Thomas W. Britt

Deriving benefits from stressful events: the role of engagement in meaningful work and hardiness.

This research explored the relationship between the meaningfulness of work, personality hardiness, and deriving long-term benefits from a stressful event. U.S. soldiers participating in a peacekeeping mission to Bosnia completed measures assessing the meaning of their work and personality hardiness midway through a 1-year deployment (mid-deployment) and completed a measure of deriving benefits from the deployment 4-5 months after it was over (postdeployment). Structural equation modeling revealed that personality hardiness was associated with being engaged in meaningful work during the deployment, which was strongly associated with deriving benefits from the deployment months after it was over. Enriching experiences were also associated with deriving benefits from the deployment. Discussion focuses on the linkages between personality processes, meaningful work, and deriving benefits from a stressful experience.

The Stigma of Mental Health Problems in the Military

The present review addresses the perceived stigma associated with admitting a mental health problem and seeking help for that problem in the military. Evidence regarding the public stigma associated with mental disorders is reviewed, indicating that the public generally holds negative stereotypes toward individuals with psychological problems, leading to potential discrimination toward these individuals. The internalization of these negative beliefs results in self-stigma, leading to reduced self-esteem and motivation to seek help. Even if soldiers form an intention to seek help for their psychological difficulty, barriers to mental health care may prevent the soldier from receiving the help they need. An overall model is proposed to illustrate how the stigma associated with psychological problems can prevent soldiers getting needed help for psychological difficulties and proposed interventions for reducing stigma in a civilian context are considered for military personnel.

Stigma, Negative Attitudes About Treatment, and Utilization of Mental Health Care Among Soldiers

Stigma and organizational barriers have been identified as factors for why a small proportion of soldiers with psychological problems seek professional help. In this article, we examine the impact of negative attitudes toward treatment on treatment seeking among soldiers previously deployed to Afghanistan or Iraq (n = 2,623). We asked soldiers with psychological problems questions about stigma, organizational barriers, negative attitudes toward treatment, and whether they sought treatment for their psychological problems. We found that negative attitudes about treatment inversely predicted treatment seeking. These results provide a more comprehensive examination of reasons that soldiers do not seek needed treatment and highlight the need for policy aimed at reducing negative attitudes toward mental health treatment.

Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans.

OBJECTIVES The study conducted a longitudinal assessment of insomnia as an antecedent versus consequence of posttraumatic stress disorder (PTSD) and depression symptoms among combat veterans. DESIGN Two postdeployment time points were used in combination with structural equation modeling to examine the relative strength of two possible directions of prediction: insomnia as a predictor of psychological symptoms, and psychological symptoms as a predictor of insomnia. Participants were active duty soldiers (N = 659) in a brigade combat team who were assessed 4 months after their return from a 12-month deployment to Iraq, and then again eight months later. RESULTS Although both insomnia and psychological symptoms were associated at both time periods and across time periods, insomnia at 4 months postdeployment was a significant predictor of change in depression and PTSD symptoms at 12 months postdeployment, whereas depression and PTSD symptoms at 4 months postdeployment were not significant predictors of change in insomnia at 12 months postdeployment. CONCLUSIONS Results support the role of insomnia in the development of additional psychological problems and highlight the clinical implications for combat veterans, to include the importance of longitudinal assessment and monitoring of sleep disturbances, and the need for early intervention.

Organizational Work-Family Resources as Predictors of Job Performance and Attitudes: The Process of Work-Family Conflict and Enrichment

The goal of the current study was to test a model where organizational resources (aimed at managing work and family responsibilities) predict job attitudes and supervisor ratings of performance through the mechanisms of work-family conflict and work-family enrichment. Employees (n = 174) at a large metropolitan hospital were surveyed at two time periods regarding perceptions of family supportive supervisor behaviors (FSSB), family supportive organizational perceptions (FSOP), bidirectional work-family conflict, bidirectional work-family enrichment, and job attitudes. Supervisors were also asked to provide performance ratings at Time 2. Results revealed FSSB at Time 1 predicted job satisfaction, organizational commitment and intention to leave, as well as supervisor ratings of performance, at Time 2. In addition, both work-family enrichment and family-work enrichment were found to mediate relationships between FSSB and various organizational outcomes, while work-family conflict was not a significant mediator. Results support further testing of supervisor behaviors specific to family support, as well models that include bidirectional work-family enrichment as the mechanism by which work-family resources predict employee and organizational outcomes.

Self-Engagement, Stressors, and Health: A Longitudinal Study

The authors examined whether engagement in a performance domain could buffer or exacerbate the consequences of different stressors. Soldiers completed measures of engagement in work, work demands (days training, work hours, and subjective work overload), and symptoms at two time periods. Engagement in work interacted with days training and work hours at Time 1 to predict health symptoms at Time 2 (after controlling Time 1 outcomes). Soldiers highly engaged in their jobs were less likely to report negative consequences under high levels of training/work hours in comparison to soldiers disengaged from their jobs. However, engagement in work interacted with work overload in the opposite manner, with high levels of engagement potentiating the relationship between overload and reports of health symptoms. Engagement in a domain appears to buffer individuals from stressors that do not undermine performance but may exacerbate the impact of stressors that compromise performing well in the domain.

How Leaders Can Influence the Impact That Stressors Have on Soldiers.

The present review addresses the importance of leader behaviors in influencing the extent to which various stressors soldiers experience (e.g., high workload and lack of sleep) are related to different types of strains (e.g., psychological health, poor job satisfaction, and low morale). Research conducted by the Walter Reed Army Institute of Research (WRAIR) in the area of leadership is reviewed. Researchers at the WRAIR have examined the role of leadership as a predictor of stress, as a buffer against the negative effects of stress, and as a variable that predicts or enables variables that have been found to decrease the adverse effects of stress (e.g., role clarity, self-efficacy, and job engagement). A key strength of the WRAIR program of research is the use of multilevel modeling to examine how perceptions of leadership at the unit level are related to unit and individual soldier well-being and motivation.

Predicting Work-Family Conflict From Workload, Job Attitudes, Group Attributes, and Health: A Longitudinal Study.

This article examined the concurrent and longitudinal predictors of work–family conflict (WFC) among soldiers stationed in Europe. Aspects of workload (work hours, hours of sleep, days training, perceived work overload) and measures of health and morale were the strongest concurrent predictors of WFC. For the entire sample, physical symptoms and horizontal cohesion at Time 1 were the only significant predictors of WFC 3 to 4 months later (Time 2) after controlling for WFC at Time 1. Higher levels of physical symptoms and horizontal cohesion at Time 1 predicted greater WFC at Time 2. Job satisfaction and significance emerged as additional longitudinal predictors of WFC for soldiers who were married or who had a child at home. Job satisfaction predicted reduced WFC conflict at Time 2, whereas job significance predicted increased WFC. Moderated regressions revealed that ratings of officer leadership moderated many of the longitudinal predictors of WFC, with the most consistent moderating effect being that high ratings of officer leadership increased the relation between a predictor at Time 1 and WFC at Time 2. Moderated regressions also revealed that higher unit cohesion led to increased WFC only when soldiers felt a low sense of job significance. The importance of conducting longitudinal research to investigate the antecedents of WFC is discussed.

Stigma of mental illness and service use in the military

Background Many service members do not utilize the available services designed to assist them in coping with post-traumatic stress disorder and other mental health problems that emerge during active duty. Aims In the current paper, we discuss the possible role stigma plays in the underutilization of treatments in the military, and attempt to transfer a well-articulated framework for understanding stigma and stigma-change in civilian populations to the military context. Methods The literature was searched for papers reviewing negative beliefs about mental illness and fears of stigmatization and underutilization of treatments, especially as relevant to service members. Results We explain how public stigma, self stigma, and label avoidance may emerge as barriers to care seeking and service participation in soldiers, and propose approaches/strategies for change. We then discuss a number of recent applications of these approaches in both civilian and military initiatives. Conclusions Stigma-change programs specifically created by/for the military that integrate components of education and direct contact with respected peers or veterans who have coped with mental health problems may have great utility at both the early stages of military training and later, when soldiers return from theatres of operation.

Connecting active duty and returning veterans to mental health treatment: Interventions and treatment adaptations that may reduce barriers to care

Recent military operations in Afghanistan and Iraq have involved multiple deployments and significant combat exposure, resulting in high rates of mental health problems. However, rates of treatment-seeking among military personnel are relatively low, and the military environment poses several obstacles to engaging in effective clinical interventions. The current paper first reviews barriers and facilitators of treatment-seeking and engagement among military personnel, including stigma, practical barriers, perceptions of mental health problems, and attitudes towards treatment. Next, this paper reviews treatment adaptations and other interventions that are intended to reduce barriers to care among active duty and returning military personnel. These include early interventions, brief formats, integrating clinicians into the medical and military context, technology-based interventions, addressing negative treatment perceptions, screening/early identification, and enlisting unit support.