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The purpose of this study is to explore mental health difficulties, including risk and protective factors, which may impact on symptom severity after exposure to crisis situations (war, terrorism and/or natural disasters), among first responders from uniformed services.

Peer-reviewed journal articles published in English between January 2012 and March 2022 were searched in ProQuest, Wiley, Google Scholar and PubMed databases. In total, 12 articles were obtained from an original screening of 94,058 articles. Full article texts were screened for content and quality by two reviewers, with high agreeability.

Post-traumatic stress disorder and depression were the most common diagnoses. Risk factors identified were pre-deployment factors of overweight, low cognitive ability and social support, existing emotional difficulties, negative childhood experiences and stressful life events; during crisis situations factors of higher frequency and subjective severity of combat, increased rates of combat stress reaction, high levels of concerns for life and family, more stressful mission position, threat of death/severe injury and high rate of killing the enemy; and post-deployment factors, such as low social support and physical health, lack of coping mechanisms and use of avoidance strategies and social stigma. Protective factors increasing resilience and lessening symptom severity were reported as pre-deployment cognitive ability, high social support, stable physical health, effective coping, post-traumatic growth and high levels of perceived adequacy in pre-deployment preparation and training. In addition to main findings, data about author(s), publication type, population, age, type of crisis and evaluation measures were extracted. Key findings and related theories, gaps in literature and recommendations are discussed.

As yet, however, research into the factors that could serve as risk and/or protective factors are not clearly indicated in terms of post-crisis recovery. As per the authors’ knowledge, this study is an initial approach to considering this area.

Study samples, having responded to similar survey content, allowed examination of suicide risk factors for deployed soldiers relative to nondeployed or home station soldiers. Specific research questions addressed by this study are: First, what is the prevalence of suicidal behaviors among Army National Guard (ARNG) soldiers – deployed or not, and how do these rates compare with known US national and international rates? Second, what are stressful life events associated with suicidal risk? How do these compare between deployed and nondeployed soldiers? Third, what specifically about combat exposure makes soldiers at risk for suicide? And fourth, is there any evidence of stress-buffering effect between risk factors and suicidal behaviors? The paper aims to discuss these issues.

Three data sources were used. First, the responding sample for the Unit Risk Inventory consisted of 180 company-sized units with a total of 12,567 responding soldiers. Second, the responding sample for the Unit Risk Inventory-Reintegration consisted of 50 company-sized units with a total of 4,567 soldiers. The third data source was all ARNG suicides for calendar years 2007 through 2012. For each calendar year, a random sample of 1,000 ARNG soldiers was drawn to represent nonsuicides. This resulted in a study sample size of 6,523, including the 523 suicides for the years 2007 through 2012 plus 1,000 nonsuicide cases for each calendar year.

Prevalence of suicidal behaviors among soldiers was higher (for thoughts, plans, and attempts, respectively, 4-6, 1.3-2.2, and 0.7-0.08 percent) than among civilian populations (respectively, 2.6, 0.7, and 0.4 percent). Risk was highest among home station than deployed soldiers. Stressful life events associated with suicide risk included personal feelings of loneliness, anger, and frustration, followed by interpersonal behavioral problems, such as aggressive behavior toward a significant other and having committed a crime. Also evident are the beneficial effects (as a main effect and buffering effect) of feelings of cohesiveness, quality leaderships, and job satisfaction on suicidal behaviors.

Findings here were consistent with the stressor-strain hypothesis. Stressful life events were associated with suicide risk, especially, personal feelings of loneliness, anger, and frustration, followed by interpersonal behavioral problems, such as aggressive behavior toward a significant other and having committed a crime. Evident, too, were the beneficial effects of feelings of cohesiveness, quality leaderships, and job satisfaction on suicidal behaviors. Soldiers reporting these events were less likely to report suicidal behaviors and social support lessened the cumulative effect of risk factors on suicidal behaviors. Given these findings, it seems that suicide risk in the military is not uniquely different from that observed in civilian populations. The higher prevalence of suicides in the military likely has to do with proportionally more individuals who have historically shown to be at risk for suicide, namely, young males.

Strong association of individual-level attributes with suicidal behaviors, such as age, gender, and race, suggest individual-level vulnerability to suicidal behaviors. This expectation is consistent with the stress/suicide vulnerability theory (Bryan, 2014; Nock et al., 2013). Such vulnerabilities may include negative affectivity (one of the Big Five personality dimensions) and early childhood trauma to suicidal behaviors (Griffith, 2012a, 2014).

Suicide, related constructs, and their underlying processes need to be further examined in future research. Their understanding would be useful in screening individuals most at risk for suicidal behaviors, with referral and treatment, if needed. Practically, such vulnerabilities in relation to what specific experiences could be determined, potentially describing which individuals are suited best to adapt to which environments.

There has been much research on the increased suicides in the military, and to date, studies have focussed primarily on traumatic events, such as, deployments and combat exposure associated with suicidal behaviors. Yet, studies have almost exclusively examined the combat-suicide connection without reference to suicide risk factors among nondeployed or home station soldiers. This study fills this gap by examining survey responses to standardized questionnaires administered to ARNG soldiers during calendar year 2010 – one sample of deployed units either to Iraq or to Afghanistan and another sample of nondeployed or home station units.

In recent years, a wide range of psychosocial health interventions have been implemented among military service members and their families. However, there are questions over the evaluative rigor of these interventions. We conducted a systematic review of this literature, rating each relevant study (k = 111) on five evaluative rigor scales (type of control group, approach to participant assignment, outcome quality, number of measurement time points, and follow-up distality). The most frequently coded values on three of the five scales (control group type, participant assignment, and follow-up distality) were those indicating the lowest level of operationally defined rigor. Logistic regression results indicate that the evaluative rigor of intervention studies has largely remained consistent over time, with exceptions indicating that rigor has decreased. Analyses among seven military sub-populations indicate that interventions conducted among soldiers completing basic training, soldiers returning from combat deployment, and combat veterans have had, on average, the greatest evaluative rigor. However, variability in mean scores across evaluative rigor scales within sub-populations highlights the unique methodological hurdles common to different military settings. Recommendations for better standardizing the intervention evaluation process are discussed.

This chapter examines the role of stress and emotional well-being as critical antecedents of important outcomes in the military context. In it, we provide a framework for understanding the sources of stress among military personnel. Using this model, we review the risk factors associated with combat and deployment cycles in addition to protective factors, such as personality characteristics and social support, which mitigate the effects of stress on emotional well-being and performance. Finally, we evaluate efforts by military organizations to enhance the emotional well-being of service members through training programs designed to build resiliency.

We review the state of the literature concerning work–family conflict in the military, focusing on service members’ parenting roles and overall family and child well-being. This includes recognition that for many women service members, parenting considerations often arise long before a child is born, thereby further complicating work–family conflict considerations in regard to gender-specific conflict factors such as pregnancy, childbirth, postpartum, and breastfeeding. Subsequently, we consider more gender-invariant conflict factors, such as the nature of the work itself as causing conflict for the service member as parent (e.g., nontraditional hours, long separations, and child care challenges) as well as for the child (e.g., irregular contact with parent, fear for parent’s safety, and frequent relocations), and the ramifications of such conflict on service member and child well-being. Finally, we review formalized support resources that are in place to mitigate negative effects of such conflict, and make recommendations to facilitate progress in research and practice moving forward.

Expanding on earlier research, this paper aims to develop a more complete understanding of military experience as it relates to stress and burnout in law enforcement. The current study examines whether influences on stress and burnout vary between officers with military experience and officers without a military background.

Data for this study were obtained from earlier research on police staff at a Northeastern metropolitan city. A combination of analytic methods, including t‐tests and multivariate regression analysis, were used to explore the effects of variables on stress and burnout among military and non‐military officers.

The results indicate that negative exposures to demanding events influenced burnout for all officers. In contrast, negative exposures affected stress levels for those officers with no military experience. Coping techniques were important predictors of stress and burnout for both groups; however, contrary to expectations, police experience in years was not significant in any model. Demographic controls had no influence on stress and burnout for either group, with the exception of gender, which was a significant predictor of stress only for the non‐military group.

This research has implications for police departments interested in developing group‐based strategies for reducing stress and burnout among officers. The findings are limited in their capacity for wide geographical generalization, however, because this study represents the views of only one department.

In contrast with previous empirical work, the findings here demonstrate that military experience can have a favorable influence on the work outcomes of police officers. This study suggests that officers with military backgrounds are less stressed when faced with demanding situations and that military experience provides female officers with an edge in handling work‐related stressors.

The US military depends on women to meet recruiting goals, but women participate at lower rates than men. Theorists suggest that military and family policies affect women’s lower participation. Research has confirmed the impact of policy changes on women’s military service during specific time periods. The purpose of this paper is to examine how and when military policies affecting women developed over the course of history, exploring two related hypotheses: first, when women’s military participation is vital, policies affecting their military and family roles punctuate in tandem, and second, cultural values impact policy solutions to reconcile women’s roles.

Punctuated equilibrium and a women’s military participation theory informed the hypotheses. US Census and Defense Department data were used to identify periods of service when women’s military participation was vital. Historical policies were mapped and analyzed to identify policy patterns and themes affecting women’s military participation 1895–2015.

Evidence supports both hypotheses. When women are needed during wartimes, policies simultaneously encourage their service and regulate their family roles. However, policies evolved from separating servicewomen’s roles prior to the 1970s (e.g. prohibiting motherhood), to supporting their families (e.g. maternity leave) – a shift precipitated by sweeping changes in broader society and the military’s change from the draft to an All-Volunteer Force.

Findings elucidate the link between military and family policies affecting US women’s military participation and retention. Results may inform policy advocacy aimed at optimizing the US Department of Defense’s diversity efforts.

Over the course of their service, veterans are exposed to elevated levels of chronic stress that contribute to a greater prevalence of mental illness than observed in the general population. When mental illness is present, comorbidity is normative. Convergent evidence suggests that co-occurring substance use and mental illness is among the most prevalent forms of comorbidity within veteran samples. The purpose of this paper is to explore issues associated with dual diagnoses among veterans in the USA.

Research on dual diagnoses among veterans was reviewed and consolidated for presentation into three substantive content areas consisting of prevalence, associated conditions, and treatment of dual diagnoses.

Dually diagnosed veterans represent a group at particularly high risk for myriad adverse biopsychosocial and treatment outcomes, including poor health, suicidality, violence or aggressive behavior, arrest, homelessness, and unemployment. A comprehensive strategy has been implemented within the Veterans Health Administration to address dual diagnosis and related problems. Additional research is required to more readily identify co-occurring substance use and mental illness and to refine integrated intervention approaches to minimize burden while improving treatment outcomes for veterans and their families.

The current review includes a wide range of research spanning more than two decades and describing dual diagnosis among combat veterans of all modern eras. Areas in need of further research (e.g. dual diagnosis among female veterans; early detection of psychopathology and fully integrated care among returning veterans) are identified and discussed.

The purpose of this paper is to examine what helps people come through difficult events and circumstances.

A search was carried out for recent papers on adversity and thriving.

One paper reviewed 27 studies of coping and wellbeing after adversities. Maybe some kinds of adversity can help us get stronger, but people’s social contexts were not considered and the studies measured different things that may not be as easily compared as first appears. A second paper examined wellbeing at work, and reported that a certain type of supervisor is important for preventing burnout. The final paper reported on 55 people who survived depression. Many (though not all) participants felt their life was better than before. Surviving was assisted by practical and social support rather than pills.

The review of research on adversity highlights that patterns of data may look similar but may not tell us as much as we hoped. The study of workplace thriving highlighted how supervisors might support people to do their best work while preventing burnout. The study on surviving depression suggested that social resources were key to a good outcome and a better life. Social inclusion is likely to be important.

The purpose of this paper is to examine the role of suicide-related mental imagery in suicidal behavior. It was hypothesized that greater frequency and vividness of suicide-related imagery would be associated with more suicidal behaviors, and acquired capability for suicide was expected to mediate this relationship. Hypotheses were tested by surveying 237 undergraduate students (59 percent female; mean age=20) who completed self-report measures that assessed suicidal cognitions, acquired capability for suicide, and history of self-harm behaviors.

Hypotheses were tested by surveying 237 undergraduate students (59 percent female; mean age=20) who completed self-report measures that assessed suicidal cognitions, acquired capability for suicide, and history of self-harm behaviors.

Results suggested that frequency and vividness of suicide-related imagery were positively correlated with suicidality. Acquired capability was not related to study variables; thus additional mediational analysis was unwarranted.

Few studies have examined suicidal imagery and how it relates to actual self-harm behavior. The current study provides an exploratory view of features of imagery related to suicidal thoughts; findings imply that understanding mental imagery may play an important role in clinical risk assessment and treatment for suicidality.