COVID-19 Concerns, Information Needs, and Adverse Mental Health Outcomes among U.S. Soldiers.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic disrupted U.S. Military operations and potentially compounded the risk for adverse mental health outcomes by layering unique occupational stress on top of general restrictions, fears, and concerns.

Impact of the COVID-19 pandemic on army families: Household finances, familial experiences, and soldiers' behavioral health.

The Coronavirus Disease 2019 (COVID-19) pandemic has significantly impacted employment and finances, childcare, and behavioral health across the United States. The Behavioral Health Advisory Team assessed the pandemic's impact on the behavioral health of U.S.

US soldiers and the role of leadership: COVID-19, mental health, and adherence to public health guidelines.

Background: Previous studies have documented the impact of domain-specific leadership behaviors on targeted health outcomes in employees. The goal of the present study was to determine the association between specific leadership behaviors addressing COVID-19 and US soldiers' mental health and adherence to COVID-19 public health guidelines.

Methods: An electronic, anonymous survey was administered to US Army soldiers across three major commands (N = 7,829) from December 2020 to January 2021.

Order effects in PTSD network analysis: important implications for diagnostic conceptualization, treatment refinement, and research.

Background: For decades confirmatory factor analysis (CFA) has been the preeminent method to study the underlying structure of posttraumatic stress disorder (PTSD); however, methodological limitations of CFA have led to the emergence of other analytic approaches. In particular, network analysis has become a gold standard to investigate the structure and relationships between PTSD symptoms. A key methodological limitation, however, which has significant clinical implications, is the lack of data on the potential impact of item order effects on the conclusions reached through network analyses.

Behavioral health of US military veterinary personnel deployed to Afghanistan.

OBJECTIVE To compare symptoms of compromised behavioral health (BH symptoms) and factors protecting against those symptoms (protective factors) in military veterinary and nonveterinary health-care personnel deployed to Afghanistan. DESIGN Cross-sectional survey. SAMPLE 237 deployed military health-care personnel (21 veterinary and 216 nonveterinary).

Soldiers and Leaders With Combat Experience: Unit Health and Climate.

: The present study investigated the association between previous deployment experience and somatic symptoms, mental health, unit climate perceptions, anger, and risk taking among junior-enlisted soldiers who were preparing to deploy or who were in garrison, or home duty station. The study also investigated potential differences in these variables based on unit leader deployment history. : Soldiers in a combat unit were surveyed either in a predeployment ( = 1,554; one week before deployment) or garrison setting ( = 1,326).

Professional Stress and Burnout in U.S. Military Medical Personnel Deployed to Afghanistan.

Background: Studies of medical staff members have consistently documented high levels of burnout compared to those in other professions. Although there are studies of burnout in military medical staff, there are gaps in understanding the experience of medical staff while they are deployed and few occupationally-related factors associated with decreased burnout have been identified in this population.

Purpose: To assess work-related variables accounting for burnout over and above rank, post-traumatic stress disorder (PTSD) symptoms, and professional stressors in the deployed environment.

Building social resilience in soldiers: A double dissociative randomized controlled study.

Can social resilience be trained? We report results of a double-dissociative randomized controlled study in which 48 Army platoons were randomly assigned to social resilience training (intervention condition) or cultural awareness training (active control group). The same surveys were administered to all platoons at baseline and after the completion of training to determine the short-term training effects, generalization effects beyond training, and possible adverse effects. Multilevel modeling analyses indicated that social resilience, compared with cultural awareness, training produced small but significant improvements in social cognition (e.

Longitudinal determinants of mental health treatment-seeking by US soldiers.

Background: Studies with members of the armed forces have found a gap between reports of mental health symptoms and treatment-seeking.

Aims: To assess the impact of attitudes on treatment-seeking behaviours in soldiers returning from a combat deployment.

Method: A sample of 529 US soldiers were surveyed 4 months (time 1) and 12 months (time 2) post-deployment.

Behavioral health leadership: new directions in occupational mental health.

The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership.

Assessing functional impairment in a working military population: the Walter Reed functional impairment scale.

Measurement of functional impairment is a priority for the military and other professional work groups routinely exposed to stressful traumatic events as part of their occupation. Standard measures of impairment used in general or chronically ill populations contain many items not suitable for these populations, and include mental health symptoms items that are not true measures of functioning. We created a new, 14-item scale-the Walter Reed Functional Impairment Scale-to assess functioning in 4 domains (physical, occupational, social, and personal).

Trends in mental health services utilization and stigma in US soldiers from 2002 to 2011.

Objectives: We characterized trends in mental health services utilization and stigma over the course of the Afghanistan and Iraq wars among active-component US soldiers.

Methods: We evaluated trends in mental health services utilization and stigma using US Army data from the Health-Related Behavior (HRB) surveys from 2002, 2005, and 2008 (n = 12,835) and the Land Combat Study (LCS) surveys administered to soldiers annually from 2003 to 2009 and again in 2011 (n = 22,627).

Results: HRB and LCS data suggested increased mental health services utilization and decreased stigma in US soldiers between 2002 and 2011.

Embedded behavioral health providers: an assessment with the Army National Guard.

Although the Army has recently begun the practice of embedding behavioral health care providers (EBHP) in units in an effort to improve soldier well-being, the efficacy of this practice has not been evaluated. This study assesses 1 of the first programs implemented by the military. Using cross-sectional data obtained from a confidential survey of 12 company-level units in the California Army National Guard (n = 1,132), this study examines differences between units with and without EBHPs across a number of measures.

Changes in alcohol use after traumatic experiences: the impact of combat on Army National Guardsmen.

Objective: This research documents the impact of combat experiences on alcohol use and misuse among National Guard soldiers. Whereas much research regarding combat personnel is based on post-experience data, this study's design uses both pre- and post-deployment data to identify the association between different types of combat experiences and changes in substance use and misuse.

Method: A National Guard Infantry Brigade Combat Team was surveyed before and after its deployment to Iraq in 2005-2006.

Mental health outcomes in US and UK military personnel returning from Iraq.

Background: Research of military personnel who deployed to the conflicts in Iraq or Afghanistan has suggested that there are differences in mental health outcomes between UK and US military personnel.

Aims: To compare the prevalence of post-traumatic stress disorder (PTSD), hazardous alcohol consumption, aggressive behaviour and multiple physical symptoms in US and UK military personnel deployed to Iraq.

Method: Data were from one US (n = 1560) and one UK (n = 313) study of post-deployment military health of army personnel who had deployed to Iraq during 2007-2008.

Unethical battlefield conduct reported by soldiers serving in the Iraq war.

Research involving military service members has shown a strong relationship between combat experiences and increased risk for posttraumatic stress disorder (PTSD) and other mental health problems. Comparatively little research has examined the relationship between combat experiences, PTSD, aggression, and unethical conduct on the battlefield, although news stories sometimes suggest links between unethical conduct and disorders such as PTSD. This study systematically examined whether unethical conduct is a proxy for aggression and whether specific combat experiences and PTSD are independently associated with unethical behavior.

2003-2009 marital functioning trends among U.S. enlisted soldiers following combat deployments.

Objective: This study examined 2003-2009 trends in three marital functioning indicators: marital quality, infidelity, and separation/divorce intent, and in marital dissolution rates among U.S. soldiers.

The effects of mental health symptoms and organizational climate on intent to leave the military among combat veterans.

Frequent deployments to Iraq and Afghanistan have placed a strain on military retention. There is a need to determine contributing factors predicting intent to leave the military. The purpose of this study was to determine to what extent soldiers' mental health symptoms and perceptions of organizational climate are associated with intent to leave the military.

Benefit finding at war: a matter of time.

Benefit finding, described as one's ability to find benefits from stressful situations, has been hypothesized as a buffer against the negative effects of stress on mental health outcomes. Nonetheless, many have questioned the buffering potential of benefit finding in the face of prolonged and excessive stress such as is found in the combat environment. This study suggests that the length of a combat deployment and benefit finding may impact the relationship between combat exposure and posttraumatic stress disorder (PTSD) symptoms.

Posttraumatic stress disorder associated with combat service in Iraq or Afghanistan: reconciling prevalence differences between studies.

Studies of posttraumatic stress disorder (PTSD) prevalence associated with deployment to Iraq or Afghanistan report wide variability, making interpretation and projection for research and public health purposes difficult. This article placed this literature within a military context. Studies were categorized according to deployment time-frame, screening case definition, and study group (operational infantry units exposed to direct combat versus population samples with a high proportion of support personnel).

Grief and physical health outcomes in U.S. soldiers returning from combat.

Background: Few studies have measured the burden of physical health problems after Iraq/Afghanistan deployment, except in association with post-traumatic stress disorder (PTSD) or mild traumatic brain injury (mTBI). Grief, a correlate of health problems in the general population, has not been systematically examined. We aimed to identify the prevalence of post-deployment physical health problems and their association with difficulty coping with grief.

Dispositional optimism buffers combat veterans from the negative effects of warzone stress on mental health symptoms and work impairment.

The study examined dispositional optimism s role in buffering the effect of warzone stress on mental health symptoms and mental health symptoms on work impairment. A total of 2,439 soldiers from an active-duty brigade combat team were surveyed following a 12-month deployment to Iraq. Posttraumatic stress disorder (PTSD) symptoms, depression symptoms, combat exposure, deployment demands, and work impairment were measured.

Mental health advisory teams: a proactive examination of mental health during combat deployments.

Mental health advisory teams (MHATs) conduct comprehensive mental health surveillance of US service members in combat environments. Since 2003, six teams have deployed to Iraq and four have deployed to Afghanistan, and results have played a key role influencing behavioural health policy. The repeated deployments of the teams have provided opportunities for processes to be refined, and this refinement has led to a scientifically rigorous and replicable approach.