Page 39 - Biobehavioral Resilence to Stress

16 Biobehavioral Resilience to Stress

Conclusions and Recommendations

Improvements in military screening would support the development of a
military force whose members are optimally suited to handle the physical
and psychological demands of military training, service, and combat. In
addition, the U.S. General Accounting Office reports that tens of millions of

federal dollars could be saved annually by the reduction of military attrition
through improved screening (e.g., General Accounting Offi ce, 1982, 1997).

With these objectives in mind, we off er specific recommendations to pro-
mote relevant advancement in the areas of basic research, enlistment stand-
ards, psychological screening, and information sharing.

Basic Research

There is a clear and pressing need to identify and assess specifi c factors
that influence psychological risk and resilience to stress. Current research

already underway may be very helpful in this respect. As previously noted,
a collaborative DoD–CDC research initiative has begun to examine the
effects of childhood abuse on psychological and physical well-being in

adulthood. This is an essential area of investigation whose results should
inform the advancement of theory, experimentation, and application (e.g.,
psychological screening).
In addition, the DoD and Veterans Administration Medical Center are

currently involved in a joint effort (Recruit Assessment Program [RAP]) that
may eventually support routine collection of demographic, psychosocial,
occupational, and health risk data from all new U.S. military personnel.

Although the explicit focus of the RAP effort is to improve the quality of
personnel medical records, the resulting data may also directly or indirectly

support the identification of psychosocial and demographic risk factors for
stress-related health problems.
Much additional basic research is needed. We know that a number of
factors are related to military attrition and overall mental health, including
demographic factors, education, intelligence, criminal history, smoking
behavior, prior mental health history, childhood abuse, and personality.
However, little is known about how these factors interact with one another.
Similarly, little is known about the underlying mechanisms by which these
factors exert their effects. For example, the occurrence of childhood abuse

might have an eff ect on education level, criminal history, smoking behav-
ior, prior mental health history, and personality. If so, this may help us
to understand the observed correlation between child abuse and attri-
tion. It is useful to study correlative relationships among specifi c factors
and outcome, but in order to identify meaningful markers and predictors

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