Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T21:22:38.608Z Has data issue: false hasContentIssue false
  • English
  • Français

Baseline Burnout Symptoms Predict Visuospatial Executive Function During Survival School Training in Special Operations Military Personnel

Published online by Cambridge University Press:  05 April 2011

Charles A. Morgan III ,
Bartlett Russell ,
Jeff McNeil ,
Jeff Maxwell ,
Peter J. Snyder ,
Steven M. Southwick  and
Robert H. Pietrzak
Charles A. Morgan III
Affiliation:
Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
Bartlett Russell
Affiliation:
Cognitive Motor Neuroscience, Department of Kinesiology, School of Public Health, and Center for Advanced Study of Language, University of Maryland, College Park, Maryland
Jeff McNeil
Affiliation:
U.S. Army Special Operations Command, Fort Bragg, North Carolina
Jeff Maxwell
Affiliation:
U.S. Army Proving Grounds, Aberdeen, Maryland
Peter J. Snyder
Affiliation:
Rhode Island Hospital & Department of Neurology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
Steven M. Southwick
Affiliation:
Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
Robert H. Pietrzak*
Affiliation:
Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
*
Correspondence and reprint requests to: Robert H. Pietrzak, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, and Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue/151E, West Haven, CT 06516. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Burnout symptoms, which are characterized by exhaustion, cynicism, and a reduced sense of professional efficacy, may deleteriously affect cognitive function in military personnel. A total of 32 U.S. Military Special Operations personnel enrolled in Survival School completed measures of trauma history, dissociation, and burnout before training. They then completed the Groton Maze Learning Test (GMLT), a neuropsychological measure of integrative visuospatial executive function during three field-based phases of Survival School—enemy evasion, captivity/interrogation, and escape/release from captivity. Lower pre-training perceptions of professional efficacy were associated with reduced executive function during all of the field-based phases of Survival School, even after adjustment for years of education, cynicism, and baseline GMLT scores. Magnitudes of decrements in executive function in Marines with low efficacy relative to those with high efficacy increased as training progressed and ranged from .58 during enemy evasion to .99 during escape/release from captivity. Pre-training perceptions of burnout may predict visuospatial executive function during naturalistic training-related stress in military personnel. Assessment of burnout symptoms, particularly perceptions of professional efficacy, may help identify military personnel at risk for stress-related executive dysfunction. (JINS, 2011, 17, 494–501)

Keywords

BurnoutStressCognitionLearningExecutive functionMilitaryTraining
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 3 , May 2011 , pp. 494 - 501
Copyright
Copyright © The International Neuropsychological Society 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahola, K., Honkonen, T., Kivimaki, M., Virtanen, M., Isometsa, E., Aromaa, A., Lönnqvist, J. (2006). Contribution of burnout to the association between job strain and depression: The health 2000 study. Journal of Occupational and Environmental Medicine, 48, 1023–1030.Google Scholar
Benight, C.C., Bandura, A. (2004). Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behaviour Research and Therapy, 42, 1129–1148.Google Scholar
Bremner, J.D., Krystal, J.H., Putnam, F.W., Southwick, S.M., Marmar, C., Charney, D.S., Mazure, C.M. (1998). Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS). Journal of Traumatic Stress, 11, 125–136.Google Scholar
Chen, K.H., Chuah, L.Y., Sim, S.K., Chee, M.W. (2010). Hippocampal region-specific contributions to memory performance in normal elderly. Brain and Cognition, 72, 400–407.Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Connor, K.M., Davidson, J.R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82.Google Scholar
De Vente, W., Olff, M., Van Amsterdam, J.G., Kamphuis, J.H., Emmelkamp, P.M. (2003). Physiological differences between burnout patients and healthy controls: Blood pressure, heart rate, and cortisol responses. Occupational and Environmental Medicine, 60(Suppl. 1), i54–i61.Google Scholar
Gaab, J., Blattler, N., Menzi, T., Pabst, B., Stoyer, S., Ehlert, U. (2003). Randomized controlled evaluation of the effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects. Psychoneuroendocrinology, 28, 767–779.Google Scholar
Horner, M.D., Hamner, M.B. (2002). Neurocognitive functioning in posttraumatic stress disorder. Neuropsychology Review, 12, 15–30.Google Scholar
Johnson, D.C., Polusny, M.A., Erbes, C.R., King, D., King, L., Litz, B.T., Southwick, S.M. (in press). Development and initial validation of the Response to Stressful Experiences Scale (RSES). Military Medicine.Google Scholar
Lieberman, H.R., Bathalon, G.P., Falco, C.M., Kramer, F.M., Morgan, C.A. 3rd, Niro, P. (2005). Severe decrements in cognition function and mood induced by sleep loss, heat, dehydration, and undernutrition during simulated combat. Biological Psychiatry, 57, 422–429.Google Scholar
Lieberman, H.R., Bathalon, G.P., Falco, C.M., Morgan, C.A. 3rd, Niro, P.J., Tharion, W.J. (2005). The fog of war: Decrements in cognitive performance and mood associated with combat-like stress. Aviation, Space, and Environmental Medicine, 76(7 Suppl.), C7–C14.Google ScholarPubMed
Maslach, C., Jackson, S.E., Leiter, M.P. (1996). Maslach Burnout Inventory manual. Palo Alto, CA: Consulting Psychologist Press.Google Scholar
Maslach, C., Schaufeli, W.B., Leiter, M.P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.CrossRefGoogle ScholarPubMed
Mathewson, K.J., Dywan, J., Snyder, P.J., Tays, W.J., Segalowitz, S.J. (2008). Aging and electrocortical response to error feedback during a spatial learning task. Psychophysiology, 45, 936–948.Google Scholar
Morgan, C.A. 3rd, Cho, T., Hazlett, G., Coric, V., Morgan, J. (2002). The impact of burnout on human physiology and on operational performance: A prospective study of soldiers enrolled in the combat diver qualification course. Yale Journal of Biology and Medicine, 75, 199–205.Google ScholarPubMed
Morgan, C.A. 3rd, Doran, A., Steffian, G., Hazlett, G., Southwick, S.M. (2006). Stress-induced deficits in working memory and visuo-constructive abilities in Special Operations soldiers. Biological Psychiatry, 60, 722–729.CrossRefGoogle ScholarPubMed
Morgan, C.A. 3rd, Hazlett, G., Wang, S., Richardson, E.G. Jr., Schnurr, P., Southwick, S.M. (2001). Symptoms of dissociation in humans experiencing acute, uncontrollable stress: A prospective investigation. American Journal of Psychiatry, 158, 1239–1247.Google Scholar
Morgan, C.A. 3rd, Krystal, J.H., Southwick, S.M. (2003). Toward early pharmacological posttraumatic stress intervention. Biological Psychiatry, 53, 834–843.Google Scholar
Morgan, C.A. 3rd, Rasmusson, A., Pietrzak, R.H., Coric, V., Southwick, S.M. (2009). Relationships among plasma dehydroepiandrosterone and dehydroepiandrosterone sulfate, cortisol, symptoms of dissociation, and objective performance in humans exposed to underwater navigation stress. Biological Psychiatry, 66, 334–340.CrossRefGoogle ScholarPubMed
Morgan, C.A., Southwick, S.M., Hazlett, G., Dial-Ward, M. (2008). Baseline dissociation and prospective success in special forces assessment and selection. Psychiatry, 5, 53–58.Google ScholarPubMed
Morgan, C.A. 3rd, Wang, S., Mason, J., Southwick, S.M., Fox, P., Hazlett, G., Greenfield, G. (2000) (Hormone profiles in humans experiencing military survival training. Biological Psychiatry, 47, 891–901.Google Scholar
Ohman, L., Nordin, S., Bergdahl, J., Slunga Birgander, L., Stigsdotter Neely, A. (2007). Cognitive function in outpatients with perceived chronic stress. Scandinavian Journal of Work and Environmental Health, 33, 223–232.Google Scholar
Onen Sertoz, O., Tolga Binbay, I., Koylu, E., Noyan, A., Yildirim, E., Elbi Mete, H. (2008). The role of BDNF and HPA axis in the neurobiology of burnout syndrome. Progress in Neuropsychopharmacology and Biological Psychiatry, 32, 1459–1465.Google Scholar
Paulus, M.P., Potterat, E.G., Taylor, M.K., Van Orden, K.F., Bauman, J., Momen, N., Swain, J.L. (2009) A neuroscience approach to optimizing brain resources for human performance in extreme environments. Neuroscience and Biobehavioral Reviews, 33, 1080–1088.Google Scholar
Pickering, M.A., Hammermeister, J., Ohlson, C., Holliday, B., Ulmer, G. (2010). An exploratory investigation of relationships among mental skills and resilience in Warrior Transition Unit cadre members. Military Medicine, 175, 213–219.Google Scholar
Pietrzak, R.H., Fredrickson, A., Snyder, P.J., Maruff, P. (2010). A comparison of statistical approaches used to evaluate change in cognitive function following pharmacologic challenge: An example with lorazepam. Human Psychopharmacology, 25, 335–341.CrossRefGoogle ScholarPubMed
Pietrzak, R.H., Maruff, P., Mayes, L.C., Roman, S.A., Sosa, J.A., Snyder, P.J. (2008). An examination of the construct validity and factor structure of the Groton Maze Learning Test, a new measure of spatial working memory, learning efficiency, and error monitoring. Archives of Clinical Neuropsychology, 23, 433–445.Google Scholar
Pietrzak, R.H., Maruff, P., Snyder, P.J. (2009b). Convergent validity and effect of instruction modification on the Groton Maze Learning Test, a new measure of spatial working memory and error monitoring. International Journal of Neuroscience, 119, 1137–1149.Google Scholar
Pietrzak, R.H., Maruff, P., Snyder, P.J. (2009a). Methodological improvements in quantifying cognitive change in clinical trials: An example with single-dose administration of donepezil. Journal of Nutrition, Health, and Aging, 13, 268–273.Google Scholar
Robbins, T.W., Arnsten, A.F. (2009). The neuropsychopharmacology of fronto-executive function: Monoaminergic modulation. Annual Review of Neuroscience, 32, 267–287.CrossRefGoogle ScholarPubMed
Roelofs, J., Verbraak, M., Keijsers, G.P.J., de Bruin, M.B.N., Schmidt, A.J.M. (2005). Psychometric properties of a Dutch version of the Maslach Burnout Inventory General Survey (MBI-DV) in individuals with and without clinical burnout. Stress and Health, 21, 17–25.Google Scholar
Sandstrom, A., Rhodin, I.N., Lundberg, M., Olsson, T., Nyberg, L. (2005). Impaired cognitive performance in patients with chronic burnout syndrome. Biological Psychology, 69, 271–279.Google Scholar
Schnurr, P., Vielhauer, M., Weathers, F., Findler, M. (1999). The Brief Trauma Questionnaire. White River Junction, VT: National Center for Posttraumatic Stress Disorder.Google Scholar
Snyder, P.J., Bednar, M.M., Cromer, J.R., Maruff, P. (2005). Reversal of scopolamine-induced deficits with a single dose of donepezil, an acetylcholinesterase inhibitor. Alzheimer's & Dementia, 1, 126–135.CrossRefGoogle ScholarPubMed
Snyder, P.J., Werth, J., Giordani, B., Caveney, A.F., Feltner, D., Maruff, P. (2005). A method for determining the magnitude of change across different cognitive functions in clinical trials: The effects of acute administration of two different doses alprazolam. Human Psychopharmacology, 20, 263–273.Google Scholar
Ursin, H., Eriksen, H. (2010). Cognitive activation theory of stress (CATS). Neuroscience and Biobehavioral Reviews, 34, 877–891.Google Scholar
Whealin, J.M., Batzer, W.B., Morgan, C.A. 3rd, Detwiler, H.F. Jr., Schnurr, P.P., Friedman, M.J. (2007). Cohesion, burnout, and past trauma in tri-service medical and support personnel. Military Medicine, 172, 266–272.CrossRefGoogle ScholarPubMed
Wingenfeld, K., Schulz, M., Damkroeger, A., Rose, M., Driessen, M. (2009). Elevated diurnal salivary cortisol in nurses is associated with burnout but not with vital exhaustion. Psychoneuroendocrinology, 34, 1144–1151.Google Scholar
Wingo, A.P., Fani, N., Bradley, B., Ressler, K.J. (2010). Psychological resilience and neurocognitive performance in a traumatized community sample. Depression and Anxiety, 27, 768–774.Google Scholar