pub2] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence). AUTHORS' CONCLUSIONS For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
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Affiliation(s)
| | | | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Choi KW, Chen CY, Ursano RJ, Sun X, Jain S, Kessler RC, Koenen KC, Wang MJ, Wynn GH, Campbell-Sills L, Stein MB, Smoller JW. Prospective study of polygenic risk, protective factors, and incident depression following combat deployment in US Army soldiers. Psychol Med 2020; 50:737-745. [PMID: 30982473 PMCID: PMC8293300 DOI: 10.1017/s0033291719000527] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Whereas genetic susceptibility increases the risk for major depressive disorder (MDD), non-genetic protective factors may mitigate this risk. In a large-scale prospective study of US Army soldiers, we examined whether trait resilience and/or unit cohesion could protect against the onset of MDD following combat deployment, even in soldiers at high polygenic risk. METHODS Data were analyzed from 3079 soldiers of European ancestry assessed before and after their deployment to Afghanistan. Incident MDD was defined as no MDD episode at pre-deployment, followed by a MDD episode following deployment. Polygenic risk scores were constructed from a large-scale genome-wide association study of major depression. We first examined the main effects of the MDD PRS and each protective factor on incident MDD. We then tested the effects of each protective factor on incident MDD across strata of polygenic risk. RESULTS Polygenic risk showed a dose-response relationship to depression, such that soldiers at high polygenic risk had greatest odds for incident MDD. Both unit cohesion and trait resilience were prospectively associated with reduced risk for incident MDD. Notably, the protective effect of unit cohesion persisted even in soldiers at highest polygenic risk. CONCLUSIONS Polygenic risk was associated with new-onset MDD in deployed soldiers. However, unit cohesion - an index of perceived support and morale - was protective against incident MDD even among those at highest genetic risk, and may represent a potent target for promoting resilience in vulnerable soldiers. Findings illustrate the value of combining genomic and environmental data in a prospective design to identify robust protective factors for mental health.
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Affiliation(s)
- Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - Chia-Yen Chen
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Robert J Ursano
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Xiaoying Sun
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Sonia Jain
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - Min-Jung Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gary H Wynn
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Laura Campbell-Sills
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Murray B Stein
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
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van der Meulen E, van der Velden PG, van Aert RCM, van Veldhoven MJPM. Longitudinal associations of psychological resilience with mental health and functioning among military personnel: A meta-analysis of prospective studies. Soc Sci Med 2020; 255:112814. [PMID: 32388075 DOI: 10.1016/j.socscimed.2020.112814] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 01/06/2020] [Accepted: 01/20/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Military personnel are exposed to severe stressors across different stages of their career that may have a negative impact on mental health and functioning. It is often suggested that psychological resilience plays an important role in the maintenance and/or enhancement of their mental health and functioning under these circumstances. METHOD A systematic literature search was conducted using PsycINFO, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences Collection, Web of Science, and PubMed up to August of 2019 retrieving 3,698 reports. Schmidt and Hunter meta-analytical techniques were used to assess the predictive value of psychological resilience on ten different military relevant mental health and functioning outcomes. Multivariate meta-analysis assessed the origin of heterogeneity among bivariate effect sizes. RESULTS The effect sizes of 40 eligible peer-reviewed papers covering 40 unique samples were included in the meta-analysis. Seventy-eight percent of these studies were published after 2010 and were predominantly conducted in western countries. Bivariate effect sizes were low to medium (absolute values: 0.08 to 0.36) and multivariate effect sizes, adjusting for across studies varying sets of covariates, were low to trivial (absolute values: 0.02 to 0.08). Moderator analyses using multivariate meta-analysis on 60 bivariate effect sizes, revealed no significant effect of type of psychological resilience scale, time-lag, and career stage. CONCLUSIONS The current review found no indications that different conceptualizations of psychological resilience across a variety of research designs, are strongly predictive of mental health and functioning among military personnel. Future directions (moderator/mediator models, stressor type specifications, and directionality) for prospective studies are discussed. Our results question the usefulness of interventions to enhance the resilience of soldiers to improve their mental health and functioning.
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Affiliation(s)
- Erik van der Meulen
- Academy of Healthcare, NHL Stenden University of Applied Sciences, Leeuwarden, the Netherlands; Intervict, Tilburg University, Tilburg, the Netherlands.
| | - Peter G van der Velden
- CentERdata, Tilburg, the Netherlands; Tilburg University's Network on Health and Labour (NETHLAB), Tilburg, the Netherlands
| | - Robbie C M van Aert
- Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
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Wan C, Berlinguette MK, Skomorovsky A. The impact of financial satisfaction on well-being of Canadian military members. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2019. [DOI: 10.3138/jmvfh.5.s1.2018-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction: The ability to attain financial satisfaction is becoming progressively difficult due to increasing living standards, costs, and accruement of debt. Military members are arguably at greater risk of being dissatisfied with their current financial situation and suffering from financial strain and psychological distress due to the demands of a military lifestyle. Methods: The present study aimed to explore the predictive relationships between financial satisfaction and daily coping ability on two facets of well-being – life satisfaction and psychological distress – among Canadian military personnel. Results: The hierarchical regression results demonstrated that financial satisfaction was a significant predictor of life satisfaction and psychological distress. Moreover, daily coping ability played a vital role in improving participants’ life satisfaction and reducing psychological distress, above and beyond the positive impact of financial satisfaction. Discussion: The qualitative difference between the predictors and outcome variables as well as directions for future research are discussed.
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Affiliation(s)
- Cynthia Wan
- Director General Military Personnel Research and Analysis Department of National Defence, Ottawa, Ontario, Canada
| | - M. Katharine Berlinguette
- Director General Military Personnel Research and Analysis Department of National Defence, Ottawa, Ontario, Canada
| | - Alla Skomorovsky
- Director General Military Personnel Research and Analysis Department of National Defence, Ottawa, Ontario, Canada
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Luzipo P, Van Dyk G. Organisation climate mediation of the relationship between hardiness, self-efficacy, and job satisfaction among military followers. JOURNAL OF PSYCHOLOGY IN AFRICA 2018. [DOI: 10.1080/14330237.2018.1475461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Palesa Luzipo
- Department of Industrial Psychology, Faculty of Military Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Gideon Van Dyk
- Department of Industrial Psychology, Faculty of Military Sciences, Stellenbosch University, Stellenbosch, South Africa
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van der Meulen E, van der Velden PG, Setti I, van Veldhoven MJPM. Predictive value of psychological resilience for mental health disturbances: A three-wave prospective study among police officers. Psychiatry Res 2018; 260:486-494. [PMID: 29289832 DOI: 10.1016/j.psychres.2017.12.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 11/30/2022]
Abstract
Psychological resilience is considered an important predictor for mental health disturbances among rescue workers. To what extent resilience predicts mental health disturbances among police officers at different stages while adjusting for existing (mental) health disturbances is unclear. Among 566 police officers resilience was operationalized by the Resilience Scale-nl and the Mental Toughness Questionnaire-48 questionnaires (8 scales in total). Mental health disturbances (such as depression symptoms and PTSD) and other health-related variables were assessed at baseline and follow-ups at three and nine months. Hierarchical logistic regression analyses assessed the predictive values of the 8 resilience scales for mental health disturbances at baseline (n = 566), three months (n = 566) and nine months (n = 364), adjusted for demographics, work circumstances, and health-related factors at baseline. Seven of the eight resilience scales at baseline were cross sectional associated with mental health disturbances at baseline. Only four scales were independent predictors for mental health disturbances at three months. When examining mental health disturbances at nine months, only one resilience scale remained a significant predictor. In sum, psychological resilience has a declining protective capacity for mental health disturbances over a medium time-span, specifically when corrected for baseline mental health disturbances.
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Affiliation(s)
- Erik van der Meulen
- International Victimology Institute Tilburg, Tilburg University, Tilburg, The Netherlands.
| | - Peter G van der Velden
- International Victimology Institute Tilburg, Tilburg University, Tilburg, The Netherlands
| | - Ilaria Setti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Helmreich I, Kunzler A, Chmitorz A, König J, Binder H, Wessa M, Lieb K. Psychological interventions for resilience enhancement in adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2017. [DOI: 10.1002/14651858.cd012527] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Isabella Helmreich
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
| | - Angela Kunzler
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
| | - Andrea Chmitorz
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
| | - Jochem König
- University Medical Center of the Johannes Gutenberg University Mainz; Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI); Obere Zahlbacher Str. 69 Mainz Rhineland-Palatinate Germany 55131
| | - Harald Binder
- University Medical Center of the Johannes Gutenberg University Mainz; Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI); Obere Zahlbacher Str. 69 Mainz Rhineland-Palatinate Germany 55131
| | - Michèle Wessa
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- Johannes Gutenberg University Mainz; Department of Clinical Psychology and Neuropsychology, Institute for Psychology; Wallstraße 3 Mainz Rhineland-Palatinate Germany 55122
| | - Klaus Lieb
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
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Lee JEC, Phinney B, Watkins K, Zamorski MA. Psychosocial Pathways Linking Adverse Childhood Experiences to Mental Health in Recently Deployed Canadian Military Service Members. J Trauma Stress 2016; 29:124-31. [PMID: 26954537 DOI: 10.1002/jts.22085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 11/15/2015] [Accepted: 01/11/2016] [Indexed: 11/12/2022]
Abstract
Multiple pathways have been suggested to account for the relationship of adverse childhood experiences (ACEs) and well-being in adulthood, including interpersonal difficulties, the underestimation of one's sense of mastery, and a greater propensity to experience stressors later in life. This study was conducted to examine the association between ACEs and mental health in Canadian Armed Forces (CAF) personnel, and the possible mediating roles of social support, mastery, and combat stressors in that relationship. The study consisted of a prospective analysis involving 3,319 CAF members upon their return from an overseas deployment. Results were that ACEs were associated with poorer mental health (β = -.14, p < .001) and that approximately 42.6% of this relationship could be explained by the mediating effects of low social support, low mastery, and a greater number of combat stressors. The full model, including the covariates, ACEs, social support, mastery, and combat stressors as correlates of postdeployment mental health, was statistically significant with adjusted R(2) = .28, F(9, 3309) = 141.96, p < .001. On the whole, results suggested that social support, mastery, and life stressors may be possible targets for interventions to minimize the impact of ACEs on later mental health in military personnel.
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Affiliation(s)
- Jennifer E C Lee
- Department of National Defence, Ottawa, Ontario, Canada.,Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Brigitte Phinney
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
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De La Rosa GM, Delaney EM, Webb-Murphy JA, Johnston SL. Interactive effects of stress and individual differences on alcohol use and posttraumatic stress disorder among personnel deployed to Guantanamo Bay. Addict Behav 2015; 50:128-34. [PMID: 26135332 DOI: 10.1016/j.addbeh.2015.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 05/14/2015] [Accepted: 06/04/2015] [Indexed: 11/17/2022]
Abstract
This study examines the role of factors such as perceived stress, neuroticism, beliefs in psychotherapy stigma, resilience, and demographics in understanding posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) among deployed military personnel. Results show that personnel who screened positive for PTSD were more likely to screen positive for AUD (versus those who did not screen positive for PTSD). Perceived stress, neuroticism, and psychotherapy stigma all have direct multivariate relationships with PTSD symptoms. Moderated regression analyses show that the positive relationship between perceived stress and PTSD symptoms is significantly stronger among those scoring high on neuroticism and psychotherapy stigma. The positive relationship between perceived stress and AUD symptoms is only significant among those scoring high on psychotherapy stigma. Given the moderating role of psychotherapy stigma in the relationship between perceived stress and PTSD symptoms and the relationship between perceived stress and AUD symptoms efforts to reduce the stigma associated with mental health care in the military should be expanded. Also, the current research adds to the literature highlighting the role of neuroticism as a key variable in understanding PTSD.
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Affiliation(s)
| | - Eileen M Delaney
- Naval Center for Combat and Operational Stress Control, United States
| | | | - Scott L Johnston
- Naval Center for Combat and Operational Stress Control, United States
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Ladstätter F, Garrosa E, Moreno-Jiménez B, Ponsoda V, Reales Aviles JM, Dai J. Expanding the occupational health methodology: A concatenated artificial neural network approach to model the burnout process in Chinese nurses. ERGONOMICS 2015; 59:207-221. [PMID: 26230967 DOI: 10.1080/00140139.2015.1061141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 06/04/2015] [Indexed: 06/04/2023]
Abstract
UNLABELLED Artificial neural networks are sophisticated modelling and prediction tools capable of extracting complex, non-linear relationships between predictor (input) and predicted (output) variables. This study explores this capacity by modelling non-linearities in the hardiness-modulated burnout process with a neural network. Specifically, two multi-layer feed-forward artificial neural networks are concatenated in an attempt to model the composite non-linear burnout process. Sensitivity analysis, a Monte Carlo-based global simulation technique, is then utilised to examine the first-order effects of the predictor variables on the burnout sub-dimensions and consequences. Results show that (1) this concatenated artificial neural network approach is feasible to model the burnout process, (2) sensitivity analysis is a prolific method to study the relative importance of predictor variables and (3) the relationships among variables involved in the development of burnout and its consequences are to different degrees non-linear. PRACTITIONER SUMMARY Many relationships among variables (e.g., stressors and strains) are not linear, yet researchers use linear methods such as Pearson correlation or linear regression to analyse these relationships. Artificial neural network analysis is an innovative method to analyse non-linear relationships and in combination with sensitivity analysis superior to linear methods.
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Affiliation(s)
- Felix Ladstätter
- a Department of Psychology , IE University, Cardenal Zúñiga , Segovia , Spain
| | - Eva Garrosa
- b Department of Psychology, Universidad Autónoma de Madrid , Madrid , Spain
| | | | - Vicente Ponsoda
- b Department of Psychology, Universidad Autónoma de Madrid , Madrid , Spain
| | | | - Junming Dai
- d School of Public Health, Fudan University , Shanghai , China
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Merritt VC, Lange RT, French LM. Resilience and symptom reporting following mild traumatic brain injury in military service members. Brain Inj 2015. [PMID: 26204318 DOI: 10.3109/02699052.2015.1043948] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). It was hypothesized that, as resilience increases, self-reported symptoms would decrease. RESEARCH DESIGN Cross-sectional design. METHODS AND PROCEDURES Participants were 142 US military service members who sustained a mTBI, divided into three resilience groups based on participants' responses on the Response to Stressful Experiences Scale: Moderate (n = 42); High (n = 51); and Very High (n = 49). Participants completed the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian Version (PCL-C) within 12 months following injury. MAIN OUTCOMES AND RESULTS There were significant main effects for the NSI total score, cognitive cluster and affective cluster, as well as for the PCL-C total score, avoidance cluster and hyperarousal cluster. Pairwise comparisons revealed that there was a negative relationship between resilience and self-reported symptoms overall. Specifically, participants with higher resilience reported fewer post-concussion and PTSD-related symptoms than participants with lower levels of resilience. CONCLUSIONS These findings underscore the important role that resilience plays in symptom expression in military service members with mTBI and suggest that research on targeted interventions to increase resilience in the acute phase following injury is indicated.
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Affiliation(s)
| | - Rael T Lange
- b Defense and Veterans Brain Injury Center , Bethesda , MD , USA .,c Walter Reed National Military Medical Center , Bethesda , MD , USA .,d University of British Columbia , Vancouver , BC , Canada .,e Center for Neuroscience and Regenerative Medicine , Bethesda , MD , USA , and
| | - Louis M French
- b Defense and Veterans Brain Injury Center , Bethesda , MD , USA .,c Walter Reed National Military Medical Center , Bethesda , MD , USA .,e Center for Neuroscience and Regenerative Medicine , Bethesda , MD , USA , and.,f Uniformed Services University of the Health Sciences , Bethesda , MD , USA
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Johnson N, McMahon C, Gibson F. Assisted conception, maternal personality and parenting: Associations with toddler sleep behaviour. J Paediatr Child Health 2014; 50:732-8. [PMID: 24990178 DOI: 10.1111/jpc.12654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 11/27/2022]
Abstract
AIM To explore the role of maternal personality (hardiness), sleep-related cognitions and bedtime involvement in child sleep behaviour during the second post-natal year in a sample of spontaneous and assisted conception first-time mothers. METHOD Mothers (n = 134 (spontaneous (n = 81); assisted (n = 53) conception)) reported on a resilience measure (hardiness) during pregnancy and child sleep at 7 and 19 months post-partum. At 19 months post-partum, mothers also reported on their cognitions and involvement around their child's bedtime, and half the sample used Actigraph monitors (Acitiwatch-16, Mini Mitter Co. Inc, Bend, OR, USA) to validate maternal report of child sleep. RESULTS No significant differences were found between spontaneous and assisted conception mothers on any of the study variables; therefore, assisted and spontaneous samples were combined. Structural equation modelling confirmed that lower pre-birth maternal hardiness was associated with more problematic sleep-related cognitions (β = 0.23, P < 0.01) and involvement at bedtime (β = 0.29, P < 0.01) and poorer child sleep outcomes (β = -0.33, P < 0.001) during toddlerhood, even after considering concurrent maternal mood and child temperament. CONCLUSIONS Pre-birth maternal hardiness rather than mode of conception contributes to parenting cognitions and behaviour around child sleep and, ultimately, toddlers' sleep outcomes. Findings suggest that targeting negative maternal perceptions of control and efficacy through clinical interventions could benefit toddlers' sleep.
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Affiliation(s)
- Nikki Johnson
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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Cotian MDS, Vilete L, Volchan E, Figueira I. Revisão sistemática dos aspectos psicossociais, neurobiológicos, preditores e promotores de resiliência em militares. JORNAL BRASILEIRO DE PSIQUIATRIA 2014. [DOI: 10.1590/0047-2085000000009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo: Conduzir uma revisão sistemática sobre resiliência psicológica e/ou hardiness em militares, explorando seus aspectos psicossociais, neurobiológicos, preditores e promotores. Métodos: Utilizaram-se as bases de dados PubMed/MedLine, ISI/Web of Science e PsycINFO, incluindo artigos empíricos publicados nas línguas inglesa, portuguesa e espanhola até maio de 2012. Os seguintes termos foram utilizados: “militar*”, “Army”, “war”, “veteran*”, “resilien*” e “hardiness”. Resultados: Foram incluídos 32 estudos selecionados a partir de 1.205 artigos. O foco da maioria das pesquisas recai sobre a correlação resiliência/hardiness e aspectos psicossociais. Confirmou-se o papel protetivo da resiliência/hardiness quanto ao transtorno de estresse pós-traumático (TEPT), assim como a associação direta entre resiliência e saúde. Neuropeptídeo Y (NPY) e deidroepiandrosterona (DHEA) foram os biomarcadores mais estudados. Os níveis de NPY no plasma podem representar um correlato biológico de resiliência ou recuperação dos efeitos adversos do estresse. Somente dois estudos abordaram fatores preditores de resiliência em amostras militares, sugerindo ser a exposição a situações adversas, o apoio social e o gênero fatores considerados preditores desse construto. Apenas um estudo avaliou a eficiência de intervenção para fortalecer a resiliência. Conclusão: Apesar da crucial relevância da resiliência, há poucos estudos em amostras militares. Estudos neurobiológicos como os do NPY são promissores. A ausência de ensaio randomizado controlado avaliando eficácia de intervenções promotoras da resiliência demonstra como esse construto vem sendo negligenciado nessa profissão de risco, constituindo área prioritária para foco de estudos futuros.
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Abstract
BACKGROUND Since the events surrounding September 11, 2011, and natural disasters, research on resilience has shifted from children to adult resilience. The military began to embrace the concept in 2008 in an effort to decrease the number of military service member (SM) suicides. PURPOSE The purpose of this article is to explain resilience as it relates to military SMs using the process for concept analysis outlined by Walker and Avant (2005). FINDINGS Adaptive coping, personal control, hardiness, and social support are the attributes that characterize psychological resilience in SMs. Antecedents for resilience are life events such as serious accidents, prior deployments where death is witnessed, and combat involvement. Consequences of high resilience include decreased mental health symptoms and career and personal success, while consequences of low resilience include increased mental health symptoms and participating in high-risk behaviors. PRACTICE IMPLICATIONS Understanding resilience as it relates to SMs is critical. Nurses must be able to assess SMs and be equipped to refer them or their family members to the most appropriate care. As more is learned about resilience in the military community, there may be broader implications to the civilian community. Improved understanding of psychological resilience may lead to improved interventions appropriate for both civilians and military SMs.
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McCauley SR, Wilde EA, Miller ER, Frisby ML, Garza HM, Varghese R, Levin HS, Robertson CS, McCarthy JJ. Preinjury resilience and mood as predictors of early outcome following mild traumatic brain injury. J Neurotrauma 2013; 30:642-52. [PMID: 23046394 DOI: 10.1089/neu.2012.2393] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is significant heterogeneity in outcomes following mild traumatic brain injury (mTBI). While several host factors (age, gender, and preinjury psychiatric history) have been investigated, the influence of preinjury psychological resilience and mood status in conjunction with mild TBI remains relatively unexplored. Euthymic mood and high resilience are potentially protective against anxiety and postconcussion symptoms, but their relative contributions are currently unknown. This prospective study obtained preinjury estimates of resilience and mood measures in addition to measures of anxiety (Acute Stress Disorder Scale and PTSD-Checklist-Civilian form) and postconcussion symptom severity (Rivermead Post Concussion Symptoms Questionnaire) <24 hours (Baseline), 1 week, and 1 month postinjury in patients with either mTBI (n=46) or a comparison group with orthopedic injuries not involving the head (OI, n=29). The groups did not differ on preinjury resilience or mood status at baseline, but differed significantly on measures of anxiety and postconcussion symptom severity at each subsequent study occasion. Multivariate linear regression analyses were conducted to determine if preinjury resilience and mood were significant contributors to anxiety and postconcussion symptoms during the first month postinjury after accounting for other known host factors (e.g., age at injury, gender, and education). Injury group and preinjury mood status were significant predictors for all three dependent variables at each study occasion (all p<0.007). Preinjury resilience showed a positive trend only for acute stress severity at baseline, but demonstrated significant prediction of all three dependent measures at one week and one month postinjury. These results suggest that preinjury depressed mood and resilience are significant contributors to the severity of postinjury anxiety and postconcussion symptoms, even after accounting for effects of other specific host factors.
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Affiliation(s)
- Stephen R McCauley
- Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School, Houston, Texas, USA.
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Bagnell ME, LeardMann CA, McMaster HS, Boyko EJ, Smith B, Granado NS, Smith TC. The Association of Predeployment and Deployment-Related Factors on Dimensions of Postdeployment Wellness in U.S. Military Service Members. Am J Health Promot 2013; 28:e56-66. [DOI: 10.4278/ajhp.120727-quan-366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To assess the effects of predeployment and deployment-related factors on dimensions of wellness following deployment. Design. Prospective longitudinal study. The dependent variable was dimensions of wellness. Independent variables were measured in terms of modifiable, nonmodifiable, and military factors, such as sex, race/ethnicity, service branch, smoking status, and combat experience. Setting. A large military cohort participating in the Millennium Cohort Study. Subjects. Included 10,228 participants who deployed in support of the operations in Iraq and Afghanistan. Measures. Dimensions of wellness were measured by using standardized instruments assessing self-reported physical health, mental health, and stress. Covariates were measured by using self-reported and electronic data. Analysis. Factors of postdeployment wellness were assessed by using ordinal logistic regression. Results. Most participants (78.7%) were categorized as “moderately well” post deployment. Significant modifiable predeployment predictors of postdeployment wellness included normal/underweight body mass index (odds ratio [OR] = 1.72, p < .05). Military factors significantly associated with wellness included not experiencing combat (OR = .56, p < .05), member of Air Force (OR = 2.02, p < .05) or Navy/Coast Guard (OR = 1.47, p < .05), and combat specialist occupation (OR = 1.22, p < .05). Conclusion. Multiple modifiable factors associated with postdeployment wellness were identified, which may help inform medical and military leadership on potential strategies to ensure a well force. Those trained in combat roles were more likely to be well post deployment though this apparent benefit was not conferred onto those reporting combat experiences.
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Keeling M, Knight T, Sharp D, Fertout M, Greenberg N, Chesnokov M, Rona RJ. Contrasting Beliefs About Screening for Mental Disorders Among Uk Military Personnel Returning from Deployment to Afghanistan. J Med Screen 2012; 19:206-11. [DOI: 10.1258/jms.2012.012054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective The objective of the study was to elicit beliefs and experiences of the value of a screening programme for mental illness among UK military personnel. Method Three months after returning from Afghanistan 21 army personnel participated in a qualitative study about mental health screening. One-to-one interviews were conducted and recorded. Data-driven thematic analysis was used. Researchers identified master themes represented by extracts of text from the 21 complete transcripts. Results Participants made positive remarks on the advantages of screening. Noted barriers to seeking help included: unwillingness to receive advice, a wish to deal with any problems themselves and a belief that military personnel should be strong enough to cope with any difficulties. Participants believed that overcoming barriers to participating in screening and seeking help would be best achieved by making screening compulsory. Conclusions Although respondents were positive about a screening programme for mental illness, the barriers to seeking help for mental illness appear deep rooted and reinforced by the value ascribed to hardiness.
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Affiliation(s)
- M Keeling
- Kings College London, King's Centre for Military Health Research, London, UK
| | - T Knight
- UCL Division of Psychology and Language Sciences, London, UK
| | - D Sharp
- King's College London, Academic Centre for Defence Mental Health, London, UK
| | - M Fertout
- King's College London, Academic Centre for Defence Mental Health, London, UK
| | - N Greenberg
- King's College London, Academic Centre for Defence Mental Health, London, UK
| | - M Chesnokov
- King's College London, Academic Centre for Defence Mental Health, London, UK
| | - R J Rona
- King's College London, Academic Centre for Defence Mental Health, London, UK
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Low Intensity Conflict Stress in Soldiers: Building Coping Skills and Resources. PSYCHOLOGICAL STUDIES 2012. [DOI: 10.1007/s12646-011-0142-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Taylor MK, Pietrobon R, Taverniers J, Leon MR, Fern BJ. Relationships of hardiness to physical and mental health status in military men: a test of mediated effects. J Behav Med 2011; 36:1-9. [DOI: 10.1007/s10865-011-9387-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 11/06/2011] [Indexed: 01/22/2023]
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Harville EW, Xiong X, Smith BW, Pridjian G, Elkind-Hirsch K, Buekens P. Combined effects of Hurricane Katrina and Hurricane Gustav on the mental health of mothers of small children. J Psychiatr Ment Health Nurs 2011; 18:288-96. [PMID: 21418428 PMCID: PMC3472438 DOI: 10.1111/j.1365-2850.2010.01658.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Few studies have assessed the results of multiple exposures to disaster. Our objective was to examine the effect of experiencing Hurricane Gustav on mental health of women previously exposed to Hurricane Katrina. A total of 102 women from Southern Louisiana were interviewed by telephone. Experience of the hurricanes was assessed with questions about injury, danger and damage, while depression was assessed with the Edinburgh Depression Scale and post-traumatic stress disorder using the Post-Traumatic Checklist. Minor stressors, social support, trait resilience and perceived benefit had been measured previously. Mental health was examined with linear and log-linear models. Women who had a severe experience of both Gustav and Katrina scored higher on the mental health scales, but finding new ways to cope after Katrina or feeling more prepared was not protective. About half the population had better mental health scores after Gustav than at previous measures. Improvement was more likely among those who reported high social support or low levels of minor stressors, or were younger. Trait resilience mitigated the effect of hurricane exposure. Multiple disaster experiences are associated with worse mental health overall, although many women are resilient. Perceiving benefit after the first disaster was not protective.
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Affiliation(s)
- E W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112-2715, USA.
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Delahaij R, Gaillard AW, van Dam K. Hardiness and the response to stressful situations: Investigating mediating processes. PERSONALITY AND INDIVIDUAL DIFFERENCES 2010. [DOI: 10.1016/j.paid.2010.04.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sareen J, Stein MB, Thoresen S, Belik SL, Zamorski M, Asmundson GJ. Is peacekeeping peaceful? A systematic review. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2010; 55:464-72. [PMID: 20704774 DOI: 10.1177/070674371005500710] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Jitender Sareen
- Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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35
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Bouchard S, Baus O, Bernier F, McCreary DR. Selection of Key Stressors to Develop Virtual Environments for Practicing Stress Management Skills with Military Personnel Prior to Deployment. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2010; 13:83-94. [DOI: 10.1089/cyber.2009.0336] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Stéphane Bouchard
- Université du Québec en Outaouais, Gatineau, Québec, Canada
- Laboratoire de Cyberpsychologie de l'UQO, Gatineau, Québec, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Oliver Baus
- Laboratoire de Cyberpsychologie de l'UQO, Gatineau, Québec, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - François Bernier
- Defence Research and Development Canada–ValCartier, ValCartier, Québec, Canada
| | - Donald R. McCreary
- Defence Research and Development Canada–Toronto, Toronto, Ontario, Canada
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Wells TS, LeardMann CA, Fortuna SO, Smith B, Smith TC, Ryan MAK, Boyko EJ, Blazer D. A prospective study of depression following combat deployment in support of the wars in Iraq and Afghanistan. Am J Public Health 2010; 100:90-9. [PMID: 19910353 DOI: 10.2105/ajph.2008.155432] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We investigated relations between deployment and new-onset depression among US service members recently deployed to the wars in Iraq and Afghanistan. METHODS We included 40 219 Millennium Cohort Study participants who completed baseline and follow-up questionnaires and met inclusion criteria. Participants were identified with depression if they met the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire criteria for depression at follow-up, but not at baseline. RESULTS Deployed men and women with combat exposures had the highest onset of depression, followed by those not deployed and those deployed without combat exposures. Combat-deployed men and women were at increased risk for new-onset depression compared with nondeployed men and women (men: adjusted odds ratio [AOR]=1.32; 95% confidence interval [CI]=1.13, 1.54; women: AOR=2.13; 95% CI=1.70, 2.65). Conversely, deployment without combat exposures led to decreased risk for new-onset depression compared with those who did not deploy (men: AOR=0.66; 95% CI=0.53, 0.83; women: AOR=0.65; 95% CI=0.47, 0.89). CONCLUSIONS Deployment with combat exposures is a risk factor for new-onset depression among US service members. Post-deployment screening may be beneficial for US service members exposed to combat.
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Affiliation(s)
- Timothy S Wells
- US Air Force Research Laboratory, 711th HPW/RHPA, Building 824 Room 206, 2800 Q St, Wright-Patterson AFB, OH 45433-7947, USA.
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Vance DE, Struzick T, Burrage J. Suicidal ideation, hardiness, and successful aging with HIV: considerations for nursing. J Gerontol Nurs 2009; 35:27-33. [PMID: 19476190 DOI: 10.3928/00989134-20090331-06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Several predictors of suicidal ideation found in older adults and adults with HIV are the same; synergistically, those aging with HIV may be at risk for suicidal ideation. Focusing on the concept of hardiness provides insight into mitigating suicidal ideation and accentuating successful aging with HIV. Some individuals may have hardy characteristics that counteract the detrimental effects of aging with HIV; others may require greater guidance to cope with the effects that lead to suicidal ideation. As these connections are examined, the concept of hardiness is examined in relation to aging with HIV. Implications for nursing are posited.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, AL 35294-1210, USA.
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Rushton P, Scott JE, Callister LC. "It's what we're here for:" nurses caring for military personnel during the Persian Gulf Wars. Nurs Outlook 2008; 56:179-186.e1. [PMID: 18675019 DOI: 10.1016/j.outlook.2008.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Indexed: 11/24/2022]
Abstract
Military nursing service during wartime represents significant contributions to a unique type of health care. The purposes of this study were to: (1) generate themes that elucidate combat nursing experiences, (2) honor nurses who served by sharing their stories, and (3) permanently archive accounts of nursing personnel who served during the Persian Gulf Wars during the late 20th and early 21st centuries. Eleven military nurses who provided health care to American troops in the Persian Gulf participated in a historical study as part of the ongoing Nurses at War oral history project documenting the experiences of nurses during times of armed conflict. The overriding theme, "It's what we're here for," demonstrates the commitment of nurses: a commitment to care and to sacrifice. Other themes drawn from the study included lessons learned from their wartime nursing experiences, sacrifices made, and chronicles of caring. During armed conflict in the Persian Gulf Wars, military nurses' personal stories demonstrated the importance of being engaged in making meaningful professional and historical contributions. These nurses displayed professional commitment and hardiness in the face of difficult life circumstances, saying, "We did what we had to do."
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Affiliation(s)
- Patricia Rushton
- Brigham Young University College of Nursing, Provo, UT 84602, USA
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McKenzie D. Commentary on "coping with life-threatening events was associated with better self-perceived health in a naval cross-sectional study," by Nils Magerøy, Trond Riise, Bjørn H. Johnsen, and Bente E. Moen. J Psychosom Res 2008; 65:619-21. [PMID: 19027453 DOI: 10.1016/j.jpsychores.2008.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 07/15/2008] [Accepted: 07/24/2008] [Indexed: 11/30/2022]
Affiliation(s)
- Dean McKenzie
- Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Australia.
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Vance DE, Burrage J, Couch A, Raper J. Promoting Successful Aging with HIV Through Hardiness: Implications for Nursing Practice and Research. J Gerontol Nurs 2008; 34:22-9; quiz 30-1. [DOI: 10.3928/00989134-20080601-11] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vogt DS, Rizvi SL, Shipherd JC, Resick PA. Longitudinal investigation of reciprocal relationship between stress reactions and hardiness. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2008; 34:61-73. [PMID: 18162656 DOI: 10.1177/0146167207309197] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although many studies have examined hardiness as a protective factor against stress reactions, to the authors' knowledge no studies have yet examined the impact of stress reactions on hardiness. However, there is theoretical support for this notion. In this longitudinal study of 1,571 Marine recruits who participated in a highly stressful training program, the authors applied regression-based cross-lagged analyses to examine associations between stress reactions and hardiness over time for both men and women, and they investigated social support as a moderator of these relationships. Men who were hardier at Time 1 (T1) reported lower stress reactions at Time 2 (T2), and men who experienced more stress reactions at T1 were less hardy at T2. Although the negative impact of stress reactions on hardiness was strongest when social support was low for both genders, stress reactions predicted enhanced hardiness when social support was high for women only.
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Affiliation(s)
- Dawne S Vogt
- National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, MA 02130, USA.
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Vance DE, Struzick TC, Masten J. Hardiness, Successful Aging, and HIV: Implications for Social Work. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2008; 51:260-283. [PMID: 19042651 DOI: 10.1080/01634370802039544] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
<p>With dramatic developments in the treatment of HIV/AIDS, life expectancy is increasing, resulting in more middle-aged and older adults living with this disease. Little is known about the problems, and especially the strengths, of those living and aging with HIV. Hardiness is used in the gerontological literature to describe and explain how people age successfully, despite traumatic life events and chronic diseases. Similarly, the concept of hardiness may be used to guide clinicians, researchers, and clients on how to age successfully with HIV. This article provides a review of hardiness in aging and HIV, and emphasizes its importance in facilitating successful aging with this disease. Conceptual and methodological concerns in studying hardiness and successful aging are addressed. Potential interventions and clinical implications for social work are posited for augmenting qualities of hardiness in people aging with HIV.</p>
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