ABSTRACT
Sleep disruption is an emergent military health issue, but remarkably little is known of its prevalence or comorbidities in the combat zone. This study was designed to quantify the prevalence and mental health correlates of sleep disruption among military personnel serving within a ground combat zone during Operation Enduring Freedom. This was a large, cross-sectional survey of active duty and reserve U.S. Navy personnel (N = 3,175). Self-reported sleep measures included total hours of sleep per day, total hours of sleep required to feel well-rested, difficulty falling asleep, and difficulty staying asleep. The survey also measured mental health symptoms, including post-traumatic stress symptoms, anxiety, and depression. Participants reported an average of 5.9 hours of sleep per day despite requiring on average 6.8 hours to feel well rested. More than half (56%) were classified as sleep deficient, and 67% reported 6 or fewer hours of sleep per day. Adjusted for covariates, individuals endorsing sleep disruption were at substantially elevated risk of meeting criteria for post-traumatic stress disorder, generalized anxiety disorder, and major depressive disorder. This study documents the prevalence of sleep disruption in a very large and difficult-to-access sample of military members serving in a combat zone, and details robust associations with mental health.
Subject(s)
Mental Health , Military Personnel/psychology , Sleep Wake Disorders/epidemiology , Sleep/physiology , Adolescent , Adult , Afghan Campaign 2001- , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Iraq War, 2003-2011 , Male , Prevalence , Retrospective Studies , Sleep Wake Disorders/physiopathology , United States/epidemiology , Young AdultABSTRACT
What kinds of associations underlie the associative memory illusion? In Experiment 1, lists composed of horizontal, or coordinate, free associates elicited false recognition of critical lures much more often than did lists composed of vertical, or subordinate, category instances. Experiment 2 replicated this result, and showed that the difference between free associates and category instances was not an artifact of differential levels of forward or backward associative strength. Associative structure plays an important role in the associative memory illusion: The illusion is strongest when the critical lure lies at the same level of categorization as the studied items.