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Cognitive-Adaptation Training for Improving Performance and Stress Management of Air Force Pilots

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This study investigated the effects of cognitive-adaptation training on flight performance and stress management in a sample of pilot cadets who were undergoing a basic flying program (N = 21). The aim of the training was to enhance the participants' awareness of the cognitive processes that they used in a given situation, and to strengthen reflective processes. Cadets were assigned to a training group or to a control group. In-flight performance, stress-management mode, anxiety, and mood were measured. A significant pre- to posttraining improvement in in-flight performance was observed for the lowest ranked cadets in the training group. Anxiety and mood scores did not differ significantly between the training and control groups. However, trained cadets reported changing their stress-management mode. On the whole, these results indicate that cognitive-adaptation training of the type used in this study can enhance both cognitive and emotional adaptation skills.
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... The only military study to measure performance reported no significant difference in improvement in flight score after cognitive-adaptation training (Fornette et al., 2012). A police debriefing resulted in no differences in performance relative to usual processes (Carlier, Voerman, and Gersons, 2000), whereas imagery training increased police performance after a simulated event relative to usual training (Arnetz et al., 2009). ...
... Table 4.1 summarizes the findings. Biggs et al., 2016;Carlier, Voerman, and Gersons, 2000;Castro et al., 2012;Deahl et al., 1994;Foran et al., 2013;Fornette et al., 2012;Greenberg et al., 2010;Hourani et al., 2018;Ilnicki et al., 2012;Jones et al., 2012;Mulligan et al., 2012;Pinna et al., 2017;Roy, Highland, and Costanzo, 2015;Shipherd, Salters-Pedneault, and Fordiani, 2016;Sipos et al., 2012;Sipos et al., 2014;Stetz et al., 2009;Twardzicki and Jones, 2017;Young, 2012;Zimmermann et al., 2015) Publication bias Mixed results for physiological outcomes in 2 studies; 1 study reported no effect on coping skills; 1 study reported reduced risk of (PCL > 40) at 24 months but no effect on SMD in PCL score ...
... Help-seeking stigma 2 RCTs (Mulligan et al., 2012;); 4 cohort comparisons (Russell et al., 2014;Twardzicki and Jones, 2017;Watson and Andrews, 2018;Gould, Greenberg, and Hetherton, 2007) Not applicable Meta-regression was not possible Insufficient Return to duty 8 case studies with no comparator (Holsenbeck, 1992;Hassan et al., 2010;Hoyt et al., 2015;Hung, 2008 Biggs et al., 2016;Carlier, Voerman, and Gersons, 2000;Castro et al., 2012;Deahl et al., 1994;Foran et al., 2013;Fornette et al., 2012;Greenberg et al., 2010;Hourani et al., 2018;Ilnicki et al., 2012;Mulligan et al., 2012;Pinna et al., 2017;Roy, Highland, and Costanzo, 2015;Shipherd, Salters-Pedneault, and Fordiani, 2016;Sipos et al., 2012;Sipos et al., 2014;Stetz et al., 2009;Twardzicki and Jones, 2017;Young, 2012;Zimmermann et al., 2015); 18 case studies in 19 articles (Bryan and Morrow, 2011;Bush, Ouellette, and Kinn, 2014;Carr et al., 2013;Gahm et al., 2009;Garber and Zamorski, 2012;Griffith and West, 2013;Hourani et al., 2017;Jarrett, 2013;Jones et al., 2011;Burdett et al., 2011;Judkins and Bradley, 2017; (Wesemann et al., 2016;Tuckey and Scott, 2014;Wilson et al., 2001;Cacioppo et al., 2015); 4 cohort comparisons (Larsson, Michel, and Lundin, 2000;Deahl et al., 1994;Gould, Greenberg, and Hetherton, 2007) Indirect Biggs, 2016;Carlier, Voerman, and Gersons, 2000;Castro et al., 2012;Deahl et al., 1994;Foran et al., 2013;Fornette et al., 2012;Greenberg et al., 2010;Hourani et al., 2018;Ilnicki et al., 2012;Mulligan et al., 2012;Pinna et al., 2017;Roy, Highland, and Costanzo, 2015;Shipherd, Salters-Pedneault, and Fordiani, 2016;Sipos et al., 2012;Sipos et al., 2014;Stetz et al., 2009;Twardzicki and Jones, 2017;Young, 2012;Zimmermann et al., 2015); 18 case studies in 19 articles (Bryan and Morrow, 2011;Bush, Ouellette, and Kinn, 2014;Carr et al., 2013;Gahm et al., 2009;Garber and Zamorski, 2012;Griffith and West, 2013;Hourani et al., 2017;Jarrett, 2013;Jones et al., 2011;Burdett et al., 2011;Judkins and Bradley, 2017; Overall, meta-analyses found that COSC programs had no significant difference in effect on sleep, alcohol misuse, anxiety, depression, PTSD symptoms (usually measured by PCL score), or help-seeking stigma compared with active interventions, such as a single, standard stressmanagement class. Meta-analyses also found no significant effect on alcohol misuse, depression, PTSD symptoms, PTSD case rate, stress level, or help-seeking stigma compared with no intervention. ...
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Military personnel, police officers, firefighters, and other first responders must prepare for and respond to life-threatening crises on a daily basis. This lifestyle places stress on personnel, and particularly so on military personnel who may be isolated from support systems and other resources. The authors conducted a systematic review of studies of interventions designed to prevent, identify, and manage acute occupational stress among military, law enforcement, and first responders. The body of evidence consisted of 38 controlled trials, 35 cohort comparisons, and 42 case studies with no comparison group, reported in 136 publications. Interventions consisted of resilience training, stress inoculation with biofeedback, mindfulness, psychological first aid, front-line mental health centers, two- to seven-day restoration programs, debriefing (including critical incident stress debriefing), third-location decompression, postdeployment mental health screening, reintegration programs, and family-centered programs. Study limitations (risk of bias), directness, consistency, precision, and publication bias were considered in rating the quality of evidence for each outcome area. Overall, interventions had positive effects on return to duty, absenteeism, and distress. However, there was no significant impact on symptoms of psychological disorders such as PTSD, depression, and anxiety. Because of study limitations, inconsistency of results, indirectness, and possible publication bias, there was insufficient evidence to form conclusions about the effects of most specific intervention types, components, settings, or specific populations.
... The only military study to measure performance reported no significant difference in improvement in flight score after cognitive-adaptation training (Fornette et al., 2012). A police debriefing resulted in no differences in performance relative to usual processes (Carlier, Voerman, and Gersons, 2000), whereas imagery training increased police performance after a simulated event relative to usual training (Arnetz et al., 2009). ...
... Table 4.1 summarizes the findings. Biggs et al., 2016;Carlier, Voerman, and Gersons, 2000;Castro et al., 2012;Deahl et al., 1994;Foran et al., 2013;Fornette et al., 2012;Greenberg et al., 2010;Hourani et al., 2018;Ilnicki et al., 2012;Jones et al., 2012;Mulligan et al., 2012;Pinna et al., 2017;Roy, Highland, and Costanzo, 2015;Shipherd, Salters-Pedneault, and Fordiani, 2016;Sipos et al., 2012;Sipos et al., 2014;Stetz et al., 2009;Twardzicki and Jones, 2017;Young, 2012;Zimmermann et al., 2015) Publication bias Mixed results for physiological outcomes in 2 studies; 1 study reported no effect on coping skills; 1 study reported reduced risk of (PCL > 40) at 24 months but no effect on SMD in PCL score ...
... Help-seeking stigma 2 RCTs (Mulligan et al., 2012;); 4 cohort comparisons (Russell et al., 2014;Twardzicki and Jones, 2017;Watson and Andrews, 2018;Gould, Greenberg, and Hetherton, 2007) Not applicable Meta-regression was not possible Insufficient Return to duty 8 case studies with no comparator (Holsenbeck, 1992;Hassan et al., 2010;Hoyt et al., 2015;Hung, 2008 Biggs et al., 2016;Carlier, Voerman, and Gersons, 2000;Castro et al., 2012;Deahl et al., 1994;Foran et al., 2013;Fornette et al., 2012;Greenberg et al., 2010;Hourani et al., 2018;Ilnicki et al., 2012;Mulligan et al., 2012;Pinna et al., 2017;Roy, Highland, and Costanzo, 2015;Shipherd, Salters-Pedneault, and Fordiani, 2016;Sipos et al., 2012;Sipos et al., 2014;Stetz et al., 2009;Twardzicki and Jones, 2017;Young, 2012;Zimmermann et al., 2015); 18 case studies in 19 articles (Bryan and Morrow, 2011;Bush, Ouellette, and Kinn, 2014;Carr et al., 2013;Gahm et al., 2009;Garber and Zamorski, 2012;Griffith and West, 2013;Hourani et al., 2017;Jarrett, 2013;Jones et al., 2011;Burdett et al., 2011;Judkins and Bradley, 2017; (Wesemann et al., 2016;Tuckey and Scott, 2014;Wilson et al., 2001;Cacioppo et al., 2015); 4 cohort comparisons (Larsson, Michel, and Lundin, 2000;Deahl et al., 1994;Gould, Greenberg, and Hetherton, 2007) Indirect Biggs, 2016;Carlier, Voerman, and Gersons, 2000;Castro et al., 2012;Deahl et al., 1994;Foran et al., 2013;Fornette et al., 2012;Greenberg et al., 2010;Hourani et al., 2018;Ilnicki et al., 2012;Mulligan et al., 2012;Pinna et al., 2017;Roy, Highland, and Costanzo, 2015;Shipherd, Salters-Pedneault, and Fordiani, 2016;Sipos et al., 2012;Sipos et al., 2014;Stetz et al., 2009;Twardzicki and Jones, 2017;Young, 2012;Zimmermann et al., 2015); 18 case studies in 19 articles (Bryan and Morrow, 2011;Bush, Ouellette, and Kinn, 2014;Carr et al., 2013;Gahm et al., 2009;Garber and Zamorski, 2012;Griffith and West, 2013;Hourani et al., 2017;Jarrett, 2013;Jones et al., 2011;Burdett et al., 2011;Judkins and Bradley, 2017; Overall, meta-analyses found that COSC programs had no significant difference in effect on sleep, alcohol misuse, anxiety, depression, PTSD symptoms (usually measured by PCL score), or help-seeking stigma compared with active interventions, such as a single, standard stressmanagement class. Meta-analyses also found no significant effect on alcohol misuse, depression, PTSD symptoms, PTSD case rate, stress level, or help-seeking stigma compared with no intervention. ...
Technical Report
Full-text available
Military personnel, police officers, firefighters, and other first responders must prepare for and respond to life-threatening crises on a daily basis. This lifestyle places stress on personnel, and particularly so on military personnel who may be isolated from support systems and other resources. The authors conducted a systematic review of studies of interventions designed to prevent, identify, and manage acute occupational stress among military, law enforcement, and first responders. The body of evidence consisted of 38 controlled trials, 35 cohort comparisons, and 42 case studies with no comparison group, reported in 136 publications. Interventions consisted of resilience training, stress inoculation with biofeedback, mindfulness, psychological first aid, front-line mental health centers, two- to seven-day restoration programs, debriefing (including critical incident stress debriefing), third-location decompression, postdeployment mental health screening, reintegration programs, and family-centered programs. Study limitations (risk of bias), directness, consistency, precision, and publication bias were considered in rating the quality of evidence for each outcome area. Overall, interventions had positive effects on return to duty, absenteeism, and distress. However, there was no significant impact on symptoms of psychological disorders such as PTSD, depression, and anxiety. Because of study limitations, inconsistency of results, indirectness, and possible publication bias, there was insufficient evidence to form conclusions about the effects of most specific intervention types, components, settings, or specific populations.
... Like BOOTSTRAP, Resistance to Interrogation Training 25 resulted in greater use of coping strategies. Improvements in stress management skills occurred in the Cognitive Adaptation Skills programme, 26 while aspects of social cognition (how people process, store and apply information about other people and social situations) and feelings of loneliness both improved in the Building Social Resilience programme. 27 Further positive self-efficacy and stress control effects were reported for biofeedback and arousal control during stressful training 20 although biofeedback and cognitive training did not produce significant main effects in the Pyne et al, 23 app-based deployment study. ...
Article
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... The U.S. Army has also implemented the Mindfulness-based Mental Fitness program, with positive results. 9 Large corporations are investing ...
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