Occupational Stress and Well-Being in Military Contexts: Volume 16

Post-traumatic stress disorder (PTSD) affects both civilian and military populations following wartime experiences. However, despite an abundance of research investigating civilian and military populations separately, much less focus has been given to synthesizing and integrating findings to describe how civilian and military war survivors are comparatively affected by PTSD. This review is broken down into three sections covering (1) risk factors associated with PTSD, (2) relationships between PTSD and mental health outcomes, and (3) protective factors that can attenuate PTSD and its effects. Each section covers findings for civilians and military personnel and highlights similarities and differences between groups.

Stress and the military go hand-in-hand, particularly in combat environments. While some personality traits or types weaken relationships between stress and performance, others, such as psychopathy, may strengthen them. In the present chapter, we consider the ramifications of individuals with high levels of psychopathy or psychopathic tendencies in the military with regard to both their own stress and performance and that of those around them. We discuss different reactions to psychological and physical stress, as well as the implications of psychopathic tendencies as they relate to current military issues, including gender, leadership, teamwork, turnover, post-traumatic stress disorder, and suicide. By juxtaposing relevant research findings on stress and psychopathy, we conclude that psychopathic tendencies should have neither uniformly negative nor positive effects on stress and performance in the military. Rather, effects on such individuals and the peripheral others with whom they interact will likely vary greatly depending on numerous factors.

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

This chapter focuses on military couples and factors that affect their experiences of work, stress, and health using a life course perspective. An introduction to the definition of military couples is provided followed by a brief review of previous research on marital quality and divorce among military couples. The core of the chapter describes the advantages of using a life course perspective to examine the military life course for couples, and two critical transitions of military life are more fully examined. Specifically, periodic relocation and deployment and their impacts on military couples are reviewed in detail. Future directions for research on military couples are provided, and the use of the Convoy Model of Social Relations as an integrative approach to examine military personnel and family members’ stress and health across the military life course is introduced.

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

The transition from military service to civilian employment is one of the most important factors related to post-service well-being and success. It is also one of the biggest challenges. The majority of veterans describe finding a job as the greatest challenge in transitioning to civilian life. While research has demonstrated a number of contributory factors related to difficulty in finding employment, a conceptual framework for understanding such challenges has yet to be proposed. Military transition theory describes the progression through which service members’ transition out of the military and illustrates how certain factors may create susceptibility to negative transition outcomes. The purpose of this chapter is to utilize the military transition theory to provide a foundation for understanding the factors related to successful transition to the civilian workplace after military separation.

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

Acute and chronic pain affects more Americans than heart disease, diabetes, and cancer combined. Conservative estimates suggest the total economic cost of pain in the United States is $600 billion, and more than half of this cost is due to lost productivity, such as absenteeism, presenteeism, and turnover. In addition, an escalating opioid epidemic in the United States and abroad spurred by a lack of safe and effective pain management has magnified challenges to address pain in the workforce, particularly the military. Thus, it is imperative to investigate the organizational antecedents and consequences of pain and prescription opioid misuse (POM). This chapter provides a brief introduction to pain processing and the biopsychosocial model of pain, emphasizing the relationship between stress, emotional well-being, and pain in the military workforce. We review personal and organizational risk and protective factors for pain, such as post-traumatic stress disorder, optimism, perceived organizational support, and job strain. Further, we discuss the potential adverse impact of pain on organizational outcomes, the rise of POM in military personnel, and risk factors for POM in civilian and military populations. Lastly, we propose potential organizational interventions to mitigate pain and provide the future directions for work, stress, and pain research.