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提升复原力机制研究(ARMOR):年轻新兵适应能力的前瞻性纵向研究——方法与测量的方案及原理

Advancing Research on Mechanisms of Resilience (ARMOR) Prospective Longitudinal Study of Adaptation in Young Military Recruits: Protocol and rationale for methods and measures.

作者信息

Polusny Melissa A, Marquardt Craig A, Hubbling Shelly, Campbell Emily Hagel, Arbisi Paul A, Davenport Nicholas D, Lim Kelvin O, Lissek Shumel, Schaefer Jonathan D, Sponheim Scott R, Masten Ann S, Noorbaloochi Siamak

机构信息

Minneapolis VA Health Care System, Minneapolis, MN.

Center for Care Delivery Outcomes Research, Minneapolis, MN.

出版信息

medRxiv. 2023 Jul 12:2023.07.07.23292348. doi: 10.1101/2023.07.07.23292348.

Abstract

BACKGROUND

Military service provides a unique opportunity for studying resilience, a dynamic process of successful adaptation (i.e., doing well in terms of functioning and symptoms) in response to significant adversity. Despite tremendous interest in positive adaptation among military service members, little is known about the processes underlying their resilience. Understanding neurobiological, cognitive, and social mechanisms underlying adaptive functioning following military stressor exposure is essential to enhance the resilience of military service members.

OBJECTIVES

The primary objective of the Advancing Research on Mechanisms of Resilience (ARMOR) longitudinal study is to characterize trajectories of positive adaptation among young military recruits in response to Basic Combat Training (BCT), a well-defined, uniform, 10-week period of intense stress (Aim 1) and identify promotive and protective processes contributing to individual variations in resilience (Aim 2). The secondary objective is to investigate pathways by which neurobehavioral markers of self-regulation assessed by electroencephalography (EEG) and magnetic resonance imaging (MRI) contribute to adaptive trajectories (Aim 3).

METHODS

ARMOR is an ongoing, prospective longitudinal cohort study of young military recruits who recently joined the National Guard but have not yet shipped for BCT. Participants (N=1,201) are assessed at five timepoints over the initial 2+ years of military service beginning before BCT (baseline) and followed up at 2 weeks, 6, 12, and 18 months post-BCT. At each time point, participants complete online questionnaires assessing vulnerability and protective factors, mental health and social-emotional functioning, and, at Time 0 only, a battery of neurocognitive tests. A subset of participants also complete structured diagnostic interviews, additional self-report measures, and perform neurobehavioral tasks before and after BCT during EEG sessions, and, at pre-BCT only, during MRI sessions.

RESULTS

Study enrollment began April 14, 2019 and ended in October 16, 2021. A total of 1,201 participants are enrolled in the study (68.9% male; mean age = 18.9, SD = 3.0). Follow-up data-collection is ongoing and projected to continue through March 2024. We will disseminate findings through conferences, webinars, open access publications, and communications with participants and stakeholders.

CONCLUSIONS

Results are expected to elucidate how young military recruits adapt to military stressors during the initial years of military service. Understanding positive adaptation of military recruits in the face of BCT has implications for developing prevention and intervention strategies to enhance resilience of military trainees and potentially other young people facing significant life challenges.

摘要

背景

兵役为研究复原力提供了独特的机会,复原力是一个在面对重大逆境时成功适应(即在功能和症状方面表现良好)的动态过程。尽管对军人的积极适应有着浓厚的兴趣,但对于他们复原力背后的过程却知之甚少。了解军事应激源暴露后适应性功能背后的神经生物学、认知和社会机制对于提高军人的复原力至关重要。

目的

“推进复原力机制研究(ARMOR)”纵向研究的主要目标是描绘年轻新兵在应对基础战斗训练(BCT)时的积极适应轨迹,基础战斗训练是一个明确界定、统一的为期10周的高强度压力期(目标1),并确定导致复原力个体差异的促进和保护过程(目标2)。次要目标是研究通过脑电图(EEG)和磁共振成像(MRI)评估的自我调节神经行为标志物对适应性轨迹产生影响的途径(目标3)。

方法

ARMOR是一项正在进行的前瞻性纵向队列研究,研究对象是最近加入国民警卫队但尚未前往参加基础战斗训练的年轻新兵。参与者(N = 1201)在兵役最初的2年多时间里的五个时间点接受评估,从基础战斗训练前(基线)开始,在基础战斗训练后2周、6个月、12个月和18个月进行随访。在每个时间点,参与者完成在线问卷,评估脆弱性和保护因素、心理健康和社会情感功能,并且仅在时间0时完成一系列神经认知测试。一部分参与者还在脑电图检查期间基础战斗训练前后以及仅在基础战斗训练前的磁共振成像检查期间完成结构化诊断访谈、额外的自我报告测量并执行神经行为任务。

结果

研究招募于2019年4月14日开始,2021年10月16日结束。共有1201名参与者纳入研究(68.9%为男性;平均年龄 = 18.9,标准差 = 3.0)。随访数据收集正在进行中,预计将持续到2024年3月。我们将通过会议、网络研讨会、开放获取出版物以及与参与者和利益相关者的沟通来传播研究结果。

结论

预计研究结果将阐明年轻新兵在服役最初几年如何适应军事应激源。了解新兵面对基础战斗训练时的积极适应情况对于制定预防和干预策略以提高军事学员以及可能面临重大生活挑战的其他年轻人的复原力具有重要意义

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3750/10370239/013ab79b09e5/nihpp-2023.07.07.23292348v1-f0001.jpg

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