USAF Special Tactics Operator Combat Exposure and Psychological Stress

Given the length of combat in Afghanistan, Iraq, Syria, and elsewhere, and the role special operations forces will continue to play, we believe it is imperative to gain understanding of the psychological “wear and tear” associated with sustained combat operations on these highly specialized, highly utilized personnel. This study focused on a seldom-studied group, Air Force Special Tactics (ST) operators, to assess combat exposure, current psychological stress, and preferences for support when needed. This study assessed symptoms of posttraumatic stress, depression, anxiety, sleep, anger, and perceptions of help seeking in 5 ST units. Data revealed that the majority of study participants report distress levels below clinical thresholds; however, 26% struggle with generalized stress/agitation and, at smaller percentages, other distress symptoms that have negative impact on work performance. Combat experiences were comparable or higher than Army and Marine maneuver forces, and greater amounts of exposure related to positive screening for a possible mental health disorder, generalized agitation, and posttraumatic symptoms; combat involving direct fighting and being in high-threat situations were also related to posttraumatic stress. Distress rates for Special Operations Weather personnel were higher. Attitudes toward mental health support were positive however, embedded assets were preferred over base clinic providers. We review these and other findings and offer suggestions for future research in this area.     

A Preliminary Study of DSM–5 PTSD Symptom Patterns in Veterans by Trauma Type

The all-volunteer status of the military, combined with an increasing desire to employ individuals with the requisite knowledge, skills, and abilities to perform highly sophisticated tasks, has intensified competition between military and private sector organizations attempting to attract and retain qualified personnel. In an effort to remain competitive with employers in the private sector labor market, U.S. military organizations have directed their attention to various personnel support programs aimed at meeting the needs of servicemembers and contributing to their overall quality of life. More specifically, these military services have focused on the development and validation of conceptual models that link quality of life to desired military outcomes, including personnel retention, readiness, and performance. This study extended recent quality of life research efforts by determining the applicability of a model developed and validated for Navy personnel to another branch of the military, the U.S. Marine Corps. Structural equation modeling results suggested that the Navy model provided an adequate fit to the Marine Corps data for each of the subgroups considered. Results and implications are discussed.     

Generalizability of Evidence-Based PTSD Psychotherapies to Suicidal Individuals: A Review of the Veterans Administration and Department of Defense Clinical Practice Guidelines

Posttraumatic stress disorder (PTSD) is strongly associated with suicide. The 2010 Department of Veterans Affairs/Department of Defense Clinical Practice Guidelines for PTSD (VA/DoD CPG) endorse cognitive therapy and its variants as empirically supported PTSD treatments. However, we lack an understanding about whether these treatments are generalizable to patients with suicidal ideation and/or behaviors. Randomized controlled trials (RCTs) cited in the VA/DoD CPGs were systematically reviewed for methodology, suicide-related content, and adverse event reporting. Thirty-eight RCTs were reviewed. Twenty-three reported suicide-related exclusion criteria, 15 made no mention of suicide-related inclusion/exclusion criteria. Thirty-six RCTs included depression assessments containing suicide-related items, but no suicide-relevant data were reported. Two RCTs outlined suicide risk monitoring procedures. Suicidal PTSD participants are underrepresented in PTSD RCTs and suicide risk assessment procedures were inconsistently reported. Standardized reporting of RCT methods pertaining to suicide risk to determine generalizability and safety of empirically supported PTSD treatments to this clinical population is needed.     

Book Review

Performance-based measures and ratings of executive functions were examined in a sample of adolescents with attention deficit/hyperactivity disorder (ADHD) and comparison controls. Performance-based measures of executive function included inhibition, working memory, set shifting, and planning, and ratings of these same executive functions were completed by parents and teachers. Adolescents with ADHD demonstrated lower executive function performance than controls and displayed elevated ratings on the executive function ratings by parents and teachers. Significant associations were obtained between the performance-based measures and the parent and teacher ratings, but each measure was not uniquely associated with its respective scale on the rating scales. When performance-based measures and ratings were examined as predictors of ADHD status, the parent and teacher ratings entered as significant predictors of ADHD status. Further commonality analyses indicated that performance-based measures accounted for little unique variance in predicting ADHD status and also displayed little overlap with the behavioral ratings. These findings highlight the diagnostic utility of behavioral ratings of executive function in predicting ADHD status; however, behavioral ratings should not be assumed to be a proxy for performance on measures of executive function in clinical practice.     

Executive functioning deficits in preschool children with Fetal Alcohol Spectrum Disorders

Executive function (EF) deficit is a hallmark of Fetal Alcohol Spectrum Disorders (FASD), but the vast majority of available evidence comes from school-age children and adolescents. Very little is known about EF during the critical developmental period prior to 6 years of age in FASD. We evaluated EF in 39 children with FASD (3.0–5.5 years) and a comparison group of 50 age-matched, nonexposed controls. Measures included the EF Scale for Early Childhood and a Delay of Gratification task. Compared to age-matched controls, preschool children with FASD had impairments on the EF Scale and showed more impulsivity on the Delay of Gratification task. To confirm the EF Scale finding, FASD group performance was compared to a separate normative dataset (N = 1,400). Those with FASD performed below normal (M = –0.57, SD = 0.92). Within the FASD group, IQ was correlated with the EF Scale (partial r = .60, p = .001) and Delay of Gratification (partial r = .58, p = .005). EF Scale performance did not differ significantly across levels of FASD severity (fetal alcohol syndrome [FAS], partial FAS, or alcohol-related neurobehavioral disorder [ARND]). However, compared to normative data, those with FAS had the largest deficits (M = –0.91 SD from the mean, SE = 0.23), followed by partial FAS (M = –0.66 SD from the mean, SE = 0.26), then ARND (M = –0.36 SD from the mean, SE = 0.20). These novel data show that EF deficits manifest well before the age of 6 years in children with FASD, that they occur across the spectrum, and that EF may be most impaired in children with more severe forms of FASD and/or lower IQs.     

Kinetics of diffusion via divacancies in a concentrated random fcc alloy

The diffusion kinetics in a concentrated fcc alloy are described by means of divacancies. The model chosen is the random alloy model with bound divacancies. We show that for the fcc structure the Manning formalism developed originally for monovacancies can be used intact to describe diffusion via divacancies. Monte Carlo simulation results for both tracer and collective correlation factors are in good agreement with the results of the formalism for a wide range of the component atom exchange frequencies with the divacancy except for the slower-moving component.     

Phonon densities of states of gamma-cerium and delta-cerium measured by time-of-flight inelastic neutron scattering

Time-of-flight inelastic neutron scattering spectra were measured on cerium metal at temperatures near the fcc (gamma)-to-bcc (delta) transition temperature. Phonon density-of-states (DOS) curves were extracted from data acquired over a wide range of momentum transfers. A large softening of the phonon DOS was found in going from gamma-cerium to delta-cerium, and this accounts for an increase in vibrational entropy of (0.71 +/- 0.05)k _B/atom. To be consistent with the latent heat of the gamma-delta transition, this increase in vibrational entropy must be accompanied by a large decrease in electronic entropy. The results not only confirm the recent discovery of a significant electronic contribution to the gamma-delta transition but also suggest that it may be twice that previously reported.