National Academies Press: OpenBook

Enhancing Human Performance: Background Papers, Stress Management (1988)

Chapter: 7 Prospects for Implementation

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Suggested Citation:"7 Prospects for Implementation." National Research Council. 1988. Enhancing Human Performance: Background Papers, Stress Management. Washington, DC: The National Academies Press. doi: 10.17226/785.
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Suggested Citation:"7 Prospects for Implementation." National Research Council. 1988. Enhancing Human Performance: Background Papers, Stress Management. Washington, DC: The National Academies Press. doi: 10.17226/785.
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Page 127
Suggested Citation:"7 Prospects for Implementation." National Research Council. 1988. Enhancing Human Performance: Background Papers, Stress Management. Washington, DC: The National Academies Press. doi: 10.17226/785.
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Page 128
Suggested Citation:"7 Prospects for Implementation." National Research Council. 1988. Enhancing Human Performance: Background Papers, Stress Management. Washington, DC: The National Academies Press. doi: 10.17226/785.
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Page 129
Suggested Citation:"7 Prospects for Implementation." National Research Council. 1988. Enhancing Human Performance: Background Papers, Stress Management. Washington, DC: The National Academies Press. doi: 10.17226/785.
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Page 130
Suggested Citation:"7 Prospects for Implementation." National Research Council. 1988. Enhancing Human Performance: Background Papers, Stress Management. Washington, DC: The National Academies Press. doi: 10.17226/785.
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Page 131
Suggested Citation:"7 Prospects for Implementation." National Research Council. 1988. Enhancing Human Performance: Background Papers, Stress Management. Washington, DC: The National Academies Press. doi: 10.17226/785.
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Page 132

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Stress Reduction 60 The drill instructor project developed from longitudinal research on the stressful nature of drill field duty (Novaco, Sarason, Robinson, & Cunningham, 1982; Novaco, Sarason, Robinson, & Parry, 1983), which had been initiated after studies on recruit attrition and adjustment found strong effects for training unit influences (Novaco & Sarason, 1986). The drill instructor intervention program has just entered the evaluation phase. Data are being gathered on a multitude of cognitive, personality, behavioral, and physiological variables to evaluate the effectiveness of the intervention. PROSPECTS FOR IMP~ENTATION As stipulated by the conceptual model given earlier, stress must be understood in terms of contextual conditions. The mechanisms by which environmental demands operate to produce stress reactions are linked to features of the physical ant loci-cultural milieux that affect stressor salience and signification, mitigating factors, resources, and coping processes. For example, not everyone who has a long commute to work on congested roadways is going to experience stress that is manifested by elevated blood pressure, negative mood, lowered frustration tolerance, impairments in cognitive functioning, and health problems. Indeed, such stress reactions are significantly influenced by conditions of the residential and work environments, between which one commutes, as well as by cognitive- behavioral characteristics of the individual and their efforts to cope with commuting stress (Stokols & Novaco, 1981). Similarly, whether a drill instructor exhibits stress reactions will depend on contextual conditions such as workload (which is phasic and greatest in summer months of high accessions), company and battalion policies, types of supervision received, the social climate of the drill instructor team, unexpected pressures, and his

S tress R eduction 6 . own leadership style ant personality. This is not to say that "it all depends," but to state that relevant contextual factors and their interaction can be identified, and importantly we must understand when prevailing conditions impose constraints or limitations on the degree to which certain stress coping strategies can be utilized. At the outset, a fundamental set of stress coping skills can be identified which might be considered to be a distillation of a broad range of research on stress and stress reduction practices. These are (1) self- monitorinz of somatic states, thoughts, feelings, and behavior patterns, (2) arousal reduction with regard deco both general arousal levels and particular _ occasions of activation, (3) task-orientation, which is the ability to focus on the task at hand and engage in behavior instrumental to achieving identified goals, (4) setting realistic expectations for oneself and others, (5) constructive thinking about situations, the behavior of others, and one's own behavior, especially with regard to setbacks and thwartings, (6) behavioral competence in dealing with recurrent environmental demands or problems, and (7). utilizing supportive social relationships. For the most part, these coping skills have been the basis of the intervention that Irwin Sarason and I have undertaken with Marine Corps drill instructors, with the exception of arousal reduction, which seemed less feasible in that context. On the basis of the present review, the prospects for stress reduction can be seen with regard to training environments and the provision of remedial services through mental health units. Training facilities from recruit training depots to specialized schools, such as those for drill instructors, officer candidates, NCO academies, recruiters, airborne jumpmaster, underwater demolition, etc., are prime arena for stress coping curricula as a preventive intervention. The receptivity of

Strew Reduction ~2 the audience to stress reduction messages, however, will depend upon their perception of its relevance. If the audience is experiencing stress and is looking for remedial ideas then conditions of receptivity are optimum. But when the person is either not currently stressed or does not perceive the severity of the impending stress associated with the future duty assignment, then the perceived value of the stress reduction program will be attenuated. Therefore, it will be important to not only give the audience a realistic picture of impending stress but also to tie the ideas about stress coping skills to performance enhancement. The program audience needs to see that augmenting their stress coping ability will lead to improvement in their performance, as well as in their well-being. In this regard, it is essential that such messages be delivered by highly credible sources. Whenever possible, high status role models should be the vehicle for the instructional material. As several studies indicate, training environments have stressful regimens, but the stressful conditions are phasic, with stress being higher in the early weeks. This was demonstrated by the physiological and health studies on Marine recruits, Army Officer candidates, Navy underwater demolition training, and airmen in basic training. Attrition research with Marine recruits (Mobley et al., 1979; Novaco ~ Sarason, 1986) also finds that the majority of attrition occurs early in training. From a standpoint of secondary prevention, this facilitates early detection and the provision of remedial assistance. For example, Conrad, Barry, and Patterson (1976) in a study at West Point found that the effectiveness of treatment in returning cadets to duty was related to early identification of stress symptoms. A more impressive study in this regard but concerning the enlistment period was performed by Steinberg and Durell (1968) who reviewed the service records of

S=e" Reduction 63 every uncommissioned soldier in the U.S. Army who had been hospitalized for schizophrenia from 1956-1960. They found that the rate of hospitalization is markedly increased in the early months of service and that chronic cases account for only a small fraction of this high incidence. They viewed the initial period of service as that having the greatest demand for social adaptation, accompanied by psychological stress. The implementation of secondary prevention hinges on early detection of signs that are empirically related to some outcome criteria. It is far from clear what the stress diagnostic protocol might be. Mental health screening with standardized instruments such as the MMPI is routinely done in some specialized schools, but it is unclear how general such practices are or what their utility indeed is. Physical health assessments are probably done infrequently, and I would speculate that military personnel often avoid getting physicals. I suspect that the flight surgeon is one of the last persons that a pilot would like to see. Existing stress assessment devices such as life events scales, hassle scales, symptom checklists, Type-A behavior scales, or measures of job tension might be examined as a predictive battery, but it is likely that contextual conditions can easily override personological indices. For example, in my research with Irwin Sarason on Marine Corps drill instructors, we have found that the Speed/Impatience component of Type-A behavior (assessed by the Jenkins Activity Survey) is indeed associated with stress during drill field duty and is predictive of supervision evaluations of job performance (inverse relationship). Yet a more striking discovery was that when we examined a person's rank at graduation from Drill Instructor School, we found that those who were corporals had a 50.t chance of being relieved of duty for maltreatment or drug use. A relatively small percentage of DI School candidates were corporals, but these men had been selected

Stress Reduction 6~ because they showed promise and indeed they performed very well in DI School. After graduation and the training of their first platoon, they typically were promoted to sergeant. However, our speculation is that these men adopted poor leadership styles on the drill field and probably were too intense in their approach, trying to prove themselves and rise above the two stripes conspicuously on their sleeves. By the time trouble was noticed, their rank was sergeant or above, hence the relationship of high incidence escaped attention. Our research with four DI School cohorts did receive attention by base commanders, and corporals are no longer sent to Drill Instructor School. Our consistent findings of training unit environment effects in recruit training appear also to extend into the first term of enlistment, although analyses on those recruit longitudinal data are not complete. We do know that the social environment established by drill instructors is a key factor determining attrition, adjustment, and performance. This also has effects on recruit cognitions, such as expectations for control of reinforcement (Cook, Novaco, & Sarason, 1982). Drill instructors who adopt a "firm but fair" approach as opposed to a more coercive, harassing approach, are likely to produce service men that are better adjusted and indeed perform better in the Fleet Marine Force. Preliminary analyses of archival data and ratings of FMF company commanders of our longitudinal subjects so indicate. Among the patterns that we have found is that low attrition drill instructors (those whose platoons remain relatively intact from forming to graduation) foster increases in efficacy expectations and perceptions of personal control among their recruits. In contrast, high attrition drill instructors (those whose platoons have high discharge rates) cause decreases in efficacy and lowering of perceptions of control. These findings echo the

Stress Reduction 6: efficacy themes of Rachman's (1978) analysis of fear in combat. He argues that degrees of fear are associated with controllability and confidence and that combatants having appropriate competence and confidence will be less disrupted by fear. Military organizations obviously aim to build personal efficacy, but how well particular training units achieve that objective is an open question. When there are identifiable variations in the effectiveness of training personnel, something can be learned about the proficiencies of the more successful leaders. As Bandura (1977) has delineated, efficacy expectations derive from four main sources, namely performance accomplishments, vicarious experience, verbal persuasion, and physiological states. Training unit leaders can enhance efficacy, therefore, through modeling and suggestion. They can also structure training activities to maximize personal mastery experiences for trainees. Physiological arousal is thought to be a source of efficacy expectations because if arousal is low in a stressful situation, the person will perceive themselves as less vulnerable and the potentially debilitating effects of arousal on performance will be minimized. The arousal reduction approaches reviewed earlier can be employed to promote self-regulatory skills. They must, however, be suited to the context of their application and provisions must be made for the practice of arousal reduction techniques. The study by Burke (1980) with Army Airborne trainees, for example, fell short on both of these aspects. The breathing control procedure was too complicated, and there was no monitoring of practice. In general, arousal reduction procedures require time in skill acquisition and application training. Perhaps they are tees; utilized by mental health specialists in the treatment of stress cases when there is an explicit personal reason for their use. Training in self-

Stress R eduction 6 ~ monitoring, on the other hand, is more simplified and has a broader range of application. Keeping tabs on somatic states, thought, feelings, and behavior is a fundamental skill of stress management, the point of departure for doing anything to remediate stress. When it has been estimated that in a high intensity war, one-third of the non-death casualties will be psychiatric, the value of stress coping skills should gain sway. Because stress has direct effects on performance, as well as on health and adjustment, the ability to regulate stress can be a significant asset to troops and commanders. While research on stress reduction is in its nascency, there already is a core of basic principles and techniques that can be utilized both in training and in treatment units.

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