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16 - The stress continuum model: a military organizational approach to resilience and recovery

from Section 4 - Specific challenges

Published online by Cambridge University Press:  07 September 2011

Steven M. Southwick
Affiliation:
Yale University School of Medicine
Brett T. Litz
Affiliation:
Boston University
Dennis Charney
Affiliation:
The Mount Sinai School of Medicine
Matthew J. Friedman
Affiliation:
Dartmouth University School of Medicine
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Summary

Introduction

Resilience in the face of adversity is vital for military service members to survive potential threats to their own lives and safety and to accomplish assigned missions, often for the sake of others’ survival and welfare. The ability of service members to bounce back from operational stress may also determine how successfully they reintegrate with their families and communities after returning from deployment, whether they can continue to work in military professions, and whether they develop potentially disabling mental disorders or other serious behavioral problems. Military organizations have long traditions of selecting, training, and sustaining service members to endure intense and persistent operational stress without losing their abilities to function on the battlefield, but other indices of resilience have only recently attracted the sustained interest of the military. As military organizations develop programs to promote a broader spectrum of desired stress outcomes, they are faced with a choice between expecting traditional resilience-building methods to meet untraditional objectives and creating entirely novel approaches to resilience.

Academic interest in the psychological, biological, social, and personality-trait differences associated with successful adaptation to combat and operational experiences has increased rapidly since the late 1990s. Underlying recent studies in this area has been the assumption that the incidence of various mental health and functional problems associated with combat and operational experiences might be reduced if modifiable risk and resilience factors could be identified and then targeted in military prevention programs. Unfortunately, research and translational programs to enhance resilience in members of the armed services have, so far, been limited by the lack of a unified or paradigmatic approach to conceptualizing the military and extra-military processes and functions that may lead to resilient outcomes, and even by the lack of a consensus definition of resilience. Uniform methods of measuring resilience processes or outcomes also do not yet exist. The little empirical research that has been conducted in the military has significant internal and external validity problems, greatly limiting their power to inform prevention or intervention practices, which is the basic goal of resilience research.

Type
Chapter
Information
Resilience and Mental Health
Challenges Across the Lifespan
, pp. 238 - 252
Publisher: Cambridge University Press
Print publication year: 2011

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References

Anon, 2009 http://www.nytimes.com/2009/11/28/us/28brfs-DIVORCESRISI
Appel, J. W.Beebe, G. W. 1946 Preventive psychiatry: an epidemiologic approachJournal of the American Medical Association 131 1469CrossRefGoogle Scholar
Bonanno, G. A. 2004 Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events?American Psychologist 59 20CrossRefGoogle ScholarPubMed
Bonanno, G. A.Galea, S.Bucciarelli, A.Vlahov, D. 2006 Psychological resilience after disaster: New York City in the aftermath of the September 11th terrorist attackPsychological Science 17 181CrossRefGoogle ScholarPubMed
Bonanno, G. A.Galea, S.Bucciarelli, A.Vlahov, D. 2007 What predicts psychological resilience after disaster? The role of demographics, resources, and life stressJournal of Consulting and Clinical Psychology 75 671CrossRefGoogle ScholarPubMed
Bremner, J. D. 2006 Stress and brain atrophyCNS and Neurological Disorders 5 503CrossRefGoogle ScholarPubMed
Burleigh, N. 2008 http://www.people.com/people/archive/article/0,20245668,00.html
Dean, E. T. 1997 Shook over hell: Post-traumatic stress, Vietnam, and the civil warCambridge, MAHarvard University PressGoogle Scholar
Dickstein, B. D.Suvak, M.Stein, N.Adler, A. B.Litz, B. T. 2010 23 331
Eaton, K.Sallee, F. R.Sah, R. 2007 Relevance of neuropeptide Y (NPY) in psychiatryCurrent Topics in Medicinal Chemistry 7 1645CrossRefGoogle Scholar
Feldner, M. T.Monson, C. M.Friedman, M. J. 2007 A critical analysis of approaches to targeted PTSD prevention: Current status and theoretically derived future directionsBehavior Modification 31 80CrossRefGoogle ScholarPubMed
French, S. E. 2003 Code of the warrior: Exploring warrior values past and presentLanham, MDRowman & Littlefield.Google Scholar
Giza, C. C.Hovda, D. A. 2001 The neurometabolic cascade of concussionJournal of Athletic Training 36 228Google ScholarPubMed
Heim, C.Nemeroff, C. B. 2009 Neurobiology of posttraumatic stress disorderCNS Spectrums 14 13Google ScholarPubMed
Hobfoll, S. E.Watson, P.Bell, C. C. 2007 Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidencePsychiatry 70 283CrossRefGoogle ScholarPubMed
Hobfoll, S. E.Palmieri, P. A.Johnson, R. J. 2009 Trajectories of resilience, resistance, and distress during ongoing terrorism: The case of Jews and Arabs in IsraelJournal of Consulting and Clinical Psychology 77 138CrossRefGoogle ScholarPubMed
Hoge, C. W.Auchterlonie, J. L.Milliken, C. S. 2006 Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or AfghanistanJournal of the American Medical Association 2295 1023CrossRefGoogle Scholar
Janoff-Bulman, R. 1992 Shattered assumptions: Towards a new psychology of traumaNew YorkFree PressGoogle Scholar
King, L. A.King, D. W.Bolton, E. E.Knight, J. A.Vogt, D. S. 2008 Risk factors for mental, physical, and functional health in Gulf War veteransJournal of Rehabilitation Research and Development 45 395CrossRefGoogle ScholarPubMed
Kobasa, S. C.Maddi, S. R.Kahn, S. 1982 Hardiness and health: a prospective studyJournal of Personality and Social Psychology 42 168CrossRefGoogle ScholarPubMed
Kruman, I. I.Mattson, M. P. 1999 Pivotal role of mitochondrial calcium uptake in neural cell apoptosis and necrosisJournal of Neurochemistry 72 529CrossRefGoogle ScholarPubMed
Lerner, P. 2003 Hysterical men: War, psychiatry, and the politics of trauma in Germany, 1890–1930Ithaca, NYCornell University PressGoogle Scholar
Litz, B. T. 2005 Has resilience to severe trauma been underestimated?American Psychologist 60 262CrossRefGoogle ScholarPubMed
Litz, B. T. 2007 Research on the impact of military trauma: Current status and future directionsMilitary Psychology 19 217CrossRefGoogle Scholar
Litz, B. T.Schlenger, W. E. 2009 PTSD in service members and new veterans of the Iraq and Afghanistan wars: a bibliography and critiquePTSD Research Quarterly 20 1Google Scholar
Litz, B. T.Stein, N.Delaney, E. 2009 Moral injury and moral repair in war veterans: A preliminary model and intervention strategyClinical Psychology Review 29 695CrossRefGoogle ScholarPubMed
Marin, A. 2004 From tents to sheets: an analysis of the, C.F. experience with third location decompression after deploymenthttp://www.ombudsman.forces.gc.ca/rep-rap/sr-rs/tld-dtl/app-ann-01-eng.aspGoogle Scholar
Command, Marine Corps Combat DevelopmentNavy Warfare Development Command 2010 Combat and operational stress controlQuantico, VAMarine Corps Combat Development CommandGoogle Scholar
Martin, E. I.Ressler, K. J.Binder, E.Nemeroff, C. B. 2009 The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinologyPsychiatric Clinics of North America 32 549CrossRefGoogle ScholarPubMed
McEwen, B. S. 2000 The neurobiology of stress: from serendipity to clinical relevanceBrain Research 886 172CrossRefGoogle Scholar
McEwen, B. S. 2008 Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediatorsEuropean Journal of Pharmacology 583 174CrossRefGoogle ScholarPubMed
Meagher, R. E. 2006 Herakles gone mad: Rethinking heroism in an age of endless warNorthampton, MAOlive Branch PressGoogle Scholar
Mental Health Advisory Team 2003 Operation Iraqi Freedom (OIF)Washington, DCUS Army Medical Departmenthttp://www.armymedicine.army.mil/reports/mhat/mhat.htmlGoogle Scholar
Mental Health Advisory Team 2005 Operation Iraqi Freedom (MHAT-II)Washington, DCUS Army Medical Departmenthttp://www.armymedicine.army.mil/reports/mhat/mhat.htmlGoogle Scholar
Mental Health Advisory Team 2006 Operation Iraqi Freedom 04–06 (MHAT-III)Washington, DCUS Army Medical Departmenthttp://www.armymedicine.army.mil/reports/mhat/mhat.htmlGoogle Scholar
Mental Health Advisory Team 2006 Operation Iraqi Freedom 05–07 (MHAT-IV)Washington, DCUS Army Medical Departmenthttp://www.armymedicine.army.mil/reports/mhat/mhat.htmlGoogle Scholar
Mental Health Advisory Team 2008 Washington, DCUS Army Medical Departmenthttp://www.armymedicine.army.mil/reports/mhat/mhat.html
Mental Health Advisory Team 2009 Operation Iraqi Freedom 07–09 (MHAT-VI)Washington, DCUS Army Medical Departmenthttp://www.armymedicine.army.mil/reports/mhat/mhat.htmlGoogle Scholar
Moran, C. M. W. 1967 The anatomy of courageBostonHoughton MifflinGoogle Scholar
Morgan, C. A.Wang, S.Mason, J. 2000 Hormone profiles in humans experiencing military survival trainingBiological Psychiatry 47 891CrossRefGoogle ScholarPubMed
Morgan, C. A.Hazlett, G.Wang, S. 2001 Symptoms of dissociation in humans experiencing acute, uncontrollable stress: a prospective investigationAmerican Journal of Psychiatry 158 1239CrossRefGoogle ScholarPubMed
Mrazek, P. J.Haggerty, R. J. 1994 Reducing risks for mental disorders: Frontiers for preventive intervention researchWashington, DCNational Academies Press for the Committee on Prevention of Mental Disorders, Institute of MedicineGoogle Scholar
Nash, W. P. 2007 Figley, C. R.Nash, W. P.Combat stress injuries: Theory, research, and managementNew YorkRoutledgeGoogle Scholar
Nash, W. P. 2007 Figley, C. R.Nash, W. P.Combat stress injuries: Theory, research, and managementNew YorkRoutledge.Google Scholar
Nash, W. P. 2011 Ritchie, E. C.Operational behavioral healthWashington, DCBorden Institute.Google Scholar
Nash, W. P.Westphal, R. J.Watson, P.Litz, B. T. 2008
Nash, W. P.Silva, C.Litz, B. T. 2009 The historical origins of military and veteran mental health stigma, and the stress injury model as a means to reduce itPsychiatric Annals 39 789CrossRefGoogle Scholar
Nash, W. P.Krantz, L.Stein, N.Westphal, R. J.Litz, B. 2011 Ruzek, J.Vasterling, J.Schnurr, P.Friedman, M.Posttraumatic stress reactions: Caring for the veterans of the global war on terror193New YorkGuilford PressGoogle Scholar
Ozer, E. J.Best, S. R.Lipsey, T. L.Weiss, D. S. 2003 Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysisPsychological Bulletin 129 52CrossRefGoogle ScholarPubMed
Papa, A.Neria, Y.Litz, B. T. 2008 Traumatic bereavement in war veteransPsychiatric Annals 38 686CrossRefGoogle Scholar
Phang, S. E. 2008 Roman military service: Ideologies of discipline in the late republic and early principateNew YorkCambridge University PressCrossRefGoogle Scholar
Prigerson, H. G.Horowitz, M. J.Jacobs, S. C. 2009 Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11PLoS Medicine 6CrossRefGoogle ScholarPubMed
Shalev, A. Y. 2002 Acute stress reactions in adultsBiological Psychiatry 51 532CrossRefGoogle ScholarPubMed
Shay, J. 1994 Achilles in Vietnam: Combat trauma and the undoing of characterNew YorkScribnerGoogle Scholar
Shay, J. 2002 Odysseus in America: Combat trauma and the trials of homecomingNew YorkScribnerGoogle Scholar
Stahl, S. M. 2009 Crisis in army psychopharmacology and mental health care at Fort HoodCNS Spectrums 14 677CrossRefGoogle ScholarPubMed
Starr, B. 2002 http://archives.cnn.com/2002/US/07/26/army.wives
Stewart, P. 2009 Reutershttp://www.reuters.com/article/idUSN1752246
Taft, C. T.Stern, A. S.King, L. A.King, D. A. 1999 Modeling physical health and functional health status: the role of combat exposure, posttraumatic stress disorder, and personal resource attributesJournal of Traumatic Stress 12 3CrossRefGoogle ScholarPubMed
Tyson, A. S. 2009 http://www.washingtonpost.com/wp-dyn/content/article/2009/11/17/AR2009111703426.html
US Army 2006 Combat and operational stress controlWashington, DCDepartment of the Army,http://www.fas.org/irp/doddir/army/fm4–02–51.pdfGoogle Scholar
US Army Center for Health Promotion and Preventive Medicine 2009 Washington, DCUS Army Center for Health Promotion and Preventive Medicinehttp://www.armymedicine.army.mil/reports/FinalRedactedEpiconReport14July2009.pdf
US Department of Defense Task Force on Mental Health 2007 An achievable vision: Report of the Department of Defense Task Force on Mental HealthFalls Church, VADefense Health BoardGoogle Scholar
von Clausewitz, C. 1982 On warNew YorkPenquin BooksGoogle Scholar
Waller, M. A. 2001 Resilience in ecosystemic context: evolution of the conceptAmerican Journal of Orthopsychiatry 71 290CrossRefGoogle Scholar
Whealin, J. M.Ruzek, J. I.Southwick, S. 2008 Cognitive behavioral theory and preparation for professionals at risk for trauma exposureTrauma, Violence, and Abuse 9 100CrossRefGoogle ScholarPubMed

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