Logo: to the web site of the Swedish Defence University

Purpose – The aim of this study is to explore the subjective personal experiences of individuals that have chosen to take a personal development course focused on increased self-awareness and self-leadership.

Design/methodology/approach – A phenomenological study was performed. The data included self-reported reflections collected during an educational course and a focus group interview two months after course completion. This included data from 14 individuals, 6 men and 8 women, working in various civilian contexts.

Findings – Self-awareness and self-leadership behaviors were identified with main and subsequent subthemes. Self-awareness included the following main theme: (1) Role of reflection, including the following subthemes: (a) tool for understanding one’s own needs, (b) creates awareness of change needed, (c) tool for problem solving and (d) creates awareness of avoidance behaviors. Self-leadership behaviors included the following main and subthemes: (1) changes in private life including: (a) changes for others, (b) conscious presence in private relationships, (c) increased compassion for oneself; and (2) changes in working life: (a) increased acceptance of others, (b) courage to speak up and (c) selectivity over work tasks.

Research limitations/implications – A qualitative approach was used; thus, limiting generalized findings.Practical implications – The findings highlight individuals’ perceptions over their development process and what role the course had in the process.

Originality/value – The main contribution of the current study is outlining how and in what way individuals perceived a course on self-reflection and self-leadership influenced their self-development. The results outline specific areas of commonality that individuals believe the course contributed to change despite various work backgrounds. Opportunity for time to reflect oneself and in small groups with individuals unrelated to one’s usual background may be beneficial for offering a unique way to gain awareness of areas of meaningful changein individuals’ private and worklife.

Sammanfattning

I samband med internationella militära insatser ställs officerare och soldater inför en variation av tjänsterelaterade stressorer, däribland traumatisk händelseexponering. Trots att post-traumatisk stresstörning (PTSD) generellt sett är välstuderat i en amerikansk militär kontext, vet man mindre om dess förekomst bland svenska militära utlandsveteraner som grupp. På likartat vis vet man lite om de hälsorelaterade effekterna av moraliskt utmanande situationer, samt vilka variabler som kan associeras med moraliska skador bland svenska militära utlandsveteraner.

Syftet med föreliggande studie var att bidra med fördjupad förståelse av hälsorelaterade utfall efter traumaexponering i samband med deltagande i svenska internationella militära insatser, med ett specifikt fokus på PTSD och moralisk skada.

Studien genomfördes som en enkätstudie. Data analyserades genom sambandsanalyser för att kartlägga potentiella statistiska samband mellan variabler av intresse. Data analyserades även med mellangruppsanalyser för att se om det fanns signifikanta skillnader mellan olika grupper som kan bidra till attförklara de orsakssamband som undersöktes. Relationen mellan PTSD och moralisk skada undersöktes också.

Erhållna resultat visar, liksom tidigare forskning på området, att svenska militära utlandsveteraner mår förhållandevis bra som grupp, samtidigt som det finns individuella variationer. En mindre grupp uppvisar förekomst av PTSD-indikation och en ännu mindre grupp förekomst av indikation på moralisk skada. Något fler än de som nådde upp till gränsvärdena för indikation, uppvisade aktiva symptom som kan relateras indikation på PTSD och moralisk skada. Risken för ohälsa tycks vara som störst efter traumaexponering när stressorer enligt Akriteriet(rädslo-/hotbaserad) och moralisk skada (skam, skuld, tillitsförlust) sammanfaller i en och samma händelse, samt då man själv varit direkt involverad ihändelsen och upplever att man själv gjort sig skyldig till något som står i kontrast till egna djupt hållna värderingar.

Studien visar även på flera individ- och arbetsrelaterade faktorer som tycks ha ett samband med långsiktiga hälsoproblem. Till exempel är individer som har sökt och erhållit olika former av stöd efter hemkomst från insats (såsom att ha sökt stöd, medicinerat för ångest, depression eller sömnsvårigheter, varit sjukskriven,etc.) överrepresenterade i den grupp som skattat sin hälsa som sämst under den senaste månaden. Den högre förekomsten av indikation på PTSD och MI trots att man erhållit stöd kan indikera ett behov av behandling specifikt inriktad mot moralisk skada.

Praktiska implikationer av erhållna resultat diskuteras.

Abstract

In the context of international military operations, officers and soldiers are exposed to a variety of service-related stressors, including traumatic event exposure. Although post-traumatic stress disorder (PTSD) is generally well-studied within an American military context, less is known about its prevalence among Swedish military veterans who have served abroad as a group. Similarly, little isknown about the health-related effects of morally challenging situations, as well as which variables may be associated with moral injury among Swedish military veterans.

The purpose of the present study was to contribute to a deeper understanding of health-related outcomes following trauma exposure in connection with participation in Swedish international military operations. This included a specific focus on PTSD and moral injury.

A survey study was conducted on Swedish military veterans who have served in international missions. Data was analyzed through statistical analyses including correlation analyses to map potential statistical relationships between variables of interest and subgroup comparisons to see if significant differences between different groups could help explain the relationships identified. The relationship between PTSD and moral injury was also examined.

The results obtained show, as with previous research in the field, that Swedish military veterans abroad are doing relatively well as a group, however, there are individual differences. A smaller group show elevated levels of PTSD indications, and an even smaller group show elevated indications of so-called moral injury. Some more individuals than those who met the cutoff thresholds for indication exhibited active symptoms that may be related to PTSD and moral injury. The risk of ill health appears to be greatest after trauma exposure that results in elevated symptoms related to both PTSD criterion A (fear-based) and moral injury symptoms (guilt, shame, loss of trust) in the same event. Specifically, when the individual has been the active party in the event and feels that they are guilty of something that is in contrast to their own deeply held values.

The study also shows several individual- and work-related factors that appearto be related to long-term health problems. For example, individuals who have sought and received various forms of support after returning from deployment (such as having sought support, taken medication for anxiety, depression or sleep difficulties, been on sick leave, etc.) are overrepresented in the group who rated their health as poorest in recent months. The higher prevalence of indications of PTSD and MI during the past month, despite having received various forms of support after returning from the deployment, may indicate a need for treatments pecifically targeted at moral injury.

Practical implications of the results are discussed.

Our first aim was to explore the relationship between daily uplifts, daily hassles, and coping styles the first year after returning from international military missions and post-deployment work, family, and private reintegration in military veterans. Our second aim was to identify individual patterns regarding daily uplifts, daily hassles, and coping styles and to explore how they relate to the above-mentioned aspects of post-deployment reintegration. Questionnaire responses were received from 446 Swedish military veterans. Regression analyses showed that daily hassles and an escape-avoidance coping style made significant contributions in the predicted, negative direction to the amount of explained variance on reintegration indicator scales. A high level of perceived threat during the last mission also contributed to more negative integration. Using a person-centered approach, three unique profiles of response patterns were identified using a cluster analysis based on the uplift, hassles, and coping style scores. One profile was labeled “resilient and well-functioning”; its members showed favorable reintegration scores. A second profile was called “ambitious and struggling.” These individuals scored medium-high on the reintegration scales. The third profile consistently indicated the least favorable reintegration scores and was labeled “worried and avoidant.” The results confirm and deepen our existing knowledge.

A high number of military veterans seek professional help at primary healthcare centers for mental health problems. The main aim of this study was to map veterans’ perception of the quality of the care they received when seeking such help after their last tour of duty. A secondary aim was to explore personality and mission-related characteristics of veterans who seek professional help for mental health problems after missions. Questionnaire responses were obtained from 2512 Swedish veterans (43.4% response rate). Among the responders, 210 individuals had sought help for mental health problems at primary healthcare centers. Their perception of the quality of the healthcare was measured using the Quality from the Patient’s Perspective (QPP) questionnaire, which is derived from a theoretical model. Comparisons between the military help seekers and an age and gender matched group of civilian outpatients showed that the military group perceived the information they had received, and the commitment, empathy and respect shown by the physicians, considerably more negatively than the civilian patients. Comparisons between the help-seeking veterans and those who had not sought help, showed that the help seekers were younger and scored significantly lower on emotional stability and higher on conscientiousness. In addition, they perceived the leadership of their immediate commander during the last tour of duty more negatively and they reported fewer daily uplifts and more daily hassles during the tour. It was concluded that a more extensive collaboration between the armed forces and the healthcare system is strongly recommended and that it is necessary to provide education to healthcare providers.

This study explored existing literature regarding what social and psychological interventions currently exist for military couples/families in connection to international deployment. Asystematic scoping studies review was performed. Peer-reviewed articles were searched inthe following ProQuest databases: PsycArticles, Social Services Abstracts, and Sociological Abstracts. Twenty-four articles were identified that met the inclusion criteria. A thematic analysis was then applied. Two main themes were identified by the analysis describing the types of military support interventions, including family-based interventions and couple interventions. The existing literature covering specific interventions for military personnel and their families is limited, especially literature outside of North American military populations. Most current interventions focused on reactive psychological services, primarily during deployment and after the military employee has arrived back from duty and the family already presents symptoms of concern. Further studies are needed to represent the current support methods utilized for military personnel and their families in European contexts. Moreover, additional interventions focused on preventative health care may be a useful complement to currently offered treatment programs for helping military families mentally prepare for the specific stressors relating to military deployment. The current literature can serve as a basis for the identification of future needs in intervention and preventative psychological support for military families.

This article gives a brief insight into the types of problems encountered by, and the well-being and health of, Swedish veterans who have deployed abroad since 1990 and onwards. More specifically, it gives an overview of work-related stressors and health outcomes among Swedish deployed military veterans related to (a) trauma exposure, PTSD, and moral distress/moral injury; (b) milder stress reactions/symptoms and everyday hassles and uplifts; and (c) social outcomes in terms of deployment implications on family and close relationships.

Purpose The purpose of this study was to investigate military officers’ perception of the implicit expectations the organisation has for the officer’s private life and what implications it may have for gender norms at the organisation, family and individual levels. Design/methodology/approach A qualitative approach, using an inductive thematic analysis, was performed. The data was based on 20 interviews with military officers, including 18 men and 2 women. Findings Two main themes, with three subsequent subthemes, were identified. These themes were interpreted as being necessary for the military officer to be able to manage organisational demands. The first included the implicit expectations the organisation had for the family. The three subthemes included the officer’s acceptance of frequent travel demands, adapting private life in accordance to organisational demands and picking a partner that matches the goals of the organisation. The second identified main theme included the military officer’s descriptions of implicit expectations the organisation held for the officer’s partner. Three subthemes were identified, including the partner’s need to be independent and psychologically strong, to take the main responsibility for managing family life and to engage in emotion work with the extended family. Originality/value The findings identify important perceptions that military officers have regarding the military’s expectations for their private life and the adaptive behaviors regularly performed. These adaptive behaviors allow the military officer to be able to engage in work that sustains the organisation.

The purpose was to explore the association between the Big Five personality dimensions, the use of influencing behaviors (influencing tactics and political skill) with military staff members’ perceived performance. The sample included 185 Armed Forces staff members from various countries (predominantly the Baltic countries, Sweden, Norway and the USA). A hierarchical multiple regression indicated that the Big-Five dimensions Extraversion and Openness made statistically significant contributions (albeit low) in step 1 of the regression analysis in relation to performance, however, their contribution was weakened after the influencing behaviors were added in step 2 of the analysis. Two influencing behaviors (influencing tactic Rational persuasion and Political skill) demonstrated to be unique statistically significant contributions to perceived performance in the model as a whole, with political skill being the strongest. Practical considerations and future research directions are suggested.

This study investigates the relationship between moral stress reactions and resulting coping efforts in severely morally challenging situations. Long-term positive reactions and post-traumatic stress disorder (PTSD) indicators following morally challenging situations are also studied. The sample consisted of cadets and officers (n = 332) from Norway and Sweden. Long-term positive reactions were found to be associated with limited moral stress reactions during the challenging episode and frequent use of acceptance and positive reappraisal coping strategies. Long-term high scores on a PTSD indicator scale covaried with high scores on Openness, a strong moral stress reaction, and frequent use of instrumental coping strategies. The main conclusion is that the immediate moral stress reaction and coping strategies following morally challenging situations appear to be related to both positive long-term reactions and to indicators of PTSD.

Social effectiveness, including political skill, reflects individuals’ ways of handling interpersonal processes at work. Most research has used a variable-oriented approach to investigate associations between political skill and key organizational factors, including performance, in civil settings. Thus, little is known of whether political skill transfers to a military context and whether there are specific profiles of political skill. Combining variable-oriented and person-oriented approaches, this study used self-reports from two samples of military student officers to: (1) investigate measurement properties of the 18-item political skill inventory; (2) explore whether it is possible to identify different profiles of political skill; and (3) investigate whether such profiles differ in demographics, personality, and job performance. Exploratory (sample 1: n = 185) and confirmatory (sample 2: n = 183) factor analyses supported a four-dimensional representation of political skill including networking ability, apparent sincerity, social astuteness, and interpersonal influence. Latent profile analysis (samples 1 and 2: N = 368) identified four distinct combinations of these dimensions, namely: (1) weak political skill; (2) weak political skill with strong sincerity; (3) moderate political skill; and (4) strong political skill. Importantly, profiles differed consistently in networking ability. Subsequent comparisons suggested potentially important differences in demographics, personality, and job performance. Despite needing additional research of how profiles of political skill develop over time, these findings may have practical implications for recruitment and training in organizational settings where social effectiveness is important.