Firearm leadership: Development, analysis, and application of a novel concept to message secure storage of firearms in the military.

Suicide remains a leading cause of death in the United States (U.S.) Armed Forces. Access to firearms increases the risk of death by suicide due to the high lethality of firearm-related injuries (~90% in suicide attempts) and the highly dynamic nature of suicide which includes rapid change from low- to high-risk states. Critical gaps remain in research, programming, and communication amongst scientists, Department of Defense (DoD) programmatic leaders, front-line commanders, and service members. To enhance communication and coordination, in June 2022, the first-ever national "Firearm Suicide Prevention in the Military: Messaging and Interventions Summit" was held, with discussion of Firearm Leadership, a concept that emphasizes the importance of communication about lethal means safety (LMS) among military leaders and service members. Through a discussion of scientific literature, the points identified during the Summit, as well as presenting illustrative case examples derived from suicide death reviews, we aim to provide a conceptual model for the benefits of Firearm Leadership and how some barriers can be overcome. Following the Summit, further discussions on "Firearm Leadership" led to the development of a Firearm Leadership Factsheet.

A qualitative study of military service members undergoing medical separation.

OBJECTIVE: Little research explores military perspectives on medical disability-related transition. A qualitative study sought to understand transition experiences of United States military Service members found unfit for duty following medical and physical evaluation boards (MEBs and PEBs). METHODS: Confidential telephone interviews were conducted with 25 current and prior Service members. Participants were asked to share their experiences before, during, and after the MEB and PEB processes. Interview questions explored (1) health conditions that prompted the medical disability evaluation, (2) reactions to being recommended for separation, (3) transition-related stress and challenges, and (4) coping strategies. Salient themes were identified across chronological narratives. RESULTS: Participants expressed that debilitating physical (e.g., injury) and/or mental (e.g., post-traumatic stress disorder) illnesses prompted their medical evaluation. In response to the unfit for duty notice, some participants reported emotional distress (e.g., anxiety, anger) connected to uncertainty about the future. Other participants reported relief connected to a sense of progression toward their medical disability claim status. Transition stress included the length of the MEB/PEB process, impact of the COVID-19 pandemic on the process, financial stress, impact on family life, and compounded effect of these stressors on emotional distress, including depression and suicidal thoughts. Participants reported using adaptive (e.g., psychotherapy) and maladaptive (e.g., excessive drinking) strategies to cope with stress. CONCLUSION: Preliminary reports of emotional distress and transition stress following unfit for duty notices highlight the need for increased support and interventions to facilitate adaptive coping strategies during this vulnerable period.

Exploring the protective experiences of those who "protect and serve": A psychometric evaluation of Protective and Compensatory Experiences Survey within a military sample.

OBJECTIVE: The current study evaluates the psychometric properties of the Protective and Compensatory Experiences Survey (PACES; Morris et al., 2018) within a military population. The study's aims are to evaluate if the PACES is a reliable measure to use with military samples and to examine the validity of the PACES measure when exploring protective experiences in relation to adverse childhood experiences (ACEs) and adult traumatic stress (ATS) in an active duty military sample. METHOD: Active duty Service members were recruited to complete an online survey that included measures pertaining to ACEs, PACES, and ATS. RESULTS: The reliability and validity of PACES indicate that Service members who are involved in protective and compensatory experiences as youth are less likely to have experiences of stress both as children and as adults. CONCLUSIONS: Given the need for mission readiness of Service members and their higher likelihood to experience ACEs than civilians, the role of protective and compensatory factors is vital to their livelihood and career. PACES psychometrics offer a reliable and valid measure to use when exploring the risk and resilience experiences of Service members across the lifespan. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Health and Readiness of Service Members: ACEs to PACEs.

INTRODUCTION: Over the past three decades, a growing research base has emerged around the role of adverse childhood experiences (ACEs) in the biological, psychological, social, and relational health and development of children and adults. More recently, the role of ACEs has been researched with military service members. The purpose of this article was to provide a brief description of ACEs and an overview of the key tenets of the theory of toxic stress as well as a snapshot of ACEs and protective and compensatory experiences (PACEs) research with active duty personnel. METHODS: Ninety-seven active duty personnel completed the study including questions pertaining to demographics, adverse childhood experiences, adult adverse experiences, and PACEs survey. RESULTS: Significant findings pertaining to ACEs and PACEs were found by service member's sex and rank, with higher ACE scores for men and enlisted service members. CONCLUSIONS: The contrast by rank and sex in relation to ACEs punctuates the need for attention to ACEs and protective factors among early career service members in order to promote sustainable careers in the military.

Reciprocal Influence of Couple Dynamics and Eating Disorders.

Little research has focused on the ways that eating disorder processes and adult couple dynamics influence one another. The purpose of this study was to investigate the reciprocal influence of couple dynamics and eating disorder illness and recovery processes. We conducted 51 interviews with 17 couples where one member identified as currently suffering or having recovered from an eating disorder. Using grounded theory analytical methods, findings include the systemic interplay of the eating disorder and relationship, both partners' perspectives on the eating disorder and its role in the relationship, the noneating disorder partner's impact on the eating disorder, and coping strategies for recovery as a couple. Clinical implications for supporting couples experiencing eating disorder illness and recovery are discussed.

Effectiveness of an eating disorder preventative intervention in primary care medical settings.

OBJECTIVE: To conduct a pilot effectiveness trial of a brief dissonance-based eating disorder preventative program, the Body Project, when implemented at primary care medical clinics. METHOD: Sixty-six female adolescents between the ages of 13 and 17 who reported at least some body image dissatisfaction were recruited at two primary care clinics and randomized to Body Project groups or an educational video control condition; eating disorder risk factors and symptoms were measured at pretest, posttest, and 3-month follow-up. RESULTS: Body Project versus educational video control participants showed significantly greater reductions in thin-ideal internalization, pressure to be thin, dieting, and eating disorder symptoms at posttest, which were medium to large effect sizes. Body Project participants also showed greater decreases in body dissatisfaction and negative affect at posttest, though these moderate sized effects were not significant. Effects persisted through 3-month follow-up. CONCLUSION: Average pre-post effect sizes (d = 0.58) compare favorably to those observed in past Body Project efficacy (average d = 0.59) and effectiveness trials (average ds of 0.43 and 0.69), suggesting that primary care clinics may represent a novel venue for offering and extending the reach of this eating disorder prevention program.