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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.

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.

Harriet Martineau analyzed the structural characteristics associated with health, sickness, medicine, occupations, and the bureaucratic administration of health care in her later writings. I concentrate here on two major examples of this type of work: England and Her Soldiers (1859a) and Health, Husbandry, and Handicraft (London: Bradbury and Evans, 1861). In this type of study, in contrast to her early non-fiction, her own illnesses and bodily difficulties are invisible. Her sympathy with the sick and ill, nonetheless, helped her maintain her interest in the topic and her sense of mission to document and discuss it.

Martineau was aided in this work through a close alliance with Florence Nightingale and together they created a public sociology with a major social impact on health, war, and occupations delivering health care. Their intellectual and personal alliance is one of the first examples of female sociologists successfully co-ordinating their work for the common good, a model also applicable to their female successors at Hull-House and the University of Chicago.

Army and Joint Transformation initiatives in U.S. national defense (Shinseki, 2000) underscore the need to plan and meet mission requirements for individual soldier and small unit deployment in “close fight” scenarios (e.g. close combat, direct fire, complex terrain). This has focused interest and attention on the need for improved individual human performance research data, models, and high-fidelity simulations that can accurately represent human behavior in individual and small unit settings. New strategies are now needed to bridge the gap between performance outcome assessment and prediction (see also Pew & Mavor, 1998). The purpose of this chapter is to address epistemological and methodological issues that are fundamentally relevant to this goal.

Job performance in the US Army is a complex construct, in part because of the stressors that soldiers face, both day-to-day and during deployment. This chapter critically reviews job performance, and the connections between performance and stress and health, discussing how findings may also be relevant within the specific context of the Army. We review established conceptualizations and metrics of job performance within the Army as well as the civilian sector. Then, we discuss the existing research on the associations between performance and stress, physical health, health behaviors, and mental health. Considering these findings, we discuss lessons learned for Army performance metrics, recommending that stress- and health-related issues be incorporated into unit and leader performance metrics, with two critical caveats: (1) data are aggregated at a company level and (2) non-reactive measures are used. Finally, we discuss how existing data repositories can facilitate future research and note potential constraints of using secondary data.

This chapter uses Goffman’s concept of total institutions in a comparative case study approach to explore the role of psychotropic drugs in the process of transinstitutionalization.

This chapter interprets psychotropic drug use across four institutionalized contexts in the United States: the active-duty U.S. military, nursing homes and long-term care facilities, state and federal prisons, and the child welfare system.

This chapter documents a major unintended consequence of transinstitutionalization – the questionable distribution of psychotropics among vulnerable populations. The patterns of psychotropic use we synthesize suggest that total institutions are engaging in ethically and medically questionable practices and that psychotropics are being used to serve the bureaucratic imperatives for social control in the era of transinstitutionalization.

Psychotropic prescribing practices require close surveillance and increased scrutiny in institutional settings in the United States. The flows of mentally ill people through a vast network of total institutions raises questions about the wisdom and unintended consequences of psychotropic distribution to vulnerable populations, despite health policy makers’ efforts regulating their distribution. Medical sociologists must examine trans-institutional power arrangements that converge around the mental health of vulnerable groups.

This is the first synthesis and interpretive review of psychotropic use patterns across institutional systems in the United States. This chapter will be of value to medical sociologists, mental health professionals and administrators, pharmacologists, health system pharmacists, and sociological theorists.