Special Operations Personnel Research Articles

Neurological Effects of Repeated Blast Exposure in Special Operations Personnel.

Exposure to blast overpressure has been a pervasive feature of combat-related injuries. Studies exploring the neurological correlates of repeated low-level blast exposure in career "breachers" demonstrated higher levels of tumor necrosis factor alpha (TNFα) and interleukin (IL)-6 and decreases in IL-10 within brain-derived extracellular vesicles (BDEVs). The current pilot study was initiated in partnership with the U.S. Special Operations Command (USSOCOM) to explore whether neuroinflammation is seen within special operators with prior blast exposure. Data were analyzed from 18 service members (SMs), inclusive of 9 blast-exposed special operators with an extensive career history of repeated blast exposures and 9 controls matched by age and duration of service. Neuroinflammation was assessed utilizing positron emission tomography (PET) imaging with [18F]DPA-714. Serum was acquired to assess inflammatory biomarkers within whole serum and BDEVs. The Blast Exposure Threshold Survey (BETS) was acquired to determine blast history. Both self-report and neurocognitive measures were acquired to assess cognition. Similarity-driven Multi-view Linear Reconstruction (SiMLR) was used for joint analysis of acquired data. Analysis of BDEVs indicated significant positive associations with a generalized blast exposure value (GBEV) derived from the BETS. SiMLR-based analyses of neuroimaging demonstrated exposure-related relationships between GBEV, PET-neuroinflammation, cortical thickness, and volume loss within special operators. Affected brain networks included regions associated with memory retrieval and executive functioning, as well as visual and heteromodal processing. Post hoc assessments of cognitive measures failed to demonstrate significant associations with GBEV. This emerging evidence suggests neuroinflammation may be a key feature of the brain response to blast exposure over a career in operational personnel. The common thread of neuroinflammation observed in blast-exposed populations requires further study.

What a Special Operations Cognitive Assessment Should Look Like.

Special Operations organizations have recently demonstrated their commitment to enhanced cognitive functioning and improving brain health through the development of a Cognitive Domain. However, as this new enterprise becomes supported by more resources and personnel, a critical question involves what cognitive assessments should be conducted to evaluate cognitive functions. The assessment itself forms a crux in the Cognitive Domain that could mislead cognitive practitioners if not properly applied. Here, the discussion addresses the most important criteria to satisfy in the development of a Special Operations cognitive assessment, including operational relevance, optimization, and speed. Cognitive assessments in this domain must incorporate the following: (1) a task with clear operational relevance to ensure meaningful results, (2) no ceiling effects so that performance can support cognitive enhancement initiatives, and (3) the task itself should impose a minimal time requirement to avoid creating a substantial logistical burden. A dynamic threat assessment task supported by drift diffusion modeling can meet all requisite criteria, while also providing more insight into decision parameters of Special Operations personnel than any currently used test. The discussion concludes with a detailed description of this recommended cognitive assessment task, as well as the research and development steps needed to support its application.

Overhead Squat Mobility Assessment Does Not Detect Differences By Injury Type In Special Operations Personnel

Overhead Squat Mobility Assessment Does Not Detect Differences By Injury Type In Special Operations Personnel

The impact of interrogation stress on compliance and suggestibility in U.S. military special operations personnel

The present study was performed to test whether acute stress exposure would significantly increase human compliance and suggestibility. One hundred active duty military participants enrolled in military survival school training were randomized to receive the Gudjonsson Compliance and Suggestibility Scales (GCS and GSS) prior to, during or after exposure to interrogation stress. All participants were also assessed prior to, and after stress exposure for symptoms of dissociation. Stress exposure significantly increased compliance in individuals who exhibited a pre-stress propensity to dissociation; stress exposure significantly increased suggestibility. These data support the view that some individuals are more likely than others to experiencing an increase in compliance and in suggestibility if exposed to interrogation stress. These data also suggest that individuals who are vulnerable to stress induced increases in suggestibility and compliance can be identified using psychological measures of dissociation. La présente étude a été réalisée pour tester si l’exposition au stress aigu augmenterait significativement l’observance humaine et la suggestibilité. Cent participants militaires en service actif inscrits à une formation dans une école de survie militaire ont été randomisés pour recevoir les échelles de conformité et de suggestibilité Gudjonsson (GCS et GSS) avant, pendant ou après l’exposition au stress de l’interrogatoire. Tous les participants ont également été évalués avant et après l’exposition au stress pour les symptômes de dissociation. L’exposition au stress augmentait significativement l’observance chez les individus qui présentaient une propension à la dissociation avant le stress. L’exposition au stress augmentait considérablement la suggestibilité. Ces données soutiennent l’idée que certaines personnes sont plus susceptibles que d’autres de connaître une augmentation de la conformité et de la suggestibilité si elles sont exposées au stress de l’interrogatoire. Ces données suggèrent également que les personnes vulnérables à l’augmentation de la suggestibilité et de l’observance induites par le stress peuvent être identifiées à l’aide de mesures psychologiques de dissociation.

Reliability and Factors Associated with False Positives on the Vestibular/Ocular Motor Screening (VOMS) Tool in US Military Personnel

Abstract Purpose The US Military recently added the Vestibular/Ocular Motor Screening (VOMS) to the Military Acute Concussion Evaluation-2 (MACE-2). However, there are no published data on the VOMS in US military personnel. The purpose of this study was to examine the reliability of the VOMS and factors associated with false positives in healthy US Army Special Operations (USASOC) personnel. Methods 206 healthy USASOC military personnel aged 18–40 completed VOMS between March 2018 – January 2019. Analyses included internal consistency, false-positive rates, intraclass correlation coefficients (ICC), chi-square analyses with odds ratios (OR), and independent samples t-tests. VOMS clinical cut-off scores (2+ on any symptom, >5cm for NPC) were used to determine false positives. Results Reliability for the VOMS symptom items (Cronbach alpha=.98, ICC=.90) and NPC distance (Cronbach’s alpha=.98, ICC=.93) were high. False positive rates ranged from 10.2% (smooth pursuits) to 16.9% (NPC distance). Concussion history was associated with a 2.5 fold increase for one or more VOMS items above cut-offs (p=.01). Participants with at least one VOMS item above cut-offs were deployed nearly 6 months longer on average than those without (p=.04). Conclusion The findings indicate that VOMS is reliable in US military personnel with few false positives. False positives were associated with concussion history and longer deployment history, which should be considered by military medical providers when administering and interpreting VOMS in this population. Moving forward, researchers should examine the stability of VOMS and its ability to identify mTBI in this population.

Association between leukocyte telomere length and hostility in US army service members

Hostility is a common form of emotionally charged anger which can lead to maladaptive and unhealthy behaviors. Significant association between shortened telomeres and greater levels of hostility has been observed in civilian populations, but has not yet been comprehensively studied in military populations. Our study investigates the relationship between hostility, post-traumatic stress disorder (PTSD), and leukocyte telomere length (LTL) in a sample of United States Army Special Operations personnel (n = 474) who deployed to Iraq and/or Afghanistan as part of combat operations. Hostility was measured with five items from the Brief Symptom Inventory (BSI). PTSD was determined using the PTSD Checklist (PCL) total score. The LTL was assessed using quantitative polymerase chain reaction methods and regression analyses were conducted to determine the association of hostility and telomere length. PTSD subjects reported higher hostility scores compared with those without PTSD. Among the participants with PTSD, those with medium or high level of hostility had shorter LTL than those with low level hostility (P < 0.01). Stepwise regression indicated that hostility level and age, but not gender and PTSD, were negatively correlated with LTL. Univariate regression showed that total hostility score was negatively associated with LTL (CI= −0.06 to −0.002, Beta= −0.095, p < 0.039) as well as a significant correlation between LTL and hostility impulses (HI) (CI= −0.108 to −0.009, Beta= −0.106, p < 0.021) and hostility controlling (HC) (CI= −0.071 to −0.002, Beta= −0.095, p < 0.004). Multiple regression analyses revealed that, while HC has no significant association with LTL, HI was still negatively correlated with LTL (p = 0.021). Our data indicates that LTL is associated with HI levels. Prevention and treatment efforts designed to reduce hostility may help mitigate risk for LTL shortening, a process of cellular aging, and thus slow accelerated aged-related health outcomes.

Performance Enhancement Assessment and Coaching in US Army Special Operations: Rapidly Enhancing Performance Through Targeted, Tailored Feedback.

Performance enhancement coaching poses significant benefits to individuals and organizations, such as improved job satisfaction and goal achievement. Given their training and experience in assessment and feedback, operational psychologists assigned to Special Operations units are uniquely positioned to provide performance enhancement coaching tailored to Operators and enablers. A preliminary program evaluation was conducted of the Performance Enhancement Assessment and Coaching (PEAC) Program. A sample of 32 Operators and enablers assigned to a US Army Special Operations Forces (ARSOF) unit voluntarily participated in the PEAC Program and completed one 90-minute coaching session. Following their coaching session, Soldiers provided qualitative and quantitative feedback on their coaching experience. Soldiers overwhelmingly agreed that the PEAC Program was worth their time and helpful towards achieving their goals. Results indicate the PEAC Program enhanced Soldiers' perceived self-awareness, self-efficacy, and job performance. Results also suggest performance enhancement coaching may improve pass rates on interpersonally demanding Special Operations courses. Performance enhancement coaching delivers considerable value for Special Operations personnel and their organizations in relatively minimal time. Operational psychologist coaches (OPCs) assigned to Special Operations units can leverage their assessment skills to provide targeted, tailored performance enhancement coaching and increase value to their organizations.

Long-term predictive models of risk factors for early chronic kidney disease: a longitudinal study.

BackgroundThe high incidence and prevalence of chronic kidney disease (CKD) in Taiwan have produced tremendous burdens on health care resources. The work environment of air force special operations personnel engenders high psychological stress, and the resulting increased blood pressure can lead to glomerular hypertension and accelerated glomerular injury in the long term. The aim of the study was to establish the predictive models to define the predictors of CKD.ResultsThe results indicated that the prevalence of CKD over 4 consecutive years was 3.8%, 9.4%, 9.0%, and 9.4%. The capability of using occult blood in urine to predict the risk of CKD after 1, 2, and 3 years was statistically significant. The age-adjusted odds ratio (OR) and 95% confidence interval (CI) were 7.94 (95% CI: 2.61–24.14), 12.35 (95% CI: 4.02–37.94) and 4.25 (95% CI: 1.32–13.70), respectively.DiscussionThe predictive power of occult blood in urine for the risk of CKD in each model was statistically significant. Future investigations can explore the feasibility of implementing simple and accurate urine dipsticks for preliminary testing besides annual aircrew physical examinations to facilitate early detection and treatment.MethodsThis study was a longitudinal study, in which air force special operations personnel who received physical examinations at military hospitals between 2004 and 2010 were selected. CKD was determined based on the definition provided by the US National Kidney Foundation. Overall, 212 participants that could be followed continuously for 4 years were analyzed.

Prediction equation for estimating total daily energy requirements of special operations personnel

BackgroundSpecial Operations Forces (SOF) engage in a variety of military tasks with many producing high energy expenditures, leading to undesired energy deficits and loss of body mass. Therefore, the ability to accurately estimate daily energy requirements would be useful for accurate logistical planning.PurposeGenerate a predictive equation estimating energy requirements of SOF.MethodsRetrospective analysis of data collected from SOF personnel engaged in 12 different SOF training scenarios. Energy expenditure and total body water were determined using the doubly-labeled water technique. Physical activity level was determined as daily energy expenditure divided by resting metabolic rate. Physical activity level was broken into quartiles (0 = mission prep, 1 = common warrior tasks, 2 = battle drills, 3 = specialized intense activity) to generate a physical activity factor (PAF). Regression analysis was used to construct two predictive equations (Model A; body mass and PAF, Model B; fat-free mass and PAF) estimating daily energy expenditures.ResultsAverage measured energy expenditure during SOF training was 4468 (range: 3700 to 6300) Kcal·d-1. Regression analysis revealed that physical activity level (r = 0.91; P < 0.05) and body mass (r = 0.28; P < 0.05; Model A), or fat-free mass (FFM; r = 0.32; P < 0.05; Model B) were the factors that most highly predicted energy expenditures. Predictive equations coupling PAF with body mass (Model A) and FFM (Model B), were correlated (r = 0.74 and r = 0.76, respectively) and did not differ [mean ± SEM: Model A; 4463 ± 65 Kcal·d− 1, Model B; 4462 ± 61 Kcal·d− 1] from DLW measured energy expenditures.ConclusionBy quantifying and grouping SOF training exercises into activity factors, SOF energy requirements can be predicted with reasonable accuracy and these equations used by dietetic/logistical personnel to plan appropriate feeding regimens to meet SOF nutritional requirements across their mission profile.

Social Support and Mental Health Outcomes Among U.S. Army Special Operations Personnel

Mental health disorders continue to plague service members and veterans; thus, new approaches are required to help address such outcomes. The identification of risk and resilience factors for these disorders in specific populations can better inform both treatment and prevention strategies. This study focuses on a unique population of U.S. Army Special Operations personnel to assess how specific avenues of social support and personal morale are related to mental health outcomes. The results indicate that, whereas personal morale and friend support reduce the relationship between combat experiences and posttraumatic stress disorder (PTSD), strong unit support exacerbates the negative effects of combat experiences in relation to PTSD. The study thus shows that although informal social support can lessen postdeployment mental health concerns, military populations with strong internal bonds may be at greater risk of PTSD because the support that they receive from fellow service members may heighten the traumatic impact of combat experiences.

Impact of Military Dining Facility Serving Modifications on the Nutritional Intake of Special Operations Personnel

Military dining facilities (DFAC) aim to provide a nutrient dense diet that meets all nutritional needs of Warfighter customers, but meeting the nutritional needs of Special Operations Forces (SOF) personnel with high dietary energy and protein requirements can be challenging. The purpose of this study was to assess if an SOF garrison DFAC using tailored menu modification and employing customized nutrition labeling would provide adequate energy and protein while improving the nutrient density of food consumed by personnel enrolled in the small unit tactics iteration of the rigorous Special Forces Qualification Course. Menu modifications included increased availability of fruits, vegetables, fish, and healthy fats. The labeling strategy was focused on identifying performance‐facilitating versus performance‐limiting foods to influence diner choice in an ad libitum dining environment. We evaluated three independent but consecutive classes, at the same point during the course. Group one served as baseline (N=90), and groups two (N=112) and three (N=120) served as follow‐up to menu modification, and menu modification plus labeling interventions, respectively. Nutrient intake was estimated using digital photography of all participant trays before and after meals on two consecutive days of meals, and comparisons to reference standards, and nutrient density of foods consumed was assessed using the Healthy Eating Index (HEI). Compared to baseline, total HEI score increased (62.7±8.5 vs 52.6±9.2, p&lt;0.01) and HEI across all domains increased except dairy (decreased) and vegetables (unchanged). Intakes of beta carotene and of high omega‐3 seafood increased while saturated fat intakes decreased (50±14 vs 69±22g·day−1, p&lt;0.01). Total dietary energy intake decreased (4029±894 vs 4869±1099kcal·day−1, p&lt;0.01), but was within guidelines for this population (125% of Military Dietary Reference Intakes), protein intakes were maintained at 2.0g·kg−1·day−1, sufficient for offsetting lean mass losses associated with periods of energy deficit. The decrease in dietary energy may be due to SOF personnel consuming less total fat (167 vs 205g·day−1, p&lt;0.01), and carbohydrates (481 vs 581g·day−1, p&lt;0.01). The observations indicate that modifications to the menu served to SOF personnel and employing customized nutrition labeling in the food service area can successfully increase the nutrient density and maintain adequate protein in the diets consumed by Warfighters dining ad libitum. The views expressed are those of the authors and do not reflect official policy of the Departments of the Army, Defense, or the U.S. Government.Support or Funding InformationThe study was funded by the US Army.

Vitamin D Correlation with Testosterone Concentration in US Army Special Operations Personnel

Vitamin D has been positively correlated with testosterone in older men, but these hormonal relationships have not been examined in younger, active military personnel. Therefore, the purpose of this study was to identify significant correlations between vitamin D and testosterone concentrations in male Special Operations Soldiers. This retrospective analysis examined unique cases of serum vitamin D assessments ordered at Womack Army Medical Center, Fort Bragg, NC, from January 2012 – September 2013. Inclusion criteria were male Special Operations soldiers who had a total testosterone assessment within 21 days of vitamin D assessment, yielding 312 service member records. Mean serum vitamin D concentrations were 29.9±9.6 ng/ml (range 10‐63), with 52% of subjects in the deficient range of &lt;30 ng/ml according to the Army Medical Department guidelines. In vitamin D deficient subjects, serum vitamin D concentrations were a significant positive predictor of total testosterone when controlling for age and body mass index. Independent Variable Testosterone in Vitamin D Deficient Men (n=135) β Ρ Vitamin D 8.429 0.008 Age ‐2.604 0.183 Body Mass Index ‐1.569 0.678 Model R2 0.062 These data indicate that deficient vitamin D concentrations may inhibit testosterone production and potentially limit human performance. Operational stress of military training has been shown to suppress testosterone concentrations in healthy men, causing muscle catabolism and fatigue, symptoms also characteristic of vitamin D deficiency. Given that more than half of male soldiers had insufficient vitamin D status in a southern latitude, measuring vitamin D concentrations in collaboration with testosterone assessments may be warranted.No funding was used to support this work.

The 10 commandments of nutrition: 2014.

The US Special Operations Command requires sound recommendations on nutrition to ensure optimal performance of Special Operations personnel. New information continues to emerge, and previous recommendations need to be modified as the evidence base continues to grow. The first 10 Commandments of Nutrition were published in the SEAL professional journal Full Mission Profile in 1992, published for the second time in this journal in 2005, and now revised a second time to reflect the newest science. Whether you are part of the Special Operations Forces (SOF) community or an athlete seeking to improve your performance, these are simple and helpful nutrition guidelines to follow.

Application of Entropy-weight Fuzzy Comprehensive Evaluation Method in Post Safety Competency Appraisal of Special Operation Staff in Coal Enterprises

For individual miners with the phenomenon of accident proneness, this study proposes to establish a competency model of miner safety management. On this basis, entropy-weight method is used to determine the weights of competency indexes at all levels, and fuzzy comprehensive evaluation is applied to score security competency. The computerized solving is realized with the help of Matlab programming. The results show that the entropy-weight fuzzy comprehensive evaluation method of the post safety competence of coal mine special operations personnel is feasible.

Baseline Burnout Symptoms Predict Visuospatial Executive Function During Survival School Training in Special Operations Military Personnel

Burnout symptoms, which are characterized by exhaustion, cynicism, and a reduced sense of professional efficacy, may deleteriously affect cognitive function in military personnel. A total of 32 U.S. Military Special Operations personnel enrolled in Survival School completed measures of trauma history, dissociation, and burnout before training. They then completed the Groton Maze Learning Test (GMLT), a neuropsychological measure of integrative visuospatial executive function during three field-based phases of Survival School-enemy evasion, captivity/interrogation, and escape/release from captivity. Lower pre-training perceptions of professional efficacy were associated with reduced executive function during all of the field-based phases of Survival School, even after adjustment for years of education, cynicism, and baseline GMLT scores. Magnitudes of decrements in executive function in Marines with low efficacy relative to those with high efficacy increased as training progressed and ranged from .58 during enemy evasion to .99 during escape/release from captivity. Pre-training perceptions of burnout may predict visuospatial executive function during naturalistic training-related stress in military personnel. Assessment of burnout symptoms, particularly perceptions of professional efficacy, may help identify military personnel at risk for stress-related executive dysfunction.

Commitment to Nested Collectives in Special Operations Forces

Contemporary investigations of workplace commitment include research on commitment components and commitment to multiple, and sometimes nested, work units. Research on commitment within the hierarchical military structure may be particularly reflective of these perspectives. Affective commitment to 2 nested organizational units (Special Operations Forces and the military) was hypothesized to be distinguishable from each another and from military continuance commitment. Further, a model portraying the hypothesized relations between satisfaction and affective commitment for the 2 organizational units and career intentions was examined. Special Operations personnel (n = 3,968) from 3 service branches completed satisfaction and career intentions items in addition to modified versions (Gade, Tiggle, & Schumm, 2003/this issue) of the Meyer and Allen (1984) commitment scales. Results of the research supported the distinction between the commitment scales and provided support for the model. Implications for operational environments and future research are discussed.