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The aim was to explore the relationship between moral injury symptoms, individual and military potential antecedent variables, and mental health scales. Responses were obtained from 504 Swedish military veterans. Findings showed that moral injury symptoms were modestly related to emotional stability and combat exposure. Moral injury symptoms were moderately strongly related to stress-related physical and psychological symptoms and strongly related to PTSD indication. The results suggest a strong conceptual overlap between moral injury symptoms and PTSD indication. The association between moral injury symptoms and stress-related physical and psychological symptoms was discussed from an intervention perspective. The study also adds to previous research in that the sample had more favorable mental health, when measured by stress-related symptoms and PTSD indication. Possible reasons for this are strict selection criteria and a lower frequency and intensity of combat exposure.

Purpose

This study is a scoping literature review of research into post-traumatic stress disorder (PTSD) and moral injury (MI) in active-duty military personnel and veterans in Ukraine. This study aims to explore the existing research regarding the relationship between PTSD and MI in Ukrainian military personnel to identify the need for future research in a vulnerable social group that is exposed to a high level of conflict.

Design/methodology/approach

This scoping review includes the results of peer-reviewed articles from online databases (PubMed, Science Direct, PsycArticles, Military Database, Sociological Abstract, Psychology Database, PTSD Pubs, Web of Science), which were searched for publications in English, Ukrainian and Russian. The data obtained was organized using Preferred Reporting Items for Systematic Reviews extension for scoping reviews and Meta-Analyses, the Critical Appraisal Skills Programme Qualitative Studies Checklist and Joanna Briggs Institute Critical Appraisal Checklist. Data was analyzed and categorized using an inductive thematic analysis.

Findings

According to the thematic analysis, the following themes were identified in a Ukrainian military context: sources of PTSD, sources of moral injury, symptoms of PTSD, symptoms of moral injury and treating and prevention mechanisms. All studies included in the scoping review (32) report on PTSD and/or MI in military groups in Ukraine. They find the gap in research and in numerous comprehensive studies problematic and underline the need for more effective rehabilitation programs.

Practical implications

A scoping review was conducted to thematically map the research in the area, identify any knowledge gaps deficit about PTSD and MI in Military personnel in Ukraine and contribute to further development of effective rehabilitation programs.

Originality/value

The sparsity of the existing literature highlights the need for further research into enhancing the mental health services provided to military personnel. In addition, there is a growing need to further explore trauma exposure and potentially morally injurious events related to PTSD and MI, in particular. Such a review has not yet been carried out, which adds value to the current paper.

Purpose

The aim of this study was twofold, first to examine the relationship between developmental leadership (a Scandinavian culture adapted version of transformational leadership) and instrumental leadership, as well as the relationship between these leadership variables and indices of performance and job satisfaction. Second, to identify individual patterns regarding developmental and instrumental leadership.

Design/methodology/approach

Using a longitudinal design, questionnaire data were collected three times among Swedish conscripts and voluntarily employed soldiers during their basic military training (n = 667 at T1, n = 503 at T2 and n = 554 at T3).

Findings

The main findings were: (1) high observed correlations between the developmental and instrumental leadership scales on all measurement occasions; (2) a low to moderate amount of explained variance explained by these leadership scales in regression analyses with performance and job satisfaction as dependent variables, where developmental leadership was strongly associated with ratings of job satisfaction and instrumental leadership accounted for a higher proportion of the variance on ratings of performance and (3) the identification of three distinct profiles of response patterns on the leadership scales, which were fairly similar across time and indicate a temporal consistency of leadership styles.

Research limitations/implications

Methodological strengths include the longitudinal study design, the comparatively large sample size, the use of well-established measurement scales and the person-centered approach allowing for the identification of response patterns. Study weaknesses include too few background variables and the use of self-report ratings only. From a work and organizational perspective, the sample with low-level conscripts and soldiers could also be regarded as unusual.

Practical implications

Education of leaders should focus on the importance of both interpersonal and instrumental aspects. There is also a need for development of leadership training fostering leaders’ instrumental leadership skills.

Originality/value

The study responds to the call from leadership researchers to further research on instrumental leadership and its relationship to the FRLT across diverse organizational contexts. Longitudinal comparisons of developmental (transformational) and instrumental leadership resulted in more trustworthy results as both a variable-oriented and a person-oriented approach was used.

Research shows that high-level military and sport leaders share a high-stress and high-stakes leader role due to similar experiences of demanding conditions mainly manifested in psychological burden. This raises research questions about leaders’ psychological strategies to maintain their mental health and performance under demanding conditions. Thus, the current study investigated how experienced demanding conditions were related to self-rated leader performance level and mental health indicators among high-level military and sport leaders and whether the application of psychological skills by these leaders moderated these relationships. A composite questionnaire was used to collect data longitudinally, once a week for four consecutive weeks. Fifty-two Swedish high-ranking military officers and executives in elite team sport organizations completed the questionnaire. Multilevel analysis revealed no effect of demanding conditions on leader performance, but they harmed leader vitality and were associated with higher stress symptoms. Moreover, psychological skills did not moderate the relationship between demanding conditions and leader performance. However, motivational and instructional self-talk negatively moderated the relationship between demanding conditions and vitality. In contrast, emotional regulation, comprised of mindfulness and cognitive reappraisal, positively moderated vitality. Emphasizing the nuanced application of psychological skills is crucial while avoiding one-sided beliefs about their positive effects. Interventions are suggested to focus on vitality and related psychological skills to ensure leaders feel good while performing under demanding conditions. More cross-contextual leadership research, suggestively applied research, is needed to better understand the links between high-level military and sport leaders’ psychological skills, leader performance, and mental health under demanding conditions.

Boken ger en unik summering av tio års forskning om militära veteraners hantering av stress före, under och efter utlandstjänstgöring. Det handlar om en kombination av akut stress, moralisk stress och ackumulerad vardagsstress. Ett panorama av stress­reaktioner presenteras liksom olika påverkande faktorer. Boken avslutas med 19 åtgärdsförslag riktade till enskilda personer, ledare, den militära organisationens högre chefer samt professionella aktörer inom hälso- och sjukvården. Den primära målgruppen är militära veteraner och potentiellt blivande sådana, såsom officerare, specialistofficerare, gruppchefer och soldater, liksom personer som utbildar sig till dessa yrken. Till de sekundära målgrupperna hör stödverksamheter inom Försvarsmakten och andra yrkesgrupper som riskerar att hamna i starkt stressfyllda situationer.

Purpose

The study aims to gain a deeper understanding of stressors and stress management among Norwegian firefighters in rural areas.

Design/methodology/approach

The study employed an inductive approach with semi-structured interviews with 13 participants from fire and rescue services in Innlandet County, Norway, and were analyzed in line with thematic analysis.

Findings

Rural firefighters face stressors similar to urban firefighters, but with unique challenges such as personal connection to victims, extended response times, broader responsibility and work–life balance issues. This study presents a model identifying factors serving as a resource base and at each incident phase (before, during and after), and at individual, group and organizational levels that can be stressors or aids in stress management. Focusing on the individual level, the paper highlights the importance of a strong “Resource Base” for effective stress management, in addition to mental preparedness en route, on-site avoidance (professionalism and shielding) and post-incident approach coping (dealing with the aftermath and letting go).

Research limitations/implications

An inductive approach only, a narrow geographical focus on one Norwegian county and a male-only participant base may have limited broader insights, cross-country comparisons and gender-specific findings.

Practical implications

Emphasizing individual coping strategies and tailored training can enhance stress management and efficiency in high-stress situations, well-being and career longevity in rural firefighting.

Originality/value

Unique to this study is the rural context and the inclusion of Norwegian firefighters, in addition to the consideration of interconnected factors of stress and stress management.

In contrast to an acute crisis that must be dealt with immediately, the handling of low-intensity crisis such as pandemics, cyber threats, climate crisis, increased resistance to antibiotics, etc. can often wait. However, it cannot wait too long because then the cost can be detrimental. The aim was to systematically review and evaluate the research on leadership and management at the organizational level in low-intensity crisis. A scoping review was performed which was limited to peer-review based articles, focusing on leadership and management at the organizational level. The analysis consisted of an explorative, inductive thematic analysis. Codes were identified in the texts and formed the basis of categories, which, in turn, were grouped into themes. The following four themes emerged in the analysis of the obtained literature: (1) general framing conditions; (2) predominantly management-related aspects; (3) predominantly leadership-related aspects; and (4) predominantly subordinate-related aspects. Most aspects found can be related to general leadership and management research and studies on short-term, acute crisis. A key finding was that few peer-reviewed articles were found, confirming that leadership and management in low-intensity crisis is an under-researched area. Given the challenges of ongoing and expected low-intensity crisis, more research focusing specifically on this kind of leadership and management is needed.

Background: Experience of trauma may cause serious consequences for mental health and self-image. Self-efficacy and perceptions of everyday stress have shown to impact mental health in a great manner. The aim of this study was to explore the longitudinal effects of a 12-week comprehensive treatment programme, including physical exercise, nutrition, social training, and psychoeducation, in addition to traditional psychopharmacology and psychotherapy, on self-efficacy, hassles and uplifts, and symptoms of anxiety and depression in traumatized women in a clinical context.

Method: Forty-eight female inpatients with a mean age of 43.7 years (SD = 10.7) receiving psychiatric treatment in a Norwegian psychiatric clinic participated in the longitudinal study. Patients responded to the questionnaires General Self-Efficacy Scale (GSES), the Stress Profile (hassles and uplifts), and the Hopkins Symptoms Checklist (HSCL-10) at three points in time: at baseline, at the end of treatment, and three months after treatment. As the data were not normally distributed, non-parametric tests for dependent samples were used to analyse the data. However, as the residuals were considered normally distributed, a hierarchical multiple regression analysis was conducted.

Results: All instruments, except for uplifts, showed significant changes during treatment, e.g. self-efficacy increased from 25.0 to 26.0, p = .036. A hierarchical regression conducted at baseline, with symptoms of psychological distress as the dependent variable, and age, self-efficacy, hassles, and uplifts as predictors, showed that self-efficacy was a significant predictor. At three months after treatment, the same hierarchical regression model revealed that all included predictors except age were significant, and the total variance explained by the model was 61.6 percent.

Conclusion: Three months after completed treatment the results indicated associations between an increase in self-efficacy, a reduced frequency of daily hassles and a higher frequency of daily uplifts and a reduction in psychological distress.

The aim was to: (1) identify individual profiles in young men regarding personality and cognitive appraisal style employing easy-to-use instruments, and (2) to explore how such profiles relate to biological stress indicators. The sample consisted of 173 male Lithuanian conscripts. An assessment was made after one month into their basic military training. Levels of cortisol, cortisone and testosterone were established through analysis of hair samples. Psychological assessments included the Big Five model of personality as well as cognitive appraisal style and perceived stress during the previous month of service. Four unique personality profiles were identified in a cluster analysis that differed significantly as theoretically expected on the Perceived Stress Scale. Statistically significant between-profile differences were found on cortisol and cortisone but not on testosterone. The personality profile with the highest scores on all three biological markers was characterized by high scores on Extraversion and Openness and low scores on Agreeableness. Second, three distinct cognitive appraisal style profiles emerged. They were related as theoretically expected to perceived stress, but they were unrelated to the hair steroid hormone concentration levels. Third, the combination of the most psychologically vulnerable personality profile, which included low scores on Emotional stability, and the most stressed cognitive appraisal style profile, yielded the clearest result and showed that it was possible to detect individuals with significantly higher stress-related hair steroid hormone levels using psychological instruments. Practical potential implications include identification of individuals who are most psychologically vulnerable and in need of close monitoring.

Purpose

The aim was to explore if self-rated psychological symptoms in military veterans covary strong enough with established PTSD scales to make a symptom checklist a useful screening tool.

Methodology

A Swedish sample of military veterans (n = 1,859) responded to a questionnaire which contained a checklist of ten psychological symptoms and a test of PTSD indication. The items measured the situation during the last month. All symptoms had the following response choices: 1 (Never), 2 (Seldom), 3 (Sometimes), 4 (Often) and 5 (Very often). The choices Often and Very often were combined and form the basis of the analysis.

Findings

The majority of individuals in the military sample reported that they had not experienced any of the ten psychological symptoms often or very often during the last month. Approximately 5% of the men and 9% of the women scored five symptoms or more. Among the men who reported five symptoms or more, about one third scored above a higher established PTSD cut-off value (PCL-4 > 44).

Originality

The psychological symptom checklist represents a new approach to PTSD indication screening and identification of individuals who may need further support.

Research limitations and strengths

Clinical assessment of PTSD would be a necessary complement for those that indicate further need. Study strengths include a large sample, use of established scales and a straightforward and simple statistical analysis.

Practical implications

The checklist is easy to administer and score. After a brief introduction, it takes about two minutes to complete.