Military Psychology最新文献

This article provides firsthand accounts of the combat experiences of Ukrainian soldiers, emphasizing the psychological toll of their exposure to morally injurious events during modern combat operations. Case studies illustrate the various contexts in which moral injuries might occur involving both military members and civilians. Other psychological issues that co-occur with moral issues as a result of combat exposures are presented including traumatic stress, profound grief, and various threats to individual identity. The authors include an analysis of the utility of the recent American Psychiatric Association's (APA) revision of DSM-5-TR that now includes moral issues and how this conceptualization captures the experiences of soldiers fighting in the Russia-Ukraine War. The case studies presented reveal that there remain important experiences and responses that are not fully captured by the new APA conceptualization of moral injury, such as existential ethical crisis, survivor guilt, disruption of one's role or identity, and the failure of others to uphold societal norms and expectations. Various approaches to facilitate recovery from moral injury are discussed. These approaches include the use of debriefings, remembrance memorials and structured therapeutic interventions. These approaches are intended to facilitate the soldier's recovery from moral injury by providing immediate emotional relief, and by facilitating the soldier's cognitive awareness of how morally injurious events can change and shape individual and collective identity. This study highlights the unique challenges faced by military personnel in modern, high-intensity warfare, and the need for early and targeted mental health interventions, including building resilience and promoting psycho-social well-being.

The shift from counterinsurgency to large-scale combat operations (LSCO) presents new challenges for delivering military mental healthcare, including resource limitations, disruptions to medical evacuation, and degraded network connectivity. The anticipated constraints in LSCO may delay access to specialty care, necessitating scalable approaches to address mental health care needs. To explore how mental healthcare needs have been addressed in similar contexts, this scoping review aims to chart the literature on interventions administered by personnel without formal mental health specialization or credentials in military or comparable operational settings. The review followed Arksey and O'Malley's five-stage methodological framework to chart, collate, summarize, and report relevant findings. A systematic search strategy was used to identify literature from four databases (PubMed, CINAHL, PsycINFO, and Embase), and the authors conducted a full-text screening. Twenty-three studies met the inclusion criteria and informed the development of the conceptual model. Interventions were categorized by personnel role and mapped onto the Stress Continuum Model. The model offers a scalable, mission-adaptive approach that accounts for personnel roles and practice scopes. Rather than prescribing a fixed solution, the conceptual model provides leaders and medical planners with flexible, evidence-informed options. Findings illustrate how leaders, informal peers, trained peers, and non-specialty medical personnel may be incorporated into a role-based psychological support strategy for austere environments, including during LSCO.

Exposure therapy for posttraumatic stress disorder (PTSD) is efficacious for treating patients with multiple traumatic events. However, individuals with PTSD with exposure to multiple traumatic events are theorized to experience differences in emotional reactivity and fear extinction processes compared to those exposed to a single traumatic event. Thus, there is concern that individuals exposed to multiple traumatic events respond to exposure therapy differently than individuals reporting a single traumatic event. This study examined the impact of trauma frequency on exposure therapy processes, including within-session habituation, between-session habituation, and treatment outcomes in a sample of male veterans and active-duty military with combat-related PTSD engaging in Trauma Management Therapy (N = 81). Individuals in both groups demonstrated significant improvements in PTSD symptoms from pre- to post-treatment. Of primary interest, individuals presenting with multiple traumatic events and single traumatic events demonstrated similar within- and between-session habituation, length and number of exposure sessions, rates of fear activation, and symptom reduction. The only significant difference observed was slower within-session habituation during the first Trauma Management Therapy session for individuals exposed to multiple traumatic events compared to individuals exposed to a single traumatic event. Results indicate that PTSD resulting from multiple traumatic events are as responsive to exposure therapy as those whose PTSD was caused by a single event. These preliminary results suggest that clinicians can utilize evidence-based exposure therapies to treat veterans and military personnel with multiple traumatic event histories.

Following the October 7th 2023 HAMAS' attack, approximately 220,000 Israeli reservists were mobilized. This study examined anxiety among women whose partners were mobilized and assessed the protective roles of resilience, self-efficacy, and sense of coherence (SOC) as independent variables, in anxiety as a dependent variable. In a cross-sectional correlational design, 265 female partners completed validated instruments. Psychological variables were analyzed alongside demographic and contextual factors using correlation and moderation analyses. Seventy-five percent of participants scored above the severe-anxiety threshold. SOC and resilience showed significant inverse associations with anxiety, whereas self-efficacy was not significantly correlated. Within SOC, comprehensibility and manageability were each negatively related to anxiety, and meaningfulness was positively associated with selfefficacy. More frequent home visits by the deployed partners were linked to lower anxiety and higher self-efficacy. Women with children reported greater resilience and lower anxiety than those without children. These findings suggest that cognitive and instrumental components of SOC, together with resilience, help buffer distress in spouses of reservists under acute conflict conditions. Tailored psychosocial interventions that strengthen comprehensibility and manageability, bolster resilience, and facilitate contact with deployed partners may mitigate anxiety in this high-risk group. The null association for self-efficacy suggests confidence may be insufficient under sustained threat. Programs should prioritize screening, psychoeducation, and communication protocols between units and families, alongside parent-focused supports, to protect mental health during prolonged mobilizations and the transition to post-deployment. Longitudinal research is warranted to clarify causal pathways and inform targeted support.

For veterans, early life stressors, such as childhood trauma and experience of combat-related events, are associated with reporting greater levels of anger. Anger, if maintained over time, can have detrimental effects on mental health such as posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Some modifiable factors, such as self-compassion and posttraumatic growth have been shown to mitigate long-term symptomology. Veterans (n = 1,230) completed online surveys at baseline and 9-, 12-, 18-, and 24-month follow-up. We used a latent transition model to understand how emergent classes of childhood trauma and combat experience are associated with trajectories of anger over the study period. We also explored PTSD and AUD as outcomes of emergent transitions and, further, how self-compassion and posttraumatic growth moderate transition patterns. Veterans in the High severity/polytrauma exposure trauma class had a transition probability (Pr) of 0.76 into the stable high anger trajectory class. Those veterans in the combat exposure only class had a high probability of transitioning into the stable low anger class (Pr = 0.97). Veterans in the moderate childhood trauma - moderate combat class had a greater probability of transitioning into the stable high anger class (Pr = 0.66). Results show that PTSD and AUD symptoms are greatest when veterans transition into the stable high anger class. However, this is partially mitigated by higher levels of self-compassion and posttraumatic growth. While anger and trauma are both often associated with all of these mental health conditions, they do not appear to function and interact in a similar way.

Despite the efficacy of trauma-focused therapies, many veterans with PTSD leave treatment prematurely and experience persistent functional impairments. This is often due to anxiety and logistical difficulties surrounding in vivo exposures. Augmented Reality Exposure Therapy (ARET) offers a novel approach to delivering trauma-relevant stimuli within real-world environments. The current study gathered stakeholder feedback to refine an ARET platform (ExpandXR), originally developed for first responders with PTSD, to better meet the needs of veterans with military trauma. Ten veterans and eleven national expert clinicians participated in structured feedback sessions. Veterans completed the Credibility Expectancy Questionnaire (CEQ) and responded to open-ended prompts, while expert clinicians provided narrative feedback. Qualitative data were analyzed using reflexive thematic analysis. Themes emphasized the importance of realism, social engagement, and contextual triggers (e.g. noise, confinement). Clinicians highlighted the need for clinical flexibility and applicability across diverse trauma presentations. Stakeholder feedback informed key platform enhancements, including Artificial Intelligence (AI)-driven interactions and customizable exposure scenarios. ARET was perceived by both veterans and clinicians as a feasible, engaging, and clinically impactful intervention. It holds promise as a tool for enhancing functional recovery in veterans with PTSD.

It is anticipated that behavioral health (BH) support will be limited in future deployed environments. The new BH GEAR training was developed to train non-behavioral health providers (NBHPs) to manage BH needs, bridging this gap. However, it is unknown if NBHPs experience negative beliefs toward offering BH support. This study investigated if these negative attitudes occur among NBHPs and associated factors. As part of a larger study, 86 NBHPs, completed a pre-training and post-deployment survey. Participants were also surveyed on stigma toward receiving BH care, training, their scope of work, demographics, and unit characteristics. Few NBHPs endorsed negative attitudes toward offering BH help (10.6%-23.6%). Negative attitudes toward offering BH care were significantly associated with lower team cohesion, less BH-related training, greater stigma toward receiving BH care, barriers to care and self-reliance, and the belief that BH care is not in their scope of work. When controlling for all significant factors, greater stigma toward receiving BH care and self-reliance, and less team cohesion was predictive of negative attitudes. No association was found between negative attitudes toward offering BH care and discussing BH issues with soldiers post-deployment. There was no significant difference in attitudes pre-training and post-deployment. Units will rely on NBHPs in future environments for BH support, thus it is crucial to understand factors which may inhibit care. Factors that bolster team cohesion and reduce stigma may help to reduce any negative attitudes NBHPs' have toward offering BH help to their soldiers, increasing readiness and mission success.

United States Air Force remotely piloted aircraft (RPA) aircrew and support personnel perform critical missions in support of military operations around the world. The high value placed on the work of these individuals has resulted in increased workload and heightened risk of adverse psychological health outcomes. The impact of this can be detrimental to the health of the individual as well as the success of the RPA mission. To address these concerns, a combat-to-reconstitution policy was developed to provide additional downtime and recovery to RPA personnel, and recently piloted in some units within the RPA community. A total of 397 RPA personnel, of which 26% (n = 103) indicated their schedule was either internal or external reconstitution, completed an anonymous occupational health assessment sometime between November 2021 and July 2022. Responses included a mixture of both positive and negative experiences during the implementation of reconstitution, along with recommendations for improvements. Certain reconstitution-related sources of stress (e.g. work overload, lack of resources), were found to increase risk of burnout or psychological distress. Overall, this preliminary study provides a foundational landscape for the scientific and operational understanding of reconstitution as an operational intervention to improve recovery.

Close Quarters Battle (CQB) is an operational approach in confined spaces gaining increasing significance in urban combat missions. Due to its high psychophysiological demands, the CQB ability is an essential selection criterion for special forces. Until now, there has been no research on predictors of CQB capability. This study examined the influence of the Big Five personality traits, self-esteem, resilience, attentional ability, 2D:4D digit ratio, and mindfulness on the CQB performance. The German sample comprised a total of n = 45 individuals (n = 29police special forces; n = 16 unspecialized soldiers) who conducted psychometrics and a CQB test consisting of three scenarios. In these scenarios, two independent experts evaluated tactical behavior, weapon handling, gaze behavior, response time, and failures using a standardized behavioral observation instrument based on video recordings (external cameras and mobile eye-tracking). The results revealed that only extraversion predicted the CQB performance (β = -.40, p = .035). However, the mean 2D:4D ratio was strongly associated with gaze behavior (r = .45, p = .007), tactical behavior (r = .41, p = .019), and attentional ability (p = .57, p < .001). Surprisingly, the findings indicate that CQB, as a high-risk and analytical task, is better performed by introverted personnel.

As the Army continues to adapt to evolving mission demands and global threats, those who execute the mission - both soldiers and Department of the Army (DA) civilians - must also adapt to changing occupational demands and requirements. Occupational stress within the military community is a threat to health and wellbeing that impacts not only individual soldiers and civilian personnel, but also units, families, and the broader military community. Hardiness is an operational requirement for military success, spirituality might be a means to positively impact soldier and DA Civilian hardiness. This study sought to understand the relationship between spirituality and hardiness within the Army, which included data collected from U.S. Army soldiers (N = 313) and DA Civilians (N = 276). We hypothesized that increased individual spirituality have a direct relationship with the positive aspects of hardiness and an inverse relationship with the negative aspects of hardiness as defined by the dual process model of hardiness. Employing regression analysis, empirical support was found to support our hypotheses for relationships between spirituality and hardiness variables, with increased spirituality relating to increased positive hardiness and decreased negative hardiness traits. Military leaders can use that knowledge to develop and test targeted interventions that may help to increase positive hardiness and decrease negative hardiness in the Army. Further, Holistic Health and Fitness programming may benefit from improved psychological function by incorporating training that integrates hardiness and spirituality concepts.