Military Psychology最新文献

Suicide is a significant public health concern among the military population. Thus, it is vital to understand suicide risk factors in this population. Alcohol use and post-traumatic stress disorder (PTSD) have been identified as risk factors for suicidality, whereas belongingness has been identified as a protective factor. This study aims to further clarify these relationships by examining the moderating effect of PTSD symptoms on the association between alcohol use and suicidality, and between belongingness and suicidality. We conducted secondary data analysis from currently serving members' surveys included in the Military Suicide Research Consortium Common Data Elements (MSRC-CDE) database (N = 2,361). Multiple linear regressions were conducted to examine the associations of alcohol use, belongingness, and PTSD symptoms on suicidality. Findings showed a significant interaction between alcohol use and PTSD symptoms, and between belongingness and PTSD symptoms, suggesting that PTSD symptoms moderated both associations. At lower PTSD symptoms levels, higher alcohol use was associated with higher suicidality. At higher PTSD symptoms levels, lower belongingness was associated with higher suicidality. These findings highlight the importance of screening and treating military personnel for PTSD, given that with its interaction with higher alcohol use and decreased belongingness, PTSD may increase the risk for suicidality.

The U.S. Army's Division Psychiatrist (DIVPSYCH) has evolved from an ad-hoc "shell-shock" specialist to a multidisciplinary leader embedded within division staffs. This narrative review, based on targeted literature searches and doctrinal sources, traces 20th-21st century military history, doctrine, and policy, highlights contemporary duties, and evaluates how best to employ psychiatrists in future large-scale combat operations (LSCO). Historical experience supports proximity-based care to conserve fighting strength, while recent organizational reforms have shifted many psychiatrists toward staff and supervisory roles. Anticipated LSCO constraints, such as high casualty densities, dispersed formations, contested evacuation, and mobility, demand approaches that increase psychiatrists' clinical reach near casualties while preserving command-level consultation. We outline four courses of action (COAs) for employing future psychiatrists in LSCO: retain DIVPSYCH roles in divisions; place senior psychiatrists at corps or theater-level, with junior psychiatrists or behavioral health officers in divisions; embed more psychiatrists in field hospitals and Combat and Operational Stress Control (COSC) detachments; and create mobile psychiatric augmentation teams. Each COA is analyzed for feasibility, risks, and trade-offs. We recommend a hybrid model that balances immediate command counsel with forward clinical capacity.

Armed forces officers typically undergo initial leadership training to prepare them to command subordinates in demanding and often hazardous situations. However, the naïve or implicit assumptions of untrained officer cadets can potentially influence how they view leadership and attribute trust toward their own leaders. For example, aggression and fearlessness might be associated with prototypical military leadership and therefore emulated by untrained cadets. The purpose of this study is to examine the relationship between a military leader's personality (using reinforcement sensitivity theory) and their initial military training on their subordinate's perceptions of transformational leadership and abusive supervision. In a study of 161 officer cadets enrolled in initial military training and 647 matched subordinates, we found that leaders with high defensive fight (associated with aggression) were viewed as more transformational by untrained rather than trained cadets. Furthermore, leaders with low behavioral inhibition (associated with low self-control) were viewed as more abusive supervisors by trained rather than untrained cadets. Finally, we found that leaders with high reward reactivity (associated with positive emotions) were viewed as transformational leaders with high levels of subordinate trust by trained rather than untrained cadets. The findings from this study enhance our understanding of the way leader personality and military training relate to subordinate perceptions of leadership and trust during the formative phase of a military leader's career.

This study estimated the prevalence of behavioral health conditions among military spouses and examined their associations with military life stressors. Participants were 17,485 spouses enrolled in Panel 2 (2020-2021) of the Millennium Cohort Family Study recruited from a representative sample of married service members with 1-5 years of military service across all branches and components. Population-weighted prevalence estimates were calculated for eight conditions: anxiety, depression, alcohol misuse, somatization, binge eating, insomnia, posttraumatic stress disorder (PTSD), and problematic anger. Logistic regression models examined associations between spouse-reported military life stressors and each condition. Results indicated that more than 40% of spouses reported at least one behavioral health condition, with somatization (24.4%; 95% CI 23.5-25.3) and anxiety (22.0%; 95% CI 21.1-22.8) being the most common. Nearly one-quarter reported multiple conditions. However, the majority of military spouses reported good overall behavioral health. Military life stress was positively associated with all eight outcomes. These findings suggest that addressing key sources of military life stress may help reduce the burden of behavioral health problems among military spouses.

Future large-scale combat operations (LSCO) will face limited evacuation capabilities, necessitating prolonged field care and placing immense psychological and operational demands on deployed healthcare teams. To address these challenges, a shift from individual to team-centered resilience is essential. Team-centered resilience leverages the collective strength of teams, serving as a critical strategy to mitigate morale and mental health impacts stemming from adverse patient outcomes common in LSCO environments. This approach is built on three main components: targeted preparation, strategic communication, and fostering a culture of team-centered support. Targeted preparation integrates end-of-life care training into Tactical Combat Casualty Care (TCCC), effective communication techniques, team and resource management, and lessons from past conflicts. Strategic communication and debriefing practices enhance team dynamics, adaptability, and functionality in high-stress situations. Training in self-regulation and self-management further supports team cohesion and resilience. An initial model for team resilience is introduced, underpinned by four foundational pillars and emphasizing the development of critical knowledge, skills, and abilities (KSAs). It calls for cultivating a culture of resilience to sustain performance and well-being in high-stakes environments. Implementing these strategies can enhance adaptability, resourcefulness, and mission success for both military and civilian healthcare teams.

Sleep loss, ubiquitous in the military and especially severe during combat deployments, constitutes a threat to the health and effectiveness of service members (SMs). Mitigating these negative effects depends upon the ability to accurately measure them; however, the utility of current subjective sleep and daytime sleepiness measures, which have been validated in civilian populations, is unclear for SMs. Specifically, established clinical thresholds for poor sleep quality and pathological sleepiness may not accurately reflect the sleep health of previously deployed SMs. The present scoping review was conducted to determine if prior military deployment results in pervasive sleep disturbance as defined by standard subjective measures. The findings suggest that it does, but because objective performance was not included in the reviewed studies, the extent to which these findings actually reflect meaningful impairment is unknown. Future studies using objective measures are needed to determine whether combat deployment results in immediately consequential and long-term deficits in sleep and daytime functioning. Such research will clarify whether currently available subjective measures are appropriate for previously deployed SMs or if new, population-specific measures should be developed, particularly as future large-scale combat operations (LSCO) are expected to involve increasingly severe sleep loss.

Large-Scale Combat Operations (LSCO) will necessitate behavioral health professionals who can deploy interventions that can be applied by non-behavioral health professionals in a prolonged field setting, representing a fundamental shift from the service delivery in garrison. Unfortunately, this means there will be little opportunity for behavioral health professionals to gain experience prior to implementation, which can risk mission failure due to inadequate preparation. Simulation education and exercise training are hallmarks of both military and healthcare training but have been underutilized in behavioral health domains. The current study presents the results of a qualitative evaluation of a novel simulation-based training exercise for behavioral health training in a military field setting. Graduates of an interprofessional military behavioral health training program were contacted approximately 4-9 years after their engagement in this training and asked to reflect on how this training experience influenced their readiness for behavioral health care in deployed settings. Results indicated that a simulation-based training methodology can faithfully capture some of the key facets of behavioral health intervention in austere and/or deployed settings - with numerous respondents indicating fidelity in comparison to relevant real-world scenarios subsequently faced at various points following graduation. Both positive and critical feedback from participants are discussed regarding the potential further development of simulation-based training programs, as well as the necessary scalability in the context of future LSCOs.

This study examined psychological predictors of willingness to fight among Ukrainian service members during the ongoing war and whether associations vary by combat experience. A cross-sectional sample of N = 172 personnel (121 combat-experienced; 51 non-combat) completed measures of motivation, Big Five traits, conflict-handling styles, communication skills, and professional hardiness. Descriptive group contrasts emphasized effect sizes (Welch's t with Hedges' g or rank-biserial r where appropriate). Bivariate Pearson correlations (Fisher-z CIs, false-discovery-rate adjustment for the set with willingness) and a theory-driven hierarchical regression with heteroskedasticity-robust standard errors were used; moderation was tested with Combat × predictor interactions. Combat-experienced personnel reported higher willingness to fight (g = .48, 95% CI [.15, .81]) and small-to-moderate differences on several traits (e.g. higher Extraversion, Conscientiousness, Competing; lower Avoiding). Zero-order correlations with willingness were strongest for Intrinsic motivation (r = .51), Professional control (r = .40), Professional commitment (r = .39), Openness (r = .37), and Challenge acceptance (r = .34). The final model explained R2 = .49 (adj. R2 = .41); two predictors made unique contributions to willingness to fight: combat experience (β = .43, 95% CI [.10, .77], p = .011) and Intrinsic motivation (β = .35, 95% CI [.17, .52], p < .001). A planned Avoiding × Combat interaction was significant (β = .49, p = .019) with opposite-direction but individually non-significant simple slopes. Findings underscore Intrinsic motivation as the central psychological predictor of willingness to fight, with combat experience providing an additional independent contribution and interpersonal tendencies showing experience-contingent nuances.

Once the International Committee of the Red Cross hands over released hostages to Israeli hands, the first persons they meet - before they transfer to hospitals and meet their families - are military mental and medical professionals. This encounter is a challenge to both the returnees and the professionals meeting them. Over the initial handover process, the returnees feel exposed and vulnerable in the intermediate situation between captivity and return to their previous reality. Their reactions at that interim time are likely to be varied, ranging from joy and euphoria to sadness, a sense of alienation, anxiety, and disconnection. The initial reception time could prove an opportunity to offer interventions that might lead to effective adaptive responses upon returning to Israel. The present article describes the preparations made urgently to receive released hostages and the protocol developed to provide the best response to their needs on their arrival. The protocol described in this article, formulated at the IDF Combat Stress Reaction Unit, takes into account the needs of the released hostages and the responses required to meet these needs. The main protocol principles include a warm welcome to instill a sense of security and adjust the human touch to the complex situation and trust-building methods based on mirroring subjects' emotions and leading them gently in the desired directions. Based on strict professional principles, the protocol covers an initial mental assessment, availability of personal, family, and community resources, and establishing contact with medical teams for follow-up treatment in medical facilities.

traumatic stress disorder is a debilitating condition often resistant to pharmacotherapy alone. Compassion-focused therapy may offer additional benefits in the treatment of post-traumatic stress disorder. We evaluated the effectiveness of compassion-focused therapy as an adjunct to standard pharmacological treatment for reducing post-traumatic stress disorder symptom severity in male veterans. A randomized controlled trial was conducted involving 50 male veterans with post-traumatic stress disorder diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Participants were randomly allocated to either an intervention group receiving a weekly 8-session compassion-focused therapy program alongside pharmacotherapy or a control group receiving pharmacotherapy alone. Symptom severity, depression, and anxiety were measured at baseline and post-intervention. The compassion-focused therapy group exhibited significant reductions in all post-traumatic stress disorder symptoms, including reexperiencing, avoidance, hyperarousal, emotional numbness, as well as depression and anxiety (all p < .001). The control group showed modest, but statistically significant, decreases in depression and anxiety (both p < .001). Participants in the control group failed to improve reexperience, hyper-arousal, avoidance, and emotional numbness (all p ≥ .162). Between-group analysis demonstrated the superior efficacy of compassion-focused therapy, with statistically and clinically meaningful differences in all outcomes (all p < .001). Compassion-focused therapy is an effective adjunctive treatment for post-traumatic stress disorder, providing substantial symptom reductions beyond pharmacotherapy alone. These findings support its integration into standard care for individuals with post-traumatic stress disorder and encourage further research on its long-term benefits and broader applicability.