Soldier Fitness Research Articles

Comprehensive Soldier Fitness and the future of psychology.

Psychology responded to the national needs in World War I and World War II and was itself transformed. National need calls a third time: unprecedented levels of posttraumatic stress disorder, depression, suicide, and anxiety along with a need for a resilient Army capable of meeting the persistent warfare of the foreseeable future. As a large part of the Comprehensive Soldier Fitness program, positive psychology is meeting this need with new tests, with new fitness courses, and with resilience training. These developments may transform the practice of psychology and psychology's relation to medicine and education.

The Comprehensive Soldier Fitness Program: Family skills component.

Field combat stress clinics and research have identified the signature event that precedes thoughts of suicide and homicide in combat soldiers in Iraq and Afghanistan: a distressing personal relationship event with a stateside partner. In response to this alarming information, we have identified critical factors and precipitating incidents as well as critical social skills that form the basis for changing communication between soldiers and their stateside partners. A pilot program is described that proved effective with small groups of soldiers who were led by a male-female professional team and given structured reading and social skills training exercises based on Gottman and Silver's (1999) book The seven principles for making marriage work. Recommendations for future training are made based upon our assessment of the family issues facing the combat soldier in Iraq and Afghanistan. In conclusion, we describe the family fitness interventions and program elements of the skill building trainings within the family component of the Comprehensive Soldier Fitness program, which can be delivered via online interactive technology as well as face to face with families.

Assessment for the U.S. Army Comprehensive Soldier Fitness program: The Global Assessment Tool.

Psychology and the U.S. military have a long history of collaboration. The U.S. Army Comprehensive Soldier Fitness (CSF) program aims to measure the psychosocial strengths and assets of soldiers as well as their problems, to identify those in need of basic training in a given domain as well as those who would benefit from advanced training, and then to provide that training. The goals of the CSF program include the promotion of well-being as well as the prevention of problems. Assessment is the linchpin of the CSF program, and the Global Assessment Tool (GAT) is a self-report survey that measures psychosocial fitness in emotional, social, family, and spiritual domains. We review the history of psychological assessment in the military and the lessons taught by this history. Then we describe the process by which the GAT was developed and evaluated. We conclude with a discussion of pending next steps in the development and use of the GAT.

Bringing science to bear: An empirical assessment of the Comprehensive Soldier Fitness program.

This article outlines the U.S. Army's effort to empirically validate and assess the Comprehensive Soldier Fitness (CSF) program. The empirical assessment includes four major components. First, the CSF scientific staff is currently conducting a longitudinal study to determine if the Master Resilience Training program and the Comprehensive Resilience Modules lead to lasting resilience development in soldiers. Second, the CSF program has partnered with other researchers to conduct a series of longitudinal studies examining the link between physiological, neurobiological, and psychological resilience factors. Third, the CSF program is also incorporating institutional-level data to determine if its material influences health, behavioral, and career outcomes. Fourth, group randomized trials are being conducted to ensure that resilience training incorporated under the CSF program is effective with soldiers. A specific rationale and methodologies are discussed.

The dark side of comprehensive soldier fitness.

Comprehensive Soldier Fitness (CSF), the focus of the January 2011 special issue of the American Psychologist, is a $125 million resilience training initiative designed to reduce and prevent the adverse psychological consequences of combat for soldiers and veterans. These are worthy goals. Soldiers and veterans deserve the best care possible, and military psychologists have critically important roles to play. But the special issue is troubling in several important respects. Elsewhere, we have offered a detailed review (Eidelson, Pilisuk, & Soldz, 2011). Here we offer only a summary of our concerns. The CSF program is a massive research project launched without pilot testing to determine, first, the effectiveness of the training in a military environment. This is highly irregular and obviously worrisome considering the stakes. No evidence was provided indicating that CSF received preliminary review by an independent ethics review board. There are other ethically fraught possibilities.This special issue reveals much about current moral challenges facing the profession of psychology.

Missing: Critical and skeptical perspectives on comprehensive soldier fitness.

The author read with interest, and concern, the January 2011 issue of the American Psychologist. The Special Issue on Comprehensive Soldier Fitness addressed a hugely consequential national issue and offered a vision for psychological resilience along with an elaborate set of supporting articles, concluding with some comments on "Objections" to psychologists working with the military. While a bold vision was offered and a game plan presented, no data or evidence are yet available (it is far too early in the process), and that should concern us all. The author hopes the American Psychological Association (APA) and the American Psychologist offer skeptical and critical views in future issues on the issue of the psychological health of our military and as evidence emerges regarding the Comprehensive Soldier Fitness program.

Comprehensive Soldier Fitness: Building resilience in a challenging institutional context.

The Comprehensive Soldier Fitness (CSF) program is designed to increase psychological strength and positive performance and to reduce the incidence of maladaptive responses of the entire U.S. Army. Based on the principles of positive psychology, CSF is a historically unique approach to behavioral health in a large (1.1 million members) organization. There are four program elements: (a) the assessment of emotional, social, family, and spiritual fitness; (b) individualized learning modules to improve fitness in these domains; (c) formal resilience training; and (d) training of Army master resilience trainers (MRTs) to instill better thinking skills and resilience in their subordinates. In contrast to traditional approaches, CSF is proactive; rather than waiting to see who has a negative outcome following stress, it provides ways of improving resilience for all members of the Army. CSF aims to move the full spectrum of responses to trauma and adversity-ranging from stress-related disorders to ordinary resilience-toward personal growth. This program may provide a model for implementing similar interventions in other very large institutions.

The Harvard Fatigue Laboratory: contributions to World War II

The war contributions of the Harvard Fatigue Laboratory in Cambridge, MA, were recorded in 169 Technical Reports, most of which were sent to the Office of the Quartermaster General. Earlier reports were sent to the National Research Council and the Office of Scientific Research and Development. Many of the reports from 1941 and later dealt with either physical fitness of soldiers or the energetic cost of military tasks in extreme heat and cold. New military emergency rations to be manufactured in large quantities were analyzed in the Fatigue Laboratory and then tested in the field. Newly designed cold weather clothing was tested in the cold chamber at -40 degrees F, and desired improvements were made and tested in the field by staff and soldiers in tents and sleeping bags. Electrically heated clothing was designed for high-altitude flight crews and tested both in laboratory chambers and field tests before being issued. This eye witness account of the Harvard Fatigue Laboratory during World War II was recorded by Dr. G. Edgar Folk, who is likely the sole surviving member of that famous laboratory.

Army Trying to Solve Puzzle of Rising Suicide Rates

Army Trying to Solve Puzzle of Rising Suicide Rates

Religion Often too Crucial to Ignore in Therapy

Religion Often too Crucial to Ignore in Therapy

Combat Just One Cause of Army Suicide Crisis

Back to table of contents Previous article Next article Professional NewsFull AccessCombat Just One Cause of Army Suicide CrisisAaron LevinAaron LevinSearch for more papers by this authorPublished Online:6 Mar 2009https://doi.org/10.1176/pn.44.5.0004Suicides among members of the U.S. Army increased for the fourth straight year in 2008, nearly doubling since 2004, despite the service's efforts at awareness and prevention. The Army also said that as many as 24 service members may have committed suicide in January, more than the number killed in combat in Iraq and Afghanistan that month.At least 128 suicides occurred among active-duty soldiers in 2008, and 15 cases are still under investigation by the Armed Forces medical examiner. In 2004, 67 soldiers committed suicide.The 2008 deaths represented a suicide rate of 20.2 per 100,000 active-duty personnel, up from 12.7 in 2005. The comparable, demographically adjusted rate for the overall U.S. population was 19.2 per 100,000 in 2005.Further, 43 members of the Army Reserve or National Guard not on active duty also killed themselves last year.Comparison with civilian or national rates is difficult, however, because the military background of persons committing suicide in the general population is not always recorded on death certificates.“We want the families who have lost loved ones to suicide to understand how deeply we feel their loss and that we are committed to doing everything possible to prevent this tragedy in our Army,” said Secretary of the Army Pete Geren in a statement.According to the Army, 30 percent of suicides occurred during deployment to Iraq or Afghanistan, 35 percent happened after deployment, and 35 percent occurred among troops who had never deployed to a war zone.The Army figures do not include the suicides by soldiers who have left the service. The Department of Veterans Affairs (VA) reported last year that 254 veterans (of all services) under its care who left the military between September 11, 2001, and the end of 2006 committed suicide.The rise in those numbers partly reflects the increased number of veterans leaving military service since 2001. Not all discharged military personnel choose to obtain medical care from the VA, so the VA count may underestimate the number of suicides among those who served in the two current conflicts.Suicide remains a challenge for which military leaders must identify effective prevention initiatives, said Adm. Mike Mullen, chair of the Joint Chiefs of Staff.“We have got to be able to support those individuals in ways that, in some cases, we haven't quite figured out yet,” said Mullen in a February speech at Grove City College in Pennsylvania. “Part of [the problem] has got to be the pressure of these constant deployments into combat, where young individuals ... whose lives change forever see things and do things they had never imagined.”The Army has developed or expanded programs in recent years to try to decrease the stigma surrounding mental health issues and encourage soldiers to seek help for themselves or for troubled buddies. The “Battlemind” program, originally designed to prepare soldiers psychologically for the stresses of combat, has now been expanded to include spouses and also cover the homecoming from war.“Battlemind” is part of a new Comprehensive Soldier Fitness strategy intended to give mental resiliency the same status traditionally accorded to physical health. The Army Chaplains Corps provides training for officers and soldiers in suicide risk recognition and prevention. The service has also begun hiring additional psychiatrists, psychologists, social workers, and other mental health care providers to support its troops.In January the Army ordered commanders throughout the service to hold two to four hours of suicide prevention training between February 15 and March 15, followed by a “chain-teaching” program to reach all members of the service.The deaths by suicide of four Army recruiters in the Houston area were attributed to “poor command climate, failing personal relationships, and long stressful workdays....” Those conclusions prompted Geren to order a one-day “standdown” on February 13 for all Army and Army Reserve recruiters during which they could receive training in leadership, suicide-prevention, and coping skills.To improve the research base about suicide in the armed forces, the Army also signed a memorandum of understanding with the National Institute of Mental Health last October to study ways to reduce suicide.The proposed research seeks to evaluate risk and protective factors leading to suicide-related events to influence the development of effective strategies to reduce suicide risk and enhance resilience, according to the NIMH request for applications.“This study will evaluate selected samples of soldiers across all phases of Army service, both cross-sectionally and longitudinally, including entry-level training and service, predeployment training, deployment and noncombat assignments, postdeployment, and postseparation reintegration to civilian life,” according to the Army-NIMH memo. ▪ ISSUES NewArchived

Physical Fitness, Training Volume, and Self-Determined Motivation in Soldiers during a Peacekeeping Mission

The goal was to register physical training volume and to measure changes in physical fitness in soldiers during a peacekeeping mission. The relationship between these factors and motivation for physical training was also investigated. Physical training volume was registered and maximal oxygen uptake, 3-km run time, sit-ups, push-ups, and chin-ups were tested before and after 1 year of service for 71 Norwegian soldiers in the international Kosovo Force. Self-determined motivation was measured at the end of the service. Physical training volume was 117 +/- 77 minutes/week. The average maximal oxygen uptake decreased by 2.5 +/- 0.8% (p < 0.01). Intrinsic motivation positively predicted physical training volume (p < 0.01). A large variation in training volume was found, and only one-third of the soldiers improved physical fitness and maintained body weight. Fostering intrinsic motivation toward physical training is key to increasing training volume. However, obligatory training could ensure a minimum of physical training among the soldiers who were least motivated for physical training.

Lung and blood mononuclear cell responses of tuberculosis patients to mycobacterial proteins

The differences in specificity of human lung and peripheral lymphocytes for mycobacterial antigens (Ag) need to be evaluated in order to identify vaccine candidates against pulmonary tuberculosis (TB). Therefore, the present study examined the response to low molecular weight secretory proteins of Mycobacterium tuberculosis in bronchoalveolar lavage (BAL) and peripheral blood mononuclear cells (PBMCs) from minimal pulmonary TB and non-TB patients. Ag85A, Ag85B, culture filtrate protein (CFP)-31, CFP-22.5, CFP-21, M. tuberculosis protein-64 and an as yet uncharacterised 19 kDa protein were found to be predominantly recognised by BAL cells of TB patients on the basis of lymphocyte proliferation and significant interferon-gamma release. However, recognition of CFP-8, 6-kDa early secreted antigenic target, CFP-10, CFP-14.5, M. tuberculosis secretory protein-17 and five other as yet uncharacterised low molecular weight polypeptides was found to be high on the basis of lymphocyte proliferation at the level of PBMCs. Furthermore, BAL macrophages, and not blood monocytes, were found to produce nitric oxide (NO) in response to mycobacterial Ags. Among polypeptides predominantly recognised by BAL lymphocytes, only Ag85A and Ag85B were found to induce both NO and interleukin-12 (p40) by alveolar macrophages. In conclusion, the present results indicate heterogeneity in antigen recognition by bronchoalveolar lavage cells and peripheral mononuclear blood cells of minimal tuberculosis patients, and also suggest the utility of antigen 85 complex polypeptides for the development of a future mucosal antituberculous vaccine.

Physical Fitness and Physical Training during Norwegian Military Service

Evaluate the physical fitness and training of Norwegian infantry soldiers during 10 months of compulsory military service. Maximal oxygen uptake (VO2max) and maximal numbers of sit-ups, push-ups, and chin-ups and 3-km running time were tested in 107 male infantry soldiers at the beginning and end of basic training (BT), and again at demobilization. The amount of physical training was registered throughout the military service. During BT, major improvements in sit-ups and push-ups were found. VO2max increased in soldiers with the lowest initial VO2max, but decreased to pre-BT level at demobilization. The amount of obligatory physical training was 8.5 hours x week(-1) during BT and 35% lower after BT, and was usually performed in uniform at low to moderate intensity. The amount of high-intensity endurance and strength training during compulsory military service is to low to improve the soldiers' endurance and muscular strength.

LINKING FITNESS LEVELS AND PROGRAMS TO BFORs IN THE CANADIAN FORCES

The Canadian Forces has developed bona fide occupational requirements (BFORs) for their Land Force Command. These include: a 13 km march with a 24.5 kg pack in 2 hr 26 min 20s; a casualty evacuation carrying a soldier of similar mass and height 100m in under 60s; lifting 48 ammunition boxes weighing 20.9 kg in under 5 min; shoveling. 486 m3 of gravel in under 6 min. This project was undertaken to: determine the levels in the fitness components necessary to achieve each BFOR; to establish benchmarks to monitor progress on route to the desired levels; and to design the programs to acquire the appropriate fitness level. Four levels in each fitness component were established with level 3 being the requisite to meet the BFOR's. The scores at level 3 are: The training programs were designed to progress each soldier from their initial level to level 3 over 12+ weeks with monitoring in weeks 1, 5, and 9. The programs feature prescriptions specific to each soldier's fitness status and progress over the 12 weeks from fitness-specific training to task-specific loading. The aerobic power intervals are at speeds corresponding to 90–100% VO2max and the aerobic capacity runs are at a “just talk” pace. The aerobic training begins to incorporate weight load marches in week 7 with progressions in load, distance, pace, and frequency. Strength loads are at specific RM's with reps at one less than failure. The strength training begins to incorporate ammunition box lifts, partner carries, and shoveling in week 7 with progressions in both load and reps.Table

Physical Fitness, Age, and Injury Incidence in Infantry Soldiers

Injuries are a common occurrence in young, active civilian and military populations. This study examined injury incidence and the association of musculoskeletal injuries with age and physical fitness in soldiers. Subjects were a cohort of 298 male soldiers assigned to an infantry battalion in Alaska. The soldiers' ages were obtained from the battalion records and their physical fitness was assessed from 2-mile run times, sit-ups, and push-ups. Injuries were documented from a retrospective review of the soldiers' medical records for a 6-month period (October to March) before the fitness testing. Fifty-one percent of the soldiers suffered one or more injuries. The most common injury diagnosis was musculoskeletal pain, followed by strains, sprains, and cold-related injuries. Soldiers experienced a total of 212 separate injuries, which resulted in 1764 days of limited duty. The crude annualized injury rate was 142 injuries per 100 soldiers (one soldier could experience more than one type of injury). The proportion of soldiers injured decreased as age increased. Slower 2-mile run times and fewer sit-ups were associated with a higher incidence of musculoskeletal injuries. This study documents the injury incidence in infantry soldiers and identifies younger age and low physical fitness as potential risk factors for these injuries.

Anterior Cruciate Ligament Reconstruction using the Gore-tex Ligament

Twenty two Army patients with synthetic (Gore-tex) anterior cruciate ligament (ACL) reconstructions were reviewed (mean follow up 18 months). Reconstruction appeared to abolish the pivot shift sign in all cases, but some subjective instability persisted in all but 6 patients. Outcome was also assessed by medical (PULHHEEMS) grading: 6 patients were fully fit (graded L2), 7 returned to moderate activity but not full fitness (L3), and 9 remained severely incapacitated (L7 or L8) with 4 of this group being medically discharged. Specific operative complications included: prosthesis breakage (3 partial, 1 complete), infected prosthesis(1), and problems with the tibial screw(3). The range and frequency of complications was similar in other series. Physical fitness is an integral part of a soldier's job, placing particular demands on the knee and on surgical repair of knee injuries. Reports on the Gore-tex ACL prosthesis in other groups have been more encouraging, but there are difficulties in comparing this study with others. ACL insufficiency remains a serious problem, with implications for a soldier's fitness and career. The Gore-tex prosthesis improves stability but does not always allow a soldier to return to full fitness.

A Comparison of the Health Risk, Health Status, Self-Motivation, Psychological Symptomatic Distress, and Physical Fitness of Overweight and Normal-Weight Soldiers

The purpose of this study was to analyze the assumptions underlying the Army's Weight Control Program (AWCP) and to determine whether overweight and normal-weight soldiers differed with respect to health risk, health status, self-motivation, psychological symptomatic distress, and physical fitness. The sample consisted of 154 active-duty male and female enlisted Army soldiers assigned to the Maryland and District of Washington area: 77 overweight soldiers and 77 normal-weight soldiers were randomly selected from a gender-stratified, unit-specific list. To test the hypothesis that the two groups would differ, data were analyzed using multivariate analysis of variance (MANOVA). The hypothesis was supported. The overweight and normal-weight soldiers differed, with the former having greater health risk, lower health status, and lower physical fitness; but the two groups did not differ in self-motivation or psychological symptomatic distress. These results support the concept that obesity is associated with increased morbidity. Further studies are necessary to examine the mechanisms by which endogenous physiological factors contribute to the expression of obesity.