Perceived stigma and barriers to mental health care in Marines attending the Combat Operational Stress Control program.

The Department of Defense is aggressively addressing combat stress reactions (CSRs) through comprehensive Combat/Operational Stress Control (COSC) briefings/programs and referral resources for the prevention, identification, and treatment of stress reactions. The purpose of this study was to develop and administer a survey to assess perceptions of CSRs and barriers to care which affect help-seeking behavior in Marines attending the COSC program. A sample of 553 U.S. Marine Corps Officers and Enlisted personnel from Air (44%), Logistics (38%), and Infantry (18%) communities were recruited for the survey. The results suggested that misconceptions and stigma about CSRs still persist in Marines. The findings reinforced the need to facilitate treatment utilization by focusing on mental health-related stigma as well as organizational barriers.

Identifying blood biomarkers and physiological processes that distinguish humans with superior performance under psychological stress.

BACKGROUND: Attrition of students from aviation training is a serious financial and operational concern for the U.S. Navy. Each late stage navy aviator training failure costs the taxpayer over $1,000,000 and ultimately results in decreased operational readiness of the fleet. Currently, potential aviators are selected based on the Aviation Selection Test Battery (ASTB), which is a series of multiple-choice tests that evaluate basic and aviation-related knowledge and ability. However, the ASTB does not evaluate a person's response to stress. This is important because operating sophisticated aircraft demands exceptional performance and causes high psychological stress. Some people are more resistant to this type of stress, and consequently better able to cope with the demands of naval aviation, than others. METHODOLOGY/PRINCIPAL FINDINGS: Although many psychological studies have examined psychological stress resistance none have taken advantage of the human genome sequence. Here we use high-throughput -omic biology methods and a novel statistical data normalization method to identify plasma proteins associated with human performance under psychological stress. We identified proteins involved in four basic physiological processes: innate immunity, cardiac function, coagulation and plasma lipid physiology. CONCLUSIONS/SIGNIFICANCE: The proteins identified here further elucidate the physiological response to psychological stress and suggest a hypothesis that stress-susceptible pilots may be more prone to shock. This work also provides potential biomarkers for screening humans for capability of superior performance under stress.

Anger expression and stress responses in military men.

INTRODUCTION: A better understanding of individual differences in the human stress response may enhance prevention and treatment of operational stress reactions. In this study, we examined the relationships of anger experience and expression to stress indices during daily living and in response to military survival training in 45 men. METHODS: Prior to participation in survival training, subjects completed self-report measures of perceived stress and anger. The revised Impact of Event Scale was then administered 24 h after the conclusion of training. RESULTS: As expected, outward anger expression was positively associated with perceived stress during free living (P < 0.0125). Outward anger expression, inward anger expression, and angry temperament then combined to account for 25% of the variance in psychological impact of a stressful mock-captivity challenge. CONCLUSION: Anger characteristics are associated with human stress endpoints, both during daily living and in response to an ecologically valid stressor. These findings may assist in the prevention and treatment of operational stress reactions.

Behavioral predictors of acute stress symptoms during intense military training.

A better understanding of factors influencing human responses to acute stress is needed to enhance prevention and treatment of stress-related disorders. In the current study, the authors examined predictors of acute stress symptoms during intense military training in 35 men. In univariate and multivariate models, perceived stress, passive coping, and emotion-focused coping during daily living predicted acute stress symptoms in response to realistic survival training, whereas active coping and problem-focused coping did not. Baseline stress levels and coping styles, both of which may be modifiable, appear to play a fundamental role in the human response to acute uncontrollable stress. Additional research is needed to better elucidate the relative and interactive contributions of behavioral predictors of acute stress.

A neuroscience approach to optimizing brain resources for human performance in extreme environments.

Extreme environments requiring optimal cognitive and behavioral performance occur in a wide variety of situations ranging from complex combat operations to elite athletic competitions. Although a large literature characterizes psychological and other aspects of individual differences in performances in extreme environments, virtually nothing is known about the underlying neural basis for these differences. This review summarizes the cognitive, emotional, and behavioral consequences of exposure to extreme environments, discusses predictors of performance, and builds a case for the use of neuroscience approaches to quantify and understand optimal cognitive and behavioral performance. Extreme environments are defined as an external context that exposes individuals to demanding psychological and/or physical conditions, and which may have profound effects on cognitive and behavioral performance. Examples of these types of environments include combat situations, Olympic-level competition, and expeditions in extreme cold, at high altitudes, or in space. Optimal performance is defined as the degree to which individuals achieve a desired outcome when completing goal-oriented tasks. It is hypothesized that individual variability with respect to optimal performance in extreme environments depends on a well "contextualized" internal body state that is associated with an appropriate potential to act. This hypothesis can be translated into an experimental approach that may be useful for quantifying the degree to which individuals are particularly suited to performing optimally in demanding environments.

The effects of alternative input devices and repeated exposures on the Test of Basic Aviation Skills (TBAS) performance.

The use of computer-based, psychomotor testing systems for personnel selection and classification has gained popularity in the civilian and military worlds in recent years. However, several issues need to be resolved before adopting a computerized, psychomotor test. The purpose of this study was to compare the impact of alternative input devices used for the Test Of Basic Aviation Skills (TBAS) as well as to explore the practice effects of the TBAS. In study 1, participants were administered the TBAS tracking tests once with a throttle and once with foot pedals in a classic test-retest paradigm. The results confirmed that neither of the input devices provided a significant advantage on TBAS performance. In study 2, participants were administered the TBAS twice with a 24-hour interval between testing. The results demonstrated significant practice effects for all the TBAS subtests except for the dichotic listening tests.

False predictions about the detectability of visual changes: the role of beliefs about attention, memory, and the continuity of attended objects in causing change blindness blindness.

Recently, a number of experiments have emphasized the degree to which subjects fail to detect large changes in visual scenes. This finding, referred to as "change blindness," is often considered surprising because many people have the intuition that such changes should be easy to detect. documented this intuition by showing that the majority of subjects believe they would notice changes that are actually very rarely detected. Thus subjects exhibit a metacognitive error we refer to as "change blindness blindness." Here, we test whether CBB is caused by a misestimation of the perceptual experience associated with visual changes and show that it persists even when the pre- and postchange views are separated by long delays. In addition, subjects overestimate their change detection ability both when the relevant changes are illustrated by still pictures, and when they are illustrated using videos showing the changes occurring in real time. We conclude that CBB is a robust phenomenon that cannot be accounted for by failure to understand the specific perceptual experience associated with a change.