This study evaluates psychological treatment, specifically employing resilience treatment, as a way of helping personnel affected by trauma. Its goal is to assist the affected in preparing their minds to handle their future lives. Resilience training is a broad and essential area in today’s lives since many people across the globe face different life challenges. Hence, insights into resilience training equip with the knowledge to better cope with their situations. The study utilizes various works of literature and discusses and elaborately deduces ways in which resilience training can adequately serve as a means of mitigating the challenges resulting from trauma. Notably, the military personnel are highly susceptible to trauma compared to other people due to their encounters in uncertain deployments. Therefore, this study reviews and provides a comprehensive evaluation related to resilience training in the armed forces.
Table of Contents
Executive Summary. 1
Chapter I: Introduction. 3
General Description of the Area of Concern. 3
Definition of Terms. 7
The Significance of the Problem.. 9
Theoretical Basis for the Study. 9
Problem Statement 10
Research Questions and Hypothesis. 10
Chapter II: Literature Review.. 11
Chapter III: Methodology. 15
Research Design. 15
Data Analysis. 17
Chapter IV: Findings. 18
Chapter V: Discussion. 20
Recommendation For Future Research. 22
Works Cited. 23
Chapter I: Introduction
1. General Description of the Area of Concern.Armed forces in a country have increasingly become facilitators of all governmental efforts of keeping peace and protecting their civilians from any form of disasters. Military is like a backbone of any country that protects the government and general public from internal and external threats. In developing countries, where the public often faces mild to severe challenges of health or other natural disasters, the army is deployed to protect civilians from any form of calamity. Military units also help police in keeping peace and provide support in dealing with internal and external agents who can destabilize government.
Like other countries in the Arabian Gulf, Qatar maintains its military forces including the army, the navy, and the Emiry Guard. It also expended 1.5% of its GDP on defense as of 2010 (“SIPRIMilitary Expenditure Database”). In 2016, Qatar’s military expenditure was $4.4 billion, with a proposed increase to $7 billion by 2020 (“Future of the Qatari Defense Industry”). However,apart from protecting national interests, the Qatari military has never been deployed to international assignments.
In the present era, military forces of various countries are performing various tasks nationally and internationally such as military engagements in war-torn countries. Military officers, whether deployed inside or outside the country face, various challenges when interacting people. The deployment of forces is problematic not only for personnel but also depressing for their families. Military forces also undergo multi-national military exercises to prepare forces to be ready to face any kind of challenge, especially in disaster relief missions (Chretien et al. 178). Increasing deployment of military forces nationally and internationally keeps personnel equipped and organized with necessary skills.
Armed forces experience mental and emotional health problems with serious symptoms of Post-Traumatic Stress Disorder (PTSD) depression and suicidal thoughts, especially after deployment. According to Tanielian and Jaycox, almost 18.5% of personnel from armed forces diagnosed with PTSD or depression during deployment and approximately 7% had psychological mental health problems and Traumatic Brain Injury (TBI). In 2004, deployed U.S. troops returning home were suffering from psychological health disorders, though differences in mental health conditions varied in various groups (Hoge et al. 13). The mental health symptoms do not occur in isolation and frequently co-occur such that PTSD has common risk factor with depression.PTSD and depression symptoms were more prevalent in women than men among retuning troops, where female are seen to be at a high risk of PTSD (Ramchandet al. 56). Prevalence of PTSD and depression rate was significantly higher in troops returning from long military operations in Afghanistan and Iraq, which was different from the short 1991 Gulf War. Various studies investigated the factors associated with mental health conditions of deployed troops, both prior and after encountering with combats (Hines et al.469; Ramchand et al. 66). Despitethe vigorous relationship between war exposure and mental health conditions, it is important to investigate specific conditions that can result in poor mental health of troops before and after combat exposure. An understanding of factors associated with mental health conditions is helpful in finding suitable troops for deployment, mitigation of problems during deployment, and identifying vulnerable people.
It is important to study noncombat troop’s mental health though they seldom experience traumatic combat-related events such as gunshots, rocket attacks, explosions, and dealing with severely wounded persons. The differencebetween combatant and noncombatants during deployment is the nature of tasks and levels of engagement. The former are directly involved with the enemy and mostly serve outside the protected premises, whereas the latter are not exposed to direct adversaries and perform their professional duties within protected operating area. However, deployment is not the only source of PTSD, depression, and other mental health issues in armed forces.
Globally, most people at some point of life have been struck by a certain level of major traumas related to domestic violence, violent crime, child abuse, rape, the sudden death of loved ones, a serious automobile accident, a natural disaster, war, or a debilitating disease. Today, it is apparent that the work environment is also changing and becoming uncommon to people. As the pace of life challenges continues to grow, the ability to prepare, respond, adapt, and evolve can often mean the difference between long-term success and possible extinction. Persons who can develop resilience and agility are not only better but also more capable of thriving, a trait that can serve as a source of a better life.
Accordingly, traumatic events render the affected person into turmoil in unpredictable ways such that he or she does not respond to two people in precisely the same manner. For some, trauma resulting from the stress of a particular event develops to be chronic and lasts for years. For instance, the affected may undergo a dramatic change in appearance to become demoralized, sullen, angry, withdrawn, or even cynical. Others may become depressed and develop PTSD. Intrusive and horrific memories and endless nightmares hunt them for days, months, and even years, thus making them feel unsafe, insecure in the world, hyper-vigilant — behaviors that signify that another grave condition is about to happen. Most trauma victims choose to drink alcohol excessively and abuse drugs in order to numb their pain and dull their memories.
However, despite the impact of trauma, some people still find ways to mitigate the challenges and lead a purposeful life. For a period, after the ordeal, they may become distressed, but with time, they recover and proceed with their lives. In most cases, the survivors grow even better, stronger, and wiser as a result of the trauma. Tragedies significantly help the affected to appreciate life more, find a more important meaning of life, embark on new missions of life, and become closer to family and friends. Resilience helps people to persevere, respond to situations accordingly, adapt, and yearn for better lives than before.
Considerably, the armed forces are the most vulnerable people as far as susceptibility to trauma is concerned. They encounter unusual situations in their efforts to protect the sovereignty of their respective countries. Today, military forces of various nations serve in national and international tasks such as peacekeeping engagements in war-torn countries. Military personnel, whether deployed inside or outside the country, face significant challenges when they interact with people. The deployment of the forces is problematic not only for the officers but also depressing for families. Usually, military officers undergo multi-national military exercises aimed at preparing them in readiness to face any challenges that may erupt, especially in disaster or relief missions (Chretien et al. 174). The frequent deployments keep them equipped and organized with appropriate skills for the tasks.
Notably, armed forces experience mental and emotional health problems with severe symptoms of PTSD and suicidal thoughts, especially after deployment. The mental health consequences of wartime experiences are heavily documented and widely associated with the impact of PTSD on both military and civilian war survivors. However, the PTSD process affects these groups differently, including variation in risk factors, the severity of mental health outcomes such as depression, and the presence of protective factors.
2.Definition of Terms
It is a term that is primarily applicable in armed forces to refer to the rotation of troops into and out of an operational area. It is broadly considered as placement of the armed forces to any area of their jurisdiction within a given country in the world to fulfil the contract of service. The deployment period for the military personnel varies among nations. For instance, the deployment period for the U.S. army specifically, total mobilization period, covers 12 or more months. The pre-deployment stage begins with following orders for duty and proceeds to duty assignment in different places for a few months to a year or even more. Living away from families causes emotional upheaval for newly recruited soldiers, resulting in numbness, disorientation, sleep difficulties, loneliness, and sadness.
The term most commonly refers to a response to extreme events. It entails the capacities of people, places, and infrastructure to cope not only with hazards but also the long-term adjustment and learning processes to adapt to future threats (Fuchs and Thaler 3). Werner states that “resilience is a good development outcome despite high-risk status, sustained competence under stress, and the recovery from trauma” (81). The concept of capacities includes the physical and non-physical factors such as knowledge, motivation, institutional, and procedural capacities that permit individuals, buildings, and society to cope with events.
According to Masten, resilience is the ability to overcome adversity, which is not a personality trait but a process that strengthens individuals’ potentials (121). Psychological resilience is not confined to a personality trait, but it is a process rooted in the interaction between individuals. Resilience is the capacity to recover from any form of difficulty and not to be affected by stress and other trauma situations. For this reason, it is a positive attitude, an optimism that regulates emotions. Psychological resilience is the strength of enduring any form of traumatic stress and other adverse situations.
3.The Significance of the Problem.Armed forces experience mental and emotional health problems with severe symptoms of PTSD depression and suicidal thoughts, especially after deployment. Thus, despite a glut of research investigating military populations, much less focus has been rendered to synthesizing and integrating findings to describe the way military war survivors and civilians are comparatively affected by PTSD and resilience strategies established to help them recover from the trauma. Therefore, the area is suitable for study in order to evaluate, identify, and suggest possible remedy strategies appropriate for responding to stress resulting from military-related challenges. The purpose of this study is to draw attention to PTSD antecedents and outcomes associated with wartime in military populations. Understanding the unique impact of PTSD in the context of military status can increase the ability to provide insight and interventions when dealing with PTSD. It will also bolster the effectiveness of existing PTSD treatment by offering more targeted information.
4.Theoretical Basis for the Study.Psychological resilience is based on positive psychology movements that relate to the process of making people psychologically fit. As argued by Seligman, psychological resilience carries three qualities, namely positive emotions, positive individuals, and positive institutions (102). Positive psychology elaborates that positive feelings are contentment with the past, cheerfulness in the present, and optimistic for the future. Individual’s traits, on the other hand, include personal strengths such as the ability to do work, comparison, integrity, motivation, and self-control. Resilience is the interaction between the self of an individual, previous life experiences, and present exposure to various situations. However, sometimes, personality traits are considered as part of resilience, which is related to personality and assists in the process of adjustment after learning new experiences.
Boring emphasizes the need for a system of psychological resilience and the role of preventive measures (157). The development of such a comprehensive resilience system could make use of frameworks, which are set for recommendations toward achieving the goal and promoting prevention of adverse mental and behavioral outcomes.
5.Problem Statement.As a way to respond to the impacts of trauma in military personnel in pre-deployed and deployed conditions, the army uses educational and development programs. The programs substantiate not only stressors in the military personnel but also console their families by preparing them to adjust and cope with the stressor created during deployment through resilience building. Hoge et al. assert that several studies have indicated a positive relationship between resilience and dealing with well-being (17). Thus, resilience building training in Qatar is designed for the armed forces to develop their abilities to cope with the potentially detrimental effect of military deployments.
Military operations, especially in forward deployed positions, involve experiences with high levels of stress. Acute stress has a measurable adverse effect on soldiers’ readiness. Stress negatively affects cognitive functioning and can induce contextual fear conditioning, which could lead to the formation of stress-related disorders. Memory dysfunction, especially that of the verbal subsystem, is affected profoundly in PTSD as well as in non-injured adults and soldiers exposed to acute stress. The ability of the military to provide warriors with the means to prevent or moderate the experience of stress, which may lead to the formation of pathogenies, would be beneficial.
Research Questions and Hypothesis
Does resilience training decrease stress and trauma in armed forces before and after deployment?
Does resilience training increase the level of well-being and emotional stability?
Are there gender differences in coping with stress before and after deployment?
H0: There is the significance of resilience on stress and trauma of armed forces before and after deployment.
H0: There is the significance of resilience training on the level of well-being and emotional stability.
H0: There is the significance of gender in coping with stress before and after deployment
Chapter II: Literature Review
The current world is more complicated than ever, highly interconnected, dynamic, and characterized by uncertainty. Consequently, advancing human well-being through policy is inherently complex and challenging. Trauma and resilience informed policy development is paramount as trauma affects the well-being of people and communities, thus influencing the overall sustainability (Ferrara 4). Health is not only an essential human need but also a fundamental human right. Hence, being trauma- and resilience-informed promotes mindful practice, professional competence, and supports the recognition of human rights.
Deployment is the most challenging role of any military personnel, and it can lead to various consequences in their lives as well as their families. In combat situations, military officers undergo a high level of stress and PTSD attributed to the unique and difficult events during deployment. Stress is an inherent part of the military that potentially impairs or even compromises the readiness of armed forces. Boring explains that recent demands for multiple deployments elevate service members’ stress through family separation, the chaos of the battlefield, high risks of death, and facing the death and injury of fellow-service members (114). To deal and respond to stress requires a lot, including physical, emotional, and morals, and exposure readdress. Stressors potentially lead to stress-related ailments such as anxiety, depression, and PTSD. As a result, the general stress-related problems burden the military health system, degrade force performance and readiness, and destabilize the well-being of military personnel.
Ferrara points out that it is more beneficial to understand better the role of resilience during a traumatic experience as it is not an outcome but a process (6). It is a dynamic, multidimensional pathway formed and transformed by individually lived realities and influenced by the social context. Decision-makers, policymakers, and researchers alike are responsible for ensuring the sociopolitical context and social structures such as private, academia, public sectors, and treatment facilities, which contribute to building resources for resilience. Evidence from scholars shows that social support is essential since it offers the ability to cope and reduce emotional distress.
Based on the study by Harms and Perrewe, PTSD affects up to 8.3% of U.S. adults over their lifetime, but the number almost doubles for military war survivors (8). The authors add that well-documented outcomes of PTSD include suicide, drug and alcohol abuse, and behavioral problems at home. Besides, PTSD is often comorbid with other mental health disorders such as depression and anxiety. Due to the adverse impacts of stress and trauma, the subject of resilience training has been the epitome of discussion among the researchers globally.
In physical sciences, materials and objects are considered to be resilient if they resume their initial shape after bending or stretching. However, when it comes to people, resilience refers to the ability to “bounce back” after encountering a certain difficulty (Southwick and Charney 8). While expert psychologists define resilience in some ways, a common thread in their definitions lies in the concept of the ability to overcome adversity.
Researchers have developed various tests to measure resilience; among them are the Connor-Davidson Resilience Scale and the Response to Stressful Experience Scale (Prince-Embury and Saklofske 9). These tools are self-report instruments with a five-point Likert scale ranging from strongly agree, agree, and so on, and include statements such as ‘during and after life’s most traumatic events, I tend to find an opportunity for growth.Additional tests of resilience include the Dispositional Resilience Scale-15 that focuses on three dimensions, namely being fully engaged, having a sense of control events, and being able to view adversity as a challenge. The Resilience Scale for Children and Adolescents, on the other hand, assesses an array of attributes related to mastery, relatedness, and emotional reactivity.
The frequent and long deployments of the armed forces associated with operations and other consequences related to combat, including being subjected to stress and trauma, have tested the resilience and coping skills of military personnel and their respective families. Even though a significant number of military personnel have become resilient under a stressful situation such as deployment, many are fond of experiencing difficulties in handling stress and trauma at some point in their lives. In the recent decade, departments of defense of many countries including the United States have adopted programs that strategize in enhancing resilience training in military personnel (Meredith 19). Although scholars accept the value of resilience training, there is still a gap in empirical understanding regarding the program’s effectiveness or the extent to which they have contributed to personal resilience based on elements identified by behavioral and social science.
Schmorrow and Fidopiastisexplain that while most people can successfully respond to adverse situations, some may need help to develop these essential skills at some point during the military tenure and when returning home (58). The inability to cope with chronic and acute day-to-day stressors including separation from loved ones or adjusting to the physical and mental demands of a soldier can leave officers vulnerable to the harmful effects of stress such as substance abuse or behavioral misconduct. Teaching evidence-based strategies to promote psychological resilience, i.e. the ability to adapt to stressful situations before exposure to stress, helps in mitigating its harmful long-term effects.
Schmorrow andFidopiastisargue that the teaching programs developed are essential in strengthening psychological resilience or resilience training. However, the effectiveness of the programs is questionable. The limited body of empirical evidence within military populations and the lack of a standard definition of effective military resilience training make comparing programs difficult, while the inability to identify the effective components of a given program limits the overall utility of any concerted effort designed to develop psychological flexibility. Optimizing the program for all individuals could offer a suitable image to address urgent needs that can foster thestrategies that can foster the intended purposes of optimizing psychological health. The military personnel require a cost-effective, evidence-based psychological flexibility program that can be adaptively integrated into a variety of training approaches.
Chapter III: Methodology
1. Participants.The study entails the use of data obtained from military personnel in Qatar. The target population was Qatar Emiri Land Forces, which consists of 150 randomly selected active duty soldiers. In Qatar, a Global Assessment Tool (GAT) is administered to all soldiers annually. GAT is a type of survey tool for self-awareness that offers a snapshot of resilience and psychological health of the military personnel.
2. Measures.The dimensions of health concerns studied included social, family, and spiritual fitness. In order to evaluate the dimensions, 16 subscales optioned from GAT were adopted, which were validated measurements of psychological constructs.
3.Research Design.Resilience training is a vital event in the military resilience psychological health development initiative. The program is structured, primarily to train a soldier in readiness for deployment to cope with warzone trauma and stress. The soldiers are selected by senior leadership to attend the resilience training course held at specified camps in Qatar. For instance, the course consumes 70 hours of class time, such that most of the time is used in the skills of coping with soldiers. The exercise is done before deployment. While in training, soldiers learn core competencies in self-regulation, self-awareness, strengths of character, and coordination in wartime. The lessons have been designed to equip the officers with skills in understanding thoughts, behaviors of others and themselves, emotions, ability to discuss problems effectively. They also help them identify their strengths and those of other soldiers and overcome both team and individual challenges.
After undergoing resilience training, the GAT is then utilized to obtain assessment reports of soldiers regarding psychological health before deployment and after deployment. The researchers then evaluate the soldiers who underwent the training course and those who did not to compare the impacts of training on a soldier’s psychological health. The GAT scale used to measure the soldier’s resilience and psychological health for emotional fitness dimension as shown in figure 1 below.
1=Not like me at all
5=Very much like me
I am capable of solving a problem when something stresses me
1=Not like me at all
5=Very much like me
I am able to fit into any situation
1=Not like me at all
2=Very much like me
There is expectation of bad things to happen to me whenever something happens
Courage or bravery
1=Not at all
Depressed, hopeless, feeling down
5=Most of the time
5=most of the time
In general, I anticipate for good things to come my way thanbad ones.
Figure 1.GAT Scale utilized aspart of survey questionnaire for the study
Resilience training was evaluated by obtaining initial mean scores on the GAT after the training, which was compared to the treatment control conditions. This measure allowed researchers to determine whether the training influenced GAT scores after the military officers were subjected to training.
Data Analysis. Excel spreadsheet was used to analyze the frequencies, means, standard deviations, and the significance of various dimensions and subscales to assess the impact of resilience training on soldiers before and after training. Excel is appropriate for the study since it gives the summary and overview including the significance of each factor of assessing psychological health.
Figure 2.Data analysis used in the study pertaining survey outcomes
The changes in GAT scores before and after the training were compared across control and treatment conditions. For instance, the analysis offered a way of examining growth in soldier’s resilience and psychological health due to resilience training. Besides, demographic factors that include gender and age were considered in the analysis as a means of moderating the analysis. Resilience trainers also personally conducted their formal assessment on the impact of training. The assessment report by the experts was vital in determining what can be improved and the extent of the effects of training.
Chapter IV: Findings
The first results were obtained from the trainers who offered their expert analysis of the impacts of the training on solders. From their report, seven out of the ten trainers believed that the training was impactful in shaping their psychological health for deployment. They suggested that the lessons improved capabilities to comprehend matters better, thus fostering participants’ response to the situation. Notably, the soldiers had proper coordination in handling tasks after the training, suggesting that the resilience training impacted their mental health positively.
The analysis of data gave a comprehensive evaluation of the impacts of training. The analysis above sought to answer the questions: “Does resilience training reduce stress and trauma of armed forces soldiers during and after the deployment? Does the resilience training increase the level of well-being and the psychological health of the military personnel? Are there gender differences in coping with stress and trauma during and after deployment?” To respond, fitness scores of control and treatment were compared to determine significant differences before the training and after the training.
To find the significance of resilience training, Analysis of Variance (ANOVA) was utilized. The mean scores as shown in figure 2. present the analysis of both control and treatment conditions on each psychological health dimension or subscales. Their particular significance is shown in the column of significance. From the analysis, it is evident that there was a significant difference in treatment condition in rates of change in five dimensions and subscales of psychological health. They include emotional fitness, character, catastrophizing, friendship, and good coping. However, the control conditions showed no significance in them. Again, for catastrophizing, the treatment conditions demonstrated a significant decrease before and after training, thus implying an improvement in the psychological health of soldiers. On the other hand, control conditions depicted no significant change in catastrophizing between the two periods. On the subscale of character, control of the conditions depicted a significant decrease, hence improved psychological health, while treatment conditions demonstrated no significance across the periods.
Chapter V: Discussion
1. Summary.The study above has evaluated whether resilience training, which is the core of the program, has offered the intended impact of improving resilience and psychological health to cope with adverse conditions of deployment among military personnel. It aimed at determining whether armed forces officers subjected to the program depicted improved resilience and enhanced psychological health than those who did not undergo the training. Evidently, in most of the subscales of factors that determine improved psychological health, high scores were obtained on GAT among soldiers who received the training than those who did not. Notably, most of the psychological health factors subscales in the study demonstrated a significant change in control conditions and no significant change in treatment.
The study results answer the question of whether resilience training influences the stress and trauma of soldiers during and after deployment. From the findings, resilience training helps in reducing stress and trauma among soldiers. Additionally, the program improves the level of well-being and emotional stability of the military personnel. In addition, the conclusions of the study support the literature of other scholars on the positive impacts of resilience training.
Primarily, resilience training increases the resilience and performance of soldiers. Thus, regular training with active command supports for resilience initiatives positively influence the toughness and psychological health of the military personnel, with greater efficacy among the high-risk demographics of recruits in the service. For these reasons, resilience training should not be a one-time event but a continuous process that is thought throughout a soldier’s career and advance to become the army culture. Resilience training showed a positive impact on officers’ resilience and performance. Therefore, each soldier, through an assessment, becomes a sensor to a behavioral indicator that can inform the senior army leadership or encourage the individual to seek help. The positive outcomes have resulted from leaders adopting resilience training and skills during formations. Integrating resilience and performance enhances skills and physical performance as well as coordination as a team.
Given the rapid growth of evidence-evaluating psychological health interventions conducted among military personnel, this study sought to assess the impacts of the program of resilience training. Results indicate that the program is essential for the development of adaptive measures for soldiers to adapt to environments during deployment. Just like the finding of Watson, individual characteristics act as pre-dispositional risk factors in the role of PTSD development (7). Trauma and stress in a family of origin is a consistent predictor of PTSD among soldiers. Literature suggests that deployment stressors such as war trauma and resettlement are highly consistent with PTSD development. The findings suggest the nullification of the existing levels of resilience that individuals may rely on to combat PTSD and combat stressors in general. How individuals are aware and interpret trauma is a vital factor in the future likelihood of manifesting PTSD. Schiraldi suggested that pre-existing psychopathology mediates the relationship between early age at trauma and development of PTSD, which affect the interpretation of and response to trauma (14). Thus, it is evident that resilience, which is acquired through programs, is essential to respond better and mitigate the problem of trauma.
2. Recommendation For Future Research.The research is essentially dependent on expert judgment and qualitative research based on soldiers subjected to resilience training. In this case, the research is limited to the judgments of trainers who assessed the study population. This limitation may significantly affect the view through prejudice and biases of assessors. Besides, the research is limited to quantitative data that could enhance the reliability of the data, thus influencing the credibility of research results. Furthermore, the soldiers subjected to the program are aware of the intentions of the program, which could affect the responses in the survey data. For better results, future research should entail a distinctive data collection that employs both quantitative and qualitative data and clear sample identification with the majority of countries to give a more comprehensive overview in assessing the impacts of resilience training on soldiers.
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