Dropout has been identified as a significant problem among military populations seeking psychotherapy (Goetter et al., 2015; Hoge et al., 2014), yet an overall estimate of its exact prevalence and ...predictors does not exist. The aims of the current meta-analysis were to estimate outpatient psychotherapy dropout rates for this population and evaluate potential moderators of this event. In total, 283 articles-comprising data from 719,465 U.S. service members and veterans-met all inclusion criteria and were included in the meta-analysis. The average weighted dropout rate for all outpatient therapies was 25.6%, 95% CI 22.4%, 29.2%, and prediction interval 1.9%, 85.9%. Furthermore, dropout was 27.0% for cognitive behavioral therapies (CBTs), 25.3% for trauma treatments, 27.6% for the Department of Veterans Affairs (VA), 28.9% for individual therapies, and 9.8% for intensive outpatient settings. Findings from metaregression analyses using mixed-effects models indicated that higher dropout was linked with the following after accounting for other moderators: younger age, CBTs, nonmanualized approaches, VA versus Department of Defense settings, individual versus group therapies, and weekly versus intensive outpatient formats. Dropout was not linked with other client, therapist, treatment, and research variables. Taken together, dropout estimates were obtained for a range of military populations and treatment characteristics, including theoretical orientation, presenting concern, setting, and therapy formats. These estimates may provide potential benchmarks for therapists, administrators, and policymakers serving military populations. Leveraging dropout prevention strategies with at-risk groups highlighted in this study may enhance mental health care outcomes for this high-need population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
The mental health impact of the initial years of military service is an under-researched area. This study is the first to explore mental health trajectories and associated predictors in military ...members across the first 3-4 years of their career to provide evidence to inform early interventions.
This prospective cohort study surveyed Australian Defence personnel (
= 5329) at four time-points across their early military career. Core outcomes were psychological distress (K10+) and posttraumatic stress symptoms four-item PTSD Checklist (PCL-4) with intra-individual, organizational and event-related trajectory predictors. Latent class growth analyses (LCGAs) identified subgroups within the sample that followed similar longitudinal trajectories for these outcomes, while conditional LCGAs examined the variables that influenced patterns of mental health.
Three clear trajectories emerged for psychological distress: resilient (84.0%), worsening (9.6%) and recovery (6.5%). Four trajectories emerged for post-traumatic stress, including resilient (82.5%), recovery (9.6%), worsening (5.8%) and chronic subthreshold (2.3%) trajectories. Across both outcomes, prior trauma exposure alongside modifiable factors, such as maladaptive coping styles, and increased anger and sleep difficulties were associated with the worsening and chronic subthreshold trajectories, whilst members in the resilient trajectories were more likely to be male, report increased social support from family/friends and Australian Defence Force (ADF) sources, and use adaptive coping styles.
The emergence of symptoms of mental health problems occurs early in the military lifecycle for a significant proportion of individuals. Modifiable factors associated with wellbeing identified in this study are ideal targets for intervention, and should be embedded and consolidated throughout the military career.
This paper extends discussions of military and post-military landscapes, and prior theorisation of the prison-military complex. In so doing it highlights as-yet unresearched synergies between the ...prison and the military which take form through the repurposing of former military bases as prisons, the creation of carceral landscapes of military memorial, and the imprint left by generations of ex-military personnel occupying the prison (both as prisoners and prison staff) during the post-military phases of their lives. Consideration of these circumstances unveils prisons as postmilitary landscapes and enables a reconceptualization of the potential scope of military and post-military landscapes in general. It concludes by outlining a potential research agenda for carceral and military geographers in relation to military, post-military and postmilitary landscapes, and the prison-military complex.
During the past decade, armed drones have entered the American military arsenal as a core tactic for countering terrorism. When coupled with access to reliable information, they make it possible to ...deploy lethal force accurately across borders while keeping one's own soldiers out of harm's way. The potential to direct force with great precision also offers the possibility of reducing harm to civilians. At the same time, because drones eliminate some of the traditional constraints on the use of force—like the need to gain political support for full mobilization—they lower the threshold for launching military strikes. The development of drone use capacity across dozens of countries increases the need for global standards on the use of these weapons to assure that their deployment is strategically wise and ethically and legally sound.Presenting a robust conversation among leading scholars in the areas of international legal standards, counterterrorism strategy, humanitarian law, and the ethics of force, Drones and the Future of Armed Conflict takes account of current American drone campaigns and the developing legal, ethical, and strategic implications of this new way of warfare. Among the contributions to this volume are a thorough examination of the American government's legal justifications for the targeting of enemies using drones, an analysis of American drone campaigns' notable successes and failures, and a discussion of the linked issues of human rights, freedom of information, and government accountability.
American soldiers, sailors, airmen, and marines carried whiskey at Yorktown, Gettysburg, Manila, and Da Nang. It bolstered their courage, calmed their nerves, and treated their maladies. As a serious ...American whiskey drinker, John C. Tramazzo noticed how military service and whiskey went hand in hand during his service as a commissioned officer in the U.S. Army. In Bourbon and Bullets Tramazzo reveals the rich and dramatic connection between bourbon and military service in America.                Although others have discussed whiskey’s place in military history, Bourbon and Bullets explores the relationship between military service and some of the most notable whiskey distillers and executives working today. American servicemen Weller, Handy, Stagg, Van Winkle, and Bulleit all experienced combat before they became household names for American whiskey enthusiasts. In small towns and big cities across America, veterans of armed conflict in Panama, Somalia, Haiti, Iraq, and Afghanistan cook mash, operate stills, and push the booming industry to new heights. Bourbon and Bullets delves into the lives and military careers of these whiskey distillers and tells the story of whiskey’s role on the battlefield and in the American military community.  
This article takes a step toward filling the gap in the scholarly literature by examining the impact of religious intervention in the military on civil-military relations. Using the case of Israel, I ...argue that although the subordination of the Israeli military to elected civilians has remained intact, and the supreme command has been mostly secular, external religious authorities operate within the formal chain of command and in tandem with the formal authorities, managing the military affairs. This religious influence is apparent in three major domains: (1) the theological influence on military deployment, (2) the exclusion of women from equal participation in military service, and (3) the role expansion of the Military Rabbinate as a quasi-state agency and its reflection in the socialization of secular soldiers and the development of alternative military ethics. Consequently, extra-institutional control of the military is at work.
ObjectiveTo investigate suicide and mortality risk in deployed military veterans versus non-deployed comparators who had gone through military conscription testing.DesignPopulation-based matched ...cohort study.SettingSweden.ParticipantsParticipants were identified from the Military Service Conscription Register and deployment status from the Swedish Military Information Personnel Register. Of 1.9 million conscripts, 21 721 had deployed at some time between 1990 and 2013 (deployed military veterans). Non-deployed comparators were matched to deployed military veterans in two ways: (1) by cognitive ability, psychological assessment, mental health, body mass index, sex, birth-year and conscription-year (carefully matched), with further adjustment for exercise capacity and suicide attempt history; and (2) by sex, birth-year and conscription-year (age- and sex-matched).Main outcomeSuicide retrieved from the Swedish National Patient and Causes of Death Register until 31 December 2013.ResultsDuring a median follow-up of 12 years, 39 and 211 deaths by suicide occurred in deployed military veterans (n=21 627) and carefully matched non-deployed comparators (n=107 284), respectively (15 vs 16/100 000 person-years; adjusted HR (aHR) 1.07; 95% CI 0.75 to 1.52; p=0.72) and 329 in age- and sex-matched non-deployed comparators (n=108 140; 25/100 000 person-years; aHR 0.59; 95% CI 0.42 to 0.82; p=0.002). There were 284 and 1444 deaths by suicide or attempted suicides in deployed military veterans and carefully matched non-deployed comparators, respectively (109 vs 112; aHR 0.99; 95% CI 0.88 to 1.13; p=0.93) and 2061 in age- and sex-matched non-deployed comparators (158; aHR 0.69; 95% CI 0.61 to 0.79; p<0.001). The corresponding figures for all-cause mortality for carefully matched non-deployed comparators were 159 and 820 (61 vs 63/100 000 person-years; aHR 0.97; 95% CI 0.82 to 1.15; p=0.71) and 1289 for age- and sex-matched non-deployed comparators (98/100 000 person-years; aHR 0.62; 95% CI 0.52 to 0.73; p<0.001).ConclusionDeployed military veterans had similar suicide and mortality risk as non-deployed comparators after accounting for psychological, psychiatric and physical factors. Studies of mental health in deployed veterans need to adjust for more factors than age and sex for comparisons to be meaningful.
This research aims to explore an analytical model, gauge the interplay between psychological resilience and achieved military competencies, and examine an intermediary role of effort, proactivity, ...and self-efficacy. In this study, 337 reserve soldiers from Lithuania were investigated with the Lithuanian Military Training Competences Assessment Scale, Resilience Scale, Self-Efficacy Scale, Short Grit Scale (Grit-S), and Proactivity Scale. Our findings highlighted the importance of the psychological resilience of reserve soldiers due to its positive relationship with the personality traits. Implicit interconnectedness between psychological resilience and psychological skills together with military competences was researched, and it became evident that self-efficacy determined a statistically important mediating role (indirect effect = 0.264 **, p < 0.05) between reservists’ psychological resilience and perceived military training course results. However, the other components included in the study did not have a mediating effect (effort indirect effect = 0.03, p > 0.1; proactivity indirect effect = 0.094, p > 0.1). The research findings are important because of greater prominence of the role of reserve troops in military operations around the world and achievements in the domain of security and defense. This study has great theoretical and empirical value in making decisions concerning the psychological resilience of reserve soldiers’ promotion and sustainable improvement of military preparedness strategies.
Airpower in the War against ISIS chronicles the planning and conduct of Operation Inherent Resolve by U.S. Central Command (CENTCOM) from August 2014 to mid-2018, with a principal focus on the ...contributions of U.S. Air Forces Central Command (AFCENT).
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