Stress-Related Mental Health Symptoms in Coast Guard: Incidence, Vulnerability, and Neurocognitive Performance

Abstract

U.S. Coast Guard (CG) personnel face occupational stressors (e.g., search and rescue) which compound daily life stressors encountered by civilians. However, the degree CG personnel express stress-related mental health symptoms of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) is understudied as a military branch, and little is known concerning the interplay of vulnerabilities and neurocognitive outcomes in CG personnel. The current study addressed this knowledge gap, recruiting 241 active duty CG personnel (22% female) to assess mental health, personality, and neurocognitive function. Participants completed a battery of scales: PTSD Checklist with military and non-military prompts to screen for PTSD, Psychological Health Questionnaire 8 for MDD, and scales for behaviorally inhibited (BI) temperament, and distressed (Type D) personality. Neurocognitive performance was assessed with the Defense Automated Neurobehavioral Assessment (DANA) battery. Cluster scoring yielded an overall rate of PTSD of 15% (95% CI: 11–20%) and 8% (95% CI: 3–9%) for MDD. Non-military trauma was endorsed twice that of military trauma in those meeting criteria for PTSD. Individual vulnerabilities were predictive of stress-related mental health symptoms in active duty military personnel; specifically, BI temperament predicted PTSD whereas gender and Type D personality predicted MDD. Stress-related mental health symptoms were also associated with poorer reaction time and response inhibition. These results suggest rates of PTSD and MDD are comparable among CG personnel serving Boat Stations to those of larger military services after combat deployment. Further, vulnerabilities distinguished between PTSD and MDD, which have a high degree of co-occurrence in military samples. To what degree stress-related mental healthy symptoms and attendant neurocognitive deficits affect operational effectiveness remains unknown and warrant future study.

Inhibited Personality Temperaments Translated Through Enhanced Avoidance and Associative Learning Increase Vulnerability for PTSD

“…This relationship was the strongest for avoidance symptoms (i.e., PTSD symptom cluster C as defined in the DSM-IV). BI was also related to PTSD symptom severity in a sample of active duty Coast Guard personnel (Servatius et al., 2017). In this study, PTSD was measured with the PTSD checklist for both military and non-military experiences.…”

A computer-based avatar task designed to assess behavioral inhibition extends to behavioral avoidance but not cognitive avoidance

“…Specifically, childhood BI is a risk factor for the later development of adult PTSD ( North et al, 1999 ; Fincham et al, 2008 ; Kashdan, Morina & Priebe, 2009 ). BI also correlates with severity of PTSD symptoms ( Myers et al, 2012 ; Myers, VanMeenen & Servatius, 2012 ; Servatius et al, 2017 ). In addition, Richman & Frueh (1997) reported high levels of HA in veterans with combat related PTSD.…”

Cardiorespiratory Response to Moderate Hypercapnia in Female College Students Expressing Behaviorally Inhibited Temperament

“…Behaviorally inhibited (BI) temperament is one such vulnerability. BI is defined as a personality disposition marked by extreme withdrawal in the face of novel non-social or social challenges , with numerous studies linking BI to anxiety disorders (Biederman et al, 2001; and PTSD (Myers et al, 2012a,b;Servatius et al, 2017;Handy et al, 2018). Those individuals with BI temperament display associative learning biases, evident as facilitated acquisition of the classically conditioned eyeblink responses in adolescents (Holloway et al, 2012;Caulfield et al, 2015), adults (Allen et al, 2014(Allen et al, , 2016, active duty military (Handy et al, 2018), and veterans (Myers et al, 2012a).…”

“…Moreover, distressed (Type D) personality, a combination of negative affect and social inhibition linked to cardiovascular disease, has been reported to have low HRV (Martin et al, 2010;Bibbey et al, 2015). Both harm avoidance (Allen et al, 2017) and Type D personality (Servatius et al, 2017;Allen et al, 2018;Handy et al, 2018) are highly correlated with BI temperament. Thus, it is reasonable to expect BI to have inherently reduced HRV or alternatively greater reductions of HRV from exposure to challenges.…”

“…Possible scores range from 0 to 32 with higher scores indicating higher levels of BI. Consistent with previously established methodology (Allen et al, 2014;Servatius et al, 2017;Handy et al, 2018), individuals were classified as NI or BI based on a cut score of 15.5.…”