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Advice

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Advice

    Advice

    May2007,Volume4':!堕曼US.ChinaEducationReview,ISSN1548?6613,

    Advicetomentalhealthinterventionforrecruitsbasedonaninvestigation formentalstatusofservicemenduringbasicmilitarytraining

    LlHong.zhe2

    .

    MIAODan.min1.

    LEIMei.ying2

    .

    CHENXiao.yan2.

    LIUXiao-bing2

    (1.SchoolofAerospaceMedicine,FourthMilitaryMedicalUniversity,Xi'anShanxi710032,China;

    2.DepartmentofMentalHealth.the303rdHospitalPLA.NanningGuangxi530021,China) Abstract:Basicmilitarytrainingconsistsofhighlyregimentedtraininginthecontextoffairlyextreme

    psychosocialstressors,andsomerecruitssufferedfromrigorousdisturbanceinmind.Evenifpracticalmeasures

    whichincludeinstructivepsychologicalinterventionhavebeentakentoamelioratethedisturbance,some

    questionsstillhavenotbeensettledinourpracticalworkforrecruits.Forexample,whatarethemanifestationsof

    psychologicalproblemsforrecruits?Whatisthedifferenceofthepsychologicalproblemsatdifferentstages

    duringthetraining?Aperspectiveinvestigationwasfoundthatemotiondisturbancesbeforethetrainingand

    somaticsymptomsattheendofthe1monthoftrainingareremarkable,whichcanbeviewedas,

ifneeded,target

    symptomsinthepsychologicalintervention.Whilerecruitsgotmoreobjectivesocialsuppo~sinthelatertraining

    andtheirsleepstatushadnotshownsignificantchangeduringthemilitarytraining.Basedontheinvestigations,

    wealsosubmittedoursuggestiontomentalhealthinterventionforrecruits,andthismaybehelpfulforhealth

    educationinthearmy.

    Keywords:mentalhealth;recruits;basicmilitarytraining;intervention Militaryadministrationshaveattachedgreatimportancetothementalstatusanditsrelatedissuesof

    servicemen,especiallytothoseoftherecruits.

    Basicmilitarytrainingconsistsofhighlyregimentedtraininginthecontextoffairlyextremepsychosocial

    stressors(e.g.,isolationfromfriendsandfamily,constantmonitoringandevaluationofbehavior)aswellas

    physicalstressors(e.g.,intenseexercise,limitedsleep)duringthecourseofthetraining,someenlisteescan'tstand

    thepressurefromthetrainingconditions,andsufferfrommanykindsofmentaldisordersorgeneralmentalhealth

    problems.Aninvestigation(Klein&Hawes,1991)showedthatthesixmostcommondiagnostictypesofmental

    healthproblemsweredepressivedisorder,adjustmentdisorder,traumaticstressdisorder,posttraumaticstress

    disorder(PTSD),alcoholabuseoralcoholdependence,anxietydisordersandproblemsininterpersonal

    relationship,amongwhichtheoverwhelmingdiagnostictypewasadjustmentdisorder,accountingfor3.33%of

    thetotalnumberoftherecruits.Forgeneralmentalproblems,itwasfound(Schei,1994)thatabout48%ofthe

recruitssufferedfromthem.

    LIHong-zheng,M.D.,associateprofessor,postdoctoralinappliedpsychology,DepartmentofMentalHealth,the303rdHospital

    0fPLA:researchfields:appliedpsychologyandpsychiatry.

    MIA0Dan.min,Correspondenceauthor,Ph.D.,professorofDepartmentofPsychology,SchoolofAerospaceMedicine,Fourth

    MilitaryMedicalUniversity:researchfield:psychologicalme~urement. LEIMei.ving,Master,DepartmentofMentalHeath,the303rdHospitalofPLA:researchfield:psychiatry.

    CHENXiao.yan.DepartmentofNursing,the303rdHospitalofPLA:researchfield:nursingmanagement.

    UUXiao.bing,Master,DepartmentofMentalHealth,the303rdHospitalofPLA;researchfield:psychiatry.

    Ad~cetOmentalhealthinterventionforrecruitsbasedonaninvestigationfor mentalstatusofservicemenduringbasicmilitarytraining

    1.Background

    Mentalhealthproblemsmaybehavenegativeeffectsonindividualsthemselves,unitperformanceand

    administrationsfortheunits,andinsomeconditionsitmaybeleadtogravemilitaryaccidents.Itwasconfirmed

    (Crawford&Fiedler,1991)thatpsychologicalproblemssuchasdepression,personalitydeviationandexcessive

    anxietywereamajorcauseoffirst

    termenlistedattritionintheU.S.Navy,atleast7%oftheindividualswere attritedforpsychologicalreasons,theamountofmilitaryexpenditurewaswasted.Uptonow,wehavenotfound

    relativereportsabouttheeffectsofpsychologicalproblemsontheadministrationforunitsinChina;itisthesame

    casewiththemilitaryaccidents.However,wecouldn'tdenythenegativeeffectsofpsychologi

calproblemsinthis

    aspect.

    Therearethreepracticalmeasureswhichincludepsychologicalscreeningforrecruitsbeforetheenlistment,

    attritionsuggestionorhospitalizationforthepsychosispatients,andinstructivepsychologicalinterventionfor

    generalmentalhealthproblems.Butnow,therestillhasnostandardizedscreeninginstrumentforallkindsof

    psychiatricdisordersusedroutinelyatthetimeofaccessionintothemilitaryservice,andlikewisetherehasno

    standardizedscreeningprocedurethatcanpreventeffectivelysomeotherwisehealthyrecruitsfromdeveloping

    psychiatricsymptoms.Therefore,mentalhealthinterventionsaretheeffectivemeasuresfortherecruitsenlistedin

    thearmyduringthebasictraining,andrecentresearchesalsoshowedsomeevidencesforthesework.Forexample,

    itwasfound(Schei,1994)thatinterpersonalrelationshipandeconomicalStatuSwererelatedtomentalstatus.

    Similarly,changesinlivingconditionsandsocialsupportwereriskfactorsofmentaldisorder. However,manystudiesreportedinliteratureswerecross

    sectioninvestigations,andfewfactorswere

    concernedinsomeresearches.Infact,somequestionshavenotbeensettledinourpracticalworkforrecruits.For

    example,whatarethemanifestationsofpsychologicalproblemsforrecruits?Whatisthedifferenceofthe

    psychologicalproblemsatdifferentstagesduringthetraining?Whetherpersonalitytrait,copingstyle,andsocial

    supporthaverelationtosleepconditionsofrecruitsornot?

    Thispaperwilladdressthosequestionsmentionedabove,andthepurposesinthestudiesare:(1)To

    investigatethecharacteristicsoftherecruits'mentalstatusanditsrelatedissuesindifferentphasesduringthe

    basicmilitarytraining.(2)Toexploretherelatedfactorswhichhaveinfluenceonthesleepconditionsofrecruits.

    (3)Tooffersuggestiontothementalhealthinterventionforrecruitsduringthebasicmilitarytrainingbasedonthe

    investigationsmentionedabove.

    Permissionwasobtainedfromseverallevelsofthemilitaryauthoritiestoperformtheresearch.andassurance

    thatthemethodsusedinthisstudyprotectedtherightsoftherecruitswasacquiredfromallthecommanding

    officersandacommitteeofamilitaryhospita1.Eachrecruitwasprovidedwiththeopportunitytoacceptor

    declineparticipationinthestudy.

    2.Investigationsformentalstatusofrecruitsduringbasicmilitarytraining 2.1Methodology

    2.1.1Sample

    Thetargetpopulationconsistedof1432malerecruitswhoweresampledrandomlyfromafieldemergency

    reactionunit.Upontheirarrivalatthecamp,therecruitswereassignedtoplatoons, andeachplatoonwasmadeup

    of30

    40recruits.60platoonswereselectedinourstudies.Theconclusioncriteriaofrecruitswere:(1)Land

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    Advicetomentalhealthinterventionforrecruitsbasedonaninvestigationfor mentalstatusofservicemenduringbasicmilitarytraining

    militaryrecruitsonactivedutyduringthesamplingtimeframe;(2)recruitsselectedforthissurvey;(3)the

recruitshadtocompletethefullbasicmilitarytraining.

    2.1.2Measureinstruments

    Alltheinstrumentsmeettheneedofpsychometrics,characterizedasreasonablevalidityandreliability

    (WANGXiangdong&WANGXilin,1999).

    Theinstrumentsareasfollows,SymptomChecklist(SCL90

    R)whichassessesgeneralpsychiatric

    symptomshas90itemsforevaluatingspecialexperienceduringthepast7days.Socialsupportscale(sss)which

    assessestheconditionsofsocialsupportcontains12itemsascribingto3dimensions(thesubjectivesocialsupport,

    theobjectiveone.andthesupportutility).EysenckPersonalityQuestionnaireforadults(EPQadults)revisedfor

    Chinesewhichassessespersonalitycontains88itemsassessing4dimensionsofpersonalitytrait(Neuroticism,

    ExtrovisionorIntrovision,Psychoticism,andLie).SimpleCopingStyleQuestionnaire(SCSQ)whichassesses

    copingstyleincludes20itemsascribingto2dimensions(positivecopingstyleandnegativecopingstyle).

    PittsburghSleepQualityIndex(PSQI),a19

    itemself-reportquestionnairethatassessessleepqualityand

    disturbancesoccurredduringthepastmonth,yieldsevencomponentscores(subjectivesleepquality,sleeplatency,

    sleepduration,habitualsleepefficiency,sleepdisturbance,useofsleepingmedicationanddaytimedysfunction).

    2.1.3Procedure

    Allthedatawerecollectedbytheinvestigatorandapanelofcolleaguesduringthreesessions.SCL90,SCSQ,

    andPSQ1werecollectedrespectivelybeforethetraining(time1),attheendofthelmonthoftraining(time2),

andattheendofthe2

    monthoftraining(time3).EPQwascollectedbeforethetrainingandattheendofthe2

    monthoftraining,whileSSSattime2andattime3.Demographicdatawerecollectedbeforethetraining.

    2.1.4Statisticalmethods

    Thedistributionofanumberofquantitativevariableswasskewed,andwasconsequentlyanalyzedwithboth

    parametricandnon

    parametricstatisticalmethods.EssentiallythesalTleresultswereobtainedbybothmethods, andthefollowingpresentationisbasedonuni

    andmultivariateanalysesofvariance.ResultsbasedonFanalysis,

    paired-samplesTtest,andDunnet-test.AllthedatawereanalyzedbySPSS10.0. 2.2Results

    2.2.IDemography

    Alltheparticipantsweremalerecruits,witheducationlevelslargely(50.2%)for8years,andthemeanage

    was18.51years(SD=I.08years).Inthetotalpooloftherecruits.69.4%ofthemwerefromthecountry,andthe

    restwerefromthecity.

    2.2.2MentalsymptomsofSCL90Rindifferenttrainingphases

    Somaticsymptomsattime2testwasthehighest,thenattime1testandattime3testinsequence(P<0.01).

    Thescoresoftheothercomponents(obsessive-compulsive,interpersonalsensitivity,depression,anxiety,hostility,

    phobia,paranoid,psychiatric)ofSCL

    90attime1testwerethehighest,thenthatattime2testandtime3test

    respectively.

    2.2.3Socialsupportindifferenttrainingphases

    Nostatisticallysignificantdifferenceswerefoundbetweenthescoresofsubjectivesocialsupportindifferent

    timepointsduringthetraining(P===0.93),whilethescoresofobjectivesocialsupportincreasedandsupportutility

    decreasedafterthetraining<0.05).

    2.2.4DifferenceofthescoreofEPQduringthetraining

    Thescoresofthreedimensions,i.e.Intro.andExtroversion,Neuroticism,andLie,decreasedwhilethatof

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    Advicetomentalhealthinterventionforrecruitsbasedonaninvestigationfor mentalstatusofservicemenduringbasicmilitarytraining

    psychoticismincreasedafterthebasictrainingfP<0.O1).

    2.2.5CharacteristicofSCSQduringthetraining

    Beforeandafterthetraining,therehadstatisticallysignificantdifferencesrespectivelyinthescoresofthe

    twocomponents(positivecopingstyleandnegativecopingstyle)ofSCSQ(P<0.05).ThescoresofSCSQbefore

    thetrainingwerethehighest.thenattheendofthe1monthandthe2monthsoftraininginsequence.

    2.2.6Sleepqualityanditsrelatedfactors

    (1)Differencesofsleepqualityduringthetraining

    NosignificantdifferenceamongthetotalscoreofPSQ1werefoundduringthetraining(P--0.76),Thescore

    offunctiondisorderscausedbysleeptroubleinthedaytimeattime2,aswellasthatofsleepquality,waslower

    thallthatofattime3.

    (2)Relatedfactorsaffectingsleep

    TheoverwhelminginfluenceonthescoreofPSQ1wasfromsymptomindexofSCL.90.R,although

    neuroticismtrait,psychoticismtrait,educationlevel,lietrait,subjectivesocialsupport,andsupportutilitywere

    alsosignificantvariablesdeterminingthescoreofPSQI.Allthesevensignificantvariableswerethemainrelated

    factorsaffectingrecruits'sleep.

    3.Discussionandsuggestion

    3?1Aboutmentalsymptoms

    Generalmentalproblemscanbeseeninhealthyindividuals,

    itisconcernedwithsomeunusualsurroundings

    toalargedegree,andltsseventydoesnotmeetthediagnosticcriteriaofpsychoses.SCL-90isanapplicable

    sell-ratinginstrumenttoevaluatementalsymptomandseverity.Itisbroadlyusedintheassessmentofrecruits'

    mentalstatusinChina.However,someresultsoftherelatedreportsdifferedfromeachother ,

    forexample.our

    studies(LIHong

    zheng&CHENQiong-ni,2004)showedthatanxietysymptomsamelioratedduringthetrainin2,

    whereasMetaanalysisofus(LIHong-zheng&LIXue-rong,2003)showednosignificantdifferences.The

    inconsistencyoftheresultsmaybeascribetothatofthesamplesizeorsampletime. Theresultsofthesestudiesweresupportedbythoseofothers,anditwasfoundthatemotionproblems,for

    example,depression,anxiety,andphobia,wereveryprominentbeforethebasicmilitarytraining.For"somatic''

    symptoms,ourresultsshowedthatthesecomplaintswereratherobviousattheendofthe1monthtraining.We

    speculatedthattrainingitselfwasacontributingfactorstoit.Thisviewcanbeexplainedbyotherstudies(Clemons,

    1996),whichshowedthatphysicaltrainingatweek3(whichwastherigoroustrainingtime)couldresuitinmanv

    kindsofbodysymptoms.Therefore,thetermof"somatic"usedherecannotbeunderstoodasthemeaningin

    psychologywhichimplicatesthebodyexpressionofone'spsychicstruggle(LIHongzheng&amp;LIXue.rong,

    2003).

    Inaddition,ourresultswerecompatiblewiththoseofotherauthors(Lerew&Schmidt,1999),intheir

    researchesonservicemeninFinland;itwasfoundthatthepsychopathologicallevelofrecruitsdecreasedduringthe

    training,whichindicatedthatemotioninterventionforrecruitsbeforethetrainingwasofgreatimportance

    .However,

    itisnotthecasewithallthesymptoms,amildandmoderatelevelofanxietyisthemostbeneficialandmayhelpthe

    individualtofunctionmoreproficientlyandeffectively.Itisonlywhentheanxietylevelexceededsuchadegreethat

    arecruitcan'tstandandthefunctioningcapacityisgreatlyinducedthatanxietyinterventionisneeded.

    Whatwerethefactorsthatcontributedtotheemotiondisturbanceofrecruits?Ithasbeenstated(Clausin2&

    Company,1991)thattrainingduringthefirst3weekswasthemostdifficult.Aheavyworkloadofclassroom

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    Ad~cetomentalhealthinterventionforrecruitsbasedonaninvestigationfor mentalstatusofservicemenduringbasicmilitarytraining

    instruction,hoursofmilitarytraining,physicalfitnesstraining,andfurtherinstructionbythecompany

    commanderlefttherecruitswithminimalfreetime,thenthevigoroustrainingconditionsmayberesultedinthe

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