This article examines the study by Lin et al, which explores the effects of night sentry duties on cardiometabolic health in military personnel. The research identifies significant correlations between the frequency of night shifts and negative cardiometabolic outcomes, such as elevated resting pulse rates and lowered levels of high-density lipoprotein cholesterol. These outcomes underscore the health risks linked to partial sleep deprivation, a common challenge in military environments. The editorial highlights the clinical significance of these findings, advocating for the implementation of targeted health interventions to mitigate these risks. Strategies such as structured sleep recovery programs and lifestyle modifications are recommended to improve the health management of military personnel engaged in nocturnal duties. By addressing these issues, military health management can better safeguard the well-being and operational readiness of its personnel.

Healthcare professionals working in the Intensive Care Unit (ICU) care for patients suffering from a critical illness and their relatives. Working within a team of people with different personalities, competencies, and specialties, with constraints and demands might contribute to a working environment that is prone to conflicts and disagreements. This highlights that the ICU is a stressful place that can threaten healthcare professionals' wellbeing. This article aims to address the concept of wellbeing by describing how the stressful ICU work-environment threatens the wellbeing of health professionals and discussing how this situation jeopardizes patient safety. To promote wellbeing, it is imperative to explore actionable interventions such as improve communication skills, educational sessions on stress management, or mindfulness. Promoting ICU healthcare professionals' wellbeing through evidence-based strategies will not only increase their personal resilience but might contribute to a safer and more efficient patient care.

The purpose of the current study was to explore the lived experiences among parent leaders and a program coordinator who participated in a parent-directed training program to support other Latine parents of children with autism spectrum disorder. We used qualitative methods to explore 4 Latine parent leaders' and 1 program coordinator's experiences with a parent-directed training program to support other Latine parents who have children with autism spectrum disorder. We interviewed parent leaders and a program coordinator to learn about their lived experiences as leaders in a parent-directed training program. The following themes emerged from Interpretative Phenomenological Analysis data analysis: (a) personal growth, (b) leadership development, (c) sense of connection and community, (d) contributing to a larger and meaningful purpose, and (e) applying knowledge and skills to help other parents. A culturally adapted parent-directed training program has the potential to positively influence Latine parent leaders who are prepared to support parents of children with ASD. There were positive program impacts on parent leaders regarding personal growth, leadership development, connection and community, contribution to a larger purpose, and use of knowledge and skills to help other parents. We also discovered the importance of building a safe community for Latine parent leaders and other parents who have children with ASD in a parent-directed training program.

Individuals in the veterinary profession are experiencing significant mental health and wellbeing challenges. A holistic view of wellbeing, which encompasses both physical and mental health, underscores their interconnected nature. This integrated approach reduces the artificial separation of wellbeing facets, and highlights how mental states influence not only individuals, but also their interactions with animals, the environment, and others in the workplace. Wellbeing challenges in veterinary medicine may contribute to negative impacts in animal, human, and environmental health. Veterinary education institutions and systems are also experiencing complex challenges as they adapt to rapidly changing societal, workforce, and professional wellbeing related pressures. This review paper explores the field of positive psychology and its application in educational contexts, commonly known as positive education. A thorough exploration of the systems-informed positive education approach and ways in which it can proactively enhance veterinary professional wellbeing from within the veterinary education ecosystem are presented. It is important to recognize that individual self-care, while valuable, cannot compensate for systemic dysfunctions such as poor team dynamics, ineffective leadership, or organizational culture issues. Addressing these systemic factors is critical for creating environments that support sustained flourishing. Positive psychology interventions delivered through the pathways of individuals, groups, and organizations specifically within a veterinary education context are discussed. Limitations, considerations, and proposed measurement strategies are reviewed. The implications of implementing a systems-informed positive psychology approach to enhance wellbeing in veterinary education include creating curriculum and cultures that enable flourishing within veterinary education institutions. Strengthening the individual and collective wellbeing of veterinary professionals has the potential to enhance the quality of care provided to animals, which has myriad positive implications for animal caregivers, their communities, the environment, and society.

A high incidence of psychosocial problems in prostate cancer patients has been reported including anxiety, depression and distress. These can add to the patients' disease burden and have been associated with unfavorable cancer treatment outcomes. Interventions designed to address them have found limited success, but psychological resilience (PR) training has never been formally tested. The measurement of PR in prostate cancer patients has been described and has been associated with more favorable psychosocial outcomes in these patients but it has never been systematically reviewed. The aim of this study was to conduct the first systematic review of those studies that have measured it using standardized scales and to determine the potential for resilience training to help overcome the significant psychosocial problems faced by prostate cancer patients.

We searched the literature to identify articles that measured PR among prostate cancer patients.

Of 384 articles identified by the search criteria, there were 19 studies suitable for inclusion regarding 5,417 patients. The most commonly-used scale was the original Connor-Davidson Resilience Scale, or an abbreviated version of it. Possible scores range from 0 to 100, mean scores from these studies ranged from 72.9 to 87.1 (standard deviations varied between 13.2 and 16.3). PR was consistently associated with improved psychological outcomes including depression, anxiety and distress, although these were measured with a wide variety of methods making it difficult to quantify the effects. There was also evidence of PR mediating the physical effects of prostate cancer and treatment including urinary symptoms, fatigue and insomnia.

As resilience training has been successful in other cancer settings, it seems likely that it could improve the significant adverse psychosocial outcomes that have been reported in prostate cancer patients and trials designed to objectively test it should be encouraged.

A Syndemic model of health experience in severe mental illness (SMI) involving modifiable health behaviour contributors has been theorised but has not yet been investigated. Over the next 10 years mental ill-health and suicidal behaviours have been predicted to increase which will decrease health experience and increase hospitalisation and associated costs. This paper investigated a Syndemic model of health experience in people with SMI informed by physical activity levels, exposure to nature, personal resilience levels, drugs related (tobacco smoking and alcohol consumption), and sleep behaviours using UK Biobank data. Results implementing SEM indicate partial evidence for a Syndemic model, with personal resilience being at its centre. Contrary to previous findings, drugs related behaviours did not play an important role in the model. Implementing a Syndemic framework approach to current health care strategies could be beneficial in the development of self-management strategies for people with SMI. This is the first paper using SEM analyses to investigate SMI under the Syndemic theory paradigm.

Adverse childhood experiences (ACEs) may result in long-term mental health complications, including post-traumatic stress disorder (PTSD). ACEs are known to be more frequent among military personnel, despite their need to maintain their mental health to accomplish their missions. Self-compassion, or treating oneself with kindness and understanding, can mitigate the psychological effects of adversity but is also affected by adversity. This cross-sectional study aimed to identify the complex relationships between ACEs, self-compassion, and PTSD symptoms among 752 new recruits of the Japan Air Self-Defense Force, of whom 537 with ACEs completed the PTSD Checklist for DSM-5. Hierarchical multiple regression analysis was used to examine the independent effect of self-compassion, measured using the Self-Compassion Scale, on PTSD symptoms. Mediation effect analysis with self-compassion as a mediator was conducted on the relationship between ACEs and PTSD symptoms. We confirmed high levels of ACEs among our participants compared to a healthy population of a previous study, and approximately 6% presented PTSD symptoms above a threshold. Self-compassion was significantly negatively associated with PTSD symptoms (β = -.22, 95% confidence interval [CI], -.34 to -.11). Mediation effect analysis revealed that self-compassion partially mediated the relationship between ACEs and PTSD symptoms, explaining 6.9% of this effect, and ACEs were negatively associated with self-compassion (β = -.13, 95% CI, -.22 to -.04). These findings suggested that self-compassion is a protective factor against PTSD symptoms, whereas ACEs can decrease self-compassion. Further research should explore educational interventions to enhance self-compassion among individuals with ACEs to mitigate PTSD symptoms.

This is the protocol for a Campbell systematic review. The objectives are as follows: What are the effects of proactive resilience programmes offered to employees in high-risk occupations on resilience and psychological adaptation?

This study aimed to fill a gap in the literature regarding the role of resilience in the relationship between symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and loss of control (LOC) eating in a nonclinical sample of emerging adults. Resilience was examined as a potential moderator and as a potential mediator of ADHD symptoms and engagement in LOC eating behaviors. Improved understanding of this relationship may inform clinical intervention and risk screening methodologies for disordered eating behaviors in college students.

Participants were undergraduate students (N = 386) from a private university in the northeastern United States. Linear regression analysis examined whether greater ADHD symptoms related to greater LOC eating. Pathway analyses examined resilience as either a moderator or mediator of the relationship between ADHD symptoms and LOC eating.

A direct positive relationship was found between ADHD symptoms and LOC eating (p < .05). Resilience partially mediated this relationship, such that increased ADHD symptoms indirectly related to increased LOC eating through low resilience (p < .05).

Findings indicate that undergraduate students with greater ADHD symptoms engaged in more frequent LOC eating, and that low resilience was a partial mediator of this positive relationship.

Military gendarmes are frequently exposed to events with traumatic impact, with negative effects on emotional and physical health. The present research aims to analyse the effectiveness of Military Resilience Training (MRTR), a psychological intervention programme developed to reduce perceived stress, increase the perception of adaptive resources and strengthen resilience. Ninety-eight participants who met the inclusion criteria were enroled in a single-blind randomized controlled trial. The psychological training programme was implemented in the intervention group (n = 48) for a duration of 5 months. The participants in the control group (n = 50) were scheduled to start the training later. The levels of perceived stress, adaptive resources and resilience were measured in all participants, from the intervention and the control group, before and after the intervention, and at a 3-month follow-up. The effects of the intervention (Cohen's d) were very high for adaptive resources (d = 0.99), self-schemes (d = 1.33), family support (d = 0.70), and partner support (d = 0.66), average for resilience (d = 0.53) and stress (d = 0.49), with very high effects on military task demands (d = 1.19) and averages for friction with authority (d = 0.51). The effects were obtained only in the intervention group, and all gains were maintained at follow-up. This study provides evidence of the effectiveness of MRTR, a psychological intervention implemented in the military gendarmerie population. In the short and long term, MRTR has significant effects in reducing perceived stress, increasing the perception of adaptive resources and strengthening the resilience of military gendarmes.

Resilience is considered as a protective factor that can assist individuals to reduce post-traumatic stress reactions. In recent years, armies in many countries have widely implemented resilience training programs before deployment to prevent or reduce post-deployment combat stress reactions. Therefore, this study aims to review what is known about resilience interventions for military personnel in pre deployment.

Based on Arskey and O'Malley's framework, a scoping review was completed. This review was performed through searching databases including PubMed, Embase, Web of Science, Medline and the Cochrane Library, and screening literature to extract data, finally summarizing the findings.

A total of 25 studies focusing on resilience interventions for military personnel in pre deployment were involved and analyzed using intervention approaches, outcome measures, intervention effects, and so on.

Based on the existing evidence in this review, it is cautiously believed that the resilience intervention program for military personnel before deployment is effective. However, there is no single effective best method even the same type intervention can make different effects in different situations and populations. Therefore, the population differences and context should be fully considered in constructing and implementing program to build military personnel resilience.

The Master Resilience Training (MRT) course is the U.S. Army's resilience program of record to develop soldiers as resilience trainers within their home units. The Walter Reed Army Institute of Research (WRAIR) recently conducted an MRT Quality Improvement Evaluation (QIE) to understand perceptions of the MRT course, determine the effectiveness of the course, and provide revision recommendations for the next iteration of the course. Soldiers who were completing the MRT course were invited to take surveys and participate in interviews. Results from quantitative and qualitative data suggest that most participants felt satisfied with the training and that it was relevant for soldiers. Most participants also agreed that the training would help them become better soldiers and leaders. Along with positive feedback about the course, participants also identified areas that could be improved. Soldier feedback along with program evaluators' observation informed recommendations for improving the overall MRT course and its implementation. Program evaluators recommend MRT participants learn fewer and less complex skills, focus on coach education throughout the course, and highlight leader development by promoting motivation and enhancing effective communication. Program evaluators recommendations for ways to improve buy-in from leaders and graduated MRTs are also discussed.

Beginning in 1999, Department of Defense policy directed the military services to develop Combat and Operational Stress Control (COSC) programs to address prevention, early identification, and management of the negative effects of combat and operational stress. The aim of this study is to provide a narrative review of COSC programs and organize them into a prevention framework to clarify gaps and future directions. A systematic search was conducted to identify studies between 2001 and 2020 in peer-reviewed articles or government-sponsored reports describing an evaluation of COSC programs. The target population of these programs was US service members who had participated in an intervention designed to address combat or operational stress in a deployed, operational, or field setting. These programs then were rated for level of evidence and categorized using a tiered prevention model. This search identified 36 published evaluations of 19 COSC programs and interventions from. Most programs were described as effective in addressing target outcomes, with behavioral health outcomes reported for 13 of the 19 identified programs; the remaining six focused on knowledge base and behavior changes. Delivery of these prevention programs also ranged from peer-based implementation to formal treatment, including programs at all prevention levels. COSC interventions show promise for helping service members manage stress, with more than half of the programs showing evidence from studies using randomized designs. Future iterations of COSC program evaluations should explore the development of a joint curriculum using existing content in a tiered prevention framework.

Psychological resilience among troops can be enhanced through relatively simple interventions. Globally, various Armed Forces have successfully implemented modules for building psychological resilience. Programs from different countries are listed, evaluated and their underpinnings explored. Recommendations for a variety of feasible and culturally acceptable interventions targeted at individuals, families, units, community and organizations in the Indian context have been made; ranging from mindfulness training to embedded combat psychologists. Interventions are likely to succeed if integrated within existing basic training and unit/career programs.

There is currently no widely accepted multidimensional health assessment questionnaire for individuals in the Chinese People Liberation Army (PLA). This study developed a multidimensional health survey questionnaire (Comprehensive Health Self-Assessment Questionnaire, CHSAQ) suitable for personnel in the PLA and conducted a preliminary examination of its reliability, validity, and discriminative ability.

After 183 items from 32 dimensions were selected to form the initial version of the CHSAQ, three groups of soldiers were selected from May 2022 to April 2023 and completed three survey rounds (with 183, 131, and 55 valid items). The items were screened based on classic test theory. After screening, the final questionnaire entries were formed, the structure of the questionnaire was explored through exploratory factor analysis and confirmatory factor analysis, and its reliability, structural validity, and discriminative ability were evaluated.

The final questionnaire consisted of 8 dimensions and 55 items on job satisfaction, anxiety and depression, daily activities, physical function, the otolaryngology system, the integumentary system, sleep disorders, and the visual system. The total cumulative variance contribution rate was 64.648% according to exploratory factor analysis. According to the confirmatory factor analysis, the normed fit index (NFI) was 0.880, and the comparison fit index (CFI) was 0.893 (close to 0.90). The Cronbach's α coefficient of the total questionnaire was 0.970, the split half reliability coefficient was 0.937, and the retest reliability coefficient was 0.902. The results are presented as different pairwise comparisons.

Our study developed a self-report questionnaire for evaluating the comprehensive health status of personnel in the PLA in accordance with the standard procedure for questionnaire development. Our findings also showed that the CHSAQ for individuals in the PLA has good reliability and structural validity.

The development of resilience is of the utmost importance in military training due to the demanding and high-stress nature of combat situations. Although there have been numerous studies on resilience competencies in the military, there is a research gap when it comes to identifying the most essential competencies that should be prioritized in training programs, particularly within compressed timeframes. With the current geopolitical landscape and ongoing military conflicts in Europe, it is necessary to expedite training of soldiers, including resilience training, without compromising the effectiveness of the program. This study aims to address this research gap by using a reductionist approach to resilience training and identifying the critical competencies that senior soldiers need to be trained to coach younger soldiers to maintain psychological strength during deployment. By filling this research gap, the study will contribute to the development of more efficient and targeted resilience training programs that optimize the ability of soldiers to adapt and excel in challenging military environments.

To address the issue, this study assessed the competencies comprising the master resilience training (MRT) program, widely recognized as one of the most effective military resilience training programs. Two groups of military experts, totaling 16 individuals, were involved in the evaluation process, representing two military contexts. The first group consisted of Ukrainian military experts whose experiences primarily focused on defending their own country's territory. The second group comprised Lithuanian military experts who had greater expertise in conducting military missions abroad. The assessment of resilience competencies was carried out using a deep analysis approach through the application of effective multi-criteria decision making (MCDM). Specifically, the decision-making trial and evaluation laboratory (DEMATEL) method was used, which is a significant multicriteria technique used to determine relationships among criteria and assign weight coefficients. In this study, the DEMATEL model was extended using trapezoidal fuzzy numbers (TrFN-DEMATEL) to accommodate decision-making under uncertainty conditions.

The research findings highlight the critical importance of three core resilience competencies: self-regulation, mental agility and strength of character. The importance of each competency varies depending on the specific military context. When defending one's own country's territory, strength of character emerges as the key factor in enhancing soldiers' mental resilience. Conversely, during military operations abroad, self-regulation is the primary factor that promotes psychological resilience. Furthermore, the results show that these three primary competencies form a 'cause group' that influences other competencies through a cause-and-effect dependency.

Based on the findings, the theoretical conclusion is drawn that the importance of resilience competencies is contextually differentiated. Furthermore, each resilience competency is associated with a set of causes or effects. These are valuable insights for improving resilience competency training programs.

Military personnel needs to be resilient to be able to remain effective, motivated, and in good mental and physical health. Military organizations select on resilience to determine whether candidates are psychologically fit for their job. The INSPIRE Resilience Scale (IRS) is such a selection instrument that aims to assess the psychological resilience potential of candidates in high-risk professions. A longitudinal predictive validity study was conducted in five European Defense organizations and in the Dutch National Police. The IRS was submitted in selection (N = 11,404), and criterion data about performance and health were collected in the second half of the first training year (N = 726). The results based on correlational and regression analyses showed that the IRS scores significantly predicted the criterion measures. Emotional stability, part of the IRS, turned out to be the best predictor. Results also showed that candidates who dropped out of training had significantly lower means on the IRS in selection than candidates who were still in training in the second half of the first training year. Overall, the IRS proved to be a valid instrument to assess resilience potential in candidates for high-risk professions. Selecting on resilience may therefore contribute to training success and reduction of health problems.

Extensive training, overuse, overexertion, and repetitive movements put Soldiers at increased risk for musculoskeletal injuries (MSIs). The present study investigated the prospective association between psychological strengths, physiological and social factors, and non-combat-related MSI in a sample of 24,746 active duty Army Soldiers. Over a mean follow-up period of 21.07 months (SD = 16.07), 65.42% of the Soldiers examined were treated for an MSI. Applying survival analysis techniques and adjusting for relevant physiological and social factors, we found greater baseline Optimism, Positive Affect, Coping, and Adaptability were each associated with a modest reduction in risk of MSI (4-8%). Additionally, being older, female, married, and having a higher BMI were each associated with an increased MSI risk, whereas being an officer (relative to enlisted) and obtaining post-secondary education were each associated with a decreased MSI risk. Future research should examine the mechanisms through which psychological-based interventions may impact Soldiers' risk of MSI.

The purpose of this study was to examine competing hypotheses (positive vs. negative) on how organizational members' familiarity with multiple stakeholders differentially relates to members' social identity and perception of leadership styles grounded in relational and emotional factors. Specifically, we developed and tested a conceptual model wherein employees' familiarity with leaders, colleagues, and externals plays a differential role in predicting the extent to which they identify with their workgroup (i.e., group member prototypicality-GMP) and perceive transformational, authentic, leader-member exchange and servant leadership styles. Moreover, we examined the moderating effect of combat experience. We tested this nomological network using structural equation modeling and invariance analyses on a sample of 435 military personnel from the Italian Army (228 combat, 207 non-combat). Results indicated an invariant pattern of relationships among variables for combat and non-combat sub-samples. Specifically, familiarity with leaders positively predicted all leadership styles and GMP. Familiarity with colleagues positively predicted only GMP, whereas familiarity with externals did not predict GMP or leadership factors. Moreover, post hoc quadratic regressions showed a curvilinear inverted-U-shaped relationship between familiarity with colleagues and GMP. Militaries with low or high levels of familiarity with colleagues reported lower levels of GMP compared to militaries with moderate levels of familiarity with colleagues. Hence, at very high levels of familiarity with colleagues, GMP begins to decrease. Theoretical and practical implications of results are discussed in light of the increasing relevance of relational and emotional factors for military leadership, and the current pandemic and geopolitical turmoil.

To support soldier readiness and mitigate the mental health consequences of deployments, Army regulation mandates soldiers to receive Deployment Cycle Resilience Training (DCRT) throughout their deployment cycle. A recent evaluation revealed several issues with the existing version that threatened the relevancy and usefulness of the training. The present article details the systematic approach taken by the Research Transition Office at the Walter Reed Army Institute of Research to revise the DCRT curriculum and presents the revision updates that are now included in DCRT version 3.

Curriculum developers (n = 2) with subject matter expertise relevant to the project followed an iterative process that was critical to the efficacy of the revisions. Developers used the existing DCRT modules as the curriculum framework and utilized several materials to inform the revisions to include Army doctrine, data from the quality improvement evaluation conducted by the Walter Reed Army Institute of Research, and the current research related to the deployment cycle, resilience, and behavior change. Internal and external stakeholders (n = 31) provided iterative feedback to ensure each of the six modules met DCRT revision objectives.

The revised DCRT curriculum was implemented in August 2021. The resulting revisions included an increase in inclusivity, an emphasis on growth opportunities, an integrative approach to the deployment cycle phases, and greater practical application. Additionally, the curriculum incorporates best practices found to enhance the delivery of resilience-based psychoeducational interventions, specifically within high-risk occupational settings like the military.

The revisions outlined in this article enhance the training quality and potential effectiveness of DCRT, which can positively influence soldier and family readiness and mission success. Furthermore, the deliberate and iterative curriculum revision process can serve as a guide to other curriculum development projects, specifically within the military context. Implementation considerations and potential limitations are provided, and future directions are discussed to include the ongoing evaluation.

Resilience is an important factor in counteracting the harmful effects of stress and is associated with healthy physiological and psychological responses to stress. Previous research has demonstrated the effectiveness of resilience fostering training programs in psychobiological stress response and recovery. Few studies, however, have examined training effects in real-life high-stress situations. In this study, we compare effects of a brief resilience training (RT) and an active control training in diversity management (DMT) on psychobiological stress response to and recovery from an intense military exercise of 81 male officer cadets. Five weeks after training completion, autonomic, endocrine, and subjective state measures of cadets were measured while undergoing stressful military exercise. The RT group perceived the military stressor as more challenging, and showed higher values in motivation and positive affect than the DMT group. Cortisol increased in both groups during stress, but showed a lower cortisol increase in the RT group thereafter. These results suggest that this brief resilience training helped cadets reframe the stressful situation in a more positive light, experiencing more positive emotions, and recovering faster from stress. To strengthen young military leaders in stressful situations, resilience promoting programs should become part of basic or leadership trainings.

Post-secondary students experience elevated levels of academic stress. The objective of the current study is to examine the relationship between a three factor model of resilience (ie, mastery, emotionality reactivity, and relatedness), mindful self-care and flourishing in first-year undergraduate students.

A sample (n = 177) of first-year undergraduates were recruited from a large urban university in Alberta during the 2019-2020 academic year.

A multiple regression analysis was utilized to examine whether the three-factor model of resilience and mindful self-care predicted flourishing in undergraduate students.

Self-reported resilience significantly predicted flourishing. Specifically, a sense of mastery and a sense of relatedness was positively associated with flourishing. Additionally, mindful self-care significantly predicted flourishing. Specifically, supportive relationships and supportive structure.

University demands are significant and academic stress reduction interventions should be offered to support students entering post-secondary education.

Dispositional optimism, the expectation of positive outcomes after personal challenges, is a resilience factor associated with widespread health benefits. However, the data on pregnancy-related outcomes are more limited.

This study aimed to assess the association of early pregnancy dispositional optimism with adverse perinatal outcomes.

This was a prospective cohort study completed between May 2019 and February 2022 at a single, large tertiary medical center. Nulliparous pregnant people were recruited from outpatient obstetrical care sites. Participants completed a validated assessment of dispositional optimism at <20 weeks of gestation and were followed up until delivery. The primary outcome was an adverse maternal outcome composite that included gestational diabetes mellitus, hypertensive disorders of pregnancy, and/or cesarean delivery. The secondary outcomes included individual composite components and a neonatal morbidity composite. Bivariate analyses compared characteristics and primary and secondary outcomes by dispositional optimism score quartile. Multivariable logistic regression compared outcomes by dispositional optimism score quartile with the highest quartile serving as the referent, controlling for confounders determined a priori.

Overall, 491 pregnant people were approached for participation, and 135 pregnant people (27.5%) declined participation. Among the 284 individuals who enrolled and had complete outcome data, the median dispositional optimism score was 16.0 (interquartile range, 14-18), and 47.9% of individuals experienced at least 1 adverse maternal outcome 135 (47.9%). After adjusting for confounders, the odds of adverse maternal outcomes were significantly higher in the lowest 2 optimism quartiles: quartile 1 (adjusted odds ratio, 3.33; 95% confidence interval, 1.57-7.36) and quartile 2 (adjusted odds ratio, 2.22; 95% confidence interval, 1.05-4.79) than the highest quartile. This was driven by significantly higher rates of hypertension (quartile 1: adjusted odds ratio, 2.62; 95% confidence interval, 1.12-6.29) and cesarean delivery (quartile 1: adjusted odds ratio, 2.75; 95% confidence interval, 1.20-6.55). There was no difference noted when quartile 3 was compared with quartile 4.

Lower early pregnancy dispositional optimism was associated with significantly higher odds of adverse maternal outcomes. Interventions targeting improvements in optimism may be a novel mechanism for reducing perinatal morbidity.

Anxiety is one of the most relevant psychiatric comorbidities in people with epilepsy (PwE). The role of resilience (RES) in the development of anxiety is not well understood. We purposed to better characterize RES impact on anxiety severity in PwE.

One hundred and seventy-six PwE underwent online surveys including a collection of socio-demographic, seizure-related, and psychological variables. PwE were grouped according to the data collected; anxiety levels were compared through non-parametric statistics. Hierarchical regression analysis (HRA) and logistic regression were performed to characterize RES contribute in predicting the presence and the severity of anxiety. Mediation/moderation analysis was performed to evaluate causal effects among RES, depression, and anxiety.

Anxiety did not differ according to socio-demographic and seizure-related variables, exemption for the presence of drug-related adverse effects. Depression, RES, and sleep quality provided the major contribute on anxiety variance. The addiction of RES level in HRA and logistic regression provided a significant increase of R-squared value (p-value = 0.02) and of area under the curve (p-value = 0.03), respectively. RES modulated depression/anxiety relationship (p-value < 0.001), whereas depression did not mediate RES/anxiety correlation (p-value = 0.68).

We demonstrated that RES is a significant independent predictor of anxiety in PwE and is able to modulate depression impact on anxiety. Moreover, we confirmed the relevance of depression and sleep quality on anxiety severity.

Burnout is a serious issue that affects physicians more than the general population; however, those with higher levels of grit and resilience have been shown to experience lower levels of burnout. The primary aim was to determine the prevalence of burnout among Jordanian orthopedic surgeons, explore its risk factors, and investigate the relationship between burnout and grit and resilience.

We conducted a questionnaire-based cross-sectional study targeting a total of 180 orthopedic surgeons attending the yearly Jordanian National Orthopedic Conference (JNOC). Non-random sampling (i.e., convenience) was utilized to recruit participants. The abbreviated Maslach Burnout Inventory, short grit scale, and Connor-Davidson Resilience Scale were used. Scores were examined using the Mann-Whitney U, Kruskal-Wallis H, and Spearman's rho tests, of which results were corrected using the Bonferroni method.

Among 135 respondents, 62.2% were specialists and 37.8% were residents. About 52.0% practiced in public hospitals. Approximately 69.0% worked for more than 50 h weekly. The prevalence of burnout among all participants was 45.2% with more frequency among residents (66.7%). Burnout and the participants' grit and resilience showed an inverse relationship (ρ = -0.441 and ρ = -0.312, respectively). Age (ρ = 0.337), number of children (ρ = 0.245), and years of experience (ρ = 0.331) were positively correlated with grit. The median score for grit was higher in physicians who had or are having their residency outside Jordan (p < 0.001). Age (ρ = 0.233) and years of experience (ρ = 0.269) were positively correlated with resilience.

Jordanian orthopedic surgeons face significant rates of burnout. Institutional efforts should be taken to detect and prevent burnout in addition to enhancing the grit and resilience among orthopedic professionals.

Chronic pain and associated interference with daily activities are common in the military and impact Force readiness. Chronic pain affects one-third of service members and is a leading cause of medical non-readiness (MNR) in the military. Research suggests that underlying psychological mechanisms related to trait coping styles and pain interference (PI) affect functional outcomes, but little research exists examining this relationship within an Army population. The purpose of this study was to examine the combined effects of PI and coping on U.S. Army soldier readiness by using annual well-being data from the Global Assessment Tool (GAT) and medical non-readiness (MNR) based on duty restriction records.

The sample comprised 866,379 soldiers who completed the GAT between 2014 and 2017 with no duty restrictions at the time of baseline GAT completion; subjects were observed through 2018 for duty restrictions. Parametric survival regression models with a Weibull distribution predicted demographic-adjusted hazards of MNR by dichotomized PI (no PI/PI) and beneficial/non-beneficial use of GAT coping components (good coping, bad coping, catastrophizing-flexibility, and catastrophizing-hopelessness). Incident MNR was evaluated for all duty restrictions, and stratified by selected body systems (upper extremity, lower extremity, psychiatric).

Among soldiers with PI, hazards were higher in those reporting non-beneficial coping styles (bad coping, hopelessness) and lower in those reporting beneficial coping styles (good coping, flexibility). Across all coping styles, PI/coping interactions were particularly strong for catastrophizing-hopelessness and when examining MNR from psychiatric conditions.

These findings suggest some synergistic associations between pain and coping that may impact pain-related occupational disability. Coping skills may be an effective interventional target for chronic pain reduction/prevention within military programs, such as the Master Resilience Training Course offered to soldiers in the Army. Further research should assess whether early coping style interventions can reduce pain-related outcomes.

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a widely used assessment of resilience. However, psychometric properties of the Chinese version of CD-RISC-10 have not been well investigated in a Chinese military personnel sample.

A total of 3,129 Chinese military personnel completed the CD-RISC-10, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Among them, 528 recruits completed the CD-RISC-10, SAS, and SDS again after 3-month basic military training (BMT). Meanwhile, the commanding officers were asked to rate recruits' training performance on the training performance rating scale for recruits (TPRS). Confirmatory factor analysis (CFA) was implemented to examine the single-factor model of the CD-RISC-10, and multigroup CFA was conducted to test measurement invariance across military rank (officers vs. enlisted), gender (male vs. female), and time (before and after 3-month BMT). Internal consistency was evaluated using Cronbach's α and McDonald's ω, and test-retest reliability was tested using the intra-class correlation coefficient (ICC). The criterion-related validity of CD-RISC was evaluated using Pearson's correlation analysis between the CD-RISC-10 total score and SAS scores, SDS scores, and training performance ratings.

The single-factor model of the CD-RISC-10 showed adequate fit (CFI = 0.955-0.970, TLI = 0.943-0.962, RMSEA = 0.059-0.072) in all examined subsamples (male, female, officer, and enlisted), and strict invariance was also supported across military rank, gender, and time (ΔCFI ≤ 0.001, ΔTLI ≤ 0.005, ΔRMSEA ≤ 0.006). The CD-RISC-10 showed good internal consistency in all subsamples (Cronbach's α of > 0.93 and McDonald's ω of > 0.93) and good test-retest reliability (ICC = 0.88). Moreover, concurrent and predictive validity with the SAS and SDS scores were good (r = -0.68 to -0.49, p < 0.001). The resilience level of recruits at the beginning of BMT was significantly associated with training performance rated by supervisors after training (r = 0.29, p < 0.001).

The psychometric evidence reported in this study suggests that the CD-RISC-10 is a reliable and valid assessment of resilience and a potential predictor for mental health and military performance in Chinese military personnel.

Grit refers to the combination of passion and perseverance for long-term goals. Grit has emerged as a recent topic of interest within the medical community. With ever-increasing rates of burnout and psychological distress, increasing attention has been directed towards modulatory or protective factors for these deleterious outcomes. Grit has been studied in regard to a variety of outcomes and variables in medicine. This article reviews the current literature on grit in medicine and summarises the current research on grit and performance metrics, personality characteristics, longitudinal progression, psychological well-being, diversity, equity and inclusion, burnout and residency attrition. While there is inconclusive evidence on the influence of grit on performance metrics in medicine, research consistently demonstrates a positive correlation between grit and psychological well-being and a negative correlation between grit and burnout. After discussing some of the inherent limitations of this type of research, this article suggests some possible implications and future areas for research and their potential role in cultivating psychologically healthy physicians and promoting successful careers in medicine.

Research on resilient functioning has gained increasing interest, and some recent studies interpreted resilience in the sense of resilient functioning to stress. In the present study, we investigated the associations between resilient functioning and coping strategies, stress reactivity, self-efficacy, and well-being, and we examined whether resilient functioning could be improved through a training intervention. The participants were 110 male cadets from two infantry officers' schools of the Swiss Armed Forces. The schools were divided into an intervention and control group. The participants in the intervention group took part in the resilience training intervention, whereas the participants in the control group performed military training as usual. Data were assessed before and after the intervention period. Results showed that resilient functioning was positively associated with task-oriented coping and well-being and negatively associated with emotion-oriented coping and stress reactivity. Furthermore, resilient functioning significantly improved in the intervention group from pre- to post-intervention. The results suggested that specific interventions have the power to increase resilient functioning.

The objective of this research was to assess the relative contribution of three resilience-related dispositional resources (trait mindfulness, core self-evaluations, and optimism) to emergency medicine physicians' fatigue, retention, and productivity.

We surveyed emergency physicians employed by a national (US) medical staffing organization. The survey included measures of work stressors, resilience resources, job search behavior, and fatigue. We linked the survey responses to objective demographic and productivity measures from the organization's records.

A total of 371 respondents completed the survey. Multiple regression analyses demonstrated support for each of the three resilience-related resources as predictors. Relative weights analyses showed that resilience accounted for 14% and 62% of the outcome variance, whereas work demands accounted for between 32% and 56%.

Multiple facets of dispositional resilience are important predictors of emergency medicine physicians' occupational health, retention, and productivity.

Exposure to stress is one of the greatest contributing factors to developing a psychiatric disorder, particularly in susceptible populations. Enhancing resilience to stress could be a powerful intervention to reduce the incidence of psychiatric disease and reveal insight into the pathophysiology of psychiatric disorders. (R,S)-ketamine and its metabolites have recently been shown to exert protective effects when administered before or after a variety of stressors and may be effective, tractable prophylactic compounds against psychiatric disease. Drug dosing, sex, age, and strain in preclinical rodent studies, significantly influence the prophylactic effects of (R,S)-ketamine and related compounds. Due to the broad neurobiological actions of (R,S)-ketamine, a variety of mechanisms have been proposed to contribute to the resilience-enhancing effects of this drug, including altering various transcription factors across the genome, enhancing inhibitory connections from the prefrontal cortex, and increasing synaptic plasticity in the hippocampus. Promisingly, select data have shown that (R,S)-ketamine may be an effective prophylactic against psychiatric disorders, such as postpartum depression (PPD). Overall, this review will highlight a brief history of the prophylactic effects of (R,S)-ketamine, the potential mechanisms underlying its protective actions, and possible future directions for translating prophylactic compounds to the clinic. This article is part of the Special Issue on 'Ketamine and its Metabolites'.

Dispositional optimism (DO) is an understudied transdiagnostic resilience factor among peripartum individuals. Low DO is associated with increased fear and pain in labor and increased rates of emergent cesarean delivery, but it is unknown whether DO is associated with perceived control over the labor process.

This a planned secondary analysis of a prospective observational cohort of term parturients (n = 164) who were recruited in July and August 2021 during their delivery hospitalization at a single, tertiary medical center. Participants completed a baseline demographic survey prior to delivery and then completed evaluations of DO (Revised Life-Orientation Test [LOT-R]) and control over the labor process (Labor Agentry Scale [LAS]) during their postpartum hospitalization. DO was dichotomized into low and high by score of ≤14 or >14 on LOT-R, respectively, and labor agentry scores were compared between groups. Maternal demographics, pregnancy, and delivery characteristics were compared by DO status. Multivariable regression was performed, adjusting for known confounders (induction, labor analgesia, and mode of delivery).

Demographic, pregnancy, and neonatal characteristics were similar between those with low compared with high DO. People with low DO had significantly higher rates of cesarean section (44 vs. 24%, p = 0.02) and overall had lower LAS scores (139.4 vs. 159.4, p < 0.001), indicating that they felt less control over their labor process than those with high DO. In the multivariable regression, those with low DO had higher odds of a low LAS score after controlling for induction, labor analgesia, and mode of delivery (adjusted odds ratio = 1.29, 95% confidence interval: 1.20-1.39).

People with low DO had significantly lower perceived control over their labor, even after controlling for differences in mode of delivery. Interventions to alter DO may be an innovative way to improve birth experience and its associated perinatal mental health morbidities.

· It is unknown if there is an association between DO and perceived labor control.. · People with low DO had higher rates of cesarean delivery and lower perceived labor control.. · Altering DO may be a novel mechanism for improving birth experience..

As performance psychology expands to address different environments, military settings are viewed as a natural extension. In certain cases, however, we suggest that a sub-optimal approach has been employed, due to a lack of specific knowledge of military culture and context, coupled with a diminished emphasis on conducting psychological research targeted directly on military performance. In this paper we explore the specific and importantly unique challenges encountered when researching and consulting with Special Operation Forces (SOF) within the North Atlantic Treaty Organization (NATO) alliance. To support both researchers and practitioners, we offer an overview of the current state of knowledge in this specific domain. We highlight key differences between SOF and conventional forces, then look at the specific requirements for developing performance psychology in the SOF context. Finally, we offer some perspectives on where opportunities might have been missed and offer some suggestions for more impactful (and accurate) research and practice.

This longitudinal study examines the growth of psychological characteristics and adaptation of physiological markers of stress during a six-month assessment and selection course for U.S. Navy SEALs. Resilience, hardiness, and grit instruments were used to evaluate the psychological characteristics. Blood samples were taken to determine physiological markers related to stress adaptation; specifically, evaluating DHEA, DHEA-to-cortisol ratio, BDNF, NPY, and cortisol. Data was collected at four timepoints throughout the assessment and selection course from 353 students over three classes. Results indicated that resilience and hardiness grow after an initial decline, DHEA and DHEA-to-cortisol increased suggesting physiological adaptation. However, psychological and physiological markers do not exhibit the same growth patterns for participants in the course. This study enhances the understanding of psychological growth and physiological adaptation in a high-stress environment over an extended duration.

Because of the outbreak of COVID-19, several colleges and universities in Xi'an, China, implemented quarantine measures and closed their gates, which increased anxiety among the students.

The Perceived Social Support Scale, Perceived Risk of COVID-19 Pandemic Scale, Connor-Davidson Resilience Scale, and Self-Rating Anxiety Scale were used for measurements. SPSS26 and AMOS26 (IBM SPSS AMOS Statistics, New York, United States) were used for data analysis. Structural equation modeling (SEM) was used to test the data from the 2,251 respondents and the hypothetical model.

The students' perceived social support was discovered to have had a significant negative effect on anxiety. The students' perceived COVID-19 risk and resilience played significant mediating roles in the relationship between social support and anxiety.

When college students feel social support and have resilience, they can reduce anxiety during the epidemic stage. Therefore, education administrators and parents should help college students to identify the current situation of the epidemic environment, enrich relevant knowledge.

Suicide rates remain high among military populations. Stigmatizing beliefs about suicide contribute to the problem of heightened suicide risk as a deterrent for help-seeking. Measurement of military suicide stigma is therefore an important gap in the literature as a necessity toward the development of military suicide prevention programming. This paper assessed the factor structure, reliability, and validity of the Military Suicide Attitudes Questionnaire (MSAQ). Study 1 featured secondary analysis of a suicide risk dataset from active duty treatment-seeking military personnel (N = 200). Study 2 was a secondary analysis of a statewide assessment of Army National Guard service members' beliefs about mental health and suicide (N =1116). Factor analyses results collectively supported a four-factor Military Suicide Attitudes Questionnaire (MSAQ) structure: discomfort, unacceptability, support, and empathic views. Subscale reliabilities ranged from 0.77 to 0.83 across samples. Unacceptability and support displayed significant negative correlations with psychological distress. Men displayed more negative suicide-related beliefs compared to women counterparts. Discomfort and unacceptability beliefs displayed significant positive associations with perceived barriers to care. The final short version of the MSAQ is an efficient, multi-dimensional measure of military suicide-related beliefs. The instrument can be used for public health assessment and program evaluation in military settings.

Patients with bipolar disorder (BD) report lower quality of life and lower levels of well-being than the general population. Despite the growing availability of psychotherapeutic and self-management interventions, important unmet needs remain. These unmet needs are closely linked to positive psychology domains. Although a growing number of studies have evaluated the impact of positive psychology interventions (PPIs) on patients with severe mental illness in general, only few have addressed the application of positive psychology for BD.

This study aimed to gain insight into the opinions of patients with BD and health care professionals about (web-based) PPIs for BD and to develop and pilot-test an app containing PPIs specifically designed for patients with BD.

The study was conducted in accordance with the Center for eHealth and Disease Management road map principles and incorporated cocreation and designing for implementation. Data were collected using focus group discussions, questionnaires, rapid prototyping, and web-based feedback on a prototype from the participants. In total, 3 focus groups were conducted with 62% (8/13) of patients with BD and 38% (5/13) of professionals. The collected data were used to develop a smartphone app containing short PPIs. The content was based on PPIs for which a solid base of evidence is available. Finally, a pilot test was conducted to test the app.

Focus groups revealed that PPIs as part of the current BD treatment can potentially meet the following needs: offering hope, increasing self-esteem, expressing feelings, acceptance, and preventing social isolation. Some patients expressed concern that PPIs may provoke a manic or hypomanic episode by increasing positive affect. The pilot of the app showed that the PPIs are moderately to highly valued by the participants. There were no adverse effects such as increase in manic or hypomanic symptoms.

With the systematic use of user involvement (patients and professionals) in all steps of the development process, we were able to create an app that can potentially fulfill some of the current unmet needs in the treatment of BD. We reached consensus among consumers and professionals about the potential benefits of PPIs to address the unmet needs of patients with BD. The use of PPI for BD is intriguing and can be usefully explored in further studies. We emphasize that more evaluation studies (quantitative and qualitative) that are focused on the effect of PPIs in the treatment of BD should be conducted. In addition, to establish the working mechanisms in BD, explorative, qualitative, designed studies are required to reveal whether PPIs can address unmet needs in BD.

In the current climate of Covid-19 and world-wide social distancing, the mental health toll has been widely reported, with an expectation that the negative impact will last beyond the lockdowns. Facing the prospect of an unknown future and continuing challenges, resilience is both topical and necessary. With a call for digitally delivered interventions to help people affected by the pandemic, this study explores how playing an online positive psychology-informed board game supported people to recognise resources for resilience. Sixteen multi-national participants played in groups of 3-4 and qualitative data, collected via focus groups, was analysed using Thematic Analysis. Participants described a broadening of resources, primarily through reflecting on and remembering prior strategies and successes. Four themes are identified which, it is suggested, facilitated this in a sequential, upward spiral; the game mechanisms (release), psychological safety (reflect), meaningful conversations (remember) and anchoring of prior experiences (reuse). Critically, this study suggests that psychological safety may have been amplified by the online environment, which participants suggested enabled them to engage without interruption or inhibition. Additionally, whilst not part of the original intervention, the post-game reflection played an essential role in meaning-making and transferring learning into real-life. Future research into how online environments might not just facilitate but augment interventions is recommended. Finally, this study calls for further research into the impact of playful positive psychology interventions, suggesting a potential development of 'serious play' towards 'seriously positive play'.

Emergency department (ED) and intensive care unit (ICU) staff experience significant and ongoing exposure to mental health trauma due to the extremely high number of tragic cases consistently seen. Despite awareness of the magnitude of this problem, there is a scarcity of clinical efforts directed toward reducing and managing secondary traumatic stress and vicarious trauma. In an effort to promote resiliency in these frontline workers, we describe development and implementation of the Adapted Peer Support Resiliency Program (APSRP), a psychoeducational and cognitive reframing behavioral-based program equipped with peer support professionals who are trained in cognitive-behavioral strategies specifically tailored toward the needs of this population. The APSRP is an adaption of concepts and coping skills utilized by the Penn Resilience Program, which has previously demonstrated efficacy in combating a range of psychological problems (e.g., anxiety, depression, substance abuse, eating disorders, and severe mental illness). The APSRP incorporates a range of cognitive-behavioral strategies inclusive of cognitive reframing skills, role-playing, and behavior rehearsal. This proposed program was facilitated and supervised by a licensed mental health professional and implemented by fellow ED and ICU peer professionals. Components of the APSRP model are discussed. Suggestions for directing future efforts within this needed area are offered.

Astronauts live and work in isolated, confined, extreme (ICE) environments that create both high stress and the need for high performance. The COVID-19 pandemic created ICE-like conditions across the globe by confining people to their homes under the ever-present threat of disease. Our goal is to understand the impact of prior experience in ICE on coping, using the pandemic as a pseudo space analog environment.

We administered a survey three times with 7 days between administrations. A total of 82 participants completed all three survey sessions, and these participants were divided into three groups for analysis. The first group is those with prior experience in an ICE environment (n = 17; 7F/10 M), the second is those aged 30-55 with a master's or doctoral degree and without prior experience (n = 22; 10F/12 M), and the third is the general population (n = 43; 27F/16 M). Linear mixed models were used for statistical analysis of the results, given the unequal sample sizes.

The experienced group did not show healthier mental health scores than the astronaut-like group, but both groups displayed higher scores than the general population. However, work productivity scores for the experienced group were higher on average than the other two groups.

Results suggest that prior experience in ICE may improve the capability to maintain productivity-corresponding to the idea of resilience. However, experience may not improve mental health maintenance, suggesting that other approaches are needed to prepare astronauts for the mental health stressors of long-duration exploration missions.