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.     

Selective deficit in spatial location memory in extremely low birth weight children at age six: The PETIT Study

Spatial location memory has rarely been assessed in young children due to a scarcity of developmentally appropriate tests. This study sought to compare nonverbal learning and recall in children born extremely low birth weight (ELBW; <1000 g) and less than 33 gestational weeks (GW) with term-born children at early school age using a recently developed and adapted test. We administered a modification of the Hopkins Board to 210 children at age six; 84 born ELBW (35 born < 26 GW; 49 born 26–33 GW) and 126 term-born. Six measures were obtained: naming, trials-to-criterion, errors-to-criterion, delayed item recall, delayed location recall, and percent retention. After age correction, ELBW children had worse general cognition, item naming, delayed item recall, delayed location recall, and percent retention than term-born children. Delayed item recall and percent retention performances of ELBW children remained worse after correction for general cognition. ELBW groups (< 26 GW and 26–33 GW) groups performed worse than term-born children in naming and delayed item recall with chronological age as covariate. Those born before 26 GW, but not 26–33 GW, performed worse than term-born children in delayed location recall and percent retention. Differences remained significant after controlling for gender, maternal education, and delivery type. All three groups' performance declined from final learning trial to delayed location recall, with a decline greater for less than 26 GW than term-born children. Extreme prematurity (< 26 GW) and ELBW are significant risk factors for spatial location memory deficit. The modified Hopkins Board discriminated high-risk preterm and term-born children at early school age and appears to be a useful test to measure this rarely studied cognitive capacity.     

Prenatal SSRI exposure: Effects on later child development

The aim of this review is to integrate research on the pharmacological mechanisms of selective serotonin reuptake inhibitors (SSRIs) and the following effects on fetal brain development and child cognitive function seen in children with prenatal exposure to SSRIs. As antidepressants are transferred from the mother to the fetus through the placenta, the fetus is vulnerable to alterations in neurotransmission and possibly altered neural functioning. Because of this risk, pregnant women suffering from depression are often advised to discontinue their use of antidepressants during pregnancy. Though, maternal untreated depression may also have negative consequences for the fetus and child after birth. In the present review, we find a distinction between studies of early versus late development. Studies on early cognitive development indicate no negative effects, while studies on later development report some cognitive difficulties and behavioral problems, indicating latent effects of exposure. However, the reviewed studies are not all converging, and it is not clear whether and to what extent prenatal SSRI exposure affects cognitive development.     

Correlates of parental control and autonomy support in an interdependent culture: A look at Ghana

It is unclear whether, similar to research findings in Western societies, autonomy support is associated with positive child outcomes, and forceful control with negative outcomes in collectivist societies. A two-part study (N = 190 Ghanaian sixth graders) examined the relations of parental structure, control, and autonomy support in Ghana with child outcomes, and whether autonomy support was at odds with Ghanaian children’s values of interdependence and respect for elders. Results showed that structure was related to cognitive perceived competence, parental control was related to controlled regulation around school work and decreased academic engagement, and autonomy support was negatively related to depression and positively related to autonomous forms of motivation, engagement in school, and interestingly, children’s endorsement of collectivist cultural values. The importance of distinguishing between parental control and provision of structure, and the implication of the findings for understanding the role of parental autonomy support in diverse cultures, are discussed.     

Combat-Related Killing: Expanding Evidence-Based Treatments for PTSD

Despite its prevalence, killing in war is an experience that may not fit neatly into existing models of posttraumatic stress disorder (PTSD) and its treatment. The context in which killing occurred may be complex. Furthermore, while killing may certainly be fear based, an individual may have also killed in response to losing someone close and experiencing sadness and anger, as opposed to fear. While evidence-based treatments for PTSD may be a good starting point for killing-related trauma, we argue that existing treatments need to be expanded. Complex killing-related cognitions that may not be anticipated or identified, moral injury, self-forgiveness, and loss are all important issues that arise that may need to be addressed in greater detail. Consequently, we have developed a 6- to 8-session individual treatment module for those impacted by killing in war, expressly designed for use with existing evidence-based treatments for PTSD, currently being validated for use in clinical practice. We see this module as supplementary, rather than as a replacement, building on the skills that veterans have already learned within these treatments. By expanding the types of treatments we offer those who have killed in war, we can ensure that we are providing veterans with comprehensive treatment that takes the complexities of war and its aftermath into account.     

From the Roots of Psychosocial Practice-Therapeutic Use of Self in the Classroom: Practical Applications for Occupational Therapy Faculty

The roots of occupational therapy stem from psychosocial practice and embrace concepts of humanism, client-centered practice and therapeutic use of self. These concepts are integral to both clinical and academic settings. As the profession has moved toward graduate level education, increased numbers of non-traditional students are entering the field. Models of teaching that incorporate principles of active learning and therapeutic use of self within the classroom provide a consumer-learner-based model of education that is uniquely suited to students of diverse backgrounds, lifestyles, and educational needs. This article presents a brief overview of andragogical principles and the development of the student-faculty relationship. Mosey's concepts of conscious use of self are introduced as a means by which positive faculty-student relationships can be formed in order to enhance student learning and educational outcomes.     

A note on using alpha and stratified alpha to estimate the reliability of a test composed of item parcels

Several authors have suggested that prior to conducting a confirmatory factor analysis it may be useful to group items into a smaller number of item ‘parcels’ or ‘testlets’. The present paper mathematically shows that coefficient alpha based on these parcel scores will only exceed alpha based on the entire set of items if W, the ratio of the average covariance of items between parcels to the average covariance of items within parcels, is greater than unity. If W is less than unity, however, and errors of measurement are uncorrelated, then stratified alpha will be a better lower bound to the reliability of a measure than the other two coefficients. Stratified alpha are also equal to the true reliability of a test when items within parcels are essentially tau‐equivalent if one assumes that errors of measurement are not correlated.