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This study developed identification measures between U.S. Service Academy cadet squad members and squad leaders in peer-mentoring relationships, highlighting identification as an important antecedent to mentoring. However, research has failed to show evidence of this relationship, largely because researchers have failed to measure identification, psychometrically test their measures, or differentiate identification from related constructs. Addressing this gap, we use theories of the self and interviews of cadets and faculty members to develop measures of both mentee and mentor identification. We include these measures, along with measures of empathy and similarity, in a longitudinal study of mentoring between cadet squad leaders (n = 96) and squad members (n = 968). Factor analyses revealed a three-factor solution of mentee identification with the mentor, measuring identification, empathy, and similarity. The analyses yielded a four-factor solution of mentor identification with the mentee, measuring two forms of identification, self-image, and empathy. The findings encourage future research to employ these measures for exploring identification's role in mentoring relationships. This study developed survey questions that researchers can use to measure how much mentors identify with their mentees and mentees identify with their mentors. Researchers of mentoring believe that identification is critical to the development of mentoring relationships. The questions developed in this study can help future researchers test whether a relationship between identification and mentoring exists. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the MacArthur Community Violence Screening Instrument (MCVSI) in a heterogeneous and integrated sample of adults with mental illness (n = 4,480), including its factor structure, model fit, and psychometric properties as a function of patient sex, race, and primary diagnosis. Factor structure results indicate a unidimensional construct. Item-level analyses revealed that the MCVSI's difficulty, including the easiest and most difficult items to endorse, sometimes differed across sex, race, and primary diagnosis. However, differential item functioning was minimal across these patient characteristics, with only those without a primary diagnosis of schizophrenia indicating an increased likelihood of having "hit anyone with a fist, object or beaten anyone" compared to those with a primary diagnosis of schizophrenia. Overall, these findings support using the MCVSI as a measure of violence in studies of U.S. adults with mental illness. They also highlight the importance of using more methodologically rigorous approaches to measuring violence, including the ongoing study of the MCVSI across samples and settings. [ABSTRACT FROM AUTHOR]

Sexual offenders are at greater risk of nonsexual than sexual violence. Yet, only a handful of studies have examined the validity of risk assessments in predicting general, nonsexual violence in this population. This study examined the predictive validity of assessments completed using the Historical-Clinical-Risk Managment-20 Version 2 (HCR-20: Webster, Douglas, Eaves, & Hart, 1997), Short-Term Assessment of Risk and Treatability (START; Webster, Martin, Brink, Nicholls, & Desmarais, 2009), and Static-99R (Hanson & Thornton, 1999) in predicting institutional (nonsexual) aggression among 152 sexual offenders in a large secure forensic state hospital. Aggression data were gathered from institutional records over 90-day and 180-day follow-up periods. Results support the predictive validity of HCR-20 and START, and to a lesser extent, Static-99R assessments in predicting institutional aggression among patients detained or civilly committed pursuant to the sexually violent predator (SVP) law. In general, HCR-20 and START assessments demonstrated greater predictive validity--specifically, the HCR-20 Clinical subscale scores and START Vulnerability total scores--than Static-99R assessments across types of aggression and follow-up periods. [ABSTRACT FROM AUTHOR]

Introduction Staff nurse attrition negatively impacts readiness of the warfighter and the health and wellbeing of all beneficiaries of the Military Health System (MHS). To promote the retention of a robust nursing workforce, a complete understanding of nurses' perceptions regarding their intent to leave is necessary. The purpose of this study was to explore the free-text responses of 1,438 nurses working among military medical treatment facilities for factors influencing their intent to leave, as an indicator of potential turnover, or attrition. Materials and Methods This study employed thematic analysis to investigate the qualitative responses from the 2016 and 2018 Military Nursing Practice Environment Surveys. The study was determined to be exempt from Institutional Review Board review through the Womack Army Medical Center's Human Research Protection Program. Results Findings indicate that leadership and management (n  = 647), staffing (n  = 353), career opportunities (n  = 345), staff outcomes (n  = 247), culture (n  = 153), quality of care (n  = 99), patient care barriers (n  = 86), non-patient care activities (n  = 79), lack of formal professional development (n  = 75), and area or care environment (n  = 67) were among the top factors influencing staff nurse intent to leave, respectively. Conclusions Our findings support the evaluation of retention strategies using implementation science for nurses and nurse resource personnel (e.g. nursing assistants, technicians, medics, and corpsman) to ensure a robust nursing work force throughout the MHS. Staff nurses and resource personnel working among military treatment facilities and embedded in units supporting combat and humanitarian missions ensure access to care and health promotion of the warfighter and all MHS beneficiaries. [ABSTRACT FROM AUTHOR]

Introduction: Rates of chronic pain in military personnel are disproportionately high. Chronic pain is often associated with mental health and substance use disorders as comorbid conditions, making treatment of chronic pain complex. Mindfulness-based interventions (MBIs) are a promising behavioral approach to managing chronic pain and psychosocial sequelae. The unique nature of the military context may require adaptations to original MBIs for successful delivery in active-duty military populations. This study adapted the mindfulness-based stress reduction (MBSR) program to create a mindfulness training program that was relevant to active-duty Army personnel experiencing chronic pain. This article delineates the adaptation process employed to modify the MBSR program to the military context and discusses the resulting training program.Materials and Methods: The adaptation process consisted of three iterative stages: 1) Drafting the preliminary intervention protocol with recommendations from stakeholders, including military healthcare providers; 2) Refining the preliminary protocol after pretesting the sessions with research team members and a military Veteran advisory committee; and 3) Delivering the preliminary protocol to one cohort of active-duty Soldiers with chronic pain, collecting feedback, and further refining the intervention protocol.Results: Military-related adaptations to MBSR addressed three areas: military culture, language and terminology, and practical and logistical factors relevant to implementation in the military setting. This adaptation process resulted in a live, online program with six, weekly, sessions. Feedback from a military Veteran advisory committee resulted in modifications, including increasing military-relevant examples; preliminary testing with the target population resulted in additional modifications, including shortening the sessions to 75 min and structuring discussions more efficiently.Conclusions: The adaptation process was successful in generating an engaging mindfulness training program that was highly relevant to the military context. Obtaining input from stakeholders, such as military healthcare providers and active-duty soldiers, and iterative feedback and modification, were key to the process. Moreover, the program was designed to maintain the integrity and core elements of MBIs while adapting to military culture. A future randomized controlled trial design will be used to evaluate the effectiveness of the intervention in improving chronic pain in military personnel. This program is responsive to the military's call for nonpharmacologic treatments for chronic pain that are easily accessible. If effective, the mindfulness program has the potential for widespread dissemination to complement standard care for Service Members experiencing chronic pain. [ABSTRACT FROM AUTHOR]

Research Summary: In the program implemented in the Honest Opportunity Probation with Enforcement Demonstration Field Experiment (HOPE DFE), the following approach is taken: close monitoring; frequent drug testing; readily available substance abuse treatment; and swift, certain, and fair sanctioning to deter probationers from violating supervision conditions. We assessed in this study the costs and outcomes of the demonstration program across four jurisdictions, using 24 months of data from 625 probationers randomly assigned to probation as usual (PAU) or HOPE DFE. Our results reveal that the HOPE DFE group incurred more criminal justice costs than the PAU group over the observation period. Policy Implications: Our study results further demonstrate that HOPE in the DFE is associated with higher rates of incarceration and residential treatment, leading to an increase in total costs when compared with PAU. Jurisdictions choosing to implement programs like HOPE to hold probationers accountable would need additional resources from the criminal justice system to support the program. [ABSTRACT FROM AUTHOR]

Background: Workplace victimization is a potential risk factor for suicidal behaviors (SB) among military personnel that has been largely overlooked. This paper examines both the impact of workplace victimization on reported SB and several potential protective factors associated with such suicidal behaviors in a large sample of active duty soldiers.Methods: A case-control study was conducted with 71 soldiers who reported SB in the past 12 months, each matched on sociodemographic characteristics to two others without reported suicidal behaviors. A multiple regression model was estimated to assess the effects of risk and protective factors while controlling for other variables.Results: SB was associated with several aspects of victimization, mental health and substance abuse conditions, pain, impulsivity, stressors, negative life events, work-family conflict, active coping behaviors and positive military-related factors. Controlling for other variables, those with SB were more likely to have sought mental health or substance abuse services, to be depressed, anxious, impulsive, and less resilient than non-SB personnel.Limitations: Study limitations included the use of retrospective self-report data, absence of some known SB predictors, and a population restricted to active duty Army personnel.Conclusions: SB among active duty personnel is associated with victimization since joining the military and is protected by resiliency. These findings suggest that in addition to the usual mental health factors, these additional predictors should be accounted for in SB intervention and prevention planning for active duty personnel. [ABSTRACT FROM AUTHOR]

Understanding mental health disorder diagnosis and treatment seeking among active-duty military personnel is a topic with both clinical and policy implications. It has been well documented in military populations that individual-level military experience, including deployment history and combat exposure, influences mental health outcomes, but the impact of unit-level factors is less well understood. In the current study, we used administrative longitudinal data to examine a comprehensive set of unit- and individual-level predictors of posttraumatic stress disorder (PTSD), non-PTSD anxiety disorders, depressive disorders, and overall mental health diagnoses among Army and Marines Corps personnel. Using Cox survival models for time-dependent variables, we analyzed time from military accession (between January 1, 2001 and December 31, 2011) until first mental health diagnosis for 773,359 soldiers and 332,093 Marines. Prior diagnosis of a substance abuse disorder during one's military career, hazard ratios (HRs) = 1.68-3.10, and cumulative time spent deployed, HRs = 1.11-2.04, were the most predictive risk factors for all outcomes. Male sex, HRs = 0.35-0.57, and officer rank, HRs = 0.13-0.23, were the most protective factors. Unit-level rate of high deployment stress was a small but significant predictor of all outcomes after controlling for individual-level deployment history and other predictors, HRs = 1.01-1.05. Findings suggest both unit- and individual-level risk and protective factors of mental health diagnoses associated with treatment seeking. Clinical, including mental health assessment and management, and policy implications related to the military environment and the individual as it relates to mental health disorders are discussed. [ABSTRACT FROM AUTHOR]

To evaluate the effect of a peer-based risk reduction project on alcohol use and sexual behavior within Belize Defence Force personnel. We used a quasi-experimental, mixed quantitative and qualitative methods design to evaluate project outcomes. Two serial cross-sectional surveys were conducted [baseline (n = 126) and 6-month follow-up (n = 128)] using computer assisted self-interview. Semistructured interviews were collected from 12 peer counselors 3 months after the beginning of the project. The proportion of respondents screening positive for alcohol dependence decreased significantly from 80 % at preintervention to 66 % at postintervention (p = 0.045), and the percentage of respondents reporting that they normally drink alcohol before work decreased from 11 to 3 % (p = 0.013). Alcohol abuse and dependency scores correlated positively with the overall number of sexual partners in both male and female respondents. There was a slight decrease in the percentage of female respondents' reporting inconsistent condom use for vaginal sex (baseline 100 %, follow-up 83 %, p = 0.088), but there was no appreciable change reported in condom use among male respondents. Qualitative findings suggest that techniques to reduce the quantity of alcohol consumed were a salient focus of peer counselors, and administrative barriers can readily mitigate implementation of such interventions. In this evaluation of a risk reduction program with the BDF, we found evidence of a reduction in types of alcohol use from baseline to follow-up. Alcohol-related risk reductions carry implications for reducing sexual risk behavior in military personnel. Future research with stronger experimental design strategies may better elucidate how substance use reduction is linked with sexual risk reduction in military personnel. [ABSTRACT FROM AUTHOR]