Lifetime Suicidal Behaviors and Career Characteristics Among U.S. Army Soldiers: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

The current report presents data on lifetime prevalence of suicide ideation and nonfatal attempts as reported by the large representative sample of U.S. Army soldiers who participated in the Consolidated All‐Army Survey of the Army Study to Assess Risk and Resilience in Servicemembers (N  =  29,982). We also examine associations of key Army career characteristics with these outcomes. Prevalence estimates for lifetime suicide ideation are 12.7% among men and 20.1% among women, and for lifetime suicide attempts are 2.5% and 5.1%, respectively. Retrospective age‐of‐onset reports suggest that 53.4%–70% of these outcomes had preenlistment onsets. Results revealed that, for both men and women, being in the Regular Army, compared with being in the National Guard or Army Reserve, and being in an enlisted rank, compared with being an officer, is associated with increased risk of suicidal behaviors and that this elevated risk is present both before and after joining the Army.     

Soldiers’ perspectives of the Married Army Couples Program: A review of perceived problems and proposed solutions

The current study investigated soldiers’ perceptions of the Married Army Couples Program (MACP) using data from focus groups conducted with Army personnel in dual-military marriages. Despite the high success rate of the program (approximately 80–83%)—success being defined as establishment of a joint domicile within a 50-mile radius of each spouse’s duty station—a variety of difficulties were reported as well as consequent negative perceptions. Problems included dissatisfaction with the parameters defining joint domicile, obstacles to career advancement, lack of quality information regarding the program, and unequal allocation depending on one’s level of leadership support. Difficulties with MACP led to negative impressions of the program and of the Army as a whole. Specifically, when asked about challenges related to the program, many participants reported perceptions of a poorly functioning program, an uncaring environment, and of the Army as a hypocritical institution. For individuals in dual-military marriages, these difficulties affect quality of life. For the institution, these negative perceptions can potentially lead to problems with retention of one or both members of a dual-military couple. We propose several strategies to improve the effectiveness of MACP and to increase positive perceptions of the program based on suggestions from the focus groups in addition to the military and work literatures.     

Deployment trauma and seeking treatment for PTSD in US soldiers

Many service members in need of mental health treatment do not seek such treatment. This study investigated the frequency of Army soldiers’ exposure to specific types of deployment stressors and whether different event-types were associated with willingness to seek and actual receipt of treatment. Male soldiers who were married (n = 600) completed online surveys that assessed posttraumatic stress disorder (PTSD), willingness to seek treatment for PTSD, actual receipt of PTSD treatment, and the frequency of exposure to 4 types of potentially traumatizing warzone experiences: committing a moral injury, observing a moral injury, threats to life, and traumatic loss. Soldiers who reported greater exposure to moral injury experiences (committed or observed) were less likely to be willing to seek treatment, regardless of PTSD symptom severity. Although exposure to moral injury did not differentiate actual treatment receipt, soldiers who endorsed loss were more likely to have received treatment, regardless of PTSD symptom severity. These results suggest that the types of trauma experienced during deployment may be a factor in postdeployment treatment-seeking attitudes and behaviors.     

Implementing Firearms Restriction for Preventing U.S. Army Suicide

Suicide among U.S. Army soldiers remains a significant concern for both population health and personnel readiness, with firearms constituting the majority of soldier suicides. Means restriction, or removing an at-risk soldier’s access to lethal means, is a well-established procedure for reducing suicides. Nonetheless, various cultural, legal, and practical concerns may encumber firearms restriction implementation in the U.S. Army. This article reviews policy relevant to firearms restriction, including federal laws, Department of Defense directives, and U.S. Army regulations. Recommendations are provided for providers and commanders that balance the rights of soldiers with the need to ensure safety. In particular, installation restriction, field settings, enlisting supportive others, unit engagement, and off-installation storage are discussed. These approaches span the public health intervention model, providing numerous potential avenues to a balanced approach for firearms restriction in preventing suicide.     

Minority representation,tokenism, and well-being in army units

Racial and ethnic diversity is increasing in the US Army and women are moving into more combat roles. This puts minority soldiers at risk for being underrepresented in their work units. Tokenism theory predicts that when a work group has less than 15% representation in a social group, the numerically underrepresented minority (i.e., token) members are subject to three disadvantages: higher visibility, informal isolation, and role encapsulation. In the Army, where many companies contain small numbers of women and racial minorities, some soldiers may face additional stressors and constraints. We explored psychosocial, organizational, and health outcomes of all identifiable token women (N = 4,425) and Black soldiers (N = 5,040). Tokens were remarkably similar to non-tokens and majority soldiers on outcomes such as coping skills, adaptability, organizational trust, sleep, substance use, and pain. The intersection of token status in terms of race and gender was not related to any appreciable differences. One potential explanation is the shared Army culture that emphasizes group unity and the importance of the mission above individual characteristics and goals. The Army depends on cohesion, organizational identification, and commitment to the group in order to reduce stress and anxiety, and to maximize combat performance. For soldiers who have internalized this culture, it could be easier to see past individual differences such as gender and race and identify others in the unit as fellow soldiers primarily.     

Relationships Between Cortisol,Optimism, and Perseverance Measured in Two Military Settings

Optimism and perseverance are 2 important assets for soldiers to be able to perform competently in high-risk environments and to complete complex and stressful tasks. Traditionally, optimism is measured using questionnaires and most frequently in a retrospective manner, for example, after a mission is completed. As such, ability to persevere in challenging environments is generally taken into account when it is too late, that is, when the soldier is showing severe signs of deficiency or failing to persevere. Therefore, there is a need for more objective measurements with which to predict perseverance. We conducted and present 2 studies in which the hormone cortisol seems to play a key role, relating with optimism, and possibly predicting perseverance. In the first study, we measured cortisol levels during a computer-simulated military training mission. A significant correlation between cortisol levels and optimism measured by the revised Life Orientation Test (LOT-R) Scale was found. In the second study, we followed 29 recruits through a demanding military training course required for joining the Dutch Air Mobile Brigade. The recruits who persevered and completed the course had a higher cortisol response to a stressful training event compared with those who leave the course. A regression model showed that a combination of the soldiers’ optimism and cortisol response best predicted perseverance. This study shows that a combination of attitudinal instruments and a biomarker has potential for predicting military training course attrition.     

Discrepancy in internalized values of workers in extreme situations: Consequences for soldiers and risk for the organization

IntroductionIn the present paper, we address the double-edged role of values among Army personnel and how they can be used in information warfare. We suggest that value discrepancy may impact the agent's trust and consequently, affect behaviour and ultimately destabilize the organization.ObjectivesBased on cognitive dissonance theory and the meaning maintenance model, we hypothesized that exposing trained soldiers to information which confronts their core values and involves both their peers and their institution could promote an overwhelming reaction that could finally alter their trust in the organization.MethodTo examine the proposed model, interviews were conducted with 38 active-duty soldiers that permits to stress the importance of values for their personal life. To complete the interviews, a staged observation was led with the second set of participants (n = 21). Its goal was to evaluate the soldiers’ reaction to a message aiming at their values.ResultsQualitative and quantitative analysis of the Interviews confirmed both the importance of the said values and stressed the ambivalence toward their institution. The results of the staged observation suggested that a low credibility source of information aiming at their central values could lead to a direct emotional reaction, that could potentially lead to a decrease in institutional trust, and therefore ultimately in the organisation performance.ConclusionThe discussion focuses on the consequences of this mechanism, the fundamental necessity for the organization of taking this process into account. Finally, we suggest ways to cope with this risk which can alter strategy deployment and goal achievement.     

Child Care Use,Earnings, and Reenlistment Desires of Wives of Enlisted Soldiers in the U. S. Army

The U S . Army manages more than 600 Child Development Centers and about 12,000 Army-licensed Family Care Homes with a daily attendance of more than 80,000 children. This article analyzes use of child care services in relation to Army wives' earnings, their satisfaction with Army life, and their desire for their husbands' reenlistment in the Army. Data for wives (n = 1,007) of enlisted soldiers from a 1987 U.S. Department of the Army Survey of Families were used to estimate a system of four simultaneous equations. These data were comparable with similar data collected in 1992. Results revealed that the first criterion variable of child care use was associated positively with the wives' earnings and negatively with the age of the youngest child. The second criterion variable of wives' earnings was related positively to the use of child care services. The third criterion variable of wives' satisfaction with Army life, however, related negatively to their dissatisfaction with the cost of Army child care services. The fourth criterion variable of the wives' satisfaction with Army life was related positively to their desires for their husbands' reenlistment in the Army. Other studies suggest that a wife's desire for her husband's reenlistment has a great influence on his decision to stay. Therefore, the military policy makers might increase Army wives' satisfaction with Army life by lessening dissatisfaction with the cost of child care services, perhaps by reducing user charges for them.     

A force of change: Chris Peterson and the US Army’s Global Assessment Tool

The US Army launched the Global Assessment Tool (GAT) – a 105-item psychometric instrument taken by approximately one million soldiers annually – in October, 2009 in support of a population-wide resilience development initiative known as the Comprehensive Soldier and Family Fitness (CSF2) program. The lead developer of the GAT was Chris Peterson, and his work on this project – along with that of Nansook Park and Colonel Carl Castro – will likely leave an important and indelible mark on not only the Army, but also the field of military psychology. In this paper, we provide more detail on the history and components of the GAT. In addition, we demonstrate the practical utility of the GAT by showing that high-performing soldiers (soldiers who attained Ranger status) have relatively high GAT scores, and that soldiers with behavioral problems generally evidence low GAT scores. We conclude by discussing future directions of GAT methodology and usage in support of research.     

Neither East nor West: Some Aspects of Religion and Ritual in the Indian Army of the Raj

This article examines the conversion of the Royal Pavilion estate, Brighton, Sussex, into a military hospital for Indian casualties of the Great War (1914 –1918) in order to suggest how the religious beliefs and practices of Hindu, Sikh and Muslim soldiers were provided for in the Indian Army of the Raj. The military hospital not only made arrangements for worship but also for the observance of caste rules and the performance of funeral rites. These arrangements are discussed with reference to the series ofHandbooks for the Indian Armyand to other contemporary sources. Furthermore, this article locates the Indian Army in the context of imperial ideology both in terms of the concept of the ‘martial classes ’ and the brotherhood of all soldiers of the Empire.     

中国军人心理健康状况的横断历史研究：1990~2007

使用1990~2007年18年间的142组数据, 以横断历史研究的元分析方法, 研究了108736位中国军人的心理健康状况随年代的变化趋势。这些数据来自94篇相关研究报告, 这些研究都使用了90项症状自评量表(SCL-90)作为心理健康的测评工具。结果发现：(1)世纪之交的18年间, 中国军人的心理健康越来越好; (2)18年间, 中国军人在“人际敏感”方面变化最大, 而在“躯体化”方面变化最小; (3)18年间, 中国军人在“恐怖”方面最没问题, 而在“强迫症状”和“人际敏感”方面所表现出的问题一直突出; (4)中国独生子女军人(N = 1944)的心理健康状况低于非独生子女军人(N = 2649); (5)中国城市籍军人(N = 7808)的心理健康状况低于农村籍军人(N = 11459); (6)中国高中学历军人(N = 10189)的心理健康状况低于初中(N = 8407)和大学学历(N = 863)的军人。     

Relationships of deployment and combat experiences to postdeployment negative health conditions among Army National Guard soldiers

An interest of researchers and practitioners has been postdeployment adjustment of returned soldiers, though the primary focus has been investigating the prevalence of psychiatric conditions. Less attention has been paid to nonclinical conditions, which still have posed significant adjustment problems for soldiers, in particular, for reserve soldiers who revert back to civilian life, family, and employment. The present study examined the occurrence of postdeployment problems among returned Army National Guard soldiers (N = 4,567 in 50 company-sized units). Survey items reliably indicated 7 problem areas. Highest prevalence of problems was being angry (35.9%) and being unable to sleep (43.3%), followed by alcohol abuse (25.1% reported 5 or more drinks in 1 day). Longer deployment lengths were associated with troubled relationships and aggression toward the significant other adult and children in the household. More deployments were associated with aggression toward household children. Self-reported general combat trauma and having killed or wounded someone were associated with all problem areas. Findings are discussed relative to how combat exposure likely alters soldiers’ perceptions and behaviors, including feelings of loneliness and isolation, and risk-taking behaviors of alcohol abuse and aggression toward others.     

“先扬后抑”vs.“先抑后扬”:反馈顺序对决策信心建构的影响

本研究采用2×3被试内设计,通过操纵不同性质信息的反馈比例和反馈顺序,重点考察了反馈顺序对决策信心动态建构的影响。结果表明:(1)在不同反馈比例条件下,当个体接收到的正性反馈多于负性反馈时,个体的决策信心上升,反之则下降;当个体接收到的正性反馈等于负性反馈时,个体的决策信心下降,表现出"负性偏向";(2)"先扬后抑"与"先抑后扬"的信息反馈顺序对决策信心的动态建构产生了不同影响,表现出类似于"近因效应"的现象,"惊讶假设(surprise hypothesis)"可为此提供解释。本研究表明,在决策信心的动态建构过程中,信息的反馈顺序发挥着重要作用。     

Fahrenheit 9‐11, Need for Closure and the Priming of Affective Ambivalence: An Assessment of Intra‐affective Structures by Party Identification

This study extends priming research in political communication by focusing on an alternative political information source (i.e., Michael Moore’s Fahrenheit 9‐11), affect rather than cognitions, and the existence of intra‐affective ambivalence. In addition, two moderator variables are analyzed: political party identification and need for closure. There is a statically significant three‐way interaction between the viewing of F 9‐11, political party identification, and need for closure relative to the dependent variable of affective ambivalence toward George W. Bush. High need for closure Republicans who viewed F 9‐11 exhibited pronounced levels of Bush‐affective ambivalence. In addition, high need for closure Independents who viewed F 9‐11 exhibited far lower ambivalence toward Bush relative to their control group peers. The findings are discussed relative to the roles performed by emerging alternative political media and the expansion of the theory of priming within the context of political communication.     

Warrior Resilience and Thriving (WRT): Rational Emotive Behavior Therapy (REBT) as a Resiliency and Thriving Foundation to Prepare Warriors and Their Families for Combat Deployment and Posttraumatic Growth in Operation Iraqi Freedom, 2005–2009

Warrior Resilience and Thriving (WRT) and Warrior Family Resilience and Thriving were the U.S. Army’s first combat Soldier and Family cognitive resiliency training classes based on Rational Emotive Behavior Therapy (REBT). WRT, as a pilot program, was designed to enhance soldier and family resiliency, thriving and posttraumatic growth prior to, during and following combat deployments. WRT alloys REBT self-coaching, Army Warrior Ethos, Stoic, survivor and resiliency strategies to teach and promote advanced resiliency, emotional management and critical thinking to soldiers and their families. This article will describe efforts initiated by the author, who served twice in Operation Iraqi Freedom where he developed WRT, as well as training he conducted for over 12,500 Warriors as the Prevention Team Leader for the 98th Combat Stress Control Detachment serving Baghdad. Risk Factors for Army Warriors and families and the advantages of existential and philosophically-based interventions like REBT are described along with a brief inventory of Army resiliency initiatives.     

The collaborative assessment and management of suicidality (CAMS) versus enhanced care as usual (E-CAU) with suicidal soldiers: Moderator analyses from a randomized controlled trial

Given historically high rates of suicide among military personnel over the past decade the present study analyzed whether key demographic, military, and research-based variables moderated clinical treatment outcomes of 148 suicidal active duty US Army soldiers. This is a secondary analysis of data from a randomized controlled trial comparing the collaborative assessment and management of suicidality (CAMS) to enhanced care as usual (E-CAU; Jobes et al., 2017). Nine potential moderator variables were derived from the suicidology literature, military-specific considerations, and previous CAMS research; these were sex, age, marital status, race, lifetime suicide attempts, combat deployments, time in service, initial distress, and borderline personality disorder diagnosis. The clinical outcomes included six suicide- and mental health-related variables. Six of the eight significant moderator findings in this study showed CAMS outperforming E-CAU in certain subgroups with medium to large effect sizes ranging from 0.48 to 1.50. Collectively, the results suggest that CAMS was associated with the greatest improvement among lower complexity soldier patients, particularly those with lower initial distress and fewer deployments. Those who were married or older generally responded better to CAMS, although the results were not entirely consistent with respect to age. CAMS’s effectiveness for married soldiers and those with lower initial distress was a particularly robust finding that persisted when adjusting more stringently for multiple testing. This study sheds light on several factors associated with the success of CAMS among suicidal soldiers that can assist in matching the treatment to those that may benefit the most.     

Unit Cohesion,Resilience, and Mental Health of Soldiers in Basic Combat Training

Military unit cohesion has been shown to correlate with physical and psychological outcomes. However, little is known about the development of cohesion in the early days of military service during Basic Combat Training (BCT) and how it relates to positive support and the negative stressors of training. The current study assessed the development of unit cohesion across the 10-week BCT period (N = 1,939), and the relation of cohesion to stress, resilience, mental health measures, and BCT outcomes (graduation, passing the Army Physical Fitness Test, and final Basic Rifle Marksmanship scores). The sample was primarily male (62%), under age 25 (88%), and unmarried (88%). All putative mediators showed significant change over time. Unit cohesion increased over time (slope 0.22; p < .001), and these increases were associated with decreases in psychological distress (p < .001), sleep problems (p < .001), and tolerance of BCT stressors (p < .001), as well as increases in resilience (p < .001), confidence managing stress reactions (p < .001), and positive states of mind (p < .001). Unit cohesion was indirectly associated with successful graduation and passing the Army Physical Fitness Test through cohesion-related improvement in psychological distress, resilience, and confidence managing reactions to stress. Sleep problems also mediated BCT graduation. Cohesion effects on the Basic Rifle Marksmanship scores were mediated by psychological distress and tolerance of BCT stressors only. These results suggest that unit cohesion may play a key role in the development of psychological health among new soldiers.     

The effects of co-witness discussion on confidence and precision in eyewitness memory reports

We examined the influence of co-witness discussion on the metacognitive regulation of memory reports. Participants (N?=?92) watched a crime video. Later, a confederate confidently agreed with (gave confirming feedback), disagreed with (gave disconfirming feedback), or gave no feedback (control) regarding participants’ answers to questions about the video. Participants who received disconfirming feedback reported fewer fine-grain details than participants in the confirming and control conditions on a subsequent, individual recall test for a different question set. Unexpectedly, this decrease in fine-grain reporting was not accompanied by a decrease in participants’ confidence in the accuracy of their fine-grain responses. These results indicate that receiving social comparative feedback about one’s memory performance can affect rememberers’ metamemorial control decisions, and potentially decrease the level of detail they volunteer in later memory reports. Further research is needed to assess whether these results replicate under different experimental conditions, and to explore the effects of social influences on metamemory.     

Ambivalence and decisional conflict as a cause of psychological discomfort: Feeling tense before jumping off the fence

It has long been assumed that people experience evaluative conflict or ambivalence as unpleasant. In three studies we provide direct evidence for the assumption that ambivalence is unpleasant, but only when one has to commit to one side of the issue. In those situations ambivalence will be related to outcome uncertainty and feelings of discomfort. We examined this prediction using both self-reports and physiological measures. In a first study we manipulated ambivalence and whether or not participants had to take a clear stand vis-a vis the attitudinal issue and choose a position for or against it. Results indicate ambivalence was only related to physiological arousal when a choice had to be made. Feeling ambivalent about an issue without the necessity to choose did not result in higher levels of arousal. A second study replicated and extended these findings by including a measure of subjective uncertainty about the decision. Results showed the same pattern as in Study 1, and indicate that the relation between ambivalence and arousal is mediated by uncertainty about decisional outcomes. In the third and final study these findings are corroborated using self-report measures; these indicated that ambivalence-induced discomfort is related to specific (negative) emotions.