Improving health in the military and beyond using salutogenic design

Purpose Service members of the US Department of Defense (DoD) have alarmingly high rates of depression, anxiety, probable stress disorders and suicidality, all of which are negative health conditions exacerbated by various external stressors. High-stress work conditions – to include shift work, hazardous territories, high-stakes mission sets and generally disconnected sites – require a work environment that facilitates, rather than inhibits, stress reduction and mental well-being. This paper aims to present “salutogenic design” as an innovative approach: Salutogenic design offers demonstrated architectural solutions that improve health and well-being. Design/methodology/approach This paper describes salutogenic design strategies beginning with the need for such an approach, the call to action to implement strategic and tactical solutions and the challenges and financial impacts of such a broad and innovative strategy to improve workplace health, well-being and performance in the DoD and beyond. Examples of these strategies, via biophilic design solutions, are presented in the central Table 1 as an easy-to-reference tool and supported by the voluminous literature as referenced, in part, through this research paper. Findings Salutogenic design strategies offer innovative, financially viable solutions to help mitigate stress and improve workforce well-being while maintaining the highest level of building security requirements in access-controlled spaces and disconnected sites, such as military installations and government compounds. Research limitations/implications Issues of mental and physical health are complex and multi-faceted, and they require complex and multi-faceted solutions. Salutogenic design is presented as one facet of that solution: a tangible solution to an often-intangible issue. Further, as a novel approach to address a critical DoD issue, Table 1 bridges the common gap between high-concept design theory and practical construction-application solutions, with positive value to the health, performance, quality-of-life and well-being of service members. Originality/value To the best of the author’s knowledge, this paper is the first to approach the DoD’s imperative to reduce service members’ mental stress with “salutogenic design.”

Explanatory models of post-traumatic stress disorder (PTSD) and depression among Afghan refugees in Norway

Background The current situation in Afghanistan makes it likely that we are facing a new wave of Afghan refugees, warranting more knowledge about how to deal with mental health problems among them. This study aims to gain more knowledge on Explanatory Models (EM) of depression and post-traumatic stress disorders (PTSD) among Afghan refugees resettled in Norway. Methods We conducted six gender-separated, semi-structured focusgroup interviews based on vignettes with Afghan refugees (total N = 27). The vignettes described a fictional character with symptoms of either depression or PTSD symptoms in line with DSM-5 and ICD-10 criteria. Results The findings showed that EM varied with gender, age, generation, and migration stories. Participants suggested different potential causes, risk factors, and ways of managing symptoms of depression and PTSD depending on the context (e.g., in Norway vs. Afghanistan). In describing the causes of the depression/PTSD in the vignettes, females tended to emphasize domestic problems and gender issues while males focused more on acculturation challenges. The younger males discussed mostly traumatic experiences before and during flight as possible causes. Conclusion The practice of condensing a single set of EMs within a group may not only be analytically challenging in a time-pressed clinical setting but also misleading. Rather, we advocate asking empathic questions and roughly mapping individual refugee patients’ perceptions on causes and treatment as a better starting point for building trusting relationships and inviting patients to share and put into practice their expertise about their own lives.

Virtual Reality Exposure Therapy and Physiological Data Analysis for Treatment of Stress Disorders

Anxiety disorders are diagnosed when people become overreactive, disassociated, and feel emotionally unable to control feelings to the extent that their daily lifes are affected. Driving phobia is one of the widespread anxiety disorders in modern society, which cause problematic disruptions of a patient's daily activities. Exposure therapy is an approach gaining popularity for treating patients with stress disorders. Virtual reality (VR) technology allows people to interact with objects and stimuli in an immersive way. The VR for phobic therapy using indirect exposure, which can be safely discontinued or lowed in terms of intensity, is the area of research with literature published and patents granted. This research focuses on reviewing virtual reality exposure therapy (VRET) literature and patents. The chapter also presents the research and development of a novel driving phobia VRET system with the detailed experiments to demonstrate the design, development, implementation, enhancement, and verification of VRET.

Personified program for correction of post-stress disorders in different categories of survivors (combatants and volunteers)

Combat stress has a significant impact on the individual. It is a major cause of combat mental trauma and stress disorders development. According to the World Health Organization, combat mental trauma is a direct cause of stress disorders in 80 % of survivors of hostilities, and in its long term are often observed: maladaptation, autoaggressive behavior, anxiety and depression, addiction. Against the background of use of the developed program, positive dynamics of mental state, decrease in levels of anxiety and depression, decrease in the level of groups of PTSD symptoms on the Impact of Event Scale were noted. Reducing level of maladaptation according to the method of K. Rogers and R. Diamond and level of social frustration. Thus, the developed personalized program for the correction of post-stress disorders contributes to the productive dynamics of psychopathological symptoms, reducing emotional tension, restoring a sense of psychological well-being, creating a new cognitive model of life.

Sustained TNF signaling is required for the synaptic and behavioral response to acute stress

Acute stress triggers plasticity of forebrain synapses as well as behavioral changes. Here we reveal that Tumor Necrosis Factor α (TNF) is a required downstream mediator of the stress response in mice, necessary for stress-induced synaptic potentiation in the ventral hippocampus and for an increase in anxiety-like behaviour. Acute stress is sufficient to activate microglia, triggering the long-term release TNF. Critically, on-going TNF signaling in the ventral hippocampus is necessary to sustain both the stress-induced synaptic and behavioral changes, as these could be reversed hours after induction by antagonizing TNF signaling. This demonstrates that TNF maintains the synaptic and behavioral stress response in vivo, making TNF a potential novel therapeutic target for stress disorders.

Complex Interactions Between Sex and Stress on Heroin Seeking

Rationale: Stress plays a dual role in substance use disorders as a precursor to drug intake and a relapse precipitant. With heroin use at epidemic proportions in the United States, understanding interactions between stress disorders and opioid use disorder is vital and will aid in treatment of these frequently comorbid conditions.Objectives: Here, we combine assays of stress and contingent heroin self-administration (SA) to study behavioral adaptations in response to stress and heroin associated cues in male and female rats.Methods: Rats underwent acute restraint stress paired with an odor stimulus and heroin SA for subsequent analysis of stress and heroin cue reactivity. Lofexidine was administered during heroin SA and reinstatement testing to evaluate its therapeutic potential. Rats also underwent tests on the elevated plus maze, locomotor activity in a novel environment, and object recognition memory following stress and/or heroin.Results: A history of stress and heroin resulted in disrupted behavior on multiple levels. Stress rats avoided the stress conditioned stimulus and reinstated heroin seeking in response to it, with males reinstating to a greater extent than females. Lofexidine decreased heroin intake, reinstatement, and motor activity. Previous heroin exposure increased time spent in the closed arms of an elevated plus maze, activity in a round novel field, and resulted in object recognition memory deficits.Discussion: These studies report that a history of stress and heroin results in maladaptive coping strategies and suggests a need for future studies seeking to understand circuits recruited in this pathology and eventually help develop therapeutic approaches.

Traumatic Stress Disorders

The symptoms of posttraumatic stress disorder (PTSD) have long been recognized in medicine, history, literature, and philosophy. This chapter provides an introduction and overview to this handbook, focusing on the historical context that underlies current issues within the trauma literature. This handbook contains eight parts, focusing on classification and phenomenology; epidemiology and special populations; contributions from theory, assessment, prevention, and early intervention; treatment; and dissemination/implementation and ending with a chapter highlighting future directions. The historical underpinnings of each area are delineated, with attention to their linkage with current research. The hope for this revised edition of the Handbook of Traumatic Stress Disorders is to facilitate linkages among cross-cutting areas of study and clinical application, while providing concise, up-to-date reviews of current knowledge.

A study to Assess the Psychosocial Issues Associated with Covid-19 Pandemic among the Family Members of Third year B.Sc. Nursing Students in selected Colleges of Pathanamthitta District

Background: In January 2020, the World Health Organization (WHO) declared that Covid-19 is characterized as pandemic. It is a major health crisis affecting several nations. The crisis generates stresses throughout the population. This pandemic condition is leading the public to experience psychosocial problems such as post- traumatic stress disorders, psychological distress, depression and anxiety. Objectives: 1. To assess the psychosocial issues of family members of third year BSc nursing students regarding the covid-19 pandemic. 2. To find out the association between the psychosocial issues with demographic variables. 3. To implement psychosocial education to overcome the psychosocial issues related to covid -19 pandemic. Methodology: A Non-experimental descriptive survey design was used to assess the perceived psychosocial issues associated with COVID-19 pandemic among the family members. The study was conducted among 50 samples selected by inclusion and exclusion criteria through random sampling technique. The data was collected by using a baseline data questionnaire. The data were collected, tabulated and analyzed by using descriptive and inferential statistics. Chi-square test was used to find out the association between selected demographic variables and psychological issues. Results: In the present study, the finding shows that the 76% of the parents have moderate impact on daily life style. 64% of parents have a mild impact on finance. 61% of the parents have mild insomnia. 60% of the parents have moderate level of anxiety and depression. Conclusion: The study concludes that psychosocial issues are a common phenomenon among the parents and grandparents.