Combat Stressors Predicting Perceived Stress Among Previously Deployed Soldiers

While combat exposures are considered principle stressors in developing mental health problems, research suggests social support can reduce this risk. Using data from 1,592 previously deployed soldiers, we found five classes of soldiers based on their patterns of responses to items measuring perceived stress. In subsequent analyses, we found increased combat exposure predicted membership in classes with greater combat-related stress, while greater unit cohesion predicted membership in classes with lower perceived stress. Also, greater willingness to report misconduct predicted greater unit cohesion. Results suggest that unit cohesion plays a vital role in the reduction of perceived stress among soldiers.     

Interaction of Combat Exposure and Unit Cohesion in Predicting Suicide‐Related Ideation Among Post‐Deployment Soldiers

Suicide is one of the leading causes of death among U.S. Army soldiers. Suicide‐related ideation, which is associated with suicide attempts and suicide, can cause considerable distress. In a sample of 1,663 recently redeployed soldiers, we used factor analysis and structural equation modeling to test the associations between combat exposure, unit cohesion, and their interaction in predicting suicide‐related ideation. We found that combat exposure was a significant risk factor for suicide‐related ideation, while unit cohesion was a significant protective factor. The significant interaction between the two factors indicated that soldiers who experienced greater combat exposure but also had higher levels of unit cohesion had relatively lower levels of suicide‐related ideation. In addition, those who had higher levels of combat exposure and lower unit cohesion were most at risk for suicide‐related ideation. Our findings indicate the importance of unit cohesion in protecting soldiers from suicide‐related ideation and suggest a higher risk group of soldiers who should be targeted for interventions.     

Intimate partner cohesion and military unit cohesion: Different types of interpersonal relationships each uniquely predict soldier well-being

Although research on military populations has found that measures of personal well-being are correlated with both intimate partner cohesion and military unit cohesion, it is not clear how these correlations should be interpreted. Based on Relationship Regulation Theory, it was expected that each type of interpersonal relationship would have independent effects, that each would uniquely predict outcomes, and that effects would remain significant after controlling for person-level traits and experiences, such as trait resilience and exposure to combat. A sample of 273 active-duty military personnel completed self-report measures of cohesion in two types of interpersonal relationships (intimate relationships and military unit relationships), two control variables (trait resilience and combat exposure), and three outcome variables (well-being, negative emotionality, and trauma-related stress). Results indicated that cohesion in the two types of relationships were minimally related to each other, but both correlated with outcome variables. Effects for each type of interpersonal relationship remained significant after controlling for the other type and controlling for trait resilience and combat exposure. The results suggest that the effects of interpersonal cohesion are best understood as reflecting experiences in specific types of relationships rather than general characteristics of people in those relationships.     

Student Service Members/Veterans’ Mental Health: Who Is at a Greater Risk for Posttraumatic Stress Symptoms on College Campuses?

Using a cross-sectional design, this study surveyed 144 students on campus who are service members and veterans to determine whether posttraumatic stress (PTS) symptoms are significantly correlated with demographic factors (e.g., age, race and marital status), risk factors (e.g., military branch and combat exposure), and resources (e.g., social support and religiosity). The results confirm previous findings on correlates of PTS symptoms, provide new information about service members on campus that are at a greater risk for PTS and highlight resources that are associated with reduced PTS symptoms. These findings not only give institutions of higher learning insight into identifying specific demographics that are at a greater risk for PTS symptoms on college campuses, but also point to ways of supporting student service members/veterans by accurately targeting existing resources to the most affected populations.     

Military occupation as a moderator between combat exposure and posttraumatic stress disorder symptoms in US Army personnel

ABSTRACT

Military occupational designations are standardized classifications that help define and convey a service member’s expected duties and responsibilities. The present study examined how occupational designation was related to adverse combat-reactions, specifically posttraumatic stress disorder (PTSD). It was hypothesized that at comparable levels of combat, non-combat units would display greater symptomology than combat units. The study sample consisted of 785 combat-deployed, active-duty enlisted US Army personnel. Participants were administered self-report questionnaires, including the Combat Experiences Scale and PTSD Checklist for DSM-5. Occupation was coded using the three-branch system (i.e., Operations, Support, & Force Sustainment). Hierarchical multiple linear regression (MLR) was run to examine the effect of occupation, combat, and unit cohesion on PTSD symptoms. Operations units reported the highest frequency of combat exposure; however, Force Sustainment units displayed the highest PTSD symptoms. In MLR analysis, there was a significant interaction between Force Sustainment units and combat exposure (β = 0.10, p = .019), that was not observed in Operations or Support units. These findings demonstrate that PTSD symptom intensity is not solely a function of combat exposure, and that non-combat units may react differently when exposed to elevated levels of combat.     

Modeling the Indirect Association of Combat Exposure With Anger and Aggression During Combat Deployment: The Moderating Role of Perceived Unit Morale

Anger and aggression are common combat-related behavioral health problems. The impact of combat on anger and aggression appears to be largely attributable to symptoms of posttraumatic stress disorder (PTSD). Factors that moderate the purported pathway from combat to anger and aggression are poorly understood. We examined the conditional direct and indirect associations of combat exposure with self-reported anger and aggression using survey data collected from 592 U.S. Soldiers during a combat deployment in Afghanistan. Unit morale was examined as a moderator between combat exposure and PSTD symptoms, as well as the indirect association of combat exposure with anger and aggression via PTSD symptoms, controlling for depression symptoms. Results indicated that unit morale was negatively correlated with PTSD symptoms and self-reported anger and aggressive behaviors. Perceptions of unit morale moderated the direct association of combat exposure with PTSD symptoms. Unit morale also moderated the indirect association of combat exposure with anger and aggression through PTSD symptoms. Unit morale moderated the association of combat exposure with anger and aggression during combat operations by putatively mitigating the deleterious effect of combat on stress-related symptoms. The impact of policy and leadership on soldier and unit morale should be carefully considered given its protective role during combat operations.     

Unit Social Cohesion in the Israeli Military as a Case Study of “Don't Ask,Don't Tell”

U.S. military policy “Don't Ask Don't Tell” (DADT) restricted integration of gays in the U.S. military based on the premise that knowledge of gay peers would decrease interpersonal bonds among unit members. Despite the heated debate over DADT, this social cohesion thesis, reflecting the tensions of homosocial desire, has not been tested empirically. The Israeli military provides an operative case‐study for this thesis, given its nonexclusionary policy and intensive combat experience. Measures of perceived social cohesion and knowledge of gay peers were obtained from a sample of 417 combat and noncombat male soldiers using an inventory of interpersonal emotions towards unit members. A MANOVA of social cohesion by knowledge of gay peers and combat/noncombat unit yielded the hypothesized increase in cohesion in combat versus noncombat units. Yet contrary to the DADT premise, knowledge of gay peers did not yield decreased social cohesion. Comparisons with the U.S. military are presented, suggesting in both cases a loose coupling between stated policies and soldiers' experience on the ground. Implications of these findings for the reassessment of DADT and its repeal are discussed.     

Predicting unit performance by assessing transformational and transactional leadership

How do leadership ratings collected from units operating under stable conditions predict subsequent performance of those units operating under high stress and uncertainty? To examine this question, the authors calculated the predictive relationships for the transformational and transactional leadership of 72 light infantry rifle platoon leaders for ratings of unit potency, cohesion, and performance for U.S. Army platoons participating in combat simulation exercises. Both transformational and transactional contingent reward leadership ratings of platoon leaders and sergeants positively predicted unit performance. The relationship of platoon leadership to performance was partially mediated through the unit's level of potency and cohesion. Implications, limitations, and future directions for leadership research are discussed.     

Buffering Effects of Benefit Finding in a War Environment

Benefit finding (BF) has been extensively examined after exposure to traumatic events. However, less research has examined BF as a buffer against the negative effects of an ongoing stressful event. Data from 1,925 U.S. Army soldiers deployed in support of Operation Iraqi Freedom (OIF) was used to examine whether BF would moderate the relationship between combat exposure and posttraumatic stress disorder (PTSD) and depression. Regression analyses revealed that BF was associated with lower levels of PTSD and depression. However, we found that BF during the combat deployment was found to moderate the combat exposure–PTSD relationship, such that the relationship was stronger when BF was low. Results are discussed in terms of BF being a form of meaning-based coping that may help soldiers adjust to the challenges of war.     

Gender differences in combat-related stressors and their association with postdeployment mental health in a nationally representative sample of U.S. OEF/OIF veterans

Though the broader literature suggests that women may be more vulnerable to the effects of trauma exposure, most available studies on combat trauma have relied on samples in which women's combat exposure is limited and analyses that do not directly address gender differences in associations between combat exposure and postdeployment mental health. Female service members' increased exposure to combat in Afghanistan and Iraq provides a unique opportunity to evaluate gender differences in different dimensions of combat-related stress and associated consequence for postdeployment mental health. The current study addressed these research questions in a representative sample of female and male U.S. veterans who had returned from deployment to Afghanistan or Iraq within the previous year. As expected, women reported slightly less exposure than men to most combat-related stressors, but higher exposure to other stressors (i.e., prior life stress, deployment sexual harassment). No gender differences were observed in reports of perceived threat in the war zone. Though it was hypothesized that combat-related stressors would demonstrate stronger negative associations with postdeployment mental health for women, only one of 16 stressor × gender interactions achieved statistical significance and an evaluation of the clinical significance of these interactions revealed that effects were trivial. Results suggest that female Operation Enduring Freedom/Operation Iraqi Freedom service members may be as resilient to combat-related stress as men. Future research is needed to evaluate gender differences in the longer-term effects of combat exposure.     

The Impact of Benefit Finding and Leadership on Combat-Related PTSD Symptoms

Benefit finding and unit leadership have been identified as buffers against the negative effects of combat exposure on posttraumatic stress disorder (PTSD) symptoms. However, little is known about how these different buffers work together to protect military personnel from the negative effects of combat. We examined benefit finding and leadership as buffers of the combat–PTSD symptoms link in a sample of recently returned combat veterans (N?=?583). Results revealed that when higher levels of noncommissioned officer (NCO) leadership and benefit finding (BF) were reported, fewer PTSD symptoms were endorsed. Additionally, BF buffered the relationship between combat stress and PTSD symptoms, but only under conditions of supportive officer leadership. Implications of these findings for military settings are discussed.     

The Army's New Unit Personnel Replacement and Its Relationship to Unit Cohesion and Social Support

A recent concern of the U.S. Army's top leadership has been the deterioration of morale and cohesion in combat arms units. High personnel turnover in U.S. Army units has been viewed as a primary factor contributing to decreased unit cohesiveness. The current and traditional U.S. Army Indi- vidual Replacement (IR) System trained, assigned, and deployed soldiers to units as individuals. As a result, IR units have had as much as 45% personnel turnover annually. The new Unit Replacement (UR) System trained, assigned, and deployed soldiers as intact groups for the entire first-term soldier's enlistment. The objective of the study was to examine the effects of unit replacement on cohesion and to elaborate on the function of cohesion by examining the relationship between cohesion and social support in a sample of 3,245 soldiers in 43 line companies matched by type of replacement, type of combat arms, and stateside/overseas deployment. Soldiers in UR units in which soldiers had previously undergone Basic and Advanced Individual Training together or had their personnel stabilized reported a significantly higher level of cohesion than did soldiers in IR units. This difference persisted even when personal and unit characteristics were held constant in compari- sons. In terms of social support, UR soldiers cited more support providers in their units than did IR soldiers. Perceived satisfaction with social support and perceived helpfulness of social support provided by unit members were significantly and positively correlated with the cohesion measures, irrespective of the type of replacement. Whereas reciprocity was significantly and positively related to cohesion in commonly trained UR and IR units, it was nonsignificantly related to cohesion in personnel-stabilized UR units. Impli- cations of results for the expected effects of cohesion on the quality of interpersonal relations among unit members are discussed.     

The Relationship Between Childhood Trauma,Combat Exposure,and Posttraumatic Stress Disorder in Male Veterans

The current study investigated the effects of combat exposure, childhood trauma, and depression on posttraumatic stress disorder (PTSD) severity. Participants were 299 male veterans from the Korean War, World War II, Vietnam, and the first Gulf War who were being screened for admission to the PTSD unit. Participants were assessed with the Clinician-Administered PTSD Scale (CAPS), Combat Exposure Scale (CES), Hamilton Depression Rating Scale (HAMD), Childhood Trauma Questionnaire (CTQ), and Mississippi Scale for PTSD (MPTSD). Results of multiple regression analyses indicated that, as expected, combat exposure and depression were significant predictors of PTSD severity. When examined with combat exposure, childhood trauma has a complex relationship to PTSD severity. Examination of the interaction between the CES and CTQ suggests that when levels of combat are low and childhood trauma levels are high, the CTQ is related to higher levels of PTSD severity on the CAPS, regardless of depression. Treatment implications are discussed.     

Age Differences and Similarities in Identity Distress Following the Katrina Disaster: Theoretical and Applied Implications of Erikson��s Theory

This study examined predictions from Erikson??s lifespan developmental theory in the context of severe disaster exposure. Relationships among traumatic stress exposure, age, identity distress, and posttraumatic stress (PTS) symptoms were explored among 401 individuals (age 18?C86, mean = 32.83, SD = 14.1 years) exposed to Hurricane Katrina. Traumatic exposure experiences were related to identity distress ratings, but results suggested that the association was a function of PTS symptoms. Identity distress was negatively correlated with age, but the association between identity distress and age was moderated by the level of PTS symptoms. Identity distress was associated with PTS symptoms even while controlling for general psychological symptoms. The utility of the identity distress construct and theoretical implications for identity research in the wake of disaster are discussed.     

军事单位团队凝聚力的理论研究及应用

军事单位团队凝聚力是与作战效能紧密相关的因素。文章首先回顾了其理论的发展脉络,指出团队凝聚力是一个多维度的加工分类系统,继而介绍了常用的研究手段和测量方法,最后提出了应用性的建议和对未来研究的展望     

A study of posttraumatic stress in a student population

The authors examined the incidence of posttraumatic stress (PTS), with respect to levels of exposure to traumatic events, in a British student population. Respondents (N = 700) completed a standard questionnaire booklet that contained a posttraumatic stress disorder interview. The questionnaire collected personal demographic information and was used by researchers to ascertain whether respondents had experienced a traumatic event. Consistent with previous American studies, PTS was found to be relatively common; 23.3% of the sample showed either current or past PTS. Female participants had a significantly higher incidence of PTS than did male participants, although the latter were more likely to report having experienced a traumatic event. The experience of trauma was significantly associated with the likelihood of PTS. The authors discuss implications of their results in terms of long-term consequences of unresolved trauma.     

Intolerance of uncertainty predicts analogue posttraumatic stress following adverse life events

ABSTRACT

BACKGROUND AND OBJECTIVES: There is evidence that intolerance of uncertainty (IU) is associated with elevated post-traumatic stress (PTS) symptoms. There is a scarcity of research examining whether IU is prospectively related to PTS following exposure to negative life events. Using data from a Dutch student-sample, we examined the degree to which IU predicts post-traumatic stress symptoms associated with negative stressful life events (analogue posttraumatic stress (PTS)).

DESIGN: This was a prospective survey-study.

METHODS: A group of 193 undergraduate students completed self-report measures of Inhibitory IU, Prospective IU, and anxiety sensitivity (at Time 1, T1). One year later (at T2), participants rated adverse life-events experienced between T1 and T2, and completed a questionnaire tapping PTS associated with the most distressing event experienced in this time-frame. We hypothesized that pre-event Inhibitory IU and—to a lesser extent—Prospective IU would predict analogue PTS, after covarying for anxiety sensitivity.

RESULTS: As predicted, pre-event Inhibitory IU predicted post-event analogue PTS, even when controlling for anxiety sensitivity. With respect to distinct analogue PTS clusters, Inhibitory IU predicted PTS avoidance and PTS hyperarousal, but was unrelated to PTS reexperiencing.

CONCLUSIONS: This study confirm that IU, particularly Inhibitory IU, may convey risk for elevated PTS following adverse life events.     

Leadership Team Cohesion and Subordinate Work Unit Morale and Performance

This study examined (a) the relationship of cohesion among members of a platoon leadership team to subordinate attitudes and performance and (b) the degree of consensus among squad members and their leaders regarding the leadership team's cohesiveness. In a sample of 60 light infantry platoons, squad members' perceptions of leadership team cohesion (LC) were signifi- cantly related (at both individual and unit levels) to their cohesion, organiza- tional identification, job involvement, task motivation, career intent, and perceptions of unit effectiveness. They were also related to ratings of performance in simulated combat. Regression revealed LC to be beneficial over and above the perceived quality of the individual leaders. Most of these relationships held true from the perspective of squad leaders, and some from the perspective of platoon sergeants and platoon leaders. The degree of consensus among the different levels varied as well. The results suggest that leaders should pay more attention to the impact their cohesion or dissension may have on unit morale and performance.     

A Study of Posttraumatic Stress in a Student Population

The authors examined the incidence of posttraumatic stress (PTS), with respect to levels of exposure to traumatic events, in a British student population. Respondents (N = 700) completed a standard questionnaire booklet that contained a posttraumatic stress disorder interview. The questionnaire collected personal demographic information and was used by researchers to ascertain whether respondents had experienced a traumatic event. Consistent with previous American studies, PTS was found to be relatively common; 23.3% of the sample showed either current or past PTS. Female participants had a significantly higher incidence of PTS than did male participants, although the latter were more likely to report having experienced a traumatic event. The experience of trauma was significantly associated with the likelihood of PTS. The authors discuss implications of their results in terms of long-term consequences of unresolved trauma.     

Trauma exposure and post-traumatic stress symptoms among Syrian refugee youth in Jordan: Social support and gender as moderators

This study assessed relations between exposure to trauma and post-traumatic stress (PTS) symptoms, and whether perceived social support from family and friends and gender moderated these associations. Syrian refugee youth (N = 418, 55.0% female) attending public schools in Jordan participated. Boys reported more age-adjusted PTS symptoms than girls. Analyses revealed that family support and gender moderated the association of trauma on PTS symptoms. For males, the benefits of family support were most evident under conditions of high traumatic stress exposure, while for females, benefits of family support were evident when no loss or injury to family members had been reported. Support from friends was not helpful for either gender. School- or family-based interventions designed to treat PTS symptoms need to consider the different needs of boys and girls, particularly within the Syrian Muslim cultural context.