Stress, hardiness and eating disorder symptoms in military academy cadets.

Eating disorders are a persistent and debilitating problem, especially among college age men and women. This problem is exacerbated in occupations such as the military, where maintenance of strict standards regarding weight, fitness and appearance is important for job retention and promotion. Also, previous research confirms that stress is a contributing element to eating disorders. It is thus important to identify factors that may assist individuals to remain resilient and avoid stress-related health and eating difficulties. The present study utilizes historical data to examine the impact of stress on health and eating disorder symptoms in a representative sample of West Point military academy cadets, while testing the role of gender and hardiness as stress moderators in this relation. A survey containing measures of stress, hardiness and eating disorders symptoms was completed by 387 cadets in the fall and spring of 2000-2001. Moderation effects were tested with advanced conditional process analysis procedures developed recently by Hayes (2022). Results show that hardiness was a significant moderator, with cadets low in hardiness showing increased eating disorder symptoms and more general health symptoms. While gender was not a significant moderator with respect to eating disorder symptoms, it was significant for general health symptoms; female cadets showed more stress-related health symptoms than their male counterparts. These results suggest that eating disorder symptoms in military academy cadets and college students more generally may be reduced through programs aimed at developing hardiness attitudes and stress coping approaches.

Hardiness, leadership style and gender as predictors of leader performance in military academy cadets.

The U.S. Military Academy at West Point is widely considered the premier leader development institution in the United States. Since first admitting women in 1976, few studies have examined factors that may influence female cadets to perform as leaders in this environment. The present study analyzed archival data collected during a unique longitudinal study of leader development conducted at West Point during the years 1993-2000, the Baseline Officer Leader Development Study (BOLDS). Personality hardiness, transformational and transactional leadership styles were evaluated as potential predictors of performance as leaders, according to supervisor ratings. Regression results showed that female cadets excel as leaders, outperforming male cadets as a group. Hardiness and transformational leadership style predicted leader performance for both male and female cadets. Additional analyses indicated it is the transformational leadership element of "charismatic" (or idealized influence) leadership that accounts for this finding. The transactional component "management by exception-active" also predicted leader performance, but for male cadets only. This study confirms that hardiness and charismatic leadership style are important for leadership performance of both male and female cadets. For male cadets, leader performance was also tied to actively identifying and addressing failures in subordinates. Leader development programs for both men and women may thus be enhanced by including programs to develop personality hardiness and transformational leadership qualities.

Sex differences in hardiness, coping, and health in new West Point cadets.

The U.S. Military Academy at West Point places young men and women in a highly demanding world of extreme mental and physical challenges. As such, it provides an excellent natural laboratory in which to study how people respond and adapt to highly stressful conditions. The present study explores the role of personality hardiness and coping as stress resilience resources in new (freshmen) cadets at West Point, while also considering sex differences. Using survey methods, N = 234 cadets were assessed during their first year at West Point. Measures included personality hardiness, coping strategies, health symptoms, and number of hospitalizations for all causes. Results show that female cadets are higher in hardiness and emotion-focused coping, as well as somewhat higher in symptoms reports. For the total group, hardiness is linked to better health, both in terms of symptoms reports and hospitalizations. Multiple regression results indicate symptoms are predicted by lower hardiness, higher avoidance coping, and female sex. Conditional process path analysis reveals that the effect of hardiness on symptoms is mediated by emotion-focused coping, and that emotion-focused coping can have both positive and negative effects. This study confirms hardiness is an important stress resilience resource for both men and women in the highly stressful first year at West Point. These findings lend further support to a growing body of evidence that hardiness influences health in part via the coping strategies that people choose to apply in dealing with stressful situations.

Risk Factors for Complicated Grief in the Military Community.

Death, grief, and loss have always been a part of the military community. Historically, research on grief in the military has focused on the impact of combat operations and deployment separations on the grief experience of service members and loved ones. However, as the transient nature of military life and the dangers of military service exist outside of combat operations and military deployments, it is important to examine how grief may impact the military community in times of peace as well as war. The purpose of this commentary is to discuss the components of the military community that place its members at a higher risk of experiencing complicated grief.

Hardiness moderates the effects of COVID-19 stress on anxiety and depression.

The COVID-19 pandemic has led to sharp increases in mental health problems around the world, most notably in anxiety and depression. The present study examines hardiness and age as potential protective factors against the mental health effects of COVID-related stress. A sample of Canadians balanced across age and gender, completed an online survey including measures of COVID related stressors, hardiness, depression, and anxiety, along with age, gender, and other demographics. Conditional PROCESS analysis showed that COVID stressors led to significant increases in anxiety and depression. Hardiness moderated these relations, with those high in hardiness showing less anxiety and depression. Age was negatively related to anxiety and depression, with highest levels observed among the younger respondents. At the same time, a moderating effect of age was found with respect to depression, with older people showing sharper increases in depression as COVID-related stress goes up. Gender was not a significant factor in any of these relations, meaning that the results apply equally well to both women and men. This study provides evidence that younger people who are also low in hardiness are most vulnerable to developing anxiety and depression while under COVID stress, and so would likely benefit from preventive intervention strategies. While anxiety and depression symptoms are highest among the young, older age groups appear more vulnerable to increasing rates of depression symptoms related to COVID stress. Clinicians and practitioners should thus be especially vigilant for COVID related increases in depression among older people, and those low in psychological hardiness.

Hardiness and Burnout in Adult U.S. Workers.

OBJECTIVE: Burnout is a costly problem, and it appears to be getting worse due to COVID-related stressors. It is thus important for organizations to find better tools to prevent and mitigate worker burnout. METHODS: Conditional PROCESS path analysis was used to assess the relation of hardiness to burnout in a representative sample of U.S. workers, with sex and age as potential moderators. RESULTS: Hardiness is associated with reduced burnout symptoms. Sex did not moderate this relation. A moderating effect for age was observed, with more burnout appearing in younger, less hardy workers. CONCLUSIONS: Findings suggest hardiness operates similarly for men and women as a buffer against burnout, and that older workers are less vulnerable to burnout. Training programs to increase stress appraisals and coping skills used by more experienced, hardy workers may be beneficial in reducing burnout.

Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study.

Introduction: The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure. Methods: International experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance. Results: Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control-Performance Monitoring; (3) Arousal and Regulatory Systems-Arousal; (4) Cognitive Control-Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control-Response Selection and Inhibition/Suppression; (6) Working memory-Flexible Updating; (7) Working memory-Active Maintenance; (8) Perception and Understanding of Self-Self-knowledge; (9) Working memory-Interference Control, and (10) Expert-suggested-Shifting. Discussion: Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.

Crossing the Antarctica: Exploring the Effects of Appetite-Regulating Hormones and Indicators of Nutrition Status during a 93-Day Solo-Expedition.

Future deep space astronauts must maintain adequate nutrition despite highly stressful, isolated, confined and dangerous environments. The present case-study investigated appetite regulating hormones, nutrition status, and physical and emotional stress in a space analog condition: an explorer conducting a 93-day unsupported solo crossing of Antarctica. Using the dried blood spot (DBS) method, the subject drew samples of his blood on a regular basis during the expedition. The DBSs were later analyzed for the appetite regulating hormones leptin and adiponectin. Energy intake and nutritional status were monitored by analysis of albumin and globulin (including their ratio). Interleukin-6 (IL-6) was also analyzed and used as an energy sensor. The results showed a marked reduction in levels of the appetite-reducing hormone, leptin, and the appetite stimulating hormone, adiponectin, during both extreme physical and psychological strain. Nutrition status showed a variation over the expedition, with below-normal levels during extreme psychological strain and levels abutting the lower bounds of the normal range during a phase dominated by extreme physical hardship. The IL-6 levels varied substantially, with levels above the normal range except during the recovery phase. It was concluded that a daily intake of 5058 to 5931 calories seemed to allow recovery of both appetite and nutritional status between extreme physical and psychological hardship during a long Arctic expedition. Furthermore, IL-6 may be a sensor in the muscle-liver, muscle-fat and muscle-brain crosstalk. These results may help guide nutrition planning for future astronaut crews, mountaineers and others involved in highly demanding missions.

Resilience to Hazardous Drinking Among Never-Deployed Male United States Army Reserve and National Guard Soldiers.

BACKGROUND: Negative emotions related to never having been deployed to active duty are associated with an increased risk of hazardous drinking among United States Army Reserve/National Guard (USAR/NG) soldiers. Resiliency factors are known to buffer the effects of combat on hazardous drinking among service members who have been deployed, but it is not known whether these factors are protective for never-deployed service members, or which domains of hazardous drinking might be affected. Therefore, we examined the effects of a range of resiliency factors (i.e., marital satisfaction, psychological hardiness, intrinsic religiosity) on the relation between nondeployment emotions (NDE) and domains of hazardous drinking. METHODS: We drew a subset of data from Operation: Soldiers and Families Excelling Through the Years (N = 112 never-deployed male soldiers), an ongoing study of USAR/NG soldiers. Regression models examined the main effects of NDE on each of the domains of hazardous drinking (i.e., total Alcohol Use Disorders Identification Test [AUDIT] score, consumption subscale, dependence subscale, alcohol-related problems subscale) and effect modification of each of the resiliency factors on the relations between NDE and the domains of hazardous drinking, separately. Final models controlled for years of military service, rank (enlisted vs. officer), number of military friends in the social network, and depression. RESULTS: Greater NDE were associated with a higher total AUDIT score, alcohol consumption, and alcohol dependence (ps < 0.05), but not alcohol-related problems (p > 0.05). Marital satisfaction and psychological hardiness buffered the effects of NDE on total AUDIT score and alcohol dependence (p < 0.05). Intrinsic religiosity only modified the effect of NDE on total AUDIT score. None of the resiliency factors modified the effects of NDE on alcohol consumption or alcohol-related problems. CONCLUSIONS: Soldiers with greater NDE had a greater risk of hazardous drinking in the presence of low resilience. Interventions to promote resiliency are an important consideration for protecting USAR/NG soldiers from hazardous drinking, regardless of their deployment history.

Resilience to mental health problems and the role of deployment status among U.S. Army Reserve and National Guard Soldiers.

PURPOSE: Research suggests that interpersonal and intrapersonal resiliency factors protect against poor post-deployment mental health outcomes among Reserve/Guard soldiers who have been deployed. There is increasing awareness that never-deployed soldiers are also at risk. The purpose of this study was to examine the relationships between resiliency factors and a range of mental health outcomes among a sample of United States Army Reserve and National Guard (USAR/NG) soldiers who have and have not experienced deployment. METHODS: A subset of data was drawn from Operation: SAFETY (N = 360), an ongoing study examining the health and well-being of USAR/NG soldiers. We used a multivariate path analysis approach to examine the simultaneous effects of unit support, marital satisfaction, and psychological hardiness on the following mental health outcomes, concurrently: anger, anxiety, depression, and posttraumatic stress disorder (PTSD) symptomatology. We also examined interaction effects between resiliency factors and deployment status on mental health outcomes. RESULTS: Greater unit support (ps < 0.01), marital satisfaction (ps < 0.001), and psychological hardiness (ps < 0.001) were associated with less anger, anxiety, depression, and PTSD symptomatology. Psychological hardiness had significant interactions with deployment status on anxiety, depression, and PTSD, such that the protective effects of psychological hardiness were even stronger among never-deployed soldiers than previously deployed solders. CONCLUSION: Resiliency factors can be targeted for intervention to prevent poor mental health outcomes among USAR/NG soldiers, regardless of deployment status. Further, psychological hardiness may be an even more important protective factor among soldiers who have never been deployed.

Hardiness protects against problematic alcohol use in male, but not female, soldiers.

Military service members are at high risk for problematic substance use compared with the general population; deployment and combat exposure further increases this risk. It is thus critical to identify resiliency factors that can buffer the negative effects of military experiences and potentially prevent problematic alcohol use. The current research examines the extent to which psychological hardiness predicts lower risk of problematic alcohol use and explores potential sex differences in this association. Data are from Operation: SAFETY, an ongoing study of U.S. Army Reserve/National Guard soldiers. Negative binomial regression models examined the relation between baseline hardiness, assessed by the 15-item Dispositional Resiliency Scale, and problematic alcohol use at the 1-year follow-up, assessed by the Alcohol Use Disorders Identification Test (N = 260), controlling for baseline combat exposure (Combat Exposure subscale, Deployment Risk and Resilience Inventory-2) and baseline quantity and frequency of alcohol use. To examine the impact of hardiness on men and women, models were stratified by sex. In final, adjusted models, hardiness predicted lower risk of problematic alcohol use (adjusted risk ratio = 0.98; p < .05) for male soldiers and was unrelated to alcohol use for female soldiers (adjusted risk ratio = 1.01; p > .05). Post hoc analyses explored the impact of each dimension of hardiness (i.e., commitment, control, and challenge) on problematic alcohol use. Hardiness assessment may complement existing screening tools to identify high-risk populations; interventions to promote hardiness may help in preventing problematic alcohol use, particularly among male soldiers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Hardiness Predicts Post-Traumatic Growth and Well-Being in Severely Wounded Servicemen and Their Spouses.

INTRODUCTION: Thousands of military personnel have suffered severe wounds and traumatic amputations in recent overseas conflicts. They face multiple surgeries and long, painful rehabilitation. Despite the tremendous stress for these servicemen and families, many appear to cope quite well and even thrive despite their devastating wounds. Hardiness is a world view or mindset marked by high levels of commitment and engagement in the world, a strong sense of control, and the tendency to see change as a challenge and opportunity to learn and improve. Previous research has shown that military personnel high in hardiness are at lower risk for post-traumatic stress disorder, depression, and other psychiatric symptoms following combat exposure. This study evaluated the impact of personality hardiness on post-traumatic growth (PTG) and psychological well-being in severely wounded service members and their spouses. MATERIALS AND METHODS: Male volunteers were surveyed while in hospital for severe battle wounds including loss of limbs. All were married, and all spouses also agreed to participate. Participants (N = 44) completed measures of hardiness, PTG, well-being, and neuroticism, and answered a question regarding potential benefits of their experience. RESULTS: Hierarchical multiple regression showed that hardiness significantly predicted both PTG and well-being, while controlling for age, education, family income, and neuroticism. Both service members and spouses indicated they experienced benefits in the following areas: strengthened family ties and connections; greater appreciation for and perspective on life; new career and educational opportunities; stronger, more resilient as a person; and formed new relationships, friends, and connections. CONCLUSION: These results suggest that seriously wounded military members and their spouses who are high in hardiness are more likely to experience PTG and psychological well-being following extremely stressful experiences. Hardiness entails positive reframing of negative experiences as opportunities and challenges to overcome, and taking action to solve problems. Training programs to increase hardiness attitudes and related coping skills may thus be beneficial in facilitating healthy adaptation for severely injured patients.

Influence of hardiness, avoidance coping, and combat exposure on depression in returning war veterans: A moderated-mediation study.

BACKGROUND: Depression is a serious problem among military personnel returning from combat deployments, and is related to a range of adverse outcomes including alcohol and drug abuse, family violence and suicide. The present study explores how psychological hardiness, avoidance coping, and combat stress exposure may influence depression in U.S. Army soldiers returning from a one-year deployment to Afghanistan. METHODS: National Guard soldiers (N = 357) completed surveys upon their return to home station, including measures of hardiness, avoidance coping, combat exposure, and depression. Path analysis with ordinary least squares regression procedures (PROCESS program; Hayes, 2013) were applied to test for mediation and moderation effects among the study variables. RESULTS: Results showed a pattern of moderated-mediation. In the mediation model, hardiness had a significant effect on depression, which was mediated by avoidance coping. Soldiers low in hardiness reported using more avoidance coping strategies, which was related to increased depression. This effect in turn was seen to be conditional, moderated by level of combat exposure such that the effect was stronger at high levels of exposure. LIMITATIONS: Data are cross-sectional, and the sample consisted of male soldiers only, which may limit generalizability. CONCLUSIONS: Depression and related problems among combat veterans may be diminished by applying training programs and policies aimed at increasing hardiness attitudes and active coping skills.

Coping with recruiter stress: Hardiness, performance and well-being in US Army recruiters.

Recruiting for military service can be a highly stressful job, but it is one that is essential for success in the all-volunteer force. Military recruiters face a number of job stressors, including pressure to meet monthly production quotas, long work hours and time away from family. They also work in relative isolation, with limited work social support networks. These factors make recruiters vulnerable to burnout and early attrition. The present study examines psychological hardiness and active, problem focused coping as potential stress resilience resources in US Army recruiters. In a stratified random sample of N = 817 recruiters, hardiness was found to predict supervisor-rated performance and psychological well-being. Hardiness also interacted with problem focused coping to predict psychological well-being, suggesting a mediating role for coping. These results can be applied to help improve policy for selecting and training military recruiters.

Peer Support Services for Bereaved Survivors: A Systematic Review.

This systematic literature review assesses the evidence regarding benefits of peer support services for bereaved survivors of sudden or unexpected death. Reports were included that addressed peer support services for adults who experienced death of a family member, close friend, or coworker. Of the 32 studies meeting all inclusion criteria, most showed evidence that peer support was helpful to bereaved survivors, reducing grief symptoms and increasing well-being and personal growth. Studies also showed benefits to providers of peer support, including increased personal growth and positive meaning in life. Several studies addressed the growing trend of Internet-based peer support programs, finding that these are beneficial in part due to their easy accessibility. Peer support appears to be especially valuable for survivors of suicide loss, a result that may be related to stigma and lack of support from family and friends experienced by many suicide survivors. The reviewed studies provide consistent evidence that peer support is beneficial to bereaved survivors.

Individual Differences in Adaptability to Isolated, Confined, and Extreme Environments.

INTRODUCTION: Future deep space missions will expose astronauts to more intense stressors than previously encountered. Isolation will be greater and more prolonged, living and work areas more confined, and communications and resupply channels to Earth longer and less reliable. Astronauts will need to function more autonomously, with less guidance and support from Earth. Thus, it is important to select and train astronauts who can adapt and function effectively under extreme and variable conditions. In order to identify factors linked to individual adaptability, we conducted a systematic review of the literature on cognitive and behavioral adaptation to isolated, confined, and extreme (ICE) environments. METHODS: We searched PubMed, Embase, Web of Science, and PsychINFO databases for studies addressing individual adaptability to ICE environments. Studies were rated for quality and fidelity to long-duration space missions and key results extracted. RESULTS: There were 73 studies that met all inclusion criteria. Adaptability attributes for ICE environments include intelligence, emotional stability, self-control, openness, achievement facets of conscientiousness, optimism, mastery, introversion, hardiness, task-oriented coping, past experience, low need for social support, and adequate sleep. DISCUSSION: This review identifies individual factors linked to adaptability under ICE conditions. Further studies are needed to verify causal directions and determine the relative importance of these factors.Bartone PT, Krueger GP, Bartone JV. Individual differences in adaptability to isolated, confined, and extreme environments. Aerosp Med Hum Perform. 2018; 89(6):536-546.

Developing a Measure to Assess Emotions Associated with Never Being Deployed.

BACKGROUND: Much research has focused on stress related to deployments; however, a substantial proportion of soldiers never deploy. In a study of 1.3 million veterans, suicide risk was higher among veterans who had never deployed. Thus, not being deployed may have an impact on soldiers' well-being; however, no measures exist to assess emotions regarding non-deployment. We aimed to develop and test an original measure of non-deployment emotions. METHODS: We examined the Non-Deployment Emotions (NDE) questionnaire, a novel four-item measure of guilt, unit value, unit camaraderie, and unit connectedness in a sample of never-deployed male and female US Army Reserve/National Guard (USAR/NG) soldiers (N = 174). Data are from Operation: SAFETY (Soldiers and Families Excelling Through the Years), an ongoing survey-based study examining the health of USAR/NG soldiers and their partners. The protocol was approved by the Institutional Review Board at the State University of New York at Buffalo. The relationship between each of the items was examined by calculating correlation and alpha coefficients. Latent class analyses tested for the existence of distinct levels of negative emotions related to non-deployment. Negative binomial regression models examined the cross-sectional associations between NDE summary score and each of the following outcomes, separately: anger, anxiety, depression, and post-traumatic stress. FINDINGS: More than half of never-deployed USAR/NG soldiers expressed negative emotions for having not been deployed. "Guilt," "value," "camaraderie," and "connectedness" were each positively correlated with each other (p < 0.001) and the internal consistency reliability was high (male soldier α = 0.90, female soldier α = 0.93). Latent class analyses revealed a superior three-class model with well-delineated class membership (entropy = 0.93): "Class 1" (low NDE; 47.6%), "Class 2" (moderate NDE; 33.8%), and "Class 3" (high NDE; 18.6%). Regression models demonstrated that greater non-deployment emotions were independently associated with more severe anger (RR = 1.02, 95% CI: 1.01, 1.03, p < 0.001), anxiety (RR = 1.06, 95% CI: 1.01, 1.11, p < 0.05), depression (RR = 1.06, 95% CI: 1.01, 1.11, p < 0.05), and PTSD (RR = 1.10, 95% CI: 1.04, 1.16, p < 0.01). DISCUSSION: Findings demonstrate that negative emotions regarding non-deployment are prevalent among never-deployed USAR/NG soldiers and that these emotions are related to a mental health. The NDE provides a measure of "guilt," "value," "camaraderie," and "connectedness" specific to non-deployed soldiers and is able to well discriminate between soldiers that have low, moderately, and highly negative non-deployment emotions. These findings suggest that all military personnel, regardless of deployment status, could be at risk for negative outcomes. As with any survey-based study, there is a potential for response bias; however, given the range of responses collected with the NDE, social desirability is unlikely. Further work is needed to confirm our findings in other components of the military and to examine soldiers in the rear detachment.

Exploration into best practices in peer support for bereaved survivors.

This exploratory, qualitative study addresses the question: what are the important elements in effective peer support programs for bereaved survivors? Interviews with 10 highly experienced experts were analyzed to identify recurrent themes and elements. Findings indicate that effective peer support programs for the bereaved should be: easily accessible; confidential; provide a safe environment; use peer supporters with similar shared experiences to clients; select peer supporters carefully; partner with professional mental health providers; train peer supporters thoroughly; and provide care and monitoring for peer supporters. These results can help inform efforts to improve peer support programs for bereaved survivors.

Reliability and validity of the Korean version of the 15-item Dispositional Resilience Scale.

This study assessed the reliability and validity of the Korean version of the 15-item Dispositional Resilience Scale (DRS-15) in a sample of Korean adults. In a baseline study conducted in June 2015, the DRS-15, Center for Epidemiologic Studies-Depression Scale (CES-D), and Korean Resilience Questionnaire-53 (KRQ-53) were administered to 409 Korean adults aged 20-79 years. A 1-year follow-up study was conducted in June 2016, and the CES-D was administered to assess predictive validity. Confirmatory factor analysis identified three dimensions for the DRS-15: commitment, control, and challenge (χ2/df = 2.32, GFI = .90, AGFI = .88, RMR = .04, TLI = .91, NFI = .89, and RMSEA = .05), and concurrent and predictive validity were demonstrated via the CES-D and KRQ-53. Furthermore, the DRS-15 established known-group validity. Cronbach's alpha coefficients for internal consistency reliability of the three subscales ranged from .75 to .83. Three-week test-retest reliability coefficients ranged from .80 to .81. The KDRS-15 showed satisfactory construct and criterion validity and internal consistency.