This study is primarily concerned with the possible use and effectiveness of stress inoculation as a psychological preparation for combat. Initial fieldwork, in the form of a review of current practices and their supporting rationales, was carried out in military establishments in three small countries with conscript armies: Sweden, Switzerland and Israel. Commanders,Chief Instructors of Officer Cadet Schools,and military psychologists were interviewed: questions focused on the role, nature and evaluation of stress-related training. These data allowed a cognitive-behavioural model of the soldier in combat to be established, which identified various interventions to improve functioning during that combat. Using this model,a form of stress inoculation was constructed based on the Israeli procedure of group emotional reconstruction (GER) and involving aspects of Swedish audiovisual stress training. Subsequently,four laboratory experiments were conducted which considered the effectiveness of this stress inoculation procedure using a simulated combat stress scenario. These experimental studies were conducted with pre-conscript males in Singapore. Singapore shares common characteristics, geographical, economic, political, demographic and military, with the three countries visited. Several interesting findings emerged. First, although there was some evidence of a stress inoculation effect in terms of differences in the pattern of mood change across the treatment and test sessions(between GER and control conditions in the first two experiments),there was no persistent or lasting difference. It was concluded that the validity of the GER procedure for stress inoculation was not proved. Second, in several of the experiments, subjects' levels of arousal were observed to be reduced on exposure to "disturbing" stimuli and at times when their levels of stress remained high. It was suggested that this change from a high stress: high arousal experience (eg anxiety) to a high stress: low arousal experience (eg boredom) might reflect the subjects' use of cognitive disengagement as a coping strategy. Third, at the end of each test phase, subjects in the GER condition showed some evidence of cognitive disengagement in their mood response, except in the last experiment when they were required to complete a performance test. Finally, when the performance test was introduced in the test phase, it appears to have served as a distractor from the experience of stress for subjects in all conditions. The results are discussed in the light of the existing literature on stress inoculation, and recommendations for further research are presented.
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RC Internal medicine
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