COPING WITH COMBAT STRESS INSIGHTS INTO RESILIENCE AND POSITIVE ADAPTATION.

COPING WITH COMBAT STRESS: INSIGHTS INTO RESILIENCE AND POSITIVE

ADAPTATION

Chapter 1: Introduction

Background

The terrorist attacks of September 11, 2001 changed the lives of many people in

the United States (US), triggering the start of the Global War on Terrorism (GWOT). In

October 2001, the U.S. launched a military offensive in Afghanistan as part of Operation

Enduring Freedom (OEF), and in March 2003, Operation Iraqi Freedom (OIF) began,

surprising many. GWOT is often referred to as the Long War (Rosenau, 2006), and in

September 2010, the OIF switched to a stability mission under the name Operation New

Dawn, with the withdrawal of combat troops on 31 December 2011, although combat

operations continued in Afghanistan. Since October 2001, more than 2.5 million U.S.

military members have served in the OEF and OIF (Department of Defense, 2013). Both

of these foreign operations have exposed many members of the U.S. military to the stress

of combat. The negative effects of combat stress (CSE) have been documented in

literature since ancient times, from Homer' s Iliad, in the 9th century BC to the Epic of

Gilgamesh in the 3rd century BC and others (Brimes, Hatton, Brunet, & Schmitt, 2003).

During the U.S. Civil War, more and more military doctors and policymakers became

aware of and interested in the physical and psychological impact that fighting has had on

U.S. military members (Talbott, 1996). From the U.S. Civil War to February 2010, more

than 41 million U.S. military members have participated in major wars, with more than

980,000 war-related deaths and more than 1.4 million injured in action (Congressional

Research Service, 2010). However, these statistics do not describe the psychological

harm caused by CSE.

Hoge et al. (2004) conducted one of the first studies on the psychological impact

of OEF/OIF. They interviewed 2,530 U.S. Soldiers and Marines serving in the OIF and

3,671 U.S. Soldiers and Marines serving in the OEF. The study revealed that 16% of OIF

veterans and 11% of OEF veterans have been diagnosed with post-traumatic stress

disorder (PTSD) or have other psychopathological problems related to combat stress

exposure (CSE). CSE levels showed a significant correlation with negative

psychological symptoms. The study highlights gaps in research on the effects of combat

exposure, noting that most studies studying the impact of combat on mental health were

conducted years after veterans' military experiences. Hoge et al. focused on the

prevalence of psychopathological problems such as depression and PTSD, as well as

analyzing why some veterans don't get help for their mental health issues. This research

became a catalyst for many similar studies in the following decade.

Since 2003, the U.S. Army has sent Mental Health Advisory Teams (MHATs) to

Iraq and Afghanistan annually to research the psychological impact of fighting on

military members. Through MHAT reports, the Army collects important data on the

effects of CSE. MHAT V (2008) reported that the prevalence of mental health problems

such as acute stress reactions, depression, and anxiety was found in 17-18% of the 2,295

OIF Soldiers who participated in the well-being survey in September to October 2007,

with similar findings among the 699 OEF Soldiers surveyed. In addition, approximately

11% of Soldiers surveyed at OIF showed positive results for mild traumatic brain injury

(TBI; MHAT V).

The J-MHAT 7 (2011) report on the mental health of Soldiers and Marines in

Afghanistan collected data from two random samples: (a) 911 surveys from Soldiers and

(b) 335 surveys from Marines. The findings from the Marines are compared to previous

MHAT reports and include the following:

Marines reported more exposure to concussion and combat events.

1. Marines reported higher rates of psychological problems.

2. Marines who reported suicidal ideation did not change from previous reports.

3. Marines deployed several times reported more psychological problems.

However, the news is not all negative. The report noted:

1. Marines reported lower rates of marital problems: divorce, separation, and

adultery.

2. Marines reported higher morale, unit cohesion, and leadership perceptions.

3. Marines report a reduction in stigma to get help.

4. Marines report increased pride in what they do at the OEF.

There is no shortage of information regarding the negative health effects of the battle

Members of the U.S. military. In April 2008, the RAND Corporation's Military Health

Policy Research Center released a study on psychological and cognitive injuries in

service members of the OEF/OIF (RAND, 2008). The title of the study, Invisible War

Wounds, captures the essence of most injuries from the OEF/OIF. Compared to previous

wars that the U.S. has participated in, GWOT has resulted in fewer physical injuries and

deaths due to improved tactics, armored vehicles, and body armor; but

Due to less force, longer wars, and few deployments, there is more exposure to combat

stress, which increases the likelihood of psychological injury.

The RAND study (2008) surveyed 1,965 OEF/OIF veterans to determine the

likelihood of a diagnosis with major depression, PTSD, or TBI. The findings suggest

that of the more than 1.6 million service members serving in the OEF/OIF at the time of

the study, 300,000 may have PTSD or related symptoms, and 320,000 may have some

significant TBI (RAND). There are many negative effects of CSE on service members

who go home with no visible signs of injury, and many will manifest harmful behaviors

such as substance abuse, domestic violence, suicide, and homicide (Institute of

Medicine, 2010).

However, as surprising as it may seem, the majority of OEF/OIF veterans go

home without physical or psychological injury and will successfully adapt and adjust by

coping with CSE positively. Peterson, Park, and Castro (2011) note that although the rate

of PTSD ranges from 13% to 25%, the suicide rate is 20 per 100,000, the annual divorce

rate is 3%, most members of the U.S. military do well when they come home from war.

Martin Seligman suspects that the psychological response to military combat is a normal

distribution, and that the majority of those returning from war are resilient (Seligman &

Fowler, 2011).

The current study focuses on resilience and coping with CSE positively. I assume

that negative psychological symptomatology can coexist with positive coping with CSE;

This assumption is based on post-traumatic growth theory (PTG) research (Rieck,

Shakespeare-Finch, Morris, & Newberry, 2005). Post-traumatic growth theory

claims that positive change or growth can result from adverse circumstances or traumatic

events (Linely & Joseph, 2004a). Post-traumatic growth studies have been conducted

with a variety of populations such as rape victims, disasters, and illnesses (Joseph,

Linely, & Harris, 2005). Recently, a PTG study has been conducted with war veterans.

Pietrzak et al. (2010) conducted one of the first PTG studies with combat veterans from

the OEF/OIF. In a survey of 272 Connecticut National Guardsmen who served in the

OEF/OIF since 2003, 72% when assessed using the Post-Traumatic Growth Inventory

responded with large to very large growth based on their combat experience.

In recent years, there has been a renewed interest in resilience, stress, and coping;

however, there is a significant gap in the literature regarding coping with CSE positively.

Most of the research done on the effects of war on members of the military has examined

psychopathologies such as PTSD. Historically, psychology has generally focused on what

is wrong with a person or disease; However, with the formalization of positive

psychology, there is a renewed interest in what is true with people or health. The current

study examines and explores the psychology of what works to positively address CSE.

Resistance

Why do some individuals exposed to stress, adversity, or trauma show positive

psychological outcomes? Why do most U.S. military members exposed to combat stress

cope with this experience positively? Are some individuals more physically and

psychologically resilient? Peterson and Seligman (2004a) argue that stressful life events

can negatively affect some individuals while there are many people who

resilient in the face of adversity. These researchers note that resilience is not a "nature or

characteristic of unity" but is an "umbrella" term for those who cope well with the

experience of stress (p. 78).

Most of the constructions of psychological resilience are based on the psychology

of child development (Yates & Masten, 2004). Masten and Reed (2005) define resilience

as "a class of phenomena characterized by positive patterns of adaptation in the context

of significant difficulties and risks" (p. 75). Walsh (2006) defines resilience "as the

capacity to rise from adversity strengthened and more resourceful. It is an active process

of resilience, self-improvement, and growth in response to crises and challenges" (p. 4).

Bonanno (2008) differs from Walsh and argues that resilience is often "underestimated

and misunderstood" (p. 101). Bonanno distinguishes resilience from recovery or recovery

from adverse circumstances—resilient individuals maintain relative stability during

crises and display psychological homeostasis over time (Bonanno).

Lepore and Revenson (2006) reviewed resilience from the perspective of post-

traumatic growth focusing on three forms of resilience: (a) recovery, (b) resistance, and

illustrate the difference between the three forms of resilience, Lepore and Revenson use

the analogy of a tree blown by the wind. A restoration is described as a tree blown by

severe winds that bends without breaking and, after the wind stops, returns to its original

form (prestressed function). This form of resilience involves psychological "elasticity"

(p. 25). Resistance is described as a tree that appears to be unaffected by the wind;

basically, it is

stands firm and does not bend or break under pressure. Finally, resilience as a

reconfiguration is described as a tree that bends when severely blown over time, and

due to the severity and prolonged nature of the winds, deforms to adapt to or

accommodate the effects of stress (Lepore & Revenson). In the current study, I used the

Lepore and Revenson models.

Finally, there is a gap in the research literature with respect to resilience and

adult studies; however, over the past decade, this gap has begun to close. After

September 11, 2001, the American Psychological Association (APA) launched the

national educational resilience, prevention, and intervention initiative (Newman, 2005).

In August 2002, The Road to Resilience was announced to help reduce the impact of

traumatic stress on society and individuals, and in March 2003, APA released Resilience

in Time of War followed by Homecoming: Resilience After Wartime (Newman). The

initiative targets civilians and the military. Conceptually, resilience is the adaptive ability

to cope with physical and psychological stress positively.

Psychological Stress and Coping

Every human being is constantly experiencing stress (Selye, 1976). Hans Selye

defines stress as "the body's nonspecific response to any request" (p. 1). Selye was one of

the pioneers of stress research, developing a theory of general adaptation syndromes to

explain stress wear and tear in humans. Selye can be considered the father of modern

stress construction; His research builds a bridge from biological to psychological while

weaving a philosophy of life. He developed a stress lexicon that included terms such as

stress, distress, and eustress; he mapped biological stress

response system and is able to integrate other theories such as Walter Cannon's (Selye)

concept of physiological homeostasis.

Although stress is a ubiquitous human phenomenon, there is no unified definition

of stress. Stress is defined differently by biologists, architects, psychologists, physicists,

and sociologists; However, there are general terms used to describe and define stresses

such as strain, voltage, and load. Conceptually, psychological stress is the external or

internal tension, tension, or pressure experienced and assessed by a person along the

stress continuum from benign to extreme to traumatic as the person deals with his or her

environment.

Herbert (1997) categorized stress and stress as physical and psychological. Stress

can be internal or external, real or intangible, benign or existential stimuli (Drolet et al.,

2001). The normal human stress response system works essentially the same way in

every person; however, individual genetics, physical and psychological development,

duration of stressors, types of stressors, and stress-coping resources can exacerbate or

reduce stress responses and their impact on health and well-being (Flannery, 1999). Thus,

the human physiological stress response system can work in the same way for most

individuals; However, the human psychological stress response varies from individual to

individual due to the people factor. There are quite a lot of factors of ordinary people that

can be theorized by stress and coping patterns as in the work of Selye (1976).

From a transactionalist perspective, psychological stress "refers to the quality of

experience, which is generated through people-environment transactions that, through

excessive arousal or lack of arousal, resulting in psychological or physiological stress"

(Aldwin, 2007, p. 24). The most common transactionalist model of stress and coping was

developed by Lazarus and Folkman (1984), who stated, "psychological stress is a certain

relationship between the person and the environment that the person values as

overloading or exceeding his resources and endangering his well-being" (p. 19).

Stress affects everyone differently; Some individuals are more resilient, some have better

coping styles and strategies.

Furthermore, Lazarus and Folkman (1984) define "coping as an ever-changing

cognitive and behavioral effort to manage certain external and/or internal demands that

are judged to be burdensome or excessive of one's resources" (p. 141). From a

transactionalist perspective, Aldwin (2007) defines coping as "the use of strategies to

deal with actual or anticipated problems and the negative emotions that accompany

them" (p. 125). Coping may involve a consistent personality style over time or strategies

that vary from coping situation to situation (Lazarus, 1999). Conceptually, coping is a

process of cognitive and emotional transactional adaptation that involves coping

strategies and styles to assess and manage stress along the benign to extreme to traumatic

stress continuum.

Problem Statement

The problem I address in the current study is that to date, most research on the

effects of CSE on service members has focused on negative outcomes from exposure to

stress such as PTSD, thus leaving a significant gap in the literature on positively

addressing exposure to combat stress and resilience. Only use PsycINFO in

EBSCO and searching for peer-reviewed articles between 1914 and 2011 (World War I

to GWOT), I had the following search results, which brought this research issue into

focus: stress and coping (11,830); stress and coping and war (281); stress and coping and

military combat (2); PTSD (8,452); PTSD and coping (484); combat stress (147); combat

stress and cope ( 30); combat stress exposure (3); Combating stress exposure and coping

(0). Britt, Sinclair, and McFadden (2013) noted in the introduction to Building

Psychological Resilience in Military Personnel that in a PsycINFO peer-review search

from 2000-2010, they found 4,133 citations when looking for resilience but only 136

citations when they searched for resilience + military.

To help close research gaps on combat stress exposure, coping, and resilience, I

used a triangulation strategy along with a mixed method, in which qualitative (QUAL)

and quantitative (QUAN) data were collected side-by-side, analyzed separately, and

then integrated. This QUAL+QUAN mixed-method study explored and examined

coping outcomes in a homogeneous group of U.S. Marines who were exposed to combat

stress during OEF/OIF, and who self-reported that they coped positively with their

combat experience. In the QUAL section of this study, I explore through

phenomenological interviews how and why these Marines coped positively with their

combat experience after the OEF/OIF. During the QUAN portion of the study, I

examined the influence of the independent variable (IV) of combat stress exposure on

the dependent variable (DV) of subjective well-being by measuring the impact and role

of the moderation variable (MODV) of resilience, expectation, social support, and

personality, along with the mediating variable (MEDV) of coping.

Study Objectives

The purpose of this study was to quantitatively examine and qualitatively explore

the phenomenon of coping with the effects of CSE on a group of U.S. Marines serving in

the OEF or OIF or both, and self-report that they coped positively with their combat

experiences. These findings help fill the literature gap on psychological and health

illnesses; They added resilience, stress, and coping literature, with the goal of influencing

researchers to conduct more resilience studies to develop prevention, intervention, and

post-prevention programs and policies that will help reduce the negative impacts of CSE

on service members, their families, military agencies, and society.

Research Questions and Hypotheses

There are three research questions and five directional hypotheses for this study.

1. What was the effect of the moderation variables of resilience, hope, social

support, and personality on the effects of CSE on U.S. Marines in this study

who subjectively self-reported that they positively coped with their combat

experience?

The following directional hypotheses were tested during this study:

H01: U.S. Marines who scored average or higher on PVSIII-R® (Maddi &

Khoshaba, 2001) outperformed CSE positively (H01: μ 40).

H02: U.S. Marines who scored average or higher on the Adult Disposition

Expectancy Scale (Snyder, Rand, & Sigmon, 2005) outperformed CSE

positively

(H02: μ  49).

H03: U.S. Marines who scored average or higher on the Post-Deployment

Social Support Scale (King, King, & Vogt, 2003) positively

outperformed CSE (H03: μ  56.69).

H04: U.S. Marines scored average or higher on extraversion, openness,

thoroughness, and pleasure and low on neuroticism based on the NEO-

Five-Factor™ Inventory-3 (NEO-FFI-3™; McCrae & Costa, 2010)

positively coped with CSE (H04: μ  45 for EOAC; μ 4 5 f o r N ) .

2. What mediation effect did coping have on the effects of CSE on U.S. Marines

who participated in this study and subjectively self-reported that they coped

positively with their combat experience? The following directional

hypotheses were tested during this study to examine these hypotheses:

H05: U.S. Marines who subjectively self-report that they are coping positively

CSE report adaptive coping strategies and styles based on a Short COPE

Inventory (Carver, 1997).

3. How and why did the U.S. Marines in this study positively address their

experience of combat stress exposure? Question 3 is explored in the

qualitative strand of research and has no hypothesis.

Theoretical Basis and Conceptual Framework

The theoretical basis for the QUAN strand of this mixed-method study is applied

positive psychology, and the conceptual framework of QUAL is Husserlian

transcendental phenomenology. Positive psychology is the science of welfare. Applied

positive psychology is the study of cognition and positive emotions, positive character

strength, and virtue, and positive boards (Linely & Joseph, 2004b; Seligman &

Csikszentmihalyi, 2000; Seligman, Steen, Park, & Peterson, 2005). Cowen and Kilmer

(2002) note that historically psychology has been more concerned with psychopathology

and how to improve the human psyche. Positive psychology is focused on the prevention

of psychopathology. The health benefits achieved in practicing positive psychology are

profound and range from helping individuals find hope in the midst of depression to

stress reduction and lowering cortisol levels (Fredrickson & Losada, 2005).

The foundation of positive psychology is built on the strength of character, and

virtue (CSV; Peterson & Seligman, 2004b). There are six universal virtues in the

construction of CSV (Dahlsgaard, Christopher, & Seligman, 2005; Peterson & Seligman,

2004c). Virtue is wisdom, courage, humanity, justice, simplicity, and transcendence

(Park, Peterson, & Seligman, 2004; Seligman, Steen, Park, & Peterson, 2005). Positive

psychology is fiery, with the aim of helping individuals find a good life and human

authenticity to thrive in the midst of adversity (Dahlsgaard, Christopher, & Seligman;

Robbins, 2008). The moderation variables in this study are very suitable for the

construction of positive psychology and are described in Chapter 2.

As mentioned above, resilience and coping with stress positively are important

aspects of positive psychology (Peterson & Seligman, 2004a). Positive psychology is

concerned about risk factors that undermine well-being; However, positive psychology

focuses more on protective factors such as resilience, hope, and social support to

strengthen resilience. Positive psychology is not risk-averse or a stress-free theory of

life; Instead

Positive psychology boldly confronts challenges and threats to human well-being so that

humans can do more than just survive—they can thrive.

Since World War II, the U.S. military has continued to study stress, coping, and

combat endurance (Bartone, Pastel, & Vaitkus, 2010). The U.S. military has embraced

the positive psychology movement and its impact on training and leadership (Matthews,

2008a, 2008b). The military is deeply concerned about the physical and psychological

well-being of service members and their families, as evidenced in Department of Defense

(DoD) online initiatives such as Real Warriors, Real Battles, Real Strengths; the U.S.

Army's Comprehensive Soldier Fitness (CSF) program, and the Navy and Marine Corps

Combat Operational Stress Control (COSC) for service and family members. The Marine

Corps Commander made institutionalized resilience training a top priority for the Corps

in 2010. These initiatives and programs address resilience, stress, and coping at the

individual, operational, family, and institutional levels.

Understanding the positive and negative effects of the battle on U.S. services and

family members has been a top priority for the DoD and the Veterans Administration

(VA). The January 2011 APA Journal of American Psychologist featured a series of

articles about the U.S. CSF program. Former U.S. Chief of Staff Gen. George W. Casey,

Jr. noted that the CSF "is an integrated, proactive approach to developing psychological

resilience in our soldiers, in their family members, and in the Army's civilian workforce"

(Casey, 2011, p. 1). The Army's CSF program is aligned with the Penn Resilience

Program and positive psychology science to develop a diverse range of users

resources are available to help prevent the negative psychological effects of war by

strengthening psychological health and well-being (Cornum, Matthews, & Seligman,

2011; Reivich, Seligman, & McBride, 2011).

Finally, the conceptual framework for the QUAL strand of this mixed-method

study is based on Edmund Husserl's transcendental phenomenology. Husserl (1927)

developed transcendental phenomenology in the late 19th and early 20th centuries as a

systematic method of science, philosophy, and psychology (Giorgi, 2009; Moustakas,

1994). The meaning of making or discovering the essence of a life experience is at the

heart of transcendental phenomenology (Moerer-Urdahl & Creswell, 2004). The main

way to collect data using this method is through phenomenological interviews (King &

Horrocks, 2010). Transcendental phenomenology can be used to investigate any

phenomenon and has been used in a variety of studies, especially in nursing research

(Priest, 2004; Scannell-Desch, 2005). Positive psychology and transcendental

phenomenology are described in Chapters 2 and 3.

Conceptual Definition, Terms, and Operational Measures

Combat: War is "a violent clash of interests between or between organized

groups characterized by the use of military force" (MCDP 1, 1997, p. 3). The violence of

a war with military force is a battle. The battle zone is the environment; Fighters deal

with stress in this environment. Conceptual definition: War is a clash of wills and

interests that often results in military force and violence involving combat.

Combat stress: The Marine Corps (MCRP 6-11C, 2000) defines combat stress as

"mental, emotional, or physical strain, strain, or distress resulting from exposure to

battle-related conditions" (p. C-2). This definition was updated in MCRP 6-11C (2010) to

"a change in physical or mental function or behavior resulting from the experience of

deadly force or its consequences. These changes can be positive and adaptive or can be

negative, including distress or loss of normal function" (pp. 1-3). Combating stress

involves people-environment transactions. Combat stress can lead to distress, injury, or

illness when psychological and physical demands outweigh a person's ability to adapt,

manage, and cope with stress (Nash, 2007). Combat stress can be measured along a

continuum from benign (no threat) to extreme to traumatic (a threat to self-integrity or an

existential threat). Exposure to combat stress can result in negative or positive

psychological and physical outcomes. Conceptual definition: Combat stress is the

external and internal tension, tension, or pressure experienced and assessed by a person

along the stressor continuum from benign to extreme to traumatic as a person deals with

a combat environment.

Exposure to combat stress: The degree, magnitude, and cumulative effect

(allostasis) of exposure to combat stress-related experiences. Exposure to combat stress

can be measured on a stress continuum from light to heavy combat. Conceptual

definition: Combat stress exposure is the magnitude or intensity of combat-related

experience exposure that can be measured on a light to heavy combat continuum.

Operationally, CSE can be measured by the Combat Exposure Scale (Keane et al., 1989).

Combat stress reactions: "Expected, predictable, emotional, intellectual,

physical, and/or behavioral reactions of service members who have been exposed to

stressful events in combat or military operations other than war" (Campise, Geller, &

Campise, 2006, p. 216). Conceptual definition: Combat stress reactions are the expected

psychological and physiological reactions to combat or operational stress exposure; This

reaction is on the stress continuum from benign to extreme to traumatic when individuals

transact with a combat environment.

Combat operational stress control: "Includes all policies and programs to

prevent, identify, and treat mental injuries holistically caused by combat or other

operations" (United States Marine Corps, 2009, para. 1). The two main objectives of the

COSC are to have a ready force, and to protect and restore the well-being of Marines and

their families (para. 1). At the unit leader level, COSC is defined as "the actions and

responsibilities of leaders to promote resilience and psychological health within military

units and individuals, including families, exposed to the stress of combat or other military

operations" (MCRP 6-11C, 2010, pp. 1-3). Conceptual definition: COSC is a holistic

program of the U.S. Navy and Marine Corps to prevent and treat the effects of combat

stress on Sailors, Marines, and their families to ensure a ready and healthy combat force.

Coping "is a response aimed at reducing the physical, emotional, and

psychological burden associated with stressful and everyday life events" (Snyder &

Dinoff, 1999, p. 5). From a transactionalist perspective, Aldwin (2007) defines coping as

"the use of strategies to deal with actual or anticipated problems and the negative

emotions that accompany them" (p. 125). Coping may involve a consistent personality

style over time or strategies that vary from coping situation to situation (Lazarus, 1999).

Conceptual definition: Coping is a transactional and adaptive assessment process that

uses cognitive and emotional reassessment and coping strategies and styles to manage.

Stress along the continuum is benign to extreme to traumatic. Operationally, coping can

be measured with the Brief COPE Inventory (Carver, 1997).

Resilience is "a combination of interrelated attitudes of commitment, control, and

challenge that provide courage and existential motivation to turn circumstances from

potential disasters into growth opportunities" (Maddi, Harvey, Khoshaba, Fazel, &

Resurreccion, 2009, p. 292). Conceptual definition: Resilience is a personality construct

that manifests the existential courage to cope with stress positively through a resilient

attitude of commitment, control, and challenge. Operationally, durability can be

measured with PVSIII-R® (Maddi & Khoshaba, 2001).

Hope is "the process of thinking about one's goals, along with the motivation to

move toward (agency) and the way to achieve these goals" (Snyder, 1995, p. 355).

Conceptual definition: Hope is the setting of goals; Achieving goals requires motivation,

resources, and the ability to execute plans and achieve goals even when there are

difficulties. Operationally, expectations can be measured by the Adult Disposition

Expectation Scale (Snyder, Rand, & Sigmon, 2005).

Positive psychology is "a field of psychological theory and research that focuses

on psychological states (e.g., satisfaction, joy), individual traits or character strengths

(e.g., intimacy, integrity, altruism, wisdom), and the social institutions that make life

most worth living" (VandenBos, 2007, p. 713). Conceptual definition: Positive

psychology is the study of positive cognition, emotions, character strengths and virtues,

and institutions that influence individuals to achieve and experience a thriving life even

in a state of stress. Positive psychology is not the study of psychopathology and disease;

rather, it is a study of psychological health and wellness (well-being).

Psychological stress "refers to the quality of experience, generated through

people-environment transactions that, through excessive arousal or lack of arousal,

generate psychological or physiological distress" (Aldwin, 2007, p. 24). According to

Lazarus and Folkman (1984), "psychological stress is a certain relationship between a

person and an environment that is judged by the person to be overloading or exceeding

his resources and endangering his or her well-being" (p. 19). Conceptual definition:

Psychological stress is an external or internal tension, tension, or pressure, experienced

and assessed by a person along the stressor continuum from benign to extreme to

traumatic as a person transacts with his or her environment.

Resilience from the perspective of developmental psychology is "a class of

phenomena characterized by positive patterns of adaptation in the context of significant

difficulties and risks" (Masten & Reed, 2005, p. 75). Walsh (2006) defines resilience "as

the capacity to rise from adversity, be strengthened and more resourceful. It is an active

process of resilience, self-improvement, and growth in response to crises and challenges"

(p. 4). Newman (2005) defines resilience as "the ability of human beings to adapt in the

face of ongoing significant life tragedies, traumas, hardships, hardships, and stresses" (p.

227). The Navy and Marine Corps define resilience as "the process of preparing,

recovering from, and adjusting to life in the face of stress, adversity, trauma, or tragedy"

(MCRP 6-11C, 2010, pp. 1-3).

Conceptual definition: Resilience is the adaptive ability to cope with physical and

psychological stress positively.

Social support is "the provision of help or comfort to others, usually to help them

cope with various biological, psychological, and social stressors" (VandenBos, 2007, p.

869). Conceptual definition: Social support is the assistance provided by institutions,

groups, and individuals to assist a person in coping with physical and psychological

stress. Operationally, military social support can be measured by the Post-Deployment

Social Support Scale (King, King, & Vogt, 2003).

Stress assessment is the evaluation of stressors; verb assessment focuses on the

evaluation process, and noun assessment focuses on the "evaluative product" (Lazarus,

1999, p. 75). The stress and coping assessment model developed by Lazarus and

Folkman (1984) distinguishes two forms of conscious and unconscious judgment as

primary and secondary. Stress assessment involves evaluating stressors for personal

phenomenological meaning and assessing stressors on a benign to threatening

continuum. Conceptual definition: Stress assessment is the psychological process of

evaluating and giving meaning to stressors. Stress is an environmental factor that is felt

by individuals on a continuous from benign to extreme to traumatic.

The stress coping style is "a typical way in which a person faces and deals with

stress, anxiety-inducing situations, or emergencies" (VandenBos, 2007, p. 232). Coping

style is a personality factor that is stable over time and situations (Aldwin, 2007).

Conceptual definition: Stress coping style is usually a stable trait such as a personality

factor that influences a person's unique way of coping.

A stress coping strategy is "an action, set of actions, or thought processes used to

deal with a stressful or unpleasant situation or in modifying a person's reaction to a

stressful or unpleasant situation."

situation" (VandenBos, 2007, p. 232). Coping strategies are process-oriented and change

based on stress response (Aldwin, 2007). Conceptual definition: Stress coping strategies

are the cognitive and emotional processes that individuals use to cope with stress; This

strategy can vary from coping situation to situation.

Transcendence is a positive psychological virtue of "a force that establishes a

connection to the larger universe and gives meaning" (Peterson & Seligman, 2004c, p.

30). Transcendence is further explained by five character strengths: (a) appreciation of

beauty and excellence, (b) gratitude, (c) hope, (d) humor, and (e) spirituality (Peterson &

Seligman, 2004b, p. 30). Conceptual definition: Transcendence is the metaphysical sense

of connection with oneself, others, the universe, and for many people with God. This

connectedness gives meaning to life and helps individuals cope with stress.

Transcendental phenomenology (Husserlian) is

A philosophy that seeks to understand anything that can be experienced through

the awareness one has of anything that is 'given'—whether it is an object, a

person, or a complex circumstance—from the perspective of a conscious person

undergoing the experience. (Giorgi, 2009, p. 4)

Conceptual definition: Transcendental phenomenology is a philosophy, psychology, and

research methodology that explores the conscious human experience of any phenomenon

to explain the essence of that phenomenon.

Assumptions and Limitations

1. I assumed the authenticity and correctness of the study participants' self-

reports about their subjective conscious responses to quantitative measures

and

qualitative questions. The limitations of this assumption are social desires and

memory biases.

2. I assume that the quantitative measures used in this study and normed for the

civilian general population can be used directly with military groups. Its

limitation is the lack of previous studies comparing military and civilian

samples using this instrument.

3. I assume that the conclusions and generalizations of the research findings

can be applied to other branches of the US military. The limitations for this

study are that the samples are highly directed and homogeneous; Thus, the

sample may not be representative of the entire military population.

4. I assume that a mixed-methods approach will provide reliable, valid, and

trustworthy findings. The limitations of this approach are the potential for

uncontrolled confounding variables, misinterpretation of data, or

different/conflicting findings.

5. I assume that most U.S. Marines exposed to combat stress will cope

positively with their combat experience. The limitation is the gap in the

research literature related to addressing CSE positively.

6. I assume that coping with CSE is a normal distribution where some will be

left out of the distribution and will be diagnosed with post-traumatic stress

disorder while others will be in the right part of the distribution and

experience post-traumatic growth; however, most Marines will be in the

middle of the distribution and address their experience positively. This is

based on Seligman's claim that

"Human responses to high difficulties, such as battles, are normally distributed"

(Seligman & Fowler, 2011, p. 84). The limitation is the gap in the research

literature related to addressing CSE positively.

7. I assume that negative psychopathological symptoms of the effects of

combat stress exposure can coexist with positive psychological outcomes.

The limitation is the gap in the research literature related to addressing CSE

positively.

8. I assume and expect a level of bias. As a former enlisted Marine and an OIF

veteran as a Navy chaplain, I was exposed to combat stress but not as large as

my sample. Also, I am positively biased towards Marines who have served in

combat, which requires me to exercise discipline not to let my bias interfere

with data collection and analysis. This is why transcendental phenomenology

is a good qualitative framework for this research because of my time or the

bracket of knowledge and experience. Another limitation of this study is the

positive bias towards the participants and the phenomenon studied.

Border

The scope of the study involves discovering how and why U.S. Marines who

have been exposed to combat and who have returned home cope positively with their

combat experience. This is a narrowly focused study of stress and coping using a

directed, homogeneous, and non-randomized sample. The boundaries of this research are

limited in the context of the Marine Corps which is a strength and not a weakness.

The research population is healthy and productive, with a strong sense of identity. Using

valid and reliable positive psychological measures for the QUAN side of the research

and epochal disciplines and processes of the transcendental phenomenological QUAL

side of the study resulted in data convergence supported by scientifically observable and

verifiable findings. This mixed method study allowed me to use two methods to build a

third method of inquiry that maximizes the strengths and minimizes the weaknesses of a

single study method.

Importance of Studies

Unless there is world peace, war will continue to cause harm to individuals,

institutions, communities, cities, states, and nations. The negative effects of war can last a

lifetime and have immediate generational consequences. If the U.S. military knows why

and how military members deal with combat pressure positively, then assessments and

tools can be designed and training developed to prepare military members and their

families for the potential negative and positive effects of combat. Inherent to this study is

social change, as coping with combat stress positively can reduce the negative effects of

combat on many soldiers by strengthening resilience, thereby strengthening families,

reducing costs for mental health care, and producing better citizens. Service members of

the United States are volunteer Soldiers, Sailors, Marines, and Airmen, and when they

return to society healthy, after honorable service, they can become more productive and

positive citizens.

The nature of this research is to expand the literature on resilience, stress, and

coping research, create research interests, help military planners and policymakers create

new ones

Resilience strengthening programs, help doctors and researchers develop theories and

practices to reduce the negative psychological outcomes of war, and most importantly,

help soldiers and their families understand their military combat experiences.

Chapter Summary

Life is full of stress, and every human being experiences stress; Thus, coping

with stress positively is essential to living a good life. The literature on resilience, stress,

and coping research is rich and diverse, but there are significant gaps in the literature

with respect to coping with combat stress positively. Previous research on combating

stress has focused primarily on psychopathology or disease—not positive psychology

and health. In this mixed-method study, I helped fill the gap between psychological

illness and health, between psychopathology and positive psychology. Key points from

Chapter 1 include:

1. More than 2.5 million service members serve in the OEF/OIF and are

exposed to combat stress.

2. Statistically, more than 300,000 people have the potential to suffer from

invisible war wounds such as PTSD or TBI.

3. Most military members who return home from the war and have been

exposed to combat stress will cope positively with their combat

experience.

4. Positive psychological variables of resilience, hope, social support, and

personality moderated the independent variable effects of combat stress

exposure on the dependent variables of subjective well-being.

5. The coping variable mediates the effect of the independent variable of

combat stress exposure on the dependent variable of subjective well-being.

Chapter 2 will review the literature that focuses on the theoretical underpinnings

of positive psychology and the conceptual framework of transcendental phenomenology

as it relates to coping with CSE. Chapter 3 will explain the mixed method research plan.

Chapter 4 presents findings from mixed method data collected and analyzed.

Chapter 5 provides a discussion of findings, conclusions, and recommendations to include

impacts on social change.

Chapter 2: Literature Review

Introduction

The first part of this mixed-methods literature review examines the quantitative

theoretical basis for positively addressing combat stress (CSE) exposure. The second

part of this literature review explores the qualitative conceptual framework for

addressing CSE positively. There is a lot of research literature on resilience, stress,

coping, and negative psychological outcomes of stress, but the same literature is rare in

addressing CSE and resilience in the military; thus, there is a significant gap in the

literature on coping with CSE and resilience positively.

Basis Theoritis

Stress and Coping Theory

Stress and coping as people-environment transactions. The science of stress

and coping is vast, and the theoretical approach to researching these phenomena depends

on the scientific discipline that conducts the investigation. If stress and coping are only

biological stimulus responses, then Selye's (1976) theory of general adaptation syndrome

is sufficient to understand human reactions to stress. If sociology or traumatology is a

theoretical approach, then ecological models may work best to understand stress and

coping (Grzywacz, 2000; Harvey, 1996). For my research, I used a cognitive

transactionalist model of stress and coping developed by Lazarus and Folkman (1984).

Lazarus and Folkman (1984) developed the transactional model as a metatheory

to show that stress and coping are cognitive and evaluative processes involving

transactions between a person and the environment. According to Lazarus and Folkman,

transactionalism is "a two-way and dialectical systems approach to stress and coping" (p.

294). The people-environment transaction is not merely an interaction with the

environment but "implies a newly created level of abstraction in which the separate

elements of people and the environment are combined together to form a new relational

meaning" (p. 294). Thus, the essence of the evaluation or assessment of stress and coping

is subjectivity and phenomenology.

There are many factors people that affect stress and coping, such as external or

internal stress, the context of the stressful environment, the internal cognitive and

emotional state of the stressed individual, the individual's cognitive abilities, personality

factors, and the individual's coping strategy or style. The transactionalist theory of stress

and coping is an integrated biopsychosocial model (Aldwin, 2007). People factors can

aggravate the coping process and confuse research; Thus, being aware of individual

variables and trying to control them is very important for researchers.

Harvey (1996) defines the environment, from the perspective of traumatic stress,

as the ecological context of stress. From an interactionist point of view, the environment

is a stimulus or stress that evokes a response; while from a transactionalist perspective,

the environment is a context of stress, stressor, and potential coping resources (Aldwin,

2007). Lazarus (1999) identified four environmental variables: (a) demands, (b)

constraints, (c) opportunities, and (d) culture (pp. 61-70). Demands are negative or

positive psychological pressures that can create external and internal conflicts.

Constraints limit what a person can and cannot do about the environment and stressors.

Opportunity

involves time—the right or wrong time, or the stress of a missed opportunity. Culture is

the totality of environmental and ecological forces that come together to create, reduce, or

exacerbate stress. Thus, when the demands of the environment (stressors) exceed a

person's coping ability and resources, this leads to a person-environment transaction

mismatch that results in psychological stress, often called distress (Aldwin; Lazarus).

Stress and coping as cognitive/emotional processes. Lazarus (1999)

developed a transactionalist model of stress and coping as a cognitive assessment

process with the cognitive-motivational-emotional relational theory as the basis. In

Lazarus' metatheory, stress and emotions are seen as "joining together" (p. 86).

Historically, psychologists have more often viewed emotions as negative, irrational,

and contrary to reasoning (Lazarus). Lazarus stated,

Emotions are not judgments, but complex organized systems made up of

thoughts, beliefs, motives, meanings, subjective bodily experiences, and

physiological states, all of which arise from our struggle to survive and thrive by

understanding the world in which we live. (p. 100)

Lazarus (1999) developed a taxonomy of 15 core emotions with relational

meanings. Lazarus states, "when there is stress there is emotion" (p. 35). These emotions

and meanings are part of the cognitive mediation process and occur between stimuli and

responses. The cognitive mediation process is not a strict behavioralist model of the

stimulus response (SR) but is referred to in value expectation theory as the stimulus-

organism response (SOR; Lazarus, p. 5). O-rganism refers to cognition that occurs after

environmental stimulus and before behavioral response (Lazarus). During cognitive

assessment or the evaluative process of stress, emotions and meanings occur.

According to transactional theory, there are two evaluative processes: (a) primary

assessment and (b) secondary assessment (Lazarus & Folkman, 1984). Primary

assessment evaluates and answers the question "Am I in trouble or benefiting, now or in

the future, and in what way" (p. 30)? There are four main types of assessments: (a)

irrelevant, (b) benign-positive, (c) beneficial, and (d) stress (p. 32). Lazarus and Folkman

note that there are three types of stress assessments: (a) hazards/losses, (b) threats, and

Folkman types of assessments are not all-encompassing and may not fit into every stress

assessment transaction.

After the primary assessment process begins, one continues to evaluate

environmental information using secondary assessment, which answers the question

"What if there is anything that can be done about it" (Lazarus & Folkman, 1984, p. 31)?

Monroe and Kelley (1997) note that secondary assessment uses coping strategies and

styles to manage emotions associated with psychological stress. Assessment and coping

are iterative processes that deal with the environment and can change over time (Lazarus

& Folkman, 1987). However, Lazarus and Folkman point out that the terminology of

primary and secondary assessments leads to some unfavorable points of confusion, such

as the idea that primary assessments are more important than secondary assessments—

both assessments are as important as stress and coping processes.

Stress as a coping that focuses on problems and focuses on emotions. Coping is

"psychological stress management" (Lazarus, 1999, p. 111). Coping is a dynamic

The process involving assessment (evaluation) and assessment (evaluation) is followed

by reassessment and re-assessment, and through the process of coping relational

meaning is created and stress is managed. There are two main coping functions in the

transactionalist model: (a) problem-focused (PF) and (b) emotion-focused coping (EF).

The function of coping is not an outcome or a coping strategy but refers to the

"goal of the strategy of serving" (Lazarus & Folkman, 1984, p. 149). Problem-focused

coping functions are directed outwards, usually toward problem solving, and involve (a)

defining the problem, (b) generating a solution, and (c) cost-benefit analysis. Problem-

focused coping involves an outward-directed coping strategy to change the environment

by controlling or eliminating stressors. Emotion-focused coping functions are directed

inward to manage stressful emotions, most often by reducing emotions, but in some cases

increase emotionality during the assessment and reassessment process to help manage

stress. For example, anger, directed appropriately, can help give meaning to stress and the

experience of coping with it. Emotion-focused coping can serve to help maintain hope

and optimism (Lazarus & Folkman). Problem-focused and emotional-focused coping

functions can interact to help or hinder the coping process; Optimally, coping with

psychological stress positively leads to strategies and coping styles oriented to an

adaptive approach by managing stress and regulating emotions. Lazarus (1999)

concluded that there is no universally effective or ineffective coping strategy or style.

Stress and coping strategies and styles. Lazarus and Folkman (1984) defined

"coping as an ever-changing cognitive and behavioral effort to manage certain external

and/or internal demands that are assessed as taxing or exceeding resources

someone" (p. 141). Coping involves a personality style, which is consistent over time,

while coping strategies vary from situation to situation (Lazarus, 1999). The terms

coping style and strategy are often used interchangeably (Carver, Scheier, & Weintraub,

1989) in the stress research literature and may be confusing at times; However, for my

studies, I used coping styles and strategies as a different interaction process.

Stress-coping style is a construct of personality traits. The coping style is "the

typical way in which a person faces and deals with stress, anxiety-inducing situations, or

emergencies" (VandenBos, 2007, p. 232). Conceptually, stress coping style is a

personality factor like stable traits that influences a person's unique way of coping. On

the other hand, a stress coping strategy is "an action, set of actions, or thought processes

used to deal with a stressful or unpleasant situation or in modifying a person's reaction to

such a situation" (p. 232). Coping strategies are process-oriented and can change over

time in response to different stresses (Aldwin, 2007).

Conceptually, stress coping strategies are cognitive and emotional processes that individuals

use to cope with stress; This strategy can vary from coping situation to situation.

Stress and coping as a positive psychological construct. Lazarus (2000) notes

that positive psychology's interest in positive well-being naturally fits into transactional

stress and coping models; however, this is not without warning. Lazarus challenged

researchers and doctors not to negate the relevance of positive and negative emotionality

in stress and address it. In addition, problem-focused and emotional-focused coping do

not need to be pitted against each other, although there is valid research that

showed that emotion-focused coping and neuroticism were positively correlated with

avoidance and negative coping (Watson, David, & Suls, 1999). According to Lazarus, the

goal of positive psychology should continue to close the gap between research and

clinical practice through rigorous scientific methodologies.

The construction of positive psychology as the science of what successfully

attracts stress and coping (Heppner & Lee, 2005; Lopez, Snyder, & Rasmussen, 2003;

Snyder, 1999; Stanton, Parsa, & Austenfeld, 2005). Schwarzer and Knoll (2003)

reviewed positive coping and mastery of stress demands using proactive coping theory

with an emphasis on meaning-making, which is a hallmark of positive psychology.

Another example of positive psychology's interest in coping is shown by Bono,

Emmons, and McCullough (2004), who define and describe the psychological power of

gratitude. The researchers noted that gratitude correlates positively with coping with

stress and resilience through coping that focuses on positive emotions.

Stress and coping positively by combating stress exposure. Levin (2007)

reports that "the pressures of fighting in Iraq or Afghanistan need to be seen in a broader

context than just the risk of PTSD—the context of resilience and recovery" (para. 1). In

this same report, Charles Figley, who was one of the first U.S. Marines to return home

from Vietnam and is a co-founder of the International Society of Traumatic Stress

Studies, stated, "We need to move away from obsession with PTSD to focus on the

prevention and management of combat stress injuries" (Levin, para. 3). None of these

statements diminish the importance of researching the negative effects of such a war

PTSD and TBI; These comments emphasize the fact that more research needs to be done on

the positive outcomes of exposure to war stress.

Studies of stress and coping in the United States find their origins primarily in

military research dating back to World Wars I and II (Lazarus, 1999); however, studying

the negative effects of war in the U.S. stems from the U.S. Civil War. During the U.S.

Civil War, several terms described the negative psychological effects of war on military

members, such as homesickness, nostalgia, cowardice, and insanity (Talbott, 1996). One

of the most common terms is the soldier's heart, which, in the 1890s, was a

psychopathological term describing a combat stress reaction characterized by fatigue,

shortness of breath, rapid heartbeat, dizziness, and other cardiac symptoms (Talbott).

Talbott (1996) explained,

when Civil War soldiers 'saw elephants' as they called for action, some of them

suffered injuries they could not mention. The wounds of the mind make them

open to accusations of malingering, accusations of cowardice or accusations of

desertion." (p. 41)

Oliver Wendell Holmes, Jr. fought in the U.S. Civil War as part of the 20th

Massachusetts and was in the battle of the Potomac in 1861 (Talbott, 1996). Holmes

stated, "a lot of people have gone crazy since this campaign started out of terrible

pressure on the mind and body... I hoped to survive but I don't know" (Talbott, p. 45).

Combat stress injuries can affect noble-minded soldiers, and how soldiers cope with CSE

can affect their quality of life, well-being, and functioning. Oliver Wendell Holmes, Jr. is

an example of a tough fighter who positively copes with CSE, adapts,

and adjusting after the war, and then manifesting post-traumatic growth to live a thriving

life. Holmes went on to become the longest-serving judge on the U.S. Supreme Court

(Talbott).

Studies on trauma and the effects of war are relevant to current studies. Literature

on trauma and the military comes from the 19th-century research of Pierre Janet. Janet

believes that traumatic events and how they are remembered affect a person's ability to

cope (van der Kolk, 1994). Janet mentioned the psychological effects of the dissociation

of the war. According to Talbott (1996), dissociation "allows a person under pressure to

continue functioning although often in an autonomous and sometimes inappropriate

way" (p. 42).

In the 1940s, Abraham Kardiner conducted psychobiological research with World

War I veterans (Friedman, 1994; van der Kolk, 2001). Later, during World War II,

mental health researchers and providers developed innovative combat stress management

studies and interventions such as the landmark research by Grinker and Spiegel (1945).

Roy Grinker and John Spiegel were military psychiatrists who studied the psychological

effects of combat on service members during combat. Their first study involved ground

forces in North Africa, which resulted in the monograph War Neuroses in North Africa

(Grinker & Spiegel, 1943). This publication is a diagnostic breakthrough. Grinker and

Spiegel took lessons learned from World War I and the intervention years before World

War II and applied them to firsthand observations of the effects of combat pressure on

the army and air. This first study led to a more complete study presented in the text Men

Under Stress (Grinker & Spiegel).

Grinker and Spiegel (1945) used a case study method to analyze theoretical stress

constructions as applied to combat effects on U.S. service members. They developed a

variety of diagnostic criteria, a solid understanding of battle psychodynamics based on

personality theory, and psychotherapeutic treatment during combat and return home.

However, it seems that in the years after World War II, psychological military research

was reduced, leaving an empirical gap in the research literature. Hans Pols (1999; 2007)

describes how after World War II, American psychiatry suppressed what had been

learned during World Wars I and II with respect to identifying and treating psychological

warfare injuries. Pols (1999) called this period of American medical history a period of

"professional amnesia." With the outbreak of the Korean conflict, interest in

psychological war victims was revived (Lazarus & Folkman, 1984). Combat fatigue or

combat fatigue describes the negative effects of CSE in Korea (Soetekouw et al., 2000).

Interestingly, there has been very little research on the stress and coping of the Korean

War, which is often referred to as a silent and forgotten war.

The Vietnam War may have been a political disaster, the loss of life devastated

and demoralizing, but research on psychological stress injuries associated with the

Vietnam War resulted in scientific breakthroughs in the diagnosis, medicine, treatment,

and therapies used today to help war veterans in the past and present. During the

Vietnamese era, the symptomatology of combat stress injuries was called post-Vietnam

syndrome and is credited to the work of Dr. Chaim Shatan, who in reaction to the

elimination of traumatic war neurosis from the second edition of the Diagnostic and

Statistical Manual of Mental Disorders (DSM; American Psychiatric Association [APA],

1968), forming the Vietnam Veterans Working Group (Bloom, 2000). The results of this

working group led to the Presidential Commission to study the mental health of

Vietnamese veterans and eventually aggressive research by the Veterans Administration

(VA). This research leads to the development of post-traumatic stress disorder to replace

post-Vietnam syndrome. DSM-III (APA, 1980) includes PTSD.

Since the 1970s, research on negative psychological outcomes from military

combat has increased; however, a large gap remains in the literature regarding how

service members cope with CSE positively. There are several longitudinal studies such

as the National Vietnam Veterans Adjustment Study or independent studies such as

Suvak, Vogt, Saverese, King, and King (2002) that examine Vietnam War military

groups to determine their long-term life adjustment and well-being three decades after

exposure to combat.

The 1991 Gulf War sparked renewed interest in how service members cope with

combat pressure (Benotsch et al., 2000; Hobfoll et al., 1991; Marlowe, 2000; Sharkansky

et al., 2000). Over the past two decades, new theories describe the psychological effects

of war such as Combat Stress Reaction, Combat Stress Control, Combat Stress Injury,

and Combat Operational Stress Control. These developments help the military and the

scientific community see the psychological impact of war on military members as an

expected reaction or response to the combat environment and experience before, during,

and after the war.

Combat Stress Reaction (CRS) is "the expected, predictable, emotional,

intellectual, physical, and/or behavioral reaction of a service member who has

exposed to stressful events in combat or military operations other than war" (Campise,

Geller, & Campise, 2006, p. 216). This normative view of understanding CSR has led to

some confusion and stigma to get help to combat the associated psychological problems.

Because if CSR is seen as a normal and expected reaction, and if a service member feels

abnormal then seeking help can lead to wrong thoughts such as "I'm weak," "What

would others think of me," or "They'll kick me out if I get help." The misconception

about getting help for psychological warfare injuries fosters the stigma of getting help

that exists today and is rooted in our military history and soldier ethos.

Nash (2007) developed a combat stress injury model to help change the mentality

associated with CSR. In addition, Nash argues that the transactional model is the most

suitable for addressing CSE. Nash supports the view that coping with combat stress

involves several interacting variables such as genes, personality, social context, personal

relationships, and environment (Nash). Finally, over the past 150 years, the U.S. military

has progressed in understanding the negative and positive effects of CSE on combatants,

and is developing policies, programs, and resources to remedy the stigma of getting help.

Stress coping actions. Measuring voltage is multidimensional. Stress can be

physiologically measured by heart rate, blood pressure, and cortisol levels (Lovallo,

2005). Stress can be objectively measured using a stress checklist of major life events

such as divorce, death, illness, the birth of a child, or a job promotion (Turner &

Wheaton, 1997).

Lazarus and Folkman (1984) developed the Ways of Coping (WOC) scale to measure

subjective stress and coping. The WOC scale focuses on everyday stress and how a person

Attempt. The WOC scale has eight subscales that serve as coping options and are

divided into coping that focus on problems or emotions: (a) confrontational coping, (b)

distance,

escape, (g) planned problem-solving, and (h) positive reassessment (Lazarus & Folkman,

1987). Lazarus and Folkman show negative coping is mostly maladaptive and

detrimental to a person's health and well-being (Lazarus & Folkman). However, some

believe the WOC scale is too simple and a limited measure of stress and coping and

needs to be expanded.

In response to the potential limitations of the WOC scale, Carver, Scheier, and

Weintraub (1989) developed the COPE inventory to expand the Lazarus and Folkman

transactionalist model and the WOC size. Carver and his colleagues included their

research in behavioral self-regulation into the COPE inventory. In addition, they believe

that coping involves coping style and strategy along with the "disposition" of the coping

(p. 270). The COPE inventory has been used in a variety of studies to include breast

cancer and diabetes (Thomas & Marks, 1995; Karlsen & Bru, 2002).

In addition, the COPE Inventory has been used in many correlation studies with the Five

Factors Personality Model (Watson & Hubbard, 1996). However, Carver (1997) found

many people become impatient when taking a 60-item COPE inventory; thus he

developed the Short COPE inventory used in the current research. A brief COPE

inventory is described in Chapter 3.

Hard-Resistant Theory

Resilience as an existential courage that is operationalized. The psychological

construction of resilience evolved over the past three decades as a personality disposition

that copes with stress positively through a series of attitudes learned to produce favorable

outcomes (Maddi, 2004). Resilience is rooted in existential psychology, and according to

Maddi, it is the operationalization of existential courage. Existential psychology emerged

from existential philosophy (Brennan, 2003). Existential philosophy developed during

the 19th and 20th centuries as a reaction and response to Hegel's dialectical philosophy.

Sartre fundamentally reveals one of the core concepts of existential thought in his

popular phrase "existence precedes essence" (p. 283). The essence of existential

philosophy and psychology is to find meaning for one's life which involves decision-

making (Maddi, 1998).

Søren Kierkegaard is considered the Father of Existentialism. He provides insight

into the emotional dimension of existential thought (Evans, 1990). At the core of

existentialist philosophy and psychology are feelings of guilt, hopelessness, and anxiety;

especially how emotions are associated with the mind of limitation, alienation, and death

(MacQuarrie, 1972). These thoughts and emotions appear as an analysis of the human

self in the world. Existence (life) is always placed against nothingness (death) that

creates psychological tension—what Kierkegaard distinguishes as anxiety or anxiety

(Evans). This anxiety is also known as ontological anxiety and is generated by fear or

uncertainty of the future (Maddi, 2004).

Kierkegaard believes the ability to deal with anxiety positively is through faith in

a Christian God. Paul Tillich took this concept of faith and developed existential courage

or courage to be a substitute for faith (Maddi, 2004). Furthermore, Maddi develops

resilience as the operationalization of existential courage. According to Maddi, Harvey,

Khoshaba, Fazel, and Resurreccion (2009) "personality resilience has emerged as a

combination of interrelated attitudes of commitment, control, and challenge that provide

courage and existential motivation to turn circumstances from potential disasters into

growth opportunities" (p. 292).

Resilience as a personality trait. Kobasa (1979) in a seminal study of the effects

of stress on health helped develop a construction of resilience based on personality

theory and existential psychology. Kobasa measured the effects of stressful life events in

a group of corporate executives who experienced the deregulation of the

telecommunications industry during the late 1970s and 1980s. Kobasa began the study

with 837 executives who were sent questionnaires to develop two groups of participants:

(a) the high-stress/low-disease group and (b) the high-stress/high-illness group.

After screening the questionnaire, there were 116 people with high stress/low

disease and 150 individuals with high stress/high disease who met the research criteria;

Of these, 100 from each group were randomly selected to participate in the study.

Demographically the population of the study is homogeneous with the following group

characteristics: white males with a bachelor's degree, ages 40-49, married with two

children with a live-in partner, they are middle management executives with at least six

years of experience, and mostly Protestants who attend services regularly.

The study includes three hypotheses regarding three attitudes of resilience: (a)

control, (b) commitment, and (c) challenge. Resilience is a cumulative score that

measures these three attitudes, and it is proposed that highly resilient individuals cope

better with stress and have lower rates of disease. Kobasa (1979) measured stress and

illness using the Life Event Schedule and Social Adjustment Rating Scale and the

Disease Severity survey. To measure the three personality attitudes, Kobasa used a

variety of measures at the time that were later developed into the current resilience

measure, the Personal Views Survey-IIIR (PVSIII-R®). This preliminary study sought to

determine whether the positive personality disposition of resilience buffers the negative

effects of stress on health. Kobasa concluded based on this study that executives who

have high resilience cope better with stress and have fewer diseases. This study was the

beginning of a longitudinal study with these executives that lasted for 12 years (Maddi,

1999a).

Resilience as control, commitment, and challenge. Kobasa (1979) proposed

that people with high stress and low disease have a strong personality disposition that

separates them from individuals with high stress and disease. Strong personalities have

three repetitive characteristics: (a) the ability to control or influence stressful events, (b)

the ability to have a deep sense of commitment to life, and (c) the acceptance of change

as challenging and good (Kobasa, p. 3). Over the past 30 years researchers have

attempted to quantify and validate this psychological phenomenon in studies with

athletes (Hanton, Evans, & Neil, 2003), college students, corporate executives, members

of the military service, and people with various diseases (Maddi, Harvey, Khoshaba,

Fazel, & Resurreccion, 2009).

According to Maddi and Khoshaba (2001) "resilience is a pattern of attitudes and

skills learned" (p. 8). Individuals who are high in an attitude of commitment are willing

to seek social support and resources to cope with stress. Individuals who hold high

control have the attitude that they can positively influence their circumstances to

influence favorable outcomes. Individuals, who are high in a challenging attitude view

change as good, and are willing to learn from their circumstances whether it is positive or

negative. This resilient attitude is additive and interrelated that is combined together to

produce a resilient person (Maddi & Khoshaba).

Durability measures. Psychological constructs are not easy to measure and

many actions take years to perfect, which is a case of resilience. In the study of Kobasa

(1979) there is no single measure of resilience. Maddi and Khoshaba (2001) stated "the

first measure of HardiAttitudesTM incorporates an existing scale that seems to be

conceptually relevant, although it was originally designed with other concepts in mind"

(p. 14). Thus, the use of these measures for resilience construction has drawn worthy

criticism (Funk, 1992; Funk, & Houston, 1987). Criticism of Kobasa's study focuses on

the homogeneous nature of the sample, the scale used, and the weak correlation with

three tough attitudes, especially challenging attitudes (Funk; Maddi, 1999a). Ongoing

research tests resilient constructions, and the latest instrument for measuring resilience is

the PVSIII-R® which refutes or corrects valid criticisms of original hardiness research

(Maddi, 2004; Maddi & Khoshaba).

Resilience of commitment, control, and challenge can be measured using the

PVSIII-R® (Maddi & Khoshaba, 2001; Maddi, Khoshaba, Harvey, Fazel, &

Awakening, 2010). The PVSIII-R® was tested and validated with a variety of samples to

include undergraduate students (Maddi, Harvey, Khoshaba, Fazel, & Resurreccion,

2009), the U.S. Army Reserve Forces (Bartone, 1999), and the Israel Defense Forces

(Florian, Mikulincer, Taubman, 1995). The psychometric PVSIII-R® is presented in

Chapter 3.

Resilience and positive psychology. Psychological resilience is more than just

surviving stressful life events. Resilient individuals often develop due to stress (Maddi,

Harvey, Khoshaba, Fazel, & Resurreccion, 2009a; 2009b). Although resilience is not part

of the taxonomy of strength and virtue of positive psychology character, resilience fits

into the virtues of transcendence and the strength of the character of hope, optimism, and

future thought, and future orientation. Maddi (2006a) argues that resilience must be part

of the "mixture" of positive psychology (p. 160). Furthermore, Maddi presented a

framework and methods to help develop an integrated positive psychology that includes

the use of a comparative analytic approach to research. He believed that positive

psychology variables needed to be better differentiated either as independent or

dependent variables; For example, is resilience an independent variable that influences

the positive outcome of coping with stress or is resilience a dependent variable and when

mixed with social support helps individuals cope with stress better?

Valliant (2000) reports that resilience contributes to positive psychology as an

involuntary defense mechanism that helps reduce the effects of anxiety. Matthews

(2008a) places resilience in the construction of positive psychology and coping with

extreme combat stress. He concluded that toughness can "instill" (p. 170) a soldier before

becoming a

Exposure to combat stress and resilience can help service members positively cope with

their combat stress experiences. Durability can increase durability.

Resilience and coping positively with exposure to combat stress. Since the

Vietnam conflict, the DoD has increased research on the effects of war on military

members; however, as mentioned earlier there is a major gap in the literature on

addressing CSE positively. Recently, the DoD established the Defense Center of

Excellence for Psychological Well-Being and Traumatic Brain Injury (TBI). While PTSD

and TBI need to be researched, there should be increased interest and research on how

individual service members cope with CSE positively. The majority of those who go to

war will go home and cope positively with their combat experience; Thus, if science

knows why and how service members better cope with CSE then preventive measures

can be developed to reduce the negative impact of combat stress on service members.

Emerging research on overcoming combat stress and resilience construction is

consistently mentioned in the resilience literature (Friedl & Penetar, 2008; Garb &

Cigrang, 2008; Maddi, 2007; Waugh, Tugade, & Fredrickson, 2008). However, some

current literature, especially in Lukey and Tepe (2008), has no new evidence, with most

references to resilience coming from Kobasa (1979), or some more recent but ancient

studies by Florian, Mikulincer, and Taubman (1995) and Bartone (1999). Westphal,

Bonanno, and Bartone (2008) provide an overview of resilience and personality but most

of their references are to studies of actual human participants over five years old and

most of these studies focus on non-military samples. Finally, the literature supports the

concept that resilient individuals cope better with stress especially

those who have a positive social support system (Maddi & Hightower, 1999; Pengilly &

Dowd, 2000).

Hope Theory

Hope as a cognitive process. Snyder (1999, 2002) developed the cognitive

theory of hope in the 1980s, and continues to refine the theory through research and

clinical applications; he primarily applies hope to the broader constructs of positive

psychology and copes with stress positively. Snyder (2002) bases the theory of

expectation in cognition but does not reduce the relevance of emotions. He notes that

during a visit with prominent scholar and physician Karl Menninger on the campus of

the Menninger Foundation, it was Menninger who encouraged him to focus on hope as a

thought process (Snyder).

Menninger (1959) has long recognized the importance of hope and health. He

delivered a lecture in 1959 to the American Psychiatric Association titled "The

Academic Lecture: Hope" in which he challenged members of the association to

consider the positive impact and clinical importance of hope on doctors, patients, and

their families. Although derived from the standards of today's research literature,

Menninger's academic lecture of 1959 brought the excellence of modern positive

psychology, although its context is rooted in progressive psychoanalytic constructs.

It is interesting that expectations from the days of Greek mythology to

Menninger's lecture of 1959 are often interpreted as negative traits or psychological

states; except in Jewish and Christian theology where hope is a positive phenomenon and

an essential element of faith. Menninger (1959) helped to move hope beyond nihilism

and fatalism, beyond pessimism and optimism to the fact that "hope is humble, it is

simple, it is oneself-

less. Regardless of the ambiguity of past experiences, hope implies a process; it is an

adventure, a forward, confident quest" (p. 484). Further, Menninger concluded:

But there are many people in the world who are not our patients or students, and

who remain filled with great concern, partly because of ignorance and distrust of

each other. They suffer great suffering that all our discoveries have not corrected,

and are fascinated by great discoveries that none of us fully understand. Some of

them seek advice to us, to us whom they respect very much and are generously

rewarded with prerogatives and opportunities. They are our friends, our brothers

and sisters, our neighbors, our cousins in a foreign land. For these people—for

them and for ourselves—are we not now obliged to speak as scientists, not about

new rockets or new fuels or new bombs or new gases, but about ancient but

undiscovered truths, the validity of Hope in human development—Hope, together

with its eternal sister, Faith and Love. (p. 491)

Taking its cue from Karl Menninger, Snyder (1995) defines expectation "as the

process of thinking about one's goals, along with the motivation to move towards (the

agency) and the way to achieve these goals" (p. 355). Outlining Snyder's cognitive

definition of expectation involves three main components: (a) goal setting, (b) pathway,

and (c) agency thinking (Snyder, 2002). Making goals, planning how to achieve one's

goals, and staying motivated to achieve goals are the goals of Snyder's theory of hope. A

person who generates a path mind believes that they have the ability and talent to achieve

Purpose; Agency thinking is a motivation or positive attitude that is necessary to achieve

the target goal. The goal must be significant enough to challenge someone (Snyder). This

is a very simple interpretation of Snyder's theory of hope. The process of expectation is

more complicated than thinking, planning, believing, and achieving (Snyder et al., 2000).

For example, how does one learn or develop the ability to think to create and achieve

goals? Do they have the resources to achieve the goal? What about confusing variables

such as emotions, stressors, or phenomena that Snyder (2002) added to his model of

"surprise events" (p. 254)?

Hope as an emotion. Jarymowicz and Bar-Tal (2006) provide a detailed

analysis of emotions and theorize about the dominance of fear as a primary negative

emotion over expectation as a secondary positive emotion. They describe emotions as

"psycho-physiological reactions to all kinds of stimuli" (Jarymowicz and Bar-Tal, 2006,

p. 369). Human emotions evolved as part of adaptive survival; However, some

emotions can lead to maladaptive behavior (p. 369). The following are key lessons on

emotions gleaned from Jarymowicz and Bar-Tal (pp. 369-371).

1. Emotions are unconscious and conscious, biochemical, physiological,

affective, cognitive, and behavioral processes.

2. Emotions can produce adaptive or mal-adaptive reactions and responses.

3. Emotions help decode and give meaning to perceived stimuli.

4. The main emotions can be spontaneous, fast, uncontrollable, and

involuntary.

5. Emotions can be automatic reactions.

6. Emotions can be part of the human stress assessment, evaluation, and

decision-making process.

7. Emotions can be in the form of low-way (limbic system) or high-

street (cortex) brain function.

8. Emotions can be localized in the left hemisphere (positive emotions) or

right (negative emotions); the fear may be oriented towards the right

hemisphere, engaging in unconscious processing of intuitive information;

while left-oriented hope, involved in conscious rational cognition.

9. Emotions such as fear may be primary emotions that are produced

unconsciously in the limbic system as a protective reaction to negative stimuli

and dominate the conscious secondary positive emotions of hope.

Jarymowicz and Bar-Tal (2006) view hope primarily as cognitive, with a

secondary affective element, which agrees with Lopez, Snyder, and Pedrotti (2003) who

stated, "thoughts and emotions work hand in hand in the theory of hope to help people

pursue the coveted goals that are so important in everyday life" (p.95). Cognition helps

individuals develop hopeful goals and expectations, and the affective element of hope

helps generate positive emotions to achieve goals that create motivation to try and

achieve goals. Like Snyder (2002), Jarymowicz and Bar-Tal describe hope as a state and

a trait.

Measurement expectations. Expectations can be measured as disposition traits

and psychological states (Lopez, Snyder, & Pedrotti, 2003; Snyder, Cheavens, &

Michael, 1999; Snyder, 2002; Snyder, Rand, & Sigmon, 2005). Lopez, Snyder, and

Pedrotti reviewed more than 20 definitions and theories of hope, and examined a wide

range of validated measures of hope. Research expectations can be divided into two

main categories: (a) emotion-based, or (b) cognitive-based (Lopez, Snyder, & Pedrotti,

p. 91). Measuring expectations is challenging because of the nature of construction as

a nature and circumstance. Lopez, Snyder, and Pedrotti note that quantitative measures

of self-report expectations may not be reliable, but qualitative observational methods

along with self-reports can offer more meaningful insights into individuals'

assessments of expectations.

Snyder et al. (1991) attempted to design a validated quantitative measure of

individual expectations. After developing the theory of hope as an agency's goal, path,

and thinking, they tested the Expectation Scale. The Initial Expectation Scale is a

measure of expectation as a disposition or trait. In a subsequent study, Snyder (1995)

developed the Hope Scale to measure hope as a state of being. The Country Trait and

Expectations Scale is for adults. Then Snyder et al. (1997) refined these steps, and

developed the Child Expectation Scale. Although there are several psychological

measures of hope today, the most common and validated quantitative measure of hope in

the positive psychology literature is the Snyder scale of expectations. Expectations are

integral in coping with stress, and individuals with higher expectations often have better

logical problem-solving skills that are key to achieving goals (Jarymowicz & Bar-Tal,

2006). The Adult Disposition Expectancy Scale (ADHS) was used for the current study.

The psychometry of ADHS is described in Chapter 3.

Hope and positive psychology. As mentioned earlier, the positive psychological

classification of the six universal virtues is supported by 24 character strengths (Peterson &

Seligman, 2004b). The sixth virtue in the classification is defined transcendence

as "a force that establishes a connection to the larger universe and gives meaning"

(Peterson & Seligman, p.30). Transcendence is further explained by five character

strengths: (a) appreciation of beauty and excellence, (b) gratitude, (c) hope, (d) humor,

and (e) spirituality (p. 30).

The 24 character strengths of positive psychology are considered to be

"psychological ingredients" for a good life (Peterson & Seligman, 2004b, p. 13). They

should not be considered "exclusive or complete," and are part of a "family" of attributes

that describe virtue (p. 13). Thus, when defining and describing expectations, Peterson

and Seligman (2004d) include the traits of (a) optimism, (b) future-thinking, and (c)

future-oriented as part of a mixture that creates expectations that "represent cognitive,

emotional, and motivational attitudes toward the future" (p. 570).

Hope and cope positively by combating stress exposure. Hope theory has been

studied in the field of psychotherapy (Irving, et al., 2004), cognitive behavioral therapy

(Riskind, 2006; Snyder et al., 2000), and coping with stress (Aspinwall, 2005). However,

there is a gap in the psychological research literature related to coping with CSE

positively; especially those related to the theory of hope and positive psychology. With

limited literature and research on coping with CSE positively, one should gather from

research on coping with PTSD. Irving, Telfer, and Blake (1997) conducted a study with

72 randomly selected participants who voluntarily sought inpatient treatment for combat-

related PTSD; The researchers sought to measure expectations, coping, and social

support. They used Snyder's theory of hope and predicted that the disposition of higher

expectations would be

related to better coping skills. Irving, Telfer, and Blake made the following predictions:

1. Military veterans with combat-related PTSD will report lower levels of

disposition expectations upon admission than nonclinical samples.

2. Military veterans who receive inpatient treatment for combat-related PTSD,

with the expectation that higher dispositions during entry and exit will be

associated with adaptive coping strategies and greater social support.

3. Military veterans who receive inpatient treatment for combat-related PTSD

that builds coping skills and improves relationships during treatment will

report greater reliance on coping approaches, less reliance on avoidance

countermeasures, and improved perceptions of social support.

To test this hypothesis Irving, Telfer, and Blake (1997) were given at the entry

and exit of the Expectation Scale, Perceived Social Support Scale, Koping Response

Inventory, Beck Depression Inventory, and Mississippi Scale for Combat-Related PTSD.

Of the 72 participants, 43 completed the study from entry to exit. The findings support

the hypothesis. The researchers concluded that while military veterans seeking inpatient

treatment for combat-related PTSD may have a "deep lack of hope," their hope may be

"lost but not lost" (p. 472). Participants in this study with higher expectations and

perceived higher social support overcame PTSD more positively. Finally, the findings

from this study support the various findings described by Snyder, Cheavens, and Michael

(1999) who concluded after an extensive review of the expectation literature that

expectations help individuals cope with stress better.

Social Support Theory

Social support and coping with stress. Human beings are social and

psychological well-being is directly related to social structures such as institutions (Ryff

& Singer, 2005). Quality relationships are essential for physical and psychological health

(Taylor, Dickerson, & Klein, 2005). Being able to feel and receive social support is one

aspect of maintaining health. Social support is "the provision of help or comfort to

others, usually to help them cope with various biological, psychological, and social

stressors" (VandenBos, 2007, p. 869). Lazarus and Folkman's (1984) transactionalist

model of stress and coping views individual transactions with society as a key

component of their metatheory. They argue that the basis of social science is the

actualization of the individual in relation to society. Society and social interactions can

be a source of stress or a resource for coping (Lazarus & Folkman).

Conceptually defined: social support is the help provided by institutions, groups, and

individuals to help a person cope with physical and psychological stress.

Schwarzer and Knoll (2007) define and differentiate between perceived and

received social support. They describe different types of social support such as

instrumental, informational, and emotional support (p. 244). Social support involves

interaction. Perceived social support may never happen; while receiving social support

has occurred. In the transactionalist model of stress and coping, social support either

perceived or received can be seen as a coping resource, and can help foster self-efficacy

and adaptive coping (Schwarzer & Knoll).

Social support and positive psychology. Positive psychology is committed to

fostering positive social institutions that help individuals develop (Robbins, 2008). One

of the goals of the positive psychology movement is "the creation of a deliberate

institution that allows for good character" (Peterson & Seligman, 2004c). Historically,

positive institutions have included families, religious organizations, and schools. In

addition, the main goal of applied positive psychology is good citizenship; thus,

individuals who exhibit positive social traits are better able to contribute to the well-

being of society (Linley & Joseph, 2004). Positive psychology's emphasis on character

strengths and virtues contributes to developing an individual's ability to relate positively

to others and society; thus making positive social support an important component of

positive psychology especially in the construction of subjective and social well-being

(Keys & Magyar-Moe, 2003).

The U.S. military can be considered a positive institution that fosters and develops

strength and character virtue. The U.S. military seeks to develop positive communities

and interpersonal relationships so that family members and services can thrive and thrive.

Studies in social support have included positive psychological variables such as

optimism and resilience. Brissette, Scheier, and Carver (2002) measured the correlation

between optimism, social support, and coping with a group of young adults who

switched to college during their first year of undergraduate work. The two objectives of

the study were to measure whether or not an optimistic attitude helped develop positive

social networks, and whether social networks or social support helped individuals cope

better during stressful lives

Transition? The findings of the study concluded that the greater the optimism and

positive social support, the more adaptive coping used in stressful situations.

Social support and coping positively by combating stress exposure. Social

support can be a vulnerability or protective factor when coping with CSE (Freeman &

Freeman, 2009). Lack of social support, avoidance, or dysfunctional social support can

worsen coping with CSE; however, healthy social support that is felt or received can be a

resource to overcome CSE positively. Vogt, Rizvi, Shipherd, and Resick (2008)

conducted a study at the Marine Corps Recruit Depot of Parris Island with the aim of

examining the reciprocal nature of resilience and stress reactions during initial military

training in groups of male and female Marine recruits. The secondary objective is to

determine the relationship between resilience and social support.

The study involved 826 women and 1,021 male recruits. The participants were

given a psychological battery on the first day of training to establish a baseline of stress

reactions, resilience, perceived social support, and negative and positive affectivity. Then

at the end of the 12-week boot camp, the same steps were given again. The findings for

male and female recruits differed, in which men with higher levels of endurance entering

training camp had lower levels of stress reactions during training; Those who had a

higher level of stress reaction initially showed lower levels of resistance at the end of

training camp. Male recruits with low social support and resilience have higher stress

reactions; However, social support is not a protective factor for low or high levels of

resilience. Data on men support the theory that those who are tall

Resilience and social support use adaptive coping strategies and styles that are more

problem-focused.

The findings with the female recruitment cohort differed because resilience is a

protective factor against stress reactions; Resistance also did not decrease in those who

had an initial high-stress reaction. Female Marines with low social support and resilience

do not predict low or high stress reactions. However, those with high social support and

higher stress reactions showed a slight increase in resilience at the end of the training

camp. Overall both sexes with low social support, low resilience have higher stress

reactions; however, for women, increased stress reactions with high social support

resulted in increased resilience (Vogt, Rizvi, Shipherd, & Resick, 2008).

Social support measures. There are various measures of social support such as

the Multidimensional Scale of Perceived Social Support (Zimet, Dahlem, Zimet &

Farley, 1988); Interpersonal Support Evaluation List (Cohen, Mermelstein, Karmack, &

Hoberman, 1985); or the Post-Placement Social Support (PSS) scale (King, King, &

Vogt, 2003). PSS is part of the Deployment Risk and Resilience Inventory (DRRI) (King,

King, & Vogt). Pietrzak, Johnson, Goldstein, Malley, and Southwick (2009) conducted a

resilience study with a group of 272 reserve components and National Guard service

members who had served in the OIF or OEF. The study was facilitated through a letter

survey to compare traumatic stress, depressive symptoms, resilience, and social support.

Various psychological measures were used to enter the PSS DRRI. These findings reveal

that increased post-placement social support can reduce negativity

effects of CSE. PSS is used for current research. PSS psychometrics are described in

Chapter 3.

Personality Theory

Personality and five-factor model. Cohen and Swerdlik (2005) define

personality as "an individual's unique constellation of psychological traits and states,

including aspects of values, interests, attitudes, worldviews, acculturation, sense of

humor, cognitive and related behaviors and characteristics" (pp. I-18). Piedmont (1998)

noted that normal personality develops well by the age of 17. Furthermore, based on the

theory of genotype and phenotype — personality is stable over time but can be formed to

adapt to the environment (Piedmont).

One of the key constructions for understanding general personality theory is the

Five Factors Model (FFM). FFM was originally based on the study of lexigraphic and

early 20th-century personality adjectives by Allport and Odbert; followed by Cattell in

the 1930s (Piedmont, 1998). During the 1960s W.T. Norman developed five dimensions

of personality: (a) extraversion or surge, (b) pleasure, (c) precision, (d) emotional

stability, and (e) culture (Cohen, 2005, p. 183). Over time FFM evolved through research

into current constructions: (a) extraversion, (b) neuroticism, (c) rigor, (d) pleasure, and

(e) openness to experience (VandenBos, 2007).

FFM is sometimes referred to in the research literature as the five-factor theory

(FFT) and the "Big Five" (Bernard, Walsh, & Mills, 2005; McCrae, et al., 2000). It has

been noted that FFM and the Big Five are different, and are often "incorrectly combined"

(VandenBos, 2007, p. 378). The Big Five is a taxonomy of the five personality

dimensions mentioned above; while FFM is a means of measuring five dimensions of

personality (VandenBos, p. 378). For the purpose of the current study, FFM is

emphasized. The five dimensions or domains of personality described by FFM are

universal human personality traits (McCrae & Costa, 1997); they can build individual

personality profiles (Piedmont, 1998) and culture (McCrae & Terracciano, 2005), and

can be used in assessing some mental illnesses such as personality disorders (Bagby,

Costa, Widiger, Ryder, & Marshall, 2005; Trull, Useda, Costa, & McCrae, 1995).

Personality measurements and five-factor models. FFM can be measured by

three separate NEO™ Inventories: (a) Revised™ NEO-Personality Inventory (NEO PI-

R™), (b) NEO-3™ Personality Inventory (NEO-PI-3™), (c) NEO-Five™ Factor

Inventory-3 (NEO-FFI-3™). The NEO PI-R™ inventory has been extensively tested

nationally and internationally (Jang, McCrae, Angleitner, Riemann, & Livesley, 1998;

McCrae, Yik, Trapnell, Bond, & Paulhus, 1998) and found widespread acceptance as a

very reliable and valid measure of FFM. NEO PI-R™ has been used in counseling,

therapy, psychiatry, health psychology, industrial and organizational psychology,

genetics, and educational studies and practices (McCrae & Costa, 2010).

Recently, the NEO PI-R™ was revised and published as NEO-PI-3™ to expand its use

from adults to adolescents (McCrae & Costa). NEO-PI-3™ retains the validity and

reliability of the NEO PI-R™. NEO-FFI-3™ is a shorter version of NEO-PI-3™ and

was used in this study. The psychometry of size is described in Chapter 3. The following

is a description of each factor.

Piedmont (1998) states that with respect to the first factor, the neuroticism of

FFM measured by the NEO™ inventory "assesses affective adjustment versus emotional

stability" in individuals (p. 84). A person with a high score in neuroticism "is susceptible

to psychological distress;" high neuroticism in NEO™ does not mean that a person has a

diagnosable mental health disorder, but it can be an indicator of risk for psychiatric

problems (p. 84). Negative emotions such as fear, anger, and disgust are associated with

neuroticism (McCrae & Costa, 2010). Often people with high neuroticism are prone to

irrationality, impulsivity, and maladaptive coping stress (McCrae & Costa). In contrast,

individuals with low neuroticism are often more emotionally stable, calm, relaxed, and

use adaptive coping strategies and styles (McCrae & Costa).

Costa and McCrae (1985; as quoted in Piedmont, 1998, p. 86) define the

extraversion of the second factor "as representing the quantity and intensity of

interpersonal interactions, the need for stimulation and the capacity for excitement." A

person who scores higher on extraversion is generally more sociable, willing to seek

support, and enjoys people (Piedmont). Emotionally, extraverts generally have a positive

disposition. In the context of FFM, extraversion is the opposite of introversion; However,

introversion is not a factor in this model.

The third factor in this model is openness to experience, which means "a

proactive search and appreciation of experience for its own sake, and as a tolerance for

the exploration of the unknown" (Piedmont, 1998, p. 87). Individuals who are open are

often more creative, curious, and broad-minded (Piedmont). McCrae and Costa (2010)

note that open individuals have "active imagination, aesthetic sensitivity, attention to the

inner

feelings, a preference for variety, intellectual curiosity, and independence of judgment"

(p. 20). Individuals are open to curiosity about the internal and external world.

The fourth factor is agreement, which focuses on the individual's attitude towards

others (Piedmont, 1998). Extraversion can determine how a person relates to others;

Pleasure can determine how well a person gets along with others.

Fun can be temperamental; pleasant individuals are often altruistic, sympathetic, and

empathetic (McCrae & Costa, 2010). A person who is low in pleasure may be

antagonistic, antisocial, paranoid, and have a tendency to dependent personality disorder

(p. 20).

The final factor of FFM measured by NEO™ inventory is rigor that "assesses the

level of organization, perseverance, and motivation of individuals in goal-directed

behavior" (Piedmont, 1998, p. 90). A conscientious person has the self-control to delay

self-gratification (p. 90). Individuals who are high in consciousness often have control

over impulsivity; thus they will be low neuroticism (McCrae & Costa, 2010).

Conscientious individuals are often "purposeful, strong-willed, and determined" (p. 20).

High precision can be manifested positively as a "desire to achieve" or low precision can

be associated with compulsivity (p. 21). Finally, thoroughness is often associated with

character, so that highly conscientious individuals are often "thorough, punctual, and

reliable" (p. 20); However, those who are humble in conscience are not necessarily

immoral or have character flaws.

Each of the five factors has an aspect scale that helps measure the various

thoughts, emotions, and behaviors associated with domain size. For example, the

neuroticism domain has an aspect scale to measure "anger, depression, self-awareness,

impulsivity, and vulnerability, as well as anxiety" (McCrae & Costa, 2010, p. 21). Facet

scales help give meaning to the size of the domain (McCrae & Costa).

The five-factor scale and several aspects provide a composite profile of the people

tested with the NEO™ inventory. Profiles allow measurement administrators to

interpret findings.

NEO™ can provide personality correlations that indicate whether a person may

be psychologically equipped with a personality profile that allows them to cope with

stress positively. A person who has low neuroticism, average or higher in extraversion,

openness, rigor and pleasure can tend to cope with stress positively. Furthermore, based

on the NEO™ profile a person can establish a well-being style (personality style). The

well-being personality style is low in neuroticism and high in extraversion and is

considered to be "optimistic optimistic" (McCrae & Costa, 2010, p. 31). Finally,

although not hypothesized in this study, optimism has been positively correlated with

future-oriented expectations and thinking.

Positive personality and psychology. Positive psychology seeks to identify and

measure positive personal traits in an individual's cognition, emotions, and behavior

(Park, Peterson, & Seligman, 2004). Strength and virtue of character are positive

individual traits. As mentioned in Chapter 1, positive psychology is often identified with

six core virtues and 24 character strengths that represent a family of traits reflected

in a good life, life satisfaction, and a life that thrives in the face of adversity (Park,

Peterson, & Seligman, 2004). The question of the relationship between FFM and

character strengths and virtues of positive psychology is relevant to current research. The

five personality domains do not fall within the framework of positive psychology but are

positively correlated with character strengths (Park, Peterson, & Seligman).

Piedmont (1998) identified character as part of personality, and attributed it to

the openness trait of FFM which has an aspect scale for value; Openness to values

"means a readiness to re-examine social, political, and religious values" (p. 88).

Individuals who score high on openness to values have more tolerant attitudes and

actions toward others and are open-minded; On the other hand, someone who lacks

openness to values is potentially intolerant and closed-minded.

As part of the analysis of the NEO-PI-3™ profile there is a matrix that plots the

factors in relation to the character; For example, individuals who are high in precision

and pleasure are often willing to help others, more social, and willing to seek social

support. Adjectives that describe this character profile include: moral, respect, respect,

politeness, care, sincerity, and understanding (Piedmont, 1998). This summary suggests

that the five factors, although not part of the human superiority classification of positive

psychology, can be considered part of the family of strength and virtue of character.

Personality and resilience. Over the past decade, personality researchers have

extended variable-centered trait-oriented theory to a person-centered personality

approach (Asendorpf, 2002). This expanded approach is organized around personality

type (van Lieshout, 2000). Personality types are groups of individual traits that

collectively make up a personality profile. This approach was applied to FFM, and

Asendorpf developed a typological construct that resulted in three replicable personality

types based on individual trait groupings: (a) resilient, (b) over-controlled, and (c) under-

controlled. The resilient type is below mean in neuroticism and average or higher in the

other four FFM factors (Asendorpf).

Tough type personalities are described as well-adjusted individuals who function

well intellectually, emotionally, and socially (van Lieshout, 2000, p. 280). However, this

new approach has been criticized (Costa, Herbst, McCrae, Samuels, & Ozer, 2002).

Costa et al. (2002) showed the usefulness of the three types but showed through an

analysis of four studies using a large sample that three of the four studies did not fully

confirm the three personality types. They concluded that FFM is a better predictor of

individual personality than type grouping. The typological approach is valid, but FFM

using NEO PI-R™ is statistically and clinically more plausible (Costa et al.).

Personality, stress, and coping positively with exposure to combat stress.

Bolger and Zuckerman (1995) designed a framework for examining personality, stress,

and coping. They propose that personality can influence stress reactions and coping

choices.

They describe the stress process in two stages: (a) stress exposure, and (b) stress

reactivity. They describe stress exposure as the possibility of experiencing a particular

stressful event, and stress reactivity as "the extent to which a person is likely to exhibit

emotionality or physical reaction to a stressful event" (p. 890). Framework

Developed by Bolger & Zuckerman, it involves four possibilities about how personality

may or may not affect the stress process:

1. A zero model in which personality cannot explain any effect on the outcome of

the stress process.

2. A differential exposure model in which personality influences stress exposure

but not reactivity.

3. A differential reactivity model in which personality influences reactivity but

does not impact exposure.

4. A differential exposure-reactivity model in which personality influences

exposure to stress and reactivity.

Furthermore, stress reactivity can be divided into: (a) coping choices, and (b)

coping effectiveness (Bolger & Zuckerman, 1995). The choice of coping involves coping

style and strategy. Copping effectiveness describes how coping efforts produce positive

or negative outcomes. This framework assumes that personality can influence exposure

and reactivity by influencing coping choice and effectiveness; So if personality does

affect coping, then there are four possibilities in the outcome of coping:

1. The zero model in which coping cannot explain how personality affects coping.

2. A differential coping choice model in which personality influences

coping strategies and stress outcomes.

3. A differential coping effectiveness model in which personality affects

coping effectiveness positively or negatively.

4. A differential choice effectiveness model in which the personality acts as a

mediating factors in coping choices and moderation factors in coping

effectiveness.

Bolger and Zuckerman (1995) tested this framework with the FFM personality

factor of neuroticism. In their study, they examined stress exposure, reactivity, coping

choices, and effectiveness. They enrolled 94 introductory college psychology students,

65 females, 29 males with an average age of 19.5 years. The participants were given an

Eysenck Personality Inventory to measure neuroticism, the How to Cope, and Mood

State Profile. Each participant kept milk 14 days free from stress and reactions; Then the

same action was given again. The results revealed that the differential exposure

reactivity model was most consistent with the research data. Highly neurotic participants

experienced more stress and daily conflict, and their negative reactivity was higher with

greater stress. With regard to coping, high neurotics choose to use more coping strategies

and styles but mostly cope negatively using coping strategies that avoid escape.

This model is particularly applicable to positively address exposure to combat

stress. The essence of this study is to determine why and how U.S. Marines exposed to

combat stress cope positively with their combat experience. The above model suggests

that personality is a moderating factor in coping effectiveness, and that individuals with

high neuroticism cope less effectively or opt for avoidant coping strategies and styles.

Resilient Marines who cope positively with CSE have personality factors that allow them

to cope better by choosing effective coping strategies and styles that correlate with

differential exposure reactivity models.

Conceptual Framework

of Transcendental Phenomenology

The historical roots of transcendental phenomenology. One criticism of the

quality of the research articles reviewed for this study that used phenomenological

methods was that they did not adequately explain Husserlian's transcendental

phenomenology.

In addition, in two quality research methodology books by Creswell (1998; 2003) there

is very little historical and technical background for phenomenology in general, and

much less on Husserlian transcendental phenomenology. Creswell like other researchers

took from Husserl key philosophical, psychological and methodological components

such as epoche, subjective reflection or the concept of essence without explaining the

depth of Husserl's thought; Thus the following is provided to ensure Husserl's

transcendental phenomenological theory is incorporated into the historical context.

Transcendental phenomenology is not an empirical experimental model of the

natural sciences. Transcendental phenomenology is a priori human science developed

by Edmund Husserl. Brennan (2003) when referring to "the historian of psychology E.

G. Boring comparing the models of the great man and the Zeitgeist as they were applied

to the history of psychology" (p. 2). One can make the argument that Edmund Husserl

was a great man who was historically unknown who embodied the Zeitgeist of his time.

Subsequently, Husserl developed a new philosophical and scientific paradigm.

Kuhn (1970) describes normal science as "research based on one or more past scientific

achievements, achievements recognized by some particular scientific community for a

while as a basic supplier for further practice" (p. 4). Deep

scientific research and development, new ideas emerge and often create changes towards

new models in what Kuhn calls a paradigm shift that can lead to a scientific revolution.

Husserl said his work was built on Cartesian and Kantian philosophies and in many ways

transcendental phenomenology was neo-Cartesianism and a paradigm shift of

Kantianism. Welton (1999) notes in connection with Husserl's research

This work builds a gap that will ultimately take philosophy beyond older and tired

alternatives or psychology and formalism, realism and idealism, objectivism and

subjectivism. His attempt to integrate the theory of meaning with one of the

truths, the theory of the subject with one of the objects, changed philosophical

thought in a direction that he did not imagine. (p. viii)

Husserl was aware of the evolution of his work; He is a man on the journey, a

participant in a transcendental phenomenological attitude. His work is a paradigm shift

from natural sciences to human sciences. In a 1922 letter to a colleague, Husserl wrote:

I'm in a much worse situation than you because a big part of my job is stuck in

my script. I almost condemned my inability to put an end to my works [mich],

and the first quite late, partly only now, universal and systematic thoughts have

come to me, which, though demanded by my previous special investigation, are

now also forcing me to redo everything. Everything is in the recrystallization

stage! Maybe I work, with all the energy expenditure that is humanly possible,

just for my posthumous work. (Welton, 1999, p. xi)

From 1887 to 1936 Husserl published ten major works in German, some

translated into French, English, and Japanese. Husserl died in 1938 with more than

40,000 pages of unpublished writings currently being arranged for future publication.

Husserl never saw the impact of his work. Also, Husserl may have been defeated by

Heidegger, who was Husserl's student, colleague, and friend at the beginning of their

relationship, but in the end Heidegger became a Nazi enemy to Husserl—to the point

that Husserl was stripped of his professorship in Frieberg and German citizenship by the

Nazis before his death in 1938 (Sheehan & Palmer, 1997).

Husserl's life and work are well documented; including a prose account of his life

written by his wife Malvine (Welton, 1999). However, as Husserl's academic life spanned

more than 40 years, three professorships, crossing into the new century, involving living

through the first great war in which one of his sons was killed and the other was

wounded, he lived as a Jew who converted to Christianity in anti-Semitic Germany, the

world of Husserl's life was as complex as his research. This is why many find Husserl's

philosophy and psychology difficult to follow because there is no single definitive work

describing his ideas. Husserl continued to develop his ideas to the end, which was evident

in his 1936 publication The Crisis of European Sciences and Transcendental

Phenomenology.

For the purposes of my studies, there is one academic article written by Husserl

in 1927 that provides a conceptual framework for my research. Transcendental

phenomenology is a philosophy, psychology and research methodology. Transcendental

phenomenology has a lexicon of special and distinctive technical meaning—most of

which comes from philosophers who influenced Husserl such as Hume,

Descartes, Kant, Locke, Brentano, and Stumpf. Relevant to this study is the influence of

Franz Brentano on Husserl's thought. After Husserl completed his university work in

Germany where he studied mathematics and philosophy, he moved to Vienna where he

completed his doctoral dissertation on calculus theory and variation. Husserl returned to

Germany where he completed some tame military service; then returned to Vienna where

he attended Franz Brentano's lecture on psychology (Brennan, 2003; Welton, 1999).

Brennan notes that it was Brentano's Action Psychology that influenced Husserl for the

rest of his life.

Brentano was probably the founder of human science psychology which was an

alternative to the developing natural sciences of psychology embraced by Wundt at the

time; Husserl attended Wundt's lectures while studying in Leipzig (Brennan, 2003).

Brentano was a Catholic priest of the Dominican Order, the same as Saint Thomas

Aquinas, who influenced his doctoral topic On the Manifold Meaning of Being

According to Aristotle (Brennan, p. 169). Brentano is widely recognized for his deep

understanding of Aristotle and psychology; however, because of his intellectual prowess

he became a threat to the Catholic Church and eventually left the Priesthood and married.

In 1874 Brentano was appointed professor of philosophy in Vienna and had students

such as Karl Stumpf, Sigmund Freud, and Edmund Husserl. Although not a prolific

writer, his limited works had a significant impact on the psychology of the human

sciences. Brentano's behavioral psychology focuses on "the inseparable interaction of the

individual and the environment" (p. 169).

Brentano does not adhere to Wundt's structuralism which focuses on

experimental science in the laboratory, which is based on anthropology and animal

science (Brennan, 2003). Brentano is interested in the human sciences and human beings

(subjects) as they interact with their environment (objects and phenomena); He explores

human consciousness and intentionality—perception, judgment, intuition, and memory.

Brentano is not against natural sciences such as physiology or biology but he sees natural

sciences as information psychology of human sciences. Brentano explores the human

mind, consciousness, action, and processes of "pure psychology" (p. 171).

At the end of Brentano's academic life, he moved towards phenomenology and

"expected a psychological method that would allow psychological actions to be

described in terms of subjective and experiential people" (p. 172). Brentano introduced

Husserl to the concept of intentionality and this is where Brentano ended and Husserl's

transcendental phenomenology began.

Phenomenology and transcendental psychology: A new philosopher can start

with Husserl's first writings and read them chronologically, or one can read Husserl

backwards—I decided to take a middle path and start reading Husserl (1927); then

excerpts from his important writings (Welton, 1999). In addition, four other sources are

used to formulate a better understanding of transcendental phenomenology as a

philosophy, psychology, and research methodology: (a) Giorgi (2009), (b) King and

Horrocks (2010), (c) Moustakas (1994), and (d) Sokolowski (2000).

Husserl's article (1927) provides a good introduction to transcendental

phenomenology. Husserl begins with a broad statement:

The term 'phenomenology' designates two things: a new type of descriptive

method that made breakthroughs in philosophy at the turn of the century, and a

priori science derived from it; a science intended to provide a basic instrument

(Organon) for rigorous scientific philosophy and, in its application, to enable the

methodical reform of all sciences. Along with this philosophical phenomenology,

but not yet separated from it, however, also emerged a new psychological

discipline that paralleled it in method and content: a purely a priori

'phenomenological' psychology, which raised the claim of reform as a basic

methodological foundation on which only scientifically rigorous empirical

psychology could be established. (Welton, 1999, p. 322)

Husserl did not ignore the relevance of the natural sciences, but argued

transcendental phenomenology was the starting point for all science. He supports that the

empirical sciences of nature run parallel to transcendental phenomenology with the main

difference being attitudes; natural attitudes (science) compared to transcendental attitudes

(phenomenologies). To practice phenomenology, researchers or phenomenoologists must

shift from a natural science attitude (empirical a posteriori) to a transcendental

phenomenological attitude (nonempirical a priori). Husserl (1927) concluded with the

idea that transcendental phenomenology brought the ancient Greek philosopher, followed

by Descartes and Kant to the next level in ever-evolving philosophy and epistemology—

noting that Leibnitzian's "universal ontology" had come to fruition in transcendental

phenomenology (Welton, 1999, p. 333).

Transcendental phenomenology as a philosophy. The philosophy of

phenomenology is the exploration of human experience, consciousness, and meaning

through subjective reflection. Philosophical phenomenology includes scholarly

researchers such as Hegel, Kant, Husserl, Heidegger, Sartre, Ricouer, van Kaam, Tillich,

and Merleau-Ponty; Also, there are branches in phenomenology such as transcendental,

existential, hermeneutic, and experimental (Moustakas, 1994). Sokolowski (2000) makes

the following statement about phenomenology from a philosophical perspective:

1. Phenomenology is the study of human experiences and the ways in which

things present themselves to us in and through those experiences (p. 2).

2. Phenomenology is the self-discovery of reason in the presence of an

intelligible object (p.4).

3. Phenomenology is the science that studies the truth (p. 185).

4. Phenomenology gives us an immanent way to be transcendent (p. 196).

The transcendental phenomenology of Edmund Husserl (1927) opened the door

to human science wider. Transcendental comes from the Latin root transcendere which

means "to transcend" (Sokolowski, 2000, p. 58). Gearing (2004) notes "phenomenology

comes from the Greek phainoemn, meaning appearance, and logos, meaning reason" (p.

1430). Husserl developed his ideas by criticizing the philosophies of Descartes and Kant.

Husserl's use of transcendentals is analogous to Kant's critical use (Moustakas, 1994).

Kant's philosophy revolves around criticism in which he wants to avoid dogmatism and

skepticism by seeking pure reason and transcendental knowledge that is a priori (not

mixed with anything empirical and must be universal) and not

governed by empiricism or sensory data. Transcendental phenomenology is a philosophy,

psychology, and research methodology that explores the subjective conscious human

experience of phenomena.

Transcendental phenomenology as pure psychology. Transcendental

phenomenology is not just a complex philosophy; it is pure science and psychology

(Husserl, 1927). Husserl was critical of the psychology of his time, calling it psychic ,

and equating it with anthropology and zoology. Husserl developed pure psychology

without any pre-formed empirical dogma. Pure psychology from a transcendental

phenomenological perspective is built on the reflection of subjective experiences in the

world of life. Reflection involves the core concept of intentionality, where Husserl states

"All consciousness is 'intentional'" (p. 3). Husserl's deliberate use was directly influenced

by Franz Brentano. Every perceptible phenomenon has a deliberate structure (essence),

and deliberate reflection always involves directing the subjective consciousness of the

phenomenon to the object as it presents itself to the individual. Husserl's mantra like

Kant's is "back to things themselves" (Moustakas, 1994).

Husserl developed a unique lexicon that expanded Kantian, Cartesian, and

Lockean thought to describe transcendental phenomenology, as philosophy, psychology,

and methodology; technical terms such as epoche, noetic, noematic, eidos, eisecond

reduction, inter-subjective reduction, the world of life, and attitudes

transcendental(Moustakas, 1994). These terms describe transcendental philosophy and

psychology, and

it is essential to understand Husserl's methodology of this pure science described in

Chapter 3.

Transcendental phenomenology as a methodology. Kendler (2005) notes that

transcendental phenomenology is not Wilhelm Wundt's psychology that developed a

method for studying human consciousness around the same time as Husserl. Wundt's

method of studying human consciousness involves training research participants to

become self-aware in a highly controlled laboratory environment (Kendler). Wundt's

psychology is sensory-oriented and empirical-based; however, this method is flawed

from Husserl's perspective because training participants to be self-aware influences how

a person perceives their conscious experiences thus creating a bias (Kendler). Also,

around the time of Wundt and Husserl, another psychologist, John Watson, developed

the method and science of behavioralism. The science of behavioralism follows the rules

of empirical natural science which developed into modern cognitive psychology

(Kendler).

Husserl developed transcendental phenomenology in the midst of great

discoveries in the natural sciences and humans. Transcendental phenomenological

methods for studying conscious human experience differ from introspection or

behavioralism because transcendental phenomenology involves the scientific process of

epoche, transcendental-phenomenological reduction, imaginative variation, and

deliberate analysis (Moustakas, 1994).

Husserlian's transcendental phenomenological research methods can be used to

study any phenomenon. Wright (2002) uses this approach to "discover the spiritual

essence of palliative care" (p. 125). Wertz (2005) applied this method to study the impact

qualitative research on counseling psychology; He concludes that "the phenomenological

movement has broadened the conceptual and practical foundations of science to include

a descriptive study of subjectivity and the full human person" (p. 176).

Scannell-Desch (2005) used this method in a qualitative study with nurses on duty in

Vietnam. In her study, phenomenological interviews were conducted with 24 female

research participants. Scannell-Desch transcribed interviews and used phenomenological

methods to analyze data to develop combat nursing themes that are applied as lessons

learned for military nursing today. The Scannell-Desch study is the QUAL model for my

research.

Transcendental phenomenology and coping positively by combating stress

exposure. The QUAL section of the study was designed to explore the experience of

combat stress exposure in a sample of U.S. Marines to ask how they coped positively

with their combat experience. The QUAL research method is Husserlian transcendental

phenomenology. One unique aspect of this methodology is the epoche or bracketing of

the main researcher's knowledge and personal experience with CSE. After the interview,

QUAL data was analyzed. During the analysis, the theme of positively addressing CSE

emerges; then the principal investigator compared the dataset with the QUAN portion of

the study to develop a composite picture of U.S. Marines that positively addressed their

combat experience—a formidable soldier.

To illustrate this method, Shaw and Hector (2010) explored the lived experiences

of U.S. military members returning home from Iraq and Afghanistan using

phenomenological methods to develop thematic narratives. The objectives of this study

are

to understand the meaning of the experiences of U.S. military members in Iraq and

Afghanistan. The study involved ten U.S. military members (five National Guards, two

Army, two Army Reserves, and one Air Force), all white male, ranging in age from 23 to

56 years old. The researchers collected participant data through live interviews using

audio recordings and then transcribed the interviews into text files for analysis.

The results of data analysis from Shaw and Hector (2010) reveal the following:

the basic theme of the whole interview is work. The members of the service comment on

doing their job. One participant stated "Actual work determines many of your own

personal experiences," another stated "Experience depends on work often" (p. 130). The

themes of the figure include: being there, awareness of others, and a different world

(p.130). Sub-themes include: for or against being there, family, everyday, and danger (p.

132). Each of these themes is analyzed and compared with theoretical research to

determine implications for psychologists who can work with and treat members of

military service. There are five main findings for psychologists:

1. When working with U.S. military members who have served in Iraq and

Afghanistan, it is important to know about the work that members are

doing in theaters of operations (p. 133).

2. Explore the meaning of the experience by asking about being there and

asking questions like "What does it mean for you to serve your country in

Iraq or Afghanistan" (p. 133)?

3. If service members have families then they should be involved in

treatment planning and therapy (p. 134).

4. Helping service members rebuild routines when returning home from war (p.

134).

5. Dangerous experiences can result in trauma and disorders, knowing the signs

and symptoms of PTSD, knowing when to refer and/or how to treat PTSD

symptoms (p. 134).

Shaw and Hector (2010) phenomenological studies demonstrate the relevance of

the use of phenomenological interviews in research with service members exposed to

combat stress. Listening to members of the military recalling their stories of being in war

is a powerful method to understand the meaning of military service and how soldiers

overcome CSE. The phenomenological method can be a trustworthy research model for

exploring human life experiences.

Chapter Summary

In conclusion, the resilience, stress, and coping literature is full of research;

However, there is a significant gap in the literature with respect to positively addressing

combat stress exposure. So far, Chapter 1 introduces the context of the research, explains

the problem, describes the research method, and defines the keywords and theories.

Chapter 2 reviews the scientific literature underlying the research, linking the literature

into one comprehensive study. Chapter 3 will explain methodologies, instruments, data

collection, analysis, and ethical issues.

Chapter 3: Research Methods

Introduction

This study is a QUAL+QUAN mixed-methods research project that explores and

examines in a homogeneous group of U.S. Marines positive coping outcomes from

exposure to combat stress during OEF/OIF. In the QUAL strand of this research, I

explore through transcendental phenomenological interviews how and why these Marines

coped positively with their combat experiences. In the QUAN strand of this study, I

examined the influence of the independent variable (IV) of combat stress exposure on the

dependent variable (DV) of subjective well-being by measuring the impact and role of

moderation variables (MODV)—resilience, hope, social support, and personality—along

with the countermeasures of mediation variables (MEDV).

Using a mixed method approach logically allows me the opportunity to

simultaneously leverage two proven scientific methods, minimize the drawbacks of one

method, and maximize the strength of an integrated dataset; thus expanding potential

findings to research questions and hypotheses. In addition, the theoretical quantitative

basis of positive psychology and the qualitative conceptual framework of transcendental

phenomenology expand the scope of research. Positive psychology provides quantitative

rigor to examine the variables that are operationalized; While transcendental

phenomenology provides depth and structure to explore life experiences through

interviews and thematic data development.

In this chapter, the method is described and developed as a single concurrent

triangulation strategy (Figure 1) starting with the QUAL method followed by

QUAN. This sequence is derived from the sequence in which the data strands are

collected and the analysis is phased.

Figure 1. Simultaneous triangulation strategy model. Adapted from Research Design:

Qualitative, Quantitative, and Mixed Method Approaches (p. 214), by J.W. Creswell,

2011, Thousand Oaks, CA: Sage. Reprinted with permission from the Copyright Rights

Center. See Appendix E.

This is a single principal investigator study; thus, collecting QUAL and QUAN data

simultaneously is not possible. However, as explained below, there are clear limitations

regarding how data is collected, which minimizes contamination and bias during data

collection, analysis, and data phase integration. This chapter describes the following key

areas: (a) research design and approaches, (b) arrangements and samples, (c)

instrumentation and materials, (d) data collection and analysis, and (e) protection of

human participants.

Research Design and Approach

A pragmatic knowledge base or paradigm is used for this research. According to

Creswell (2003) pragmatism:

1. Focusing on what works to solve the problem;

2. Embracing a pluralistic approach to knowledge to solve problems;

3. Empowering researchers to choose the best method for research which is often

a mixed method; and

4. Always in a certain social context. (pp. 12-13)

The mixed method is the third methodology (Tashakkori & Teddlie, 2010), often

based on philosophical pragmatism, which finds its roots in the research and literature of

Charles Sanders Peirce, William James, and John Dewey (Johnson & Onwuegbuzie,

2004, p. 16). Pragmatism emphasizes "practical consequences and empirical findings" (p.

17). Other characteristics of pragmatism include: (a) providing a middle ground between

dogmatism and skepticism; (b) rejecting traditional dualism; (c) focusing on the natural

world to include culture, institutions, and subjective thinking; (d) exploring how humans

interact with their environment and adapt to new situations; (e) commit to strong

practical empiricism; (f) adhering to a value-oriented philosophy; and (g) generally

rejects scientific reductionism (p. 18).

Maxcy (2003) describes the historical roots of philosophical pragmatism and

compares it to formalism (positivism and empiricism). According to Maxcy, pragmatism

"moves researchers away from the consideration of a single knowledge, and to a

discourse centered on knowledge and the resulting meaning" (p. 52). In this study, I use

philosophical pragmatism to unite theoretical bases with conceptual frameworks to form

a cohesive methodology.

As mentioned above, I use a concurrent triangulation strategy (Creswell, 2003).

This strategy places equal priority on both methods by collecting data simultaneously and

then comparing or mixing (integrating) the data to "confirm, cross-validate, or

corroborate"

findings in one study" (Creswell, Clark, Gutman, & Hanson, 2003, p. 229). Data integration

during analysis leads to a mixed method interpretation of data and metainference (Creswell

& Clark, 2011).

There are three research questions and five directed hypotheses for my research.

1. What was the effect of the moderation variables of resilience, hope, social

support, and personality on the effects of CSE on U.S. Marines in this study

who subjectively self-reported that they positively coped with their combat

experience?

The following directional hypotheses were tested during this study:

H01: U.S. Marines who scored average or higher on PVSIII-R® (Maddi &

Khoshaba, 2001) outperformed CSE positively (H01: μ 40).

H02: U.S. Marines who scored average or higher on the Adult Disposition

Expectancy Scale (Snyder, Rand, & Sigmon, 2005) outperformed CSE

positively

(H02: μ  49).

H03: U.S. Marines who scored average or higher on the Post-Deployment

Social Support Scale (King, King, & Vogt, 2003) positively

outperformed CSE (H03: μ  56.69).

H04: U.S. Marines scored average or higher on extraversion, openness,

thoroughness, and pleasure and low on neuroticism based on the NEO-

Five-Factor™ Inventory-3 (NEO-FFI-3™; McCrae & Costa, 2010)

positively coped with CSE (H04: μ  45 for EOAC; μ 4 5 f o r N ) .

2. What mediation effect did coping have on the effects of CSE on U.S. Marines

who participated in this study and subjectively self-reported that they coped

positively with their combat experience? The following directional

hypotheses were tested during this study to examine these hypotheses:

H05: U.S. Marines who subjectively self-report that they are coping positively

CSE report adaptive coping strategies and styles based on a Short COPE

Inventory (Carver, 1997).

3. How and why did the U.S. Marines in this study positively address their

experience of combat stress exposure? Question 3 is explored in the

qualitative strand of research and has no hypothesis.

Finally, I considered other methods for this research such as a single-stranded

QUAL ethnographic case study or a single-stranded QUAN study on resilience, stress,

and coping. However, in research on overcoming combat stress exposure, a multifaceted

study emerged that linked questions and hypotheses to mixed-methods models.

Furthermore, in a search of the literature, it was clear from the outset that there was a

significant research gap in positively addressing combat stress exposure and resilience.

There is a lot of research on PTSD and CSE; However, there are very few if any mixed-

methods studies on the nature of current research. The following two sections describe

the QUAL and QUAN learning methods.

Qualitative Research Methodology

Transcendental Phenomenology as a Qualitative Research Method

Brief lexicon of transcendental phenomenology. Before the transcendental

phenomenological research methods are described, a brief lexicon is provided. The

following key words are found in Husserl's works translated into English and are

essential for applying transcendental phenomenology to research.

a priori: Transcendental phenomenology is a priori human science that explores

conscious inner experience—pure science that is not contaminated with empirical or

sensory data (Husserl, 1927). One could argue that empirical natural science is based on

conscious outside human experience and is a posteriori science driven by sensory data.

Intentionality: Moustakas (1994) notes, "Husserl's transcendental

phenomenology is tightly bound in the concept of intentionality" (p. 28). Intentionality

comes from Aristotle's philosophy as a mental orientation towards objects (Moustakas,

1994, p. 28). Husserl (1927) notes that he derives his intentional use from scholastics,

particularly the Neo-Scholastic Franz Brentano (Welton, 1999, p.

323). Husserl (1927) stated, "the basic character of existence as consciousness, as being

aware of something, is intentionality" (Welton, 1999, p. 323). For Husserl, all

consciousness is intentional.

Phenomenon: Built on intentionality, when individuals direct their consciousness

to an object while using a transcendental phenomenological attitude, what appears to

them mentally in their consciousness is a phenomenon, whether real or unreal.

Intuition: Husserl (1927) views intuition as an essential component of his priori

human sciences. Intuition, according to Moustakas (1994), is rooted in Cartesian thought

and is an innate competent human being. Intuition is the ability to make judgments, and

for Husserl, intuition is the essence of "going back to the things themselves" (p. 32). As

noted in Moustakas "the self for Descartes and for Husserl is a being who thinks

intuitively, a being who doubts, understands, affirms, denies, wants or opposes, feels,

imagines" (p. 32).

Epoche: The essence of practicing transcendental phenomenology in

psychological research is epoche. Epoche is practiced in a transcendental

phenomenological attitude. Epoche is Greek for "suspension", especially in philosophy as

a suspension of judgment (Liddell & Scott, 1935). According to Moustakas (1994), "In

the times, we put aside our prejudices, biases, and prejudiced notions about things" (p.

85). Essentially, "the world is placed outside of action, while remaining confined" (p.

85). This epoche contrasts with Greek skepticism, Cartesian skepticism, and Kantian

criticism. In that era, researchers saw and described the phenomenon as if for the "first

time" (Moustakas, p. 85).

The age requires disciplined concentration, focus, looking again and again, and

listening repeatedly to see the various appearances of a phenomenon (Sokolowski,

2000). Epoche is reflective meditation (Moustakas, 1994). King and Horrocks (2010)

criticizes the era for never fully achieving it because it puts aside biases, prejudices, and

prejudices, and one's prejudices are very difficult to achieve; Although epoche could not

be achieved completely, researchers did not abandon the process. Epoche is discussed

further below in relation to the role of researchers in data collection.

Transcendental and phenomenological reduction: Sokolowski (2000) points out

that the Latin root for reduction means "to lead back" (p. 49). This main backdrop is the

transcendental phenomenological mantra as "returning to things themselves" (Moustakas,

1994). This leading back reverses the natural attitude and turns into a transcendental

phenomenological attitude to practice epoche. According to Moustakas, reduction

describes the texture of what a person feels (texture description). During reduction,

epoche is practiced, examining new horizons and assortments of appearances to discover

the meaning and essence of what is observed.

Imaginative variation: Transcendental phenomenology involves the phases and

stages of observing, listening, understanding, judging, and describing.

Phenomenoologists use imagination. Moustakas (1994) notes with respect to imaginative

variations,

The goal is to arrive at a structural description of an experience, the underlying

and triggering factors that explain what is being experienced; In other words, the

'how' that speaks to the conditions that illuminate the 'what' of the experience.

How did the experience of the phenomenon become like that? (pp. 97-98)

The essence of this process is to describe the essence of the phenomenon. Moustakas

(1994), when referring to Husserl's Idea, notes that essence as Husserl "uses this concept,

meaning what is common or universal, a condition or quality without which something

would not be what it is" (p. 100).

Essence: King and Horrocks (2010) notes, "the essence of any phenomenon is

what makes it that way and not something else" (p. 178). Sokolowski (2000) states,

"essence is proven to us" and explained through "eidetik intuition" (p. 177).

Husserl (1970) distinguishes between semantic essence and intentional essence because

determining the essence of the intended object requires the conscious synthesis of noetic

and noematic processes.

Eidos, noesis, noema: Husserl used several Greek words to give a technical

structure to transcendental phenomenology and to avoid confusion with psychological

terms used in the natural sciences. The three terms that are important for understanding

transcendental phenomenology are eidos, noesis, and noema. Eidos in Greek means form

or appearance and can convey the word idea (Kittel, 1985). Husserl (1927) notes that

eidos leads to the understanding of the essence of a phenomenon through the reduction of

eiseconds.

Husserl (1927) uses noesis and noema in a correlation manner. The Greek root

for noesis and noema is noeo, which means to understand, think, or know (Würthwein,

1985). Moustakas (1994) notes, "noesis refers to the act of understanding, feeling,

thinking, remembering, or judging—all of which are embedded with hidden meanings

and hidden from consciousness" (p. 69). Noesis is deliberate and brings the phenomenon

into consciousness. Moustakas notes that "noema is what is experienced, what is from

experience, the object is correlated. Noesis is the way in which what is experienced,

experienced or acted experiencing, the subject is correlated" (p. 69). King and Horrocks

(2010) describe noema and noesis as "what we experience, and how we experience it"

(p. 177). To arrive at the essence of a phenomenon requires the union of noesis

(experience) with noema (experienced)

and achieved in the age by using reduction through reflective meditation, imagination,

phenomenological attitudes, and synthesis.

Synthesis of composite textures and structural descriptions of composites:

According to Moustakas (1994), synthesis is the final step in bringing what and how

experience into an integrated and intuitive whole that describes the essence of the

experience of the phenomenon. It is a combination of the textural and structural

descriptions of the experience.

Intersubjectivity and the world of life: Transcendental phenomenology is a

subjective human science that is easily mistaken for solipsism or radical dualism.

Husserl's phenomenological psychology (1927) seeks to unite the subjective

transcendental ego (nonempirical or pure self) with the objective natural ego (empirical

or sensory self). This unity is not a double ego but a single ego that alternates from

transcendental to natural attitudes (intersubjectivity). The world of life is the real world—

the world in which people live. The world of life is where people experience themselves

and others. The ultimate goal of transcendental phenomenology is to explore and describe

the life experiences of oneself and others in a community through shared consciousness

(Husserl).

Transcendental phenomenological research methods. Moustakas (1994) notes

that "the empirical phenomenological approach involves going back to experience to

obtain a comprehensive description that provides the basis for a reflective structural

analysis that describes the essence of experience" (p. 13). A researcher is a scientist who

collects descriptive human data of experiences and then analyzes and interprets those data

to determine the essence or structure found in the phenomenon. Husserl (1927) described

Transcendental phenomenology as a philosophy, psychology, and methodology that has

developed over time. In my current research, I use the application of Moustakas and the

adaptation of the Husserl method. See Appendix A for a step-by-step guide provided by

Moustakas (pp. 180-181).

Transcendental phenomenology and researchers. The role of researchers in

transcendental phenomenological research is unique in that researchers may have

experienced the phenomenon being studied as well as this study. As the principal

investigator for this study, I spent 12 months at the OIF during the troop surge from

October 2006 to October 2007 working at the Baghdad Iraq Multi-National Corps Joint

Operations Center. During that period of time I was exposed to combat stress.

In addition, I was deployed in the Global War on Terror in 2011 to the Gulf of Aden.

However, in both placements I did not experience the magnitude of CSE as those who

participated in my study; I also did not receive the Combat Action Tape.

Transcendental phenomenology seeks to study phenomena directly (Gearing,

2004). Since I indirectly experienced combat stress, there is the potential that this

experience can create the biases identified in Chapter 1 as assumptions and limitations.

However, this bias is not a disadvantage but an advantage for me.

The transcendental phenomenological research method seeks to manage bias through the

application of epoche (bracketing). Bracketing (epoche) is the first step I take when

collecting data.

Gearing (2004) develops a typology of six forms of brackets: (a) ideal, (b)

descriptive, (c) existential, (d) analytical, (e) reflexive (cultural), and (f) pragmatic. Each

These forms of parentheses share the essence of the age of temporary suspension of

judgment. Gearing (2004) explains the differences between each of the six forms of

bracketing which are mainly based on the researcher's philosophy and the theoretical

framework underlying the research. The ideal bracket shape is used for current

research. The ideal bracket shape is based on the Husserlian philosophy (Gearing). The

framework for ideal bracketing is "centered on descriptive phenomenology" (Gearing, p.

1436). The epoche form confines presuppositions, and seeks to discover the universal

essence of the observed phenomenon.

Bracketing also involves the final step of unbracketing when the data is analyzed,

integrated, and fully described (Gearing).

Transcendental phenomenological interviews. Seidman (2006) noted that

phenomenological interviews are a means of gathering in-depth information related to

life experiences. Phenomenological interviews use open-ended questions to guide

research participants to reconstruct their experiences of a particular phenomenon. King

and Horrocks (2010) explain the key concepts of Husserlian's transcendental

phenomenological interview. They explain the essential elements for conducting an

effective interview, which include:

1. Comfortable, quiet, safe environment; free from distractions.

2. Good audio equipment. Note that recording a conversation affects the

conversation. Explain to the interviewee how the recorded data will be used

and kept safe (informed consent).

3. Build a positive relationship with the interviewee. Always remember his strength

dimensions between researchers and research participants. The interviewee should

feel safe to open up and speak freely.

4. Ask simple, open-ended questions with investigative questions to keep the

interview flow going.

5. Avoid non-verbal communication that can be disruptive and leading.

6. Listen actively and don't make judgmental comments.

As a reflection, 13 interviews went well overall; However, the first few

interviews were more challenging because I had to learn not to be in the mold of a pastor

or counselor. During the initial interview, I found myself talking too much, making

unnecessary comments, and interrupting the interviewee's answers. The keys to a good

interview are: (a) focus on asking your questions, (b) not finish the interviewee's

sentences, (c) be comfortable with pauses to give the research participant time to think,

(d) practice before you conduct an actual IRB-approved interview.

Analysis of transcendental phenomenological data and meaning generation.

Meaning-making is at the heart of transcendental phenomenological research methods

(Giorgi, 2009). Giorgi developed a modified Husserlian approach titled Descriptive

Phenomenological Methods in Psychology to develop and interpret the psychological

meaning of QAL data. He compares the seven polarities that distinguish the natural

sciences from the human sciences: (a) experiment—other modes of research, (b) quantity

—quality, (c) measurement—meaning, (d) analysis-synthesis—explanation, (e) defined

reactions—deliberate responses, (f) identical repetition—identity through variation, and

(g) independent observers—participant observers (p. 71). In context

This mixed method studies these seven distinctive scientific criteria at work; However, three

of these seven polarities appear to be the most relevant for current research.

With regard to these three polarities, Giorgi (2009) commented, "every

phenomenon in the world has a quantitative aspect and a qualitative aspect" and that

"there is even a certain reciprocity between the two" (p. 74). Although transcendental

phenomenology includes both aspects, it begins with qualitative, a priori, investigation

and analysis. Thus, the study of the mixed method of overcoming CSE has quantitative

and qualitative components that ultimately inform both sides of the research as an

integrated unit. Another polarity that seems to be particularly relevant to current research

involves the comparison of measurements and meanings. Giorgi notes that "measurement

is the elaboration and specification of the quantitative dimension of reality" (p. 79). In

fact, meaning creation is a qualitative description of a phenomenon that answers the

question, "what is the phenomenon or experience like" (p. 79)? Finally, researchers are

independent objective observers and subjective participant observers. Thus, epoche is an

important process for both sides of the study especially when providing psychological

assessments and interviewing study participants.

The following open-ended questions are used for phenomenological interviews:

1. Please share with me about your combat tour in Iraq/Afghanistan. What

jobs do you do in the country?

2. What was the battle like?

3. What is it like to come home from war?

4. How do you cope with your combat experience after you return home?

5. Looking back, what does your combat experience mean to you today?

6. Did your combat experience change you and if so, how did it change you?

7. What advice would you give to a new Marine who has never fought and

will fight?

Operationally, I use transcendental phenomenological methods to conduct

interviews and research. The recorded interviews were transcribed into text documents

and analyzed by me. In my current research I used Giorgi's (2009) descriptive

phenomenological method to analyze texts:

1. Enter into a phenomenological attitude to read each text to get an overall

picture (Giorgi, 2009, p. 128). During this first reading, the researcher was in

an age — confined to personal knowledge and experience about the

phenomenon.

2. When using transcendental phenomenological reduction, read the text

again and highlight the unit of meaning (p. 129). Giorgi noted,

"The life experience of the researcher plays a role here because the

discrimination that occurs is directed towards the life experience of others" (p.

130). It is an intersubjective game between the researcher and the participant's

description of their life experiences.

3. Units of meaning arise using the researcher's intuition of the intended

object. At this stage in the analysis, the units of meaning are not analyzed

cognitively or psychologically.

4. Next, the participants' raw data were converted into "psychologically sensitive

phenomenological expressions" (p. 130). At this point the

researcher returns to the highlighted text to sort the units of meaning; Then the

researcher began to "interrogate each unit of meaning to discover how to express

in a way more satisfying the psychological implications of the description of the

living world" (p. 130). Researchers turned to psychological (natural) attitudes to

make this analysis.

5. During this analysis, the free imagination was used by cognitively dwelling on

the data to determine the meaning of the invariant through eisecond intuition.

When meaning or essence emerges, researchers develop a composite

description of the phenomenon being studied. It is a dismantling of the

researcher's experience where researchers use their knowledge and experience

of the phenomenon to develop composite synthesis.

Transcendental phenomenology is a priori qualitative method and mixed with

posteriori quantitative methods can expand the scope of research. As a human science,

transcendental phenomenology helps me to qualitatively explore the essence of the

phenomenon being studied; while empirical natural sciences help explain the

phenomenon quantitatively; this is explained further in Chapter 4.

Positive Psychology Quantitative

Research Methodology as a Quantitative Research Method

Positive psychology complements psychopathology. Positive psychology owes

its debt to advances in psychopathology that seek to help those who have

mental health problems; However, for too long psychology has focused on human

weaknesses, disease, and what is wrong with humans. Positive psychology is the human

science of what is right with people and focuses on human strength and health. Lopez,

Snyder, and Rasmussen (2003) explain and advocate the need to strike a balance when

assessing human weaknesses and strengths.

Positive psychology has its challenges (Sandage & Hill, 2001), and critics (Held,

2004; Lazarus, 2000; Cowen & Kilmer, 2002) who objectively point out potential

problems by overemphasizing the positive and ignoring the negative. The shadow or dark

side of positive psychology is discussed in Chapter 5. Furthermore, when measuring

subjective human psychological phenomena, researchers must ensure that the theoretical

foundation is strong and that variables such as hope, resilience, coping, and social support

are empirically based, and that the operationalized variables can be measured with valid

and reliable instruments. Paradoxically, negative psychological and emotional influences

can be positive; For example, anger can be used constructively; Denial can be a

temporary positive coping strategy, and some pessimism is needed to see the reality of

the living world.

Positive psychology, moderation, and variable mediation. The current study is

not a traditional empirical study of cause and effect; nor am I manipulating the variables

being tested. Instead I focused on measuring the magnitude of IV (combat stress

exposure) and MODV (resilience, expectations, social support, and personality) and

MEDV (coping) effects on DV (subjective well-being). As mentioned earlier, the

MODV and MEDV in this study fit perfectly into the positive psychology CSV family.

Differentiating between moderation and mediation variables is very important but

can be confusing. Often in the research literature, the mediator and moderator variables

are used interchangeably (Baron & Kenny, 1986; Bennett, 2000; Creswell, 2003). The

mediator and moderator variables have some similarities because they are the third

variable that affects the dependent variable, and in some cases the variable may be the

moderator and mediator (Muller, Judd, & Yzerbyt, 2005; Edwards & Lambert, 2007).

Bennett (2000) defines a moderator as "an independent variable that influences

the strength and/or direction of the relationship between other independent variables and

outcome variables" (p. 416). Furthermore, the mediator "is the variable that determines

how the association occurs between the independent variable and the outcome variable"

(Bennett, 2000, p. 416). The moderator emphasizes when the relationship occurs, and the

mediator emphasizes how and why the variable affects DV (Bennett). For example,

resilient people (MODV) should have higher levels of subjective well-being (DV), and

cope more positively with CSE (IV). On the other hand, how a person copes (adaptive or

less adaptive coping-MEDV) with CSE (IV) will affect subjective well-being (DV); so if

someone uses adaptive coping strategies, they are more likely to cope with CSE

positively.

Bennett (2000) notes that it is difficult to distinguish between mediation and

moderation variables as in the case of coping. Coping can be both an independent and

dependent variable (Beehr & McGrath, 1996). In addition, coping can be a variable of

mediation and moderation (Bennett). Researchers determine the type of variable

depending "on the theory and conceptual framework that guides the research" (p. 416). In

the context of current research, coping is a mediating variable. As previously noted by

MODV

affect the direction and strength of the relationship between IV and DV (Baron & Kenny,

1986). Often MODV is used in correlation studies and can be analyzed using variance

analysis (ANOVA) and multiple regression (Baron & Kenny; Bennett). The following

MODV model (Figure 2) was used for this study.

Figure 2. Moderator variable model. Adapted from "Differences in Moderator-Mediator

Variables in Social Psychology Research," by R.M. Baron and D.A. Kenny, 1986,

American Psychological Association. Reprinted with permission.

Based on Baron and Kenny (1986) this model consists of three paths:

1. Pathway A: Correlation IV and DV and the effect/impact of Combat

Stress Exposure on the subjective well-being of study participants.

2. Pathway B: Influence/impact of MODV from resilience, hope, social

support, and personality on the subjective well-being (DV) of study

participants.

3. Pathway C: IV times MODV (interaction variable) affects DV.

Baron and Kenny (1986) stated that "moderator is the third variable that

affects the zero-order correlation between the other two variables" (p. 1174). Baron

and Kenny

commented that moderation occurs when the relationship between IV and DV changes

due to MODV. They stated, "statistical analysis must measure and test the differential

effect of independent variables on dependent variables as a moderator function" (p.

1174). When measuring these effects, it is crucial to understand the level of IV and

MODV measurements as categorical or continuous or combination.

Bennett (2000) describes a general strategy for testing moderation using

hierarchical multiple regression.

1. In the first step (or steps) of regression, independent variables (including

moderators) are incorporated into the model as predictors of outcome

variables (p. 417).

2. In a separate step, the term interaction (the product of two

independent variables, which represent the moderator effect) is

included (p. 417).

3. If the term interaction describes a statistically significant amount of variance in

the dependent variable, the moderator effect is present (p. 417).

Furthermore, Baron and Kenny (1986) note that mediators explain how and why

external events take on internal (psychological) significance. In order for a variable to be

a mediator, it must meet the following criteria according to Baron and Kenny and this

relationship is illustrated in Figure 3.

Figure 3. Mediator variable model. Adapted from "Differences in Moderator-Mediator

Variables in Social Psychology Research," by R.M. Baron and D.A. Kenny, 1986,

American Psychological Association. Reprinted with permission.

1. Pathway A: Variation in IV grade significantly explains

the variation in the suspected MEDV.

2. Pathway B: Variation in MEDV significantly explains variation in DV.

3. Pathway C: When pathways A and B are controlled, the previously

significant association between IV and DV is no longer significant, with the

strongest mediation demonstration occurring when pathway C is zero. (p.

1176)

According to Baron and Kenny (1986) ANOVA is one of the tests for mediation

along with the regression model. They state that three regression equations should be

used:

1. Regress MEDV on IV.

2. Regress the DV on the IV.

3. Regress DV on IV and MEDV. (p. 1177)

In order for mediation to occur, Baron and Kenny (1986) stated that IV must

significantly affect MEDV in the first regression (Path A); IV must significantly affect

DV at the second regression (Pathway C); finally, MEDV should significantly affect DV

at the third regression (Pathway B). In this model IV is assumed to cause MEDV thus

Correlated; highly correlated variables can produce multicollinearity that can generate

less power in the third Regression Path B (Baron & Kenny).

Setup and Sample

The setting and context of the research. Understanding the military

environment, research population, and culture is essential for this research. The context

of this study is the United States Marine Corps (USMC), at the main base of the Marine

Corps. The study involved U.S. Marines exposed to combat stress during the OEF/OIF,

who earned a Combat Action Tape (CAR), returned home from the war, and self-

reported that they coped with CSE positively. This section of the dissertation describes

military demographics, military culture (soldier ethos), and combat stress environments.

In addition, the criteria for selecting participants, sampling methods and measurements,

along with the types of data collected are described.

Military demographics. The U.S. military is a volunteer force consisting of

active and reserve components along with the utilization of the state's National Guard;

this is different from past wars where members of the U.S. military may volunteer or

conscript. As noted in Chapter 1, more than 2.5 million service members have been

deployed to the OEF/OIF since 2001 (Department of Defense, 2013). The following data

is taken from a comprehensive report by the Institute of Medicine (2010) at the time of

this report

1.9 million service members have been deployed for GWOT.

1. Of the U.S. military members deployed in GWOT, 89% are men and 11% are

women, compared to almost all men serving in Vietnam; only 7,494

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women serve in Vietnam compared to more than 200,000 women in the

OEF/OIF (p. 18).

2. The current troops are older and more likely to marry children with an

average age of 34.6 years for active officers and 27.1 years for enlisted

men,

with backup component service members slightly older than active duty counterparts

(p. 18).

3. More than 40% of troops have currently been deployed more than once to the

OEF/OIF; with multiple deployments that increase their cumulative exposure

to combat stress. Placements vary from a few months to 15 months.

4. The number of dead and wounded in the war today is lower than in previous

conflicts: the ratio of deaths to wounded for the OEF is 1:5.0 and OIF 1:7.2

compared to Vietnam's 1:2.6 (p. 29). The higher ratio of deaths to casualties

in today's wars is attributed to better combat tactics, tactical armor, and

battlefield medicine.

Military culture and soldier ethos. Culture includes "the customs, values,

beliefs, knowledge, arts, and language that are distinctive of a society or community"

(VandenBos, 2007, p. 250). The U.S. military has a soldier culture and ethos that is

distinctively different from civilian society. The U.S. military consists of three branches

and four services under the Department of Defense; this does not include the U.S. Coast

Guard which falls under the Department of Homeland Security. The four military

services are the Army, Navy, Marine Corps, and Air Force; Navy and Marine Corps

101

is under the Department of the Navy. Each service has unique training methods, core

values, customs, traditions, and sub-cultures.

Christian, Stivers, and Sammons (2009) developed a model to help mental health

clinicians understand the culture of the military and the service members they can help.

They identified four unique characteristics of military culture that differ from civilian

society, and may have an impact on therapeutic interactions. These four characteristics

are: (a) collectivism versus individualism, (b) rigid hierarchism, (c) future-oriented with

a historical focus on identity, and (d) service-oriented values (p. 32). The soldier's ethos

was instilled starting with the boot camp. The U.S. military stripped individualism during

training camps and inculcated collectivism in every recruit through indoctrination.

Throughout the time military members are in the military, individuality is diminished to

build teams of fighters, inspire esprit de corps, and create high organizational morale that

is important in combat.

Rigid hierarchism or a strict rank structure creates an environment for effective

leadership that demands professional followers in the military. Military hierarchism

ensures there is a clear base of power and authority so that legitimate orders can be

issued and followed without questioning authority; Members of the service must not

follow unlawful orders and must question authority when an order is deemed unlawful.

Following orders in battle can result in death which increases the intensity of exposure to

combat stress due to the existential nature of war. Military hierarchy is defined by ranks

that are directly related to authority, identity, and position

102

within the organization. Hierarchism and rank reinforce military values, protect service

members, and provide expert leadership on the battlefield.

The military is an innovative organization that leads civil society at many levels

to include social and technological issues. Although the military is focused on future

operations, they rely heavily on their individual and collective service history to maintain

the esprit de corps and high moral state that are protective factors associated with combat

stress. Unit cohesion is essential for effective war combat, and coupled with high morale

can reduce the negative effects of CSE (Nash, 2007). Finally, each service has a set of

core values that are based on Aristotle's virtues such as honor, courage, and commitment.

Core values are essential for building teams and effective leadership. Core values are

directly related to the strength and virtue of character (positive psychology) which is a

moderation variable in this proposed study. Living by core values is a positive protective

factor and helps reduce the negative effects of exposure to combat stress.

Military battles as a stressful environment. War is "a violent clash of interests

between or between organized groups characterized by the use of military force"

(MCDP 1, 1997, p. 3). The violence of a war with military force is a battle. The combat

zone is the environment, and combatants transact within the environment to manage

combat stress. The United States Marine Corps (MCRP 6-11C, 2000) defines combat

stress as "mental, emotional, or physical strain, tension, or stress resulting from

exposure to combat-related conditions" (p. C-2). In revision MCRP 6-11C (2010), the

Navy and Marine Corps redefined combat stress as "a physical or mental change in

function or behavior resulting from the experience of lethal force or its consequences.

These changes

103

can be positive and adaptive or can be negative, including distress or loss of normal function"

(p. 1.3).

Combating stress involves people-environment transactions. Combat stress can

lead to eustress, extreme stress, distress, traumatic stress, combat stress injury or illness

when the psychological and physical demands outweigh the combatant's ability to adapt,

manage and cope with CSE. Combat stress can be measured along a continuum from

benign (no threat) to extreme to traumatic (threat to integrity, self/existential threat).

Exposure to combat stress can result in negative or positive psychological and physical

outcomes. Exposure to combat stress is the intensity or magnitude of combat stress

experienced by military members during war (combat-related conditions) and overcome

after they return home.

Research sample method, size, and selection criteria. Independently,

qualitative and quantitative research methods use distinctive sampling techniques. Often

qualitative research uses purposive sampling and quantitative uses probability sampling

(Teddlie & Yu, 2007). Mixed method research uses mixed sampling techniques. The

sampling techniques used in the current study provide the statistical power needed from

quantitative studies, and the unique transferability of qualitative studies.

As mentioned above, the setting and context of this research is USMC on a

large basis. The study only involved U.S. Marines who were awarded CAR, and who

self-reported that they overcame CSE positively. Military requirements to become

104

granted CAR is determined by the Secretary of the Navy (SECNAVINST 1650.1H,

2006) and includes the following criteria:

1. Active participation in ground combat.

2. Direct exposure to the explosion of an Improvised Explosive Device (IED)

used by the enemy, with or without the direct presence of enemy forces.

3. Personnel serving in covert or special operations, who by the nature of their

mission, are limited in their ability to return fire, and who operate in

conditions where the risk of enemy fire is great and is expected to be faced,

may be eligible for CAR. (pp. 2-33)

Research participants are recruited at the unit level, there is no salary involved, and the

only incentive to participate is to help future fighters cope with CSE positively.

Participants must return from combat for at least 12 months. Being diagnosed with TBI

or PTSD is not a disqualifying factor. Based on the post-traumatic growth theory, I

assume that negative symptomatology can coexist with coping and positive outcomes.

Based on Kemper, Stringfield, and Teddlie (2003) the most appropriate sampling

technique for my research is the intentional non-random homogeneous sampling

technique. Collins, Onwuegbuzie, and Jiao (2006) commented that this sampling

technique was used to find participants with "similar or specific characteristics" (p. 84),

and recommended that no more than 10 and no less than six participants be selected for

the QUAL portion of the study. The goal was for 10 Marines to conduct

phenomenological interviews; There were 13 volunteers interviewed.

105

Determining the sample size for the quantitative strand of the study depends on

the type of statistics produced, how the statistics will represent the population, and how

well do the statistics represent the effects of IV, MODV, and MEDV on DV? Thus

conducting a power analysis to determine the sample size is essential when designing a

study. Knowing the context and population of the research is very important. The general

context is described above. The following USMC demographics were produced by

Headquarters, Marine Corps (2010) and have not changed much in the meaning of the

published report:

1. In December 2010 there were 202,433 Marines on active duty, of which 21,655

officers and 180,778 enlisted men (1:8.3).

2. The Marine Corps is the youngest, most junior, and least married of the four

military services with 64% of Marines aged 25 years or younger, with

46.6% enlisted and 67.7% officers married.

3. There were 103,471 single Marines as of December 2010.

4. As of December 2010, there were 30,304 Marines who numbered women or

6.68%.

5. From 2003 to 2010—563,355 Marines were deployed to the OEF/OIF with

an average of 70,419 per year or nearly 1/3 of the Marine Corps deployed per

year.

Samples are described further in Chapter 4 to include power analysis and sample

size. The following sections describe the protection of human participants and other

ethical issues; then the instrumentation psychometry used for the QUAN strand study is

presented. The scales are presented in the order given.

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Protection of Human Research Participants and Ethical Issues

The protection of human participants in the pursuit of ethical human science

research is not optional. Historically, lessons learned from the Nuremberg trials of World

War II and the famous Tuskegee experiments from 1932-1972 have guided researchers to

develop strict protections for human research participants (Sieber, 2004a). Until the

1970s, most researchers in the U.S. were largely guided by personal conscience and

human ethics to not harm and treat others fairly (Sieber, 2004b). In the 1970s, the U.S.

federal government began to better regulate human participant research as described in

the Belmont Report (1979).

The Belmont Report (1979) provides a structure for research review, and

institutional oversight through the Institutional Review Board (IRB). The Belmont report

produced three ethical principles that guide researchers: (a) respect, (b) virtue, and (c)

fairness. Basically, research is not carried out only for research purposes.

According to the Belmont Report, research should benefit society and protect research

participants from harm. Human beings should not be seen as objects or subjects but as

voluntary research participants and should always be treated fairly and respectfully.

To that end, I seek to ensure the highest ethical treatment of research participants

based on the American Psychological Association (APA) Code of Ethics hereinafter

referred to as the Code of Conduct (2010) and the APA standards for Responsible

Research Behavior. Furthermore, I comply with Federal regulations and more specifically

Department of Defense Instruction 3216.02 (DoDI 3216.02, October 20, 2011);

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Secretary of the Navy Instruction 3900.39D (SECNAVINST 3900.39D, November 6,

2006) and Marine Corps Order 3900.18 (MCO 3900.18 January 21, 2011).

Scientific research especially with human participants is not a right but a

privilege; this privilege is granted by individuals, institutions, societies, and is

conditionally based on Federal codes of ethics and regulations (National Institutes of

Health, 2004). The following is a brief explanation of the ethical issues associated with

my studies. This section will review: IRB processes, informed consents, participants,

vulnerabilities, participant psychological support, reporting side effects, recruitment, and

data collection.

Institutional review board. Institutional Review Board (IRB) approval for

research with human participants is required at Walden University, and is the basis for

ethical research according to the Code of Ethics (2010). Under Walden's ethical

requirements and the Standard Code of Ethics Eight research must contain accurate

scientific information, research cannot begin until IRB approval, and research must

follow approved protocols. In addition, this study requires review and authorization of

the Department of the Navy per SECNAVINST 3900.39D (2006) and MCO 3900.18

(2011).

Before Walden's IRB could approve my study, Walden had to secure the Navy

Department's Addendum to their Federal Broad Guarantee. To achieve this, I trained

Walden's IRB through an addendum process that required an application from Walden to

the Office of Naval Research (ONR). After the ONR reviewed the application, IRB

member Walden was asked to take the Navy Department's Human Research Protection

training. Walden IRB members complete training

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and forwarded the certificate of completion to the ONR who drafted the addendum

package sent to the Surgeon General of the Navy who approved the DON Walden

Addendum to their FWA on July 27, 2012 #DoD N-A3268. Walden is now listed on the

ONR and the official website of the

http://www.med.navy.mil/bumed/humanresearch/resource/AssuranceInformation/Pages/

DoD-NavyFWA%20Addendums.aspx Bureau of Naval Medicine . As a DON-approved

research institution, IRB Walden is authorized by the Navy and Marine Corps to approve

or disapprove my research. Walden IRB reviewed my IRB application and gave consent

with reference #05-25-12-0024823 stamped on the approved Informed Consent found in

Appendix B.

However, further approval must be given within the Marine Corps to gain access

to the research participants. I have taken the following steps to comply with MCO

3900.18 (2011). The submission package to the Marine Corps Human Research

Protection Officer includes:

1. Approved proposal and IRB application.

2. CITI's intramural ethics training certificate which includes: Human

Research foundation course, bio-medical course, and refresher course.

3. Curriculum vitae.

4. Letter of Cooperation from the participating command.

5. Walden IRB approved informed consent.

The final approval of the Marine Corps was given on August 7, 2012.

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Participants, persuasion, conflicts of interest, and exploitation. The studies I

started with were unique because I was a Navy officer and a chaplain. As such, there is a

potential conflict of interest, with professional ranks and positions where participants

may have a level of social desire to do what I ask of them because of my rank and

military work or feel pressure from their command to feel compelled to participate in the

research. In the context of this research I am a student researcher and identify myself as

Mr. Dan Stallard. Thus, this identity as a non-military student researcher helps reduce the

difference in professional power and increase the autonomy of participants. Command

pressure is an important ethical issue because members of the military are considered a

vulnerable population which is discussed below in the section on vulnerability.

The ethical issues of many relationships are the factor. As mentioned above, I am

a Navy officer and a chaplain; however in the context of my studies, I present myself as

a student researcher, who is a former enlisted Marine service and OIF veteran. I wore

civilian clothes and covered my military identity. This is not a scam, as I am a student,

formerly a Marine enlisted and OIF veteran; However, I covered up my professional

military identity to protect my participants.

Section 3.05 of the Code of Conduct (2010) provides standards for safeguarding

many relationships. Section 3.06 of the Code of Conduct provides standards for conflicts

of interest. The study is designed as a research dissertation project, there is no personal

benefit on the part of the participants other than helping future fighters; The military will

not make a financial profit from the findings, unless they will probably gain insights to

positively address combat stress exposure, learn more about resilience, and

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training to strengthen future resilience as a result of these findings. Section 3.08 of the

Code of Conduct warns psychologists not to exploit relationships; Therefore, it is in the

best interest of everyone to know in advance the risks and benefits for researchers,

participants, and institutions involved in this study. This study has minimal risk.

Vulnerable populations. Respect for people, virtue, and justice are the basic

ethical principles for conducting human participant research. The USMC considers active

duty service members to be a vulnerable research population; so that there is a

requirement for the protection of additional human participants (PKP 3900.18, January

2011). Amdur (2007) notes that a person is vulnerable if they "tend to have compromised

autonomy related to decisions about research participation to a degree that would violate

the principle of respect for people" (p. 24). Subordination to senior authority is attached

to the military; thus the Marine Corps states "Regardless of the level of risk of research,

no senior should influence the decision of their subordinates whether to participate as a

research subject" (MCO 3900.18, January 2011).

To prevent exploitation of the study participants in this study, informed consent

reinforces that this study is voluntary. In addition, the command cannot force anyone to

participate; However, command training officers inform their service members via email

about the nature of the research and give them time away from work to participate in the

research. Also, the command supports and assists me in scheduling time to recruit, space

to recruit, and audio/visual equipment. The command does not directly recruit research

participants. Recruitment takes place in three main commands. I developed and

published a web page for registration www.resilient-

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warrior.org. In addition, I developed and printed a postcard-sized ad that I distributed during

a plenary hiring session—see Appendix C for an example ad.

The hiring session involves verbal and visual briefs using Power Point that include

the following:

1. Research objectives

2. Participant criteria

3. Participant engagement for tough soldier interviews and assessments

4. Partisipasi sukarela

5. Risks and benefits

6. Privacy and confidentiality

7. Registration

About 1,000 Marines attended five information sessions with 140 volunteers to

participate. Those who volunteer are registered through the website or with a pen and

paper before being approved on the day of data collection. The QUAN data collection

took place on six separate days in three locations. The command provides audio/visual

space and equipment. I provided a pen, an enrollment form, an informed consent, along

with a participant assessment sheet and an instrument booklet. Everything I use to

manage the assessment is distributed and collected by me. I use verbal and visual briefs

in Power Point to guide the administration of each assessment. The assessment sheet

contains the participant's research ID# and no personally identifiable information (PII).

Registration and consent forms based on the information provided

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contains PII submitted in participant folders and stored in a secure location; only in my

possession.

Reporting adverse events. Adverse events are defined by MCO 3900.18 as "any

unfavorable and untoward event associated with the implementation of a research

project" (p. 1, appendix 4). The U.S. Department of Health and Human Services' Office

of Human Research Protection notes there is no uniform definition of side effects across

federal entities; Yet they define and describe unexpected problems and side effects in

human research. They noted that the unforeseen problem met all of the following

criteria:

1. unforeseen (in terms of nature, severity, or frequency) given (a) the research

procedures described in protocol-related documents, such as IRB-approved

research protocols and informed consent documents; and (b) the

characteristics of the subject population being studied;

2. related or may be related to participation in the study (in this guidance

document, may be related means there is a reasonable possibility that an

incident, experience, or outcome may be caused by the procedure

involved in the study); and

3. suggests that research puts subjects or other people at greater risk of harm

(including physical, psychological, economic, or social harm) than previously

known or acknowledged. (Office of Human Research Protection, 2012, part I)

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Furthermore, Amdur and Bankert (2007) describe the side effects using the following

questions and answers:

Are the reported events serious and unexpected? Serious: Death, life-threatening

experience, hospitalization or extension of existing hospitalization, persistent or

significant disability/disability, or congenital anomaly/birth defect. Unexpected:

any adverse experience whose specificity or severity is inconsistent with the

current protocol description approved by the IRB or the currently approved

consent form. (p. 65)

In my study, I applied the definition of side effects as found in MCO 3900.18.

Walden University's Office of Research Integrity and Compliance requires that serious

adverse events must be reported to them within 5 business days. Examples of serious

side effects: participants express themselves that they want to commit suicide requiring

notification of commands, interventions and referrals. The informed consent provides the

following statement:

If you experience any discomfort or distress as a result of your participation in this

research, you should seek help from the resources available to you through the

chain of command, military medical professionals or mental health and

behavioral health services. The Marine Corps DSTRESS phone line is a 24/7

anonymous counseling service and is available to you at no cost: 1.877.476.7734

. Online DSTRESS.COM can provide you with local resources and assistance.

Finally, there were no side effects associated with the study.

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Ethical issues related to data collection and release. All data collected will be

stored securely for five years post-study. Section 9.04 of the Code of Conduct (2010)

provides standards for the release of test data. Fisher (2003) stated that the changes to

this standard are perhaps the "most significant" of the 2002 Code of Conduct and the

consequent amended 2010 Code of Conduct. Basically in the past, psychologists and test

providers had to "refrain from" releasing test materials, test results, and raw data (p.

192). The current standard authorizes psychologists with appropriate releases to provide

data to clients/patients and other authorized persons. The changes in releasing this data

are intended to meet the rights of clients/patients and study participants, and according to

Fisher are consistent with current legal decisions.

The standard does give psychologists ethical influence not to release data if the

information can be misused, misinterpreted, or cause harm to patients/clients. Test data is

confidential and can be treated similarly to confidential communications. Formal

briefings for participants will be scheduled after the dissertation is approved. The briefing

will be carried out in the context of information and education seminars. Individual

participant data will be available to each participant via secure email after briefing.

Another problem is the use of the internet for promotional utilization, registration,

and email to communicate with participants. The use of the internet and email to conduct

research has a lot of potential "landmines" (Keller & Lee, 2003, p. 218). The internet and

email systems I use are protected so that the identity of participants and research data are

not compromised. The key is to have a security plan at the beginning of the study,

communicate this plan to participants, PII code, and use

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the safest electronic means available (Nosek, Banaji & Greenwald, 2002). The following

sections discuss the instruments used in the collection of QUAN data.

Instrumentation and Materials

Combat Exposure Scale

The crux of this research is how and why most U.S. Marines cope with CSE

positively. Measuring something as ubiquitous as stress and strange as combat stress is a

challenge because the experience of the phenomenon is different for each participant; Not

to mention that the measure for CSE is based on memories from very stressful past

experiences. Watson, Juba, and Anderson (1989) tested the validity of five different

combat exposure scales: (a) Vietnam Veterans Questionnaire Combat Exposure Scale, (b)

Revised Combat Scale, (c) Military Stress Scale, (d) Objective Military Stress Scale, and

(e) Combat Exposure Scale. The authors conclude that their analysis should be viewed

with caution due to the subjective nature of wars and fighters. The level and type of

CSE varies from war to war. For example, were the protracted wars of World War II

and Vietnam the same, or were quick and decisive victories like the Desert Storm (Gulf

War I) different from the OEF/OIF? Is war symmetrical or asymmetrical, conventional

or insurgency? What is the level of battle—light or heavy; What are killed in action and

injured in action ratio? These are confusing variables that may or may not be able to be

controlled at any scale.

The VA uses the Combat Exposure Scale (CES) developed by Keane, et al.

(1989). CES is in the public domain and permission is not required to use it. CES is easy

to manage with a self-report size of seven items using a five-point Likert scale.

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Examples of questions include: (a) Have you ever been under enemy fire? And (b) How

often do you shoot bullets at the enemy? The score generated by this measure of CES

categorizes individual experiences from light to heavy combat. The original scale was

normed using a sample of 362 Vietnam Era veterans. The median age was 37.7 years

(SD = 4.0), and the average number of years of education was 13.26 (SD = 2.3); 57%

were married and 52% were white. The average score on the Combat Exposure Scale

was 25.57 (SD = 10.12); The score ranges from 1 to 41. The coefficient a is calculated

and yields a value of 0.85.

Keane CES was developed for Vietnam-era veterans, and has been used

extensively in research and clinical work with veterans seeking treatment for war-related

stress issues such as PTSD. I chose this scale as opposed to the survey used by Hoge et

al. (2004) which focused more on war-related traumatic stress, or Maguen et al. (2010)

which studied the mental health impact of killings by U.S. military members during the

OIF. CES is short, easy to manage, and a widely used measure for relative levels of

combat stress exposure. CES is carried out with pencil and paper. Each participant is

graded with a single, sustained CES score ranging from 1 (light combat) to 5 (heavy

combat). CES results are presented in Chapter 4. Since the end of my study, a new

Combat Experience Scale (Guyker, et al., 2013) has been developed that I recommend to

researchers to use in place of CES.

Subjective Well-Being Scale

Someone once stated, "If you want to know how I'm doing, just ask me."

Subjective Well-Being (SWB) is not a new construct, and there is substantial literature

describing various measures of subjective well-being (Keys & Magyar-Moe, 2003). He

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it is not my goal to explicitly measure SWB with multi-item instruments such as the

Satisfaction with Life Scale (Pavot, Diener, Colvin, & Sandvik, 1991), or multi-scale

instruments such as the Psychological Well-being Scale (Ryff & Keyes, 1995).

In my research, I assumed that the Marines overcame CSE positively. Participants

who met the criteria of the research study reported how well they coped with their combat

experience. To measure the participants' SWB, they were asked the following single-item

question on a five-point Likert scale: "Based on your combat experience, how well did

you cope with combat stress exposure?" With 1— being "I coped well with my combat

experience," 3— "I coped positively with my combat experience," and 5— "I coped very

positively with my combat experience."

Single-item surveys measuring SWB have been successfully used in the past by

researchers such as George Gallup and colleagues (Diener, Lucas, & Oishi, 2005). These

single-item surveys may have reliability and validity issues especially with participant

bias. In essence, if the individual meets the study criteria and self-reports that they are

coping positively with their combat experience, it is assumed that they are telling the

truth and being authentic. SWB scales are given with pencil and paper. The results are

presented in Chapter 4.

Personal Views Survey, Third Edition-Revised ®

The Personal Views Survey, Third Edition-Revised (PVSIII-R®) is intended to

measure resilience personality constructs that are "a combination of interrelated attitudes

of commitment, control, and challenge that provide courage and existential motivation to

transform circumstances from potential disasters into growth opportunities"

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(Maddi, Harvey, Khoshaba, Fazel, & Resurreccion, 2009, p. 292). PVSIII-R® has been

refined over the past 25 years to improve reliability and validity (Woodward, 2004).

Maddi, Khoshaba, Harvey, Fazel, and Resurreccion (2009) address constructive

criticism identified in previous studies using previous versions of the Personal View

Survey (PVS). The two main criticisms focused on ensuring the construction of

resilience measured by PVS are the unity measure of the three interrelated attitudes

commonly referred to as the 3Cs (commitment, control, and challenge). Another major

criticism focuses on the relationship between negative affectivity and neuroticism. Later

studies confirmed that PVS is not just the opposite of neuroticism, but in a study

comparing personality FFM, resilience construction was negatively correlated with

neuroticism and positive with four other personality factors (Maddi et al.).

Maddi et al. (2009) conducted a study using 1,141 undergraduate students at a

large university to measure resilience attitudes in regression studies with measures of

coping, social support, stress, and tension. They divided the volunteer participants into

six samples to compare the combination of measures with PVSIII-R®. When the results

were combined, all PVSIII-R® sample data showed a positive correlation with 3C and

resilience (commitment, 0.85 p < 0.001; control, 0.79 <.001; and challenge, .80 p<.001).

Cronbach a in this study for endurance was 0.79.

PVSIII-R® is a survey that can be conducted online or pen and paper (Maddi &

Khoshaba, 2001). The descriptive statistics for PVSIII-R® are based on the creation of

percentage scores that can range from 0-100%. PVSIII-R® has been normed

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in more than 3,000 adolescents and adults aged 15-74 years; The norming sample was

44% male and 56% female. The study of norms involves a variety of contexts from

athletes to firefighters. The percentage of hardiness is in the range of 40-60% on average

but caution should be exercised here. Many factors need to be considered when

interpreting the results of any study especially when the study involves measuring the

effects of stress.

PVSIII-R® is copyrighted, permission is granted by Salvatore Maddi (see

appendix G). PVSIII-R® is an 18-question survey using a Likert scale of zero to four;

with zero is not true at all and four is very true. Sample questions:

(a) by working hard, you can always achieve your goals, (b) my mistakes are usually

very difficult to correct, and (c) almost every day, life is really exciting and exciting for

me (Maddi & Khoshaba, 2001, p. 79). During my study, PVSIII-R® was given to the

participants during the plenary session. The survey was conducted using pen and paper.

The raw data from the survey is transferred to a password-protected spreadsheet and

emailed to the Hardiness Institute. Salvatore Maddi of the Hardiness Institute gave the

percentage data of the raw score back to me at a cost of 0.50 per participant. The results

of the hardiness data are presented in Chapter 4.

Adult Disposition Expectation Scale

The Expectation Scale developed by Snyder et al. (1991) is often referred to in

the literature as the Adult Disposition Expectation Scale (ADHS; Lopez, Snyder, &

Pedrotti, 2003) or the Trait Expectation Scale (Snyder, Rand, & Sigmon, 2005). The

need to distinguish the names of the scales is due to the expansion of construction

measurements to include the Adult State Expectation Scale (Snyder et al., 1996) and the

Child Expectation Scale (Snyder et al., 1996).

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al., 1997). ADHS has been used in research and clinical settings to include studies with

combat veterans (Crowson, Frueh, & Snyder, 2001; Irving, Telfer, & Blake, 1997).

ADHS is public domain and no permissions are required to use it. ADHS is

intended to measure the theory of hope as defined in Snyder (1995) as "the process of

thinking about one's goals, along with the motivation to move toward (agency) and the

way to achieve (path) these goals" (p. 355). ADHS measures agents and pathway

thinking as mentioned in Chapter Two. Functionally, Snyder notes that individuals who

score higher on expectations using ADHS "experience their goals in a more

phenomenologically positive way" (p. 357).

ADHS is a 12-item self-report measure using an eight-point Likert scale with one

definite false and eight true. Examples of questions include: (a) I can think of many ways

to get out of the jam, and (b) My past experiences have prepared me well for my future.

This scale has four items to measure path thinking and four items to measure agency

thinking with four items used to camouflage the scale. The coefficient of items ranges

from 0.23 to 0.63 with a coefficient of 0.74 to 0.84 (Snyder, 1995, p. 357).

ADHS has been given in reliability studies of retests with correlation in

.80+ range. Snyder notes that in concurrent validity studies expectations are positively

correlated with "self-esteem, perceived problem-solving abilities, perceived perception

of control in life, optimism, positive affectivity, and expectations of positive outcomes"

(p. 357). In addition, higher expectations "correlate negatively with social introversion,

depression, negative affectivity, and anxiety" (p. 357). ADHS is given with pencil and

paper. The results of ADHS are presented in Chapter 4.

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Inventory of Placement Risk and Resilience and Post-Placement Social Support

Scale

The Deployment Risk and Resilience Inventory (DRRI) is a reliable and validated

group of 14 measures associated with the deployment of U.S. military forces (King,

King, & Vogt, 2003). DRRI consists of 14 scales that can be given individually or

collectively depending on the need. The measures include risk and resilience factors for

the pre-deployment, deployment, and post-deployment phases of military operations. The

measures were developed and validated using samples of veterans from the First Gulf

War

(1990-91). The study was conducted using focus groups, telephone surveys, and national

mail delivery. Only the Post-Placement Social Support (PSS) measure of DRRI was used

for this study. However, it is very important to discuss the reliability and validity of the

entire DRRI before discussing PSS.

DRRI developers design the inventory by developing the initial definition, overall

construction, and domain. Next, the researchers met with six focus groups of 33

participants, all of whom were veterans of the First Gulf War, to discuss their experiences

and definitions of DRRI. With the refined definition, the researchers developed 14 risk

and resilience factors and scales. After an extensive literature search and review of the

DRRI content was developed with generally 25 items per scale. Once the inventory was

designed, the measures went through three psychometric studies: (a) a telephone survey

with 357 participants; (b) a letter survey with 495 veteran participants, and

additional measures were given to assess the correlation with the physical and mental

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health, life satisfaction, and neurocognitive deficits (King, King, & Vogt, 2003). The

The final DRRI has a range of a = 0.72 to 0.94.

The PSS is a 15-item scale intended to measure "emotional sustenance and

instrumental assistance" (King, King, & Vogt, 2003, p. 6). PSS uses a five-point Likert

scale with one strongly disagreeing and five strongly agreeing. Examples of statements

include: (a) the reception I received when I returned from my placement made me feel

appreciated for my efforts, and (b) I had issues that I could not discuss with family and

friends. The possible score range is 15 to 75, a higher score means greater social support.

The alpha for this measure is 0.87, an average of 56.69 with a standard deviation

10.52. Permission to use PSS is granted by Dawne Vogt. PSS is given with pencil and

paper. The results of PSS are presented in Chapter 4. NEO™ Five Factor Inventory-3

According to the NEO™ Professional Manual inventory (McCrae & Costa,

2010) NEO™ is intended to measure the five personality domains of FFM. NEO-3™

Five-Factor Inventory (NEO-FFI-3™; FFI-3) is a revision of the NEO-FFI™. FFI-3 is a

60-item version of the 240-item NEO-PI-3™. The NEO-PI-3™ assesses personality

FFM in individuals aged 12 years and older. NEO-PI-3™ measures five domains of

FFM personality, and measures six aspect scales for each domain. FFI-3 only measures

domains and not facet scales.

There are two versions of FFI-3: (a) Form S for self-report, (b) Form R for

observer rating. The current study uses Form S (HS; self-report and hand-scored

version). The Form S (HS) version has templates for assessing domain scale and

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converts the raw score to a T score. Age - and gender-specific T-scores based on norms

for inventory. When assessing FFI-3, if there are 10 or more unanswered items, the

inventory is considered invalid, and if there are nine or fewer blanks, the item can be

rated neutral. There are three yes or no validity checks on the last page: (a) responding to

all statements, (b) including responses throughout the line, and (c) responding accurately

and honestly (McCrae & Costa, 2010, p. 15).

NEO™ "measures traits that are close to the normal distribution of bells"

(McCrae & Costa, 2010, p. 17); so most will score average with some low scores and

some high scores on NEOs. ™ Caution should be exercised when developing personality

profiles or interpreting scores because it is easy to see the scores on each scale as black

and white. Each domain should be interpreted as a continuous dimension and not

concrete or inflexible (McCrae & Costa). The results can be easily summarized when

analyzing the norms and scores as: very low, low, average, high, and very high.

NEO™PI-3 does not use normalized T scores of "scores of about 38% in the average

range (T = 45 to 55), scores of 24% in the high range (T = 56 to 65), scores of 24% in the

low range (T = 35 to 44), scores of 7% in the very high range (T = 66 and higher), and

scores of 7% in the very low range (T = 34 and lower; p. 17).

The validity and reliability of the NEO PI-R™ are well documented (Costa &

McCrae, 1992), and carried over to the revised NEO-PI-3™ and NEO-FFI-3™. NEO-

PI-3™ was validated in three phases and samples: (1) Phase 1 adolescent samples,

(2) Phase 2 adult sample, and (3) Phase 3 high school sample (McCrae & Costa, 2010).

The adolescent sample involved 500 individuals aged 14 to 20 from 26 different states,

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51.6% were female, 84.6% were white with A's and B's for average school grades; The

adult sample involved 63 individuals aged 21 to 91 living in 29 different states, 56.1%

were female, 92.6% were white and most had a high school diploma; The high school

sample involved 4449 children aged 12 to 13 years, 52.4% female, 94.5% white and

were students A and B.

The median coefficient of a for all five factors for the first two samples was 0.82

which was consistent with the reliability of the previous NEO™. The third sample of 12-

and 13-year-olds had a median coefficient of 0.76. Data from all three samples were

analyzed extensively; detailed results were published in McCrae and Costa (2007) and

McCrae and Costa (2010). FFI-3 uses a five-point Likert scale using support from

strongly disagreeing to strongly agreeing. Examples of items from NEO-FFI-3™

include: (a) I'm not a worried person (neuroticism), (b) I really enjoy talking to people

(extraversion), (c) I experience a variety of emotions or feelings (openness), (d) I tend to

assume what's best about people (pleasure), and (e) I work hard to achieve my goals

(rigor). FFI-3 is copyrighted and permission is granted through the purchase of the

instrument from the Psychological Assessment Resource (see Appendix F). The results

for the FFI-3 inventory are presented in Chapter 4.

Short Cope Inventory

Brief Cope Inventory (BCI) is a shorter version of COPE Inventory, and is a

measure of style and theoretically based coping strategies (Carver, 1997). BCI is public

domain and permission to use it is not required. As explained in Chapter 2, COPE is an

extension of the stress and coping model of Lazarus and Folkman (1984)

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with the integration of the self-regulation theory of Carver, Scheier, and Weintraub

(1989). The COPE inventory was normed in three studies with undergraduate students

from major universities (Carver, Scheier, & Weintraub). The first study consisted of 978

participants. Factor analysis results in eigenvalues greater than 1.0; The alpha for each

scale ranged from 0.45 to 0.92, and the reliability of the test-retest from two samples of

89 and 116 students revealed an alpha ranging from 0.42 to 0.89. The second and third

studies revealed statistically similar results.

The original COPE is an inventory of 60 items using a Likert scale of one to

four. COPE's inventory has 13 scales but over time it expands to 15 scales. Examples of

COPE scales are active coping, planning, seeking social support, denial, converting to

religion, and acceptance. COPE measures the dimensions of adaptive coping and coping

that may be unproductive (counterproductive)—one can characterize this last form of

coping as less adaptive and for some maladaptive strategies. Not all less adaptive coping

strategies are maladaptive as in some cases of denial, which is often considered

avoidance; Temporary rejection can actually buffer a person from the negative effects of

stress so it is a form of adaptive coping.

Carver (1997) found in the field use of COPE inventory that many people

became impatient with the length and redundancy of inventory; so he developed BCI.

BCI is an inventory of 28 items measuring 14 coping scales using a scale of one to four

Likert with one is I haven't done this at all and four is I've done this a lot. Examples of

statements include: (a) I have switched to work or other work

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activities to distract my mind from things, (b) I have focused my efforts on doing something

about the situation I am in, and (c) I have said to myself "this is not real."

In BCI, Carver (1997) removed two scales from COPE (coping restraint and

suppression of competitive activity), three scales were renamed (positive reinterpretation

and growth was renamed to positive reframing; focus on and vent emotions was changed

to vent; mental release scale became self-diversion), a new scale called self-blame was

added. BCI is normative to use participants who experienced Hurricane Andrew. The

participants were a non-random comfort sample. There were 168 participants, 66%

female, the sample was multicultural, and 126 participants took a second inventory at six

months and a third inventory at one year for test-retest reliability.

The scales and values for BCI are: (a) active coping a = .68, (b) planning a

= .73, (c) positive reframing a = .64, (d) reception a = .57, (e) humor a = .73,

(f) religion a = .82, (g) using emotional support a = .71, (h) using instrumental support a

= .64, (i) self-diversion a = .71, (j) denial a = .54, (k) venting a = .50, (l) substance use a

= .90, (m) detachment of behavior a = .65, and (n) self-blame a = .69. The BCI scale can

be given individually if the researcher is interested in addressing a particular

phenomenon, such as addressing breast cancer. Kim, Han, Chaw, McTavish, and

Gustafson (2010) studied self-blame and positive reframing in the context of addressing

breast cancer. In this study, the researchers tested mediation and moderator variables

using the BCI self-blame and positive reframing scales. Also, Carver (1997) notes that

the time orientation of the BCI scale can be modified based on

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nature of the research. In my study, I measured coping in the present. For the current

study, BCI was administered using pen and paper during the plenary session. The BCI

does not generate an overall coping score. For the purposes of my research, adaptive

coping scales were given a total score and a total score of less adaptive coping scales to

determine which coping strategies were used more or less. The findings for BCI are

presented in Chapter 4.

Data Collection and Analysis

Onwuegbuzie and Leech (2004) note that mixed-method research can "address

much more comprehensive research objectives than conducting quantitative or

qualitative research alone" (p. 770). As mentioned earlier, the purpose of this study was

to examine and explore the phenomenon of coping with the effects of combat stress

exposure in a group of U.S. Marines serving in the OIF/OEF, and who self-reported that

they coped positively with their combat experience. To achieve this goal, I used a

triangulation strategy along with a mixed method, in which qualitative (QUAL) and

quantitative (QUAN) data were collected side by side, analyzed independently, then

triangulated to provide comprehensive answers to research questions and to test

hypotheses.

Erzberger and Kelle (2003) explain the origin of mathematical triangulation

techniques used in surveys to determine distances between various fixed points; Then

they explain how triangulation is transformed into a validation method for social science

research. Erzberger and Kelle developed the triangulation theory into the model

"Between the Theoretical Level and the Empirical Reasoning Level" (p. 462). This

triangulation model shows how QUAN and QUAL data are integrated and

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Interpreted. Erzberger and Kelle describe three possible outcomes (inferences) when

integrating (triangulating) QUAN and QAL data: (a) convergence, (b) complementary, or

conclusion through separate analysis. Complementarity means that the QUAN and

QUAL data "relate to different objects or phenomena" but complement each other

without contradicting the results (p. 466). Conflicting results mean divergent data;

however, differing and conflicting results can actually lead to new knowledge and are not

necessarily the result of poorly designed studies (p. 466).

Gradual data collection and analysis. The following step-by-step process is

used to collect and analyze the collected data. This research was conducted at the main

base of the USMC. There is a period of advertising, volunteer requests, participant

screening, followed by informed participant consent. Data-protected websites, emails,

and word-of-mouth are used to recruit participants and facilitate initial screening. Secure

online enrollment collects some basic PII, reviews and certifies volunteers who meet the

research criteria, and acknowledges that they were originally approved to participate in

the research. The signed information-based consent takes place on Day 1 of Phase 1 as

described below.

Stage I: Data Collection

Day 1: I met with participants who were screened through the website and

recruitment to explain the process for a week (one-hour session). Get signed approvals

and answer questions. The goal of the participants was 150 Marines who were on active

duty but were able to recruit 132. On Day 1, 13 Marines randomly volunteered for

interviews.

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Day 2: Conduct a phenomenological interview (one-hour interview).

Day 3: Conduct a phenomenological interview.

Day 4: Conduct a phenomenological interview.

Day 5: Gather a full group of participants to manage, CES, SWBS, NEO-FFI-

3™, BCI, PVSIII-R®, ADHS, and PSS (one-hour large group session). Recruitment,

approval, and assessment administration are repeated in the other two commands.

Interviews took place in two locations.

Phase II: QUAL Data Analysis

Part I: Transcribed interview recordings.

Part II: Using Giorgi's (2009) modified Husserlian approach to organize data.

Part III: Analyzing QUAL data and preparing initial writing using Giorgi (2009)

and the Moustakas method (2004).

Part IV: Finished texture and structural description of QUAL composites.

Stage III: QUAN Data Analysis

Part I: Conducting statistical and analytical studies of QUAN data using

SPSS. Part II: QUAN's findings have been written.

Phase IV: Integrated and interpreted QUAL/QUAN findings.

Phase V: Develop a synthetic description of a formidable soldier through triangulation of

the data set. The results are presented in Chapter 4 and discussed in Chapter 5.

Data interpretation and verification of trust and validity. Mixed method

research uses qualitative and quantitative means to ensure reliability and validity so that

data interpretation can be trusted. Reliability means that

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The instruments and measures used in the study are reliable (Mitchell & Jolley, 2004).

Validity means that the researcher measures what is meant to be measured (Mitchell &

Jolley). The most reliable action is to be free of research errors; While validity is free

from bias—there is no perfect psychological measure, and no research study is

completely free of bias.

Erzberger and Kelle (2003) note that when integrating mixed-method data,

researchers should use solid "logical reasoning and inference" (p. 466). To this end they

define and describe three forms of logical reasoning and inference: (a) deduction, (b)

induction, and (c) abduction. Deduction uses hypothesis testing to draw conclusions;

while induction makes general statements about empirical facts (Erzberger & Kelle).

Abduction is applied when the data is mixed. If the findings in a study do not have logical

reasoning through deduction and induction then abduction is used (Erzberger & Kelle).

Abductive reasoning seeks to discover new or unknown ideas.

Thematic qualitative data analysis. Giorgi (2009) provides a modified

Husserlian approach to collecting, coding, and interpreting data. Similar to Moustakas

(1994) researchers switched from natural attitudes to phenomenological attitudes which

are important for using Husserlian's philosophy, psychology, and Transcendental

Phenomenology methodology. The essence of this method is the search and description

of the essence of the phenomenon (Giorgi). Giorgi developed his phenomenological

approach based on the Duquesne school of phenomenology that emphasized psychology

and existential philosophy in the interpretation of human data collected through

phenomenological interviews.

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In my study, research participants' interviews about how they coped with combat

stress exposure were transcribed into text files. Then the description of the texture and

structure was developed. Textured and structural descriptions are unique because when

analyzing the data, the researcher can see and feel the description visually, and when

reading aloud the researcher hears the description which increases the interpretive

potential. Interacting with text repeatedly reveals new horizons and potential meanings.

Giorgi (2009) notes that when analyzing and encoding thematic data, researchers

should not go beyond what is presented in the text. Themes that emerge from the text

should not be taken out of context. Giorgi provides a few steps for his method:

1. Read the text "for the whole sense" (p. 128).

2. Define the unit of meaning as you reread the text. Units of meaning

break down the whole into parts or parts.

3. Operationally, assume a phenomenological attitude as you read the text. Mark

the text when you feel a meaningful comment or a shift in meaning.

4. Don't interrogate the meaning, just mark the unit of meaning. Researchers do

not establish units of meaning before they read the text; Let the text speak and

its meaning emerge.

5. At this time, in the exploration of life experience, the researcher helps

determine the textual meaning.

5. There may be a sense of arbitrariness in the process of determining units of

meaning—but with that, don't think too much about the process.

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6. Once the units of meaning are marked, the transformation of the natural

comments of the study participants "into psychologically sensitive

phenomenological expressions" begins (p. 130).

7. In this stage of interacting with the unit of meaning, the researcher interrogates

the marked text to develop a structure, a psychological meaning based on the

researcher's knowledge and experience with the phenomenon. This is when

psychological attitudes are involved in the analysis and interpretation of data.

8. Free imagination is used to develop categories of meaning and themes.

During the imaginative phase of interacting with the data, researchers used a

deeper level of personal awareness. Giorgi (2009) notes that when referring to Husserl's

conscious process, there is a strange scheme or act of marking. Giorgi notes that this

scheme of action is the process of "transforming the units of meaning of the world of life

into psychological expressions, and this process is aided by the method of free

imaginative variation" (p.

133). Because the researcher deliberately read the participants' descriptions of their

experiences, the researcher reduced these units of meaning to psychologically interpreted

data using an intersubjective attitude (Giorgi).

When the researcher analyzes the units of meaning, converting the data into

psychologically interpreted data, the researcher creates a table of altered data, which will

help present the thematic material that emerges during the interpretation phase. When

themes emerge, the composite, textural, and structural descriptions of all participants'

experiences are put together to provide a composite description of the collective

experiences of the research participants, these descriptions are presented in Chapter 5.

The

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A description of the synthesis of a formidable warrior is presented in Chapter 5. In

addition, a description of the textures and structures is in Appendix D.

Description of quantitative data analysis. The quantitative data for this study

involved IV (Combat Stress Exposure) which is a continuous variable determined using

the Combat Exposure Scale. The CSE score range is characterized as light to heavy

combat. DV in this study is subjective well-being and is a continuous variable based on a

one-question survey. To be in this study, participants had to overcome CSE positively. I

tested four MODVs and one MEDV that was discussed earlier. Resilience, hope, social

support and personality are MODV and sustainable. MEDV countermeasures are

categorical. The main statistical tests in this study are Pearson correlation, ANOVA, and

multiple regression. The data was analyzed using SPSS.

Chapter Summary

This chapter describes and discusses research design and approaches, mixed

methodologies, arrangements and samples, protection of human research participants and

other ethical issues, followed by a review of psychological assessment instruments along

with procedures and processes for data collection and analysis. Chapter 4 will advance

the research with a detailed presentation of the research results.

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Chapter 4: Results

Introduction

The purpose of this study was to examine and explore the coping outcomes of

U.S. Marines who were exposed to moderate to severe combat stress during OEF/OIF

and who self-reported that they coped positively with their combat experience. The

research design is a mixed method concurrent triangulation strategy, in which QUAN

and QUAL data are collected and analyzed separately; It was then integrated as a

synthetic description of a formidable warrior.

In the QUAN section of the study, the influence of the independent variable of

combat stress exposure on the dependent variable of subjective well-being was examined

by measuring the impact and role of the moderation variables of resilience, expectations,

social support, and personality, along with the coping mediation variable. MODV serves

to explain when the specified additional predictor variable directly affects the outcome

between IV and DV, while MEDV explains why the specified additional predictor

variable indirectly affects the outcome between IV and DV. Both the MODV and

MEDV effects explain some of the variances in the model being tested. In the research

section of QUAL, phenomenological interviews were used to explore how these Marines

coped positively with their combat experience.

This chapter presents the descriptive characteristics of the sample and statistical

tests used for the analysis of QUAN along with the tabulated results; In addition, QUAL

data is presented. This chapter closes with a table of psychological themes that arise

from the analysis and description of the eiseconds of coping phenomena

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positive with CSE. Chapter 5 will provide a discussion of both strands of analysis, data

integration, overall findings, implications for future research, and the application of

research to social change.

Descriptive Characteristics of the Sample

Currently, there are about 190,000 Marines on active duty; At the time of the

study, there were about 200,000. Over the past 12 years, the Marine Corps has been

actively involved in foreign emergency operations in Iraq and Afghanistan, with about

one-third of the Marine Corps deployed at all times during this period.

Since 2001, approximately 120,000 Marines have received Combat Action Bands

(CARs) as described in Chapter 3. About half of those awarded CAR are non-

infantrymen. The current study consisted mostly of infantry officers and enlisted military

personnel. To voluntarily participate in this study, U.S. Marines meet the following

minimum criteria:

1. An OEF or OIF combat veteran.

2. Receives a Combat Action Ribbon or equivalent.

3. Home for at least 12 months since the last combat deployment.

4. Report themselves coping positively with their combat experience.

Based on a directional test with a = 0.05, a population correlation coefficient

squared, and a power of 0.85, the recommended sample size is 143 (Jaccard & Becker,

2002, p. 593). The objective of the QUAN data study was a random sample of 150

volunteers. There were 139 volunteers recruited before reaching saturation. The final

number of eligible participants was 132: Two had no QUAN data, three reported

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that they didn't cope well, one was a Navy Corps, and one didn't have a CAR or

equivalent. The goal for the QUAL portion of the study was to interview 10 Marines

who were randomly selected from 132 participants. Thirteen Marines from the sample

volunteered to be interviewed. Table 1 is a description of the characteristics of the

sample.

Some demographics were mistakenly overlooked for the study, such as marital status and

education. There were 131 male participants and one female participant; Gender

differences are not studied. Table 2 presents the ranking order and rating distribution.

Quantitative Strand

The QUAN strand of this study was correlational, with one outcome variable

(DV) and more than two predictor variables (IV, MODV, MEDV); thus, Pearson

correlation, one-sided t-test, ANOVA, and multiple regression were used. To use this

parametric test, measures of central propensity and variability are analyzed for all

variables. The assumptions noted by Fields (2005) related to parametric data are:

1. Data must be distributed normally.

2. There needs to be a homogeneity of variance.

3. Data is measured at least at the interval level.

4. The data is independent; Thus, the data collected on the individuals in the

study did not affect the data of other individuals in the study. (p. 64)

The test is calculated for variable center inclination and for normal distributions

using histograms, boxplots, and normal Q-Q plots. Parametric assumptions are not

violated. Table 3 presents the central propensity measures for IV, DV, and

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MODV. Tables 4 and 5 present Pearson's correlation of IV and MODV in relation to

DV.

Table 1

Summary of Sample Characteristics (n=132)

Characteristic Range M Mdn Md SD

Age* 20-52 30.48 30.00 24.00 6.68

Years of Service 2-30 10.68 10.00 5.00 6.05

OEF Implementation** 0-1 .76 1.00 1.00 .43

OIF Deployment** 0-1 .73 1.00 1.00 .45

Total Deployment*** 1-6 2.43 2.00 2.00 1.19

Moon House 12-123 37.95 27 15 28.87

*The average age of the sample is older than the average U.S. Marines; 65% of the

Marine Corps is under the age of 25, with 39% being E3 or below. However, the age

range in this study is representative of the Marine Corps.

**53% of Marines in this study were deployed to the OEF or OIF, with 47%

participating in emergency operations overseas.

Total Deployments indicate that this sample of Marines participated in deployments

other than OEF/OIF and, on average, had been deployed 2.43 times during their service

in the USMC, with some deploying as many as 6 times.

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Table 2

Rank Sequence and Distribution (n=132)

Ranking

Order

Rating Distribution

E3* 2

E4* 32

E5* 20

E6* 7

E7* 4

E8* 3

E9* 3

W01* 24

W02* 2

W03* 1

O1E* 22

O3 4

O4 4

O5 1

O6 3

O7 1

*E3 to E9 are registered (E3-E9); (WO1-O1E) is currently a new officer but was

previously enlisted; Thus, out of 132 participants, 120 were enrolled during their combat

tour. The rank distribution in this study is a general representation of the current active

duty Marine Corps distribution, which consists of about 90% enlisted. This sample

represents a good distribution of rank and age; practically, this sample of 132 Marines is

the size of a rifle company, which is the cornerstone of the Marine Corps' ground combat

organization.

139

Table

139

Central Propensity Measures for IV, DV, and MODV (n = 132)

Variable Scale Range Sample Range M Mdn Md SD

Combating Stress

Exposure

7-35 12-32 23.54 23.50 22.00 4.75

Subjective Well-Being 1-5 1-5 3.80 4.00 5.00 1.33

Cushion resistant* 0-100 21-53 40.09 40.00 43.00 6.47

Hope 12-96 34-64 55.42 56.00 55.00 5.63

Social Support 15-75 44-73 61.55 62.00 56.00 6.30

Neuroticism 0-100 26-74 45.99 46.50 47.00 10.50

The Extraverse 0-100 28-75 56.90 56.00 51.00 10.55

Openness 0-100 25-73 51.52 50.50 48.00 10.40

Pleasure 0-100 25-68 45.67 46.00 50.00 11.30

Accuracy 0-100 30-75 55.83 56.00 55.00 10.19

In measuring the central tendency to be resilient, the distribution appears mostly normal,

but the plot of the box reveals two very low outliers; When the outliers were removed for

analysis, the average rose slightly to 40.09. The slope of the hardiness is -.439 with a

curtosis of 0.062 expressing a tendency towards a higher level of resistance; Thus,

eliminating outliers is consistent with the overall score direction. However, based on the

literature, the average score for resilience in this study was significantly lower than the

anticipated score of 60.

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Table 4

Pearson Correlation Between DV, IV, and MODV (n=132)

Variable 1 2 3 4 5

1. Subjective Well-Being DV 1 -.188* .509** .210* .230**

2. Combating Stress

Exposure

IV -.188* 1 .002 -.053 .143

3. Resilient MODV .509** .002 1 .434** .652**

4. Hope MODV .210* -.053 .434** 1 .412**

5. Social Support MODV .230** .143 .652** .412** 1

*Significant correlation at the level of 0.05 (1-tailed).

**Significant correlation at 0.01 (1-tailed).

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Table 5

Pearson Correlation Between DV, IV, and MODV, (n=132)

Variable 1 2 3 4 5 6 7

1. Subjective Well-Being DV 1 -.188* -.411** .214** .099 .214** .183*

2. Combating Stress

Exposure

IV -.188* 1 -.060 -.106 -.109 -.349** .250**

3. Neuroticism MODV -.411 .060 1 -.408** -.103 -.254** -.442**

4. Extraversion MODV .214** -.106 -.408 1 .252** .323** .182*

5. Openness MODV .099 -.109 -.103 .252** 1 .342** .069

6. Fun MODV .214** -.349** -254** .323** .342 1 -.001

7. Rigor MODV .183* .250** -.422** .182* .069 -.001 1

*Significant correlation at the level of 0.05 (1-tailed).

**Significant correlation at 0.01 (1-tailed).

The traditional zero hypothesis is not used for this study; instead, the hypothesis

is directional, and to accept the directed hypothesis as true, the critical value for the t-

distribution with a confidence level of 0.05 with 131df is specified as

1.65. Table 6 presents a single-sample t-test for Hypotheses 1-4; a single-sample t-test is

not used for Hypothesis 5 because there is no single coping strategy test statistics for BCI

—this will be described in the mediation section.

The following directional hypotheses were tested during this study:

H01: U.S. Marines who scored average or higher on PVSIII-R® (Maddi &

Khoshaba, 2001) outperformed CSE positively (H01: μ 40).

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H02: U.S. Marines who scored average or higher on the Adult Disposition

Expectancy Scale (Snyder, Rand, & Sigmon, 2005) outperformed CSE

positively

(H02: μ  49).

H03: U.S. Marines who scored average or higher on the Post-Deployment

Social Support Scale (King, King, & Vogt, 2003) positively

outperformed CSE (H03: μ  56.69).

H04: U.S. Marines scored average or higher on extraversion, openness,

thoroughness, and pleasure and low on neuroticism based on the NEO-

Five-Factor™ Inventory-3 (NEO-FFI-3™; McCrae & Costa, 2010)

positively coped with CSE (H04: μ  45 for EOAC; μ 4 5 f o r N ) .

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Table 6

Test one sample t at a 95% confidence interval with 131 df and a critical value of t

distribution of 1.65 (n=132)

Hypothesis Test Scores M M SD Df t Mr.

H01: m 40 (Resilient)** 39.80 6.47 131 -.350 .727

H02:m 49 (Hope) 55.42 5.63 131 13.12 .000*

H03: m 56.69 (Social Support) 61.55 6.29 131 8.87 .000*

H04:m μ

45 for N and 45 for EOAC; (Personality)

Neuroticism 45.99 10.50 131 1.08 .283

The Extraverse 56.90 10.55 131 12.97 .000*

Openness 51.52 10.40 131 7.20 .000*

Pleasure 45.67 11.30 131 .678 .499

Accuracy 55.83 10.19 131 12.22 .000*

*Significant test at 0.05 (2-tails).

** There are two very low resilience scores revealed in the plot of the box; however,

even with these two scores removed, M is 40.09 with an insignificant t-score

.158, which is included in the critical value of 1.65; Thus, if the traditional null

hypothesis method is used, the null hypothesis will not be rejected, or for this study, the

hypothesis is not correct based on the test of a single sample t .

The first research question identified in Chapter 1 examined the influence of

moderation variables of resilience, expectations, social support, and personality on the

effects of CSE on Marines in this study who subjectively self-reported that they coped

positively with their combat experience. To test moderation, the Baron and Kenny

(1986) model is applied using Bennett's (2000) three-step as described in Chapter 3. The

following sections provide the steps taken to analyze the effects of moderators. The

results are in Table 7-14.

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Resilience as a Moderating Variable

In the first step of multiple regression, IV (CSE) and MODV (hardiness) were

incorporated into the model as predictor variables on DV (SWB). In the second step, the

term CSE x interaction is resilient inserted into the model. As a result of step 2, if the

interaction variable describes a statistically significant amount of variance in the DV,

then the moderator effect is present. Hardiness moderated the SWB and accounted for

32.1% of the variance in the model. Table 7 presents the results of this test.

Table 7

Summary of Multiple Regression Analysis for Moderator Interactions Between

CSE_Hardiness on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan .88 .78 9.18 3.84

CSE -.05 .02 -.18* -.38 .15 -1.37*

Resilient .10 .01 .51** -.10 .09 -.49

CSE_Hardiness .008 .004 1.56*

Langkah 1: * p < .05;** p < .001; R2 = 0,295; ∆ R2 =

0,284. Langkah 2: * p < .05; R2 = 0,321; ∆ R2 =

0,305.

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Expectations as Moderation Variables

In the first step of multiple regression, IV (CSE) and MODV (expectation) were

incorporated into the model as predictor variables on DV (SWB). In the second step, the

term CSE x expectation interaction is incorporated into the model. As a result of step 2,

if the interaction variable describes a statistically significant amount of variance in the

dependent variable, then the moderator effect is present. Hope did not moderate SWB.

Table 8 presents the results of this test.

Table 8

Summary of Multiple Regression Analysis for Moderator Interactions Between CSE_

Expectations on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan 1.85 1.16 11.63 6.24

CSE -.06 .02 -.23* -.475 .260 -1.701

Hope .11 .02 .51* -.11 .11 -.48

CSE_Hope .007 .005 .11

Langkah 1: * p < .05; R2 = 0,103; ∆ R2 = 0,089.

Step 2: R2 = 0.120; ∆ R2 = 0.099.

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Social Support as a Moderation Variable

In the first step of multiple regression, IV (CSE) and MODV (social support)

were incorporated into the model as predictor variables on DV (SWB). In the second

step, the term CSE x social support interaction is incorporated into the model. As a result

of step 2, if the interaction variable describes a statistically significant amount of

variance in the dependent variable, then the moderator effect is present. Social support

moderated SWB and accounted for 12.3% of the variance in the model. Table 9 presents

the results of this test.

Table 9

Summary of Multiple Regression Analysis for Moderator Interactions Between CSE and

Social Support on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan 2.36 1.27 17.03 5.70

CSE -.05 .02 -.17* -.68 .24 -2.42*

Social Support .04 .02 .20* -.19 .09 -.91*

CSE_Social_Support .010 .004 2.46*

Langkah 1: * p < .05; R2 = 0,075; ∆ R2 = 0,061.

Langkah 2: * p < .05; R2 = 0,123; ∆ R2 = 0,103.

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Personality (NEOAC) as a Moderation Variable

In the first step of multiple regression, IV (CSE) and MODV (Personality

NEOAC) were incorporated into the model as predictor variables on DV (SWB). In the

second step, the interaction terms for each FFM factor CSE x N-E-O-A-C are

incorporated into the model; So this test was run 5 times. As a result of step 2 if the

interaction variable describes a statistically significant amount of variance in the

dependent variable, the moderator effect is present. Neuroticism moderated the SWB

and explained the 26.1 variance in the model. Extraversion, fun and rigor do not

moderate SWB. Openness moderated the SWB and accounted for 8.4% of the variance

in the model. Table 10-14 presents the results of this test.

Table 10

Summary of Multiple Regression Analysis for Moderator Interactions Between

CSE_Neuroticism on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan 7.67 .71 1.02 2.43

CSE -.06 .02 -.21* -.217 .10 -.77*

Neuroticism -.05 .01 .424* -.09 .05 -.70

CSE_ Neuroticism .006 .004 -1.47*

Step 1: *p <.01; **p<.001; R2 = 0.214; ∆ R2 = 0.202.

Step 2: *p <.05; R2 = 0.261; ∆ R2 = 0.244.

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Table 11

Summary of Multiple Regression Analysis for Moderator Interactions Between

CSE_Extraversion on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan 3.50 .88 8.76 3.02

CSE -.05 .02 -.17 -.26 .12 -.93*

The Extraverse -.03 .01 .19* -.07 .05 -.55

CSE_ Extraverse .004 .002 -1.02

Langkah 1: * p < .05; R2 = 0,073; ∆ R2 = 0,059.

Langkah 2: * p < .05; R2 = 0,0971; ∆ R2 = 0,076.

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Table 12

Summary of Multiple Regression Analysis for Moderator Interactions Between

CSE_Openness on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan 4.46 .86 11.07 2.83

CSE -.05 .02 -.17 -.31 .11 -1.13*

Openness -.01 .01 .08* -.127 .05 -.94**

CSE_ Openness .005 .002 -1.33**

Langkah 1: * p < .05; R2 = 0,041; ∆ R2 = 0,027.

Step 2: * < .01; ** < .05; R2 = 0.084; ∆ R2 = 0.063.

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Table 13

Summary of Multiple Regression Analysis for Inter-CSE_Agreeableness Moderator

Interactions on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan 3.74 .90 6.10 2.55

CSE -.04 .03 -.13 -.13 .10 -.47

Pleasure .02 .01 .17 -.03 .05 -.25

CSE_ Fun .002 .002 .45

Step 1: R2 = 0.060; ∆ R2 = 0.046.

Step 2: R2 = 0.068; ∆ R2 = 0.046.

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Table 14

Summary of Multiple Regression Analysis for Moderator Interactions Between

CSE_Conscientiousness on SWB (n = 132)

Step 1 Step 2

Variable B SE B ȕ B SE B ȕ

Konstan 3.66 .75 4.78 3.24

CSE -.07 .02 -.25* -.12 .14 -.42

Accuracy .03 .01 .25* -.01 .06 -.09

CSE_ Accuracy .001 .002 .26

Langkah 1: * p < .01; R2= 0,091; ∆ R2 = 0,077.

Step 2: R2 = 0.092; ∆ R2 = 0.071.

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Overcoming as a Mediation Variable

The second research question identified in Chapter 1 is what mediating influence

do coping have on the effects of CSE on Marines who participated in this study and who

subjectively self-reported that they coped positively with their combat experience? To

test mediation, the Baron and Kenny (1986) model is applied using Bennett's (2000)

three-step as described in Chapter 3. Countermeasures are measured using the Brief Cope

Inventory (BCI). The BCI is intended to measure 14 independent coping strategies. Table

15 presents the values for the central tendencies for the BCI coping strategy. Carver,

Weintraub, and Scheier (1989) and Carver (1997) note that individual coping strategies

can be analyzed separately or in combination depending on the researcher's interests. In

addition, as mentioned earlier, the BCI does not provide a single coping strategy index

score. However, for the purposes of the current study, numbers were calculated for

adaptive coping strategies and for less adaptive coping strategies to test the following

hypotheses:

H05: U.S. Marines who subjectively self-report that they are coping positively

CSE report adaptive coping strategies and styles based on a Short COPE

Inventory (Carver, 1997).

Table 16 presents the averages for the numbers for adaptive and less adaptive coping

strategies; Table 17 presents Pearson's Correlation between DV, IV, and MEDV.

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Table 15

Central Tendency Size for MEDV (n = 132)

Coping Variables Scale Range Sample Range M Mdn Md SD

Active coping 2-8 2-8 5.31 5.00 5.00 1.77

Emotional Support 2-8 2-8 4.48 4.00 2.00 1.93

Instrumental Support 2-8 2-8 3.98 4.00 2.00 1.86

Positive Reframing 2-8 2-8 4.68 5.00 2.00 1.91

Planning 2-8 2-8 4.09 4.00 2.00 1.82

Humor 2-8 2-8 4.12 4.00 2.00 2.06

Acceptance 2-8 2-8 6.24 7.00 8.00 1.86

Religion 2-8 2-8 4.04 3.00 2.00 2.22

Self-Disorders 2-8 2-8 4.42 4.00 3.00 1.69

Denial 2-8 2-7 2.33 2.00 2.00 .87

Substance Use 2-8 2-8 2.94 2.00 2.00 1.50

Behavioral Release 2-8 2-6 2.37 2.00 2.00 .84

Ventilation 2-8 2-8 3.52 3.00 2.00 1.55

Blame yourself 2-8 2-8 3.14 2.50 2.00 1.50

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Table 16

Average for Numbers for Adaptive and Less Adaptive Coping Strategies* (n = 132)

Coping Strategies M

Adaptive Countermeasures 36.94

Emotional Support

Active Handling

Instrumental Support

Positive Reframing

Planning

Religion

Acceptance

of Humor

Less adaptive coping 18.72

Use of Self-

Directed

Substances

Behavioral Release

Blame yourself

* The mean for the sum for adaptive and less adaptive coping strategies is not a single

coping strategy index but is a means of determining the tendency of the sample to use

more or less coping strategies and to test mediation.

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Table 17

Pearson Correlation Between DV, IV, and MEDV (n = 132)

Variable 1 2 3 4

1. Subjective Well-Being DV 1 -.188* -.043 -.533**

2. Combating Stress

Exposure

IV -.188* 1 .230** .202*

3. Adaptive

Countermeasures

MODV -.043 .230** 1 .352**

4. Less adaptive coping MODV -.533 .202* .352** 1

*Significant correlation at the level of 0.05 (1-tailed).

**Significant correlation at 0.01 (1-tailed).

To test the mediation effect of overcoming subjective well-being, the following

steps are taken. In the first step of testing for mediation, MEDV has regression in IV;

both DVs experienced regression in independent variables; Third, DV experienced

regression in IV and MEDV. In order for mediation to occur, Baron and Kenny (1986)

stated that IV must be a significant predictor of the first regression (Path A); IV should be

a significant predictor of DV in the second regression (Path C); finally, MEDV should be

a significant predictor of DV at the third regression (Path B). In this model IV is assumed

to cause MEDV. Table 18 presents the effects of adaptive coping mediators and Table 19

presents the same effects for less adaptive coping.

Adaptive coping is not a mediator; while less adaptive are mediators. Thus, less adaptive

coping has a mediating effect on SWB. However, this effect is a negative relationship

(meaning that the higher the less adaptive score rises the lower the SWB).

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Thus, the opposite was true for this study—a sample of Marines who reported

themselves coping positively using less adaptive coping strategies were fewer. Also,

when comparing the averages of each coping strategy on Table 15, one can observe the

average adaptive coping strategies are substantially higher than the less adaptive

strategies which shows this sample uses more adaptive coping strategies than less

adaptive strategies.

Table 18

Summary of Multiple Regression Analysis for Mediator Effect of Adaptive Coping Number

Between CSEs on SWB (n = 132)

Step 1 Step 2 Step 3

Variable B SE B ȕ B SE B ȕ B SE B ȕ

Konstan 25.93 4.16 5.04 .57 5.04 .66

CSE .46 .17 .23* -.05 .02 -.19* -.052 .03 -.188*

Adaptive

Countermeasures

8.18 .01 .001

Langkah 1: * p < .01; R2 = 0,053; ∆ R2 = 0,046.

Langkah 2: * p < .05; R2 = 0,035; ∆ R2 = 0,028.

Step 3: * < .05; R2 = 0.035; ∆ R2 = 0.020.

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Table 19

Summary of Multiple Regression Analysis for the Mediator Effect of Less Adaptive

Coping Number Between CSEs on SWB (n = 132)

Step 1 Step 2 Step 3

Variable B SE B ȕ B SE B ȕ B SE B ȕ

Konstan 13.83 2.13 5.04 .58 6.97 .57

CSE .20 .09 .02* -.05 .02 -.19* -.02 .02 -.08

Less adaptive coping -.14 .02 .000*

Langkah 1: * p < .05; R2 = 0,041; ∆ R2 = 0,033.

Langkah 2: * p < .05; R2 = 0,035; ∆ R2 = 0,028.

Langkah 3: * p < .001; R2 = 0,29; ∆ R2 = 0,28.

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Qualitative Strand

The third research question identified in Chapter 1 is how and why did the

Marines in this study positively cope with their exposure to combat stress? This question

was explored in the QUAL strand of studies and has no hypothesis. The QUAL strand of

this study involved 13 interviews using the phenomenological methods described in

Chapter 3. The interviewee volunteers during the registration and recruitment process.

Demographically, the interviewees were six years older than the average sample

30.48 years and an average of six years of service. Also, they are newer in combat than

the average Marine in this study and have more combat experience. With regard to

measures of central propensity for IV, DV, and MODV, the interviewees were slightly

higher on each variable than the sample; Thus the interviewees seemed to cope better

than the general sample, which may be a factor of age and maturity. When comparing

the central tendencies of MEDV—the interviewees seemed to be at the same level and

type of coping strategies as the sample. In general, the interviewees are a good

representation of the sample mainly based on rankings: 1-E4, 1-E5, 2-E7, 1-E8, 1-E9, 3-

O3, 1-O4, 1-O5, 1-O6, and 1-O7.

The phenomenological method, as outlined in Appendix A, was used by me

during the QUAL strand of studies with the aim of describing the essence of a resilient

soldier's CSE experience and how they overcame this experience. Husserl (1927) used

the two Greek words noesis and noema when attempting to capture the essence of the

observed phenomenon. As noted in Chapter 3, King and Horrocks (2010) describe noesis

and noema as "what we experience, and how we experience it" (p. 177).

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To arrive at the essence of describing a phenomenon requires the union of noesis

(experiencing) with noema (experiential), and is achieved in epoche (bracketing) using

phenomenological reduction through reflective meditation, phenomenological attitudes,

and synthesis.

According to Moustakas (1994) synthesis is the final step in bringing what and

how an experience into an integrated and intuitive whole that describes the essence of an

object, object, or experience. Wertz (2010) explains how to apply the eicad analysis

method to psychology to understand the essence of something. He developed a

procedure to distinguish how eidos (essences) are presented to the observer through

analysis. Wertz states "The general essence, eidos is found in features that do not

change through all possible variations of the individual, as a general form necessary for

the individual to be an example of the essence in question" (p. 287).

The QUAL interview was analyzed by considering four key questions:

1. What was the research participant's combat experience like?

2. What is the experience of the research participants returning home?

3. How did the study participants (noesis) positively cope with their

combat stress experiences?

4. What is the essence of the formidable warrior's experience that makes their

life experience different from others?

To answer these questions, phenomenological methods as described by

Moustakas (1994) and reinforced by Giorgi (2009) and Sokolowski (2000) are used.

Each participant interview is read aloud over and over again—starting with reading

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text files while simultaneously listening to the interview audio files to edit along with

refreshing my memory of the participants, their voices, and the content of the interview.

Next I went into the age and read the interviews that would come with the words,

thoughts and emotions of the participants without any mixture of my personal knowledge

and experience of the phenomenon.

Being in the age and combining personal knowledge and experience is

challenging and requires a quiet space to be in the conscious current of the interviewee.

Furthermore, the texts are read in the context of phenomenological reduction with

imaginative variations in the mind to observe thematic patterns in individual interviews

and collectively as a whole. In the exploration of the QAL data, seven themes emerged

from the interviews. The seven themes are: (a) emotionality, (b) moral

dilemmas/injuries, (c) self-awareness, (d) training, (e) work, (f) shared experiences, and

(g) social support.

Next I compiled a "Combat Texture and Structural Description and Overcoming

Combat Stress Exposure" for each interviewee. This description is found in Appendix D.

The last step in phenomenological analysis is eicad analysis (Wertz, 2010). Husserl

(1927) called this the reduction of eiseconds. Giorgi (2009) identifies this step in the

analysis as "eidetik generalization" (p. 195). The final step of this analysis leads to a

description of the essence of the thing being analyzed.

Sokolowski (2000) demonstrates the final step of this analysis in three levels of

thought: (a) typicality, (b) empirical universality, (c) and imaginative variation. He

illustrates this in the observation of wood. In observing the pieces of wood,

phenomenologists intuit that the wood floats; thus leading to the conclusion that

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a piece of wood floats. Through further observation it seems to the phenomenologist that

floating is similar in all pieces of wood, which makes floating an empirical universal.

So, if floating is an empirical universal then it may be the essence of wood; what made it

what it is now and if it is removed or stripped naked, it is no longer like that. Then the

observer or researcher moves on to a third level of thinking called imaginative variation

in which the imagination runs freely to see if it can grasp and understand something in a

way that "destroys" or "explodes" the essence (p. 179). Sokolowski states that "eiditic

reduction focuses on the essential form of things" (p. 194). The findings of this final step

in phenomenological analysis are discussed in Chapter 5 along with a composite

description synthesized from a formidable soldier. However, for the purpose of

presenting the results of the analysis, the following is presented as an eidetik analysis to

overcome CSE positively.

An Excursion into Consciousness

An excursion is a short trip, usually for a specific purpose and with the aim of

returning immediately. The purpose of this trip is to briefly explain how I got to this

deliberate point in my research (back to the things themselves). In the age and

phenomenological attitudes as described in Chapters 3 and 4, qualitative themes emerge

in my transcendental reflections and meditations on data. As I read phenomenological

interviews and compile textured and structural descriptions, I deliberately go back to the

data as if for the first time again, then again, and again.

Like a parent who returns to the sleeping nursery only to see again

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The child looks different but it is the same child. It amazes and wonders me in

contemplating the narratives of the fighters in my office.

As mentioned in Chapter 2, transcendental phenomenology is a priori human

science. This means that when one observes the phenomenon being studied, the

researcher starts with an attitude without an empirical mixture. Positively addressing

CSE was a criterion for participating in this study. However, I have a priori intuition

that I subjectively realize that the participants are coping with CSE positively. Is this

awareness based on the empirical assumption from the literature that most military

members go to war and go home to deal with CSE positively? Is this awareness based on

the fact that volunteer participants self-report that they cope positively to participate in

the study? The qualitative question explored in this study is how and why did they

overcome it positively? So to answer the questions, I examined their responses to a series

of questions during the phenomenological interview.

However, during this process, the questions I asked myself intuitively evolved

from "How and why do they cope with CSE positively?" to "How and why can I know

that they cope with their CSE positively?" To answer this question I entered

Epoche again and again. So how do researchers become aware of the essential nature or

essence of overcoming CSE positively? I kept asking myself "How do I know they are

coping positively with combat stress exposure?" I go back to the things themselves, over

and over again, and again to the phenomenological attitude, the times.

In my time I tied up the natural "I-researcher" attitude and entered into the

"phenomenological-I-observer" attitude. What I observed answering

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question how and why these Marines coped positively with their combat stress

experiences? For me, the first realization came from just being with them, hearing their

answers to my questions, experiencing their existence as humans, now home to war

knowing that fighting is hell, and being willing to tell me their story of overcoming CSE.

When I heard their stories, I intuitively felt they were coping with them positively; Yes,

they subjectively reported to me that they were fine before the interview, but it wasn't

until I entered their stream of conscious experience that I knew they were coping

positively. It was an internal sense to be present with the soldiers, listen to their thoughts,

experience their various emotions, observe their body language, read their interviews,

compile textured and structural descriptions that gave me an intuitive awareness that they

were actually coping positively with their combat experience.

However, how can I describe the essence of this coping experience?

The reduction of age and phenomenology brings me to the description of eidetik

below. My time with the Marines in this research was like a religious and spiritual

experience. I felt I was in the presence of the Holy One (transcendence). I experienced

truth and authenticity; This experience left me amazed, inspired; knowing that I am in the

presence of someone who is going through the darkness of the battle to return to the light

of home, and being able to describe what they are going through, along with why and

how they are coping with CSE positively. I was changed by this conversation. It's like a

quality that is hard to define or describe; it's a quality that's subjective but when you

experience it, you know it. When I experience each Marine in my study, reflecting, and

transcendentally mediating their narrative, I know they are coping with it

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positive with CSE. Now I will attempt to provide an eiditic description of the

phenomenon of coping with CSE positively as it has been presented intuitively and

creatively to me by the participants in my study.

Description of Eidetik

What is the point of coping positively with combat stress exposure? What makes

coping positively with CSE uniquely different from other stress-related coping

experiences? Positively addressing CSE is more than just people-environmental

transactions. From a transactional perspective, stress is assessed on a continuum from

beneficial, to benign, to existential with variations in between. Addressing CSE is more

than just transactions; Addressing more than just self-preservation; more than just

surviving the battle; overcoming CSE positively is about developing as a resilient

fighter. Overcoming becomes meaningful—military service of soldiers in battle is for the

good of society and the greater world. Often serving in battle and coping with combat

stress positively can lead to post-traumatic growth.

In essence, seven core themes emerge during the interview and are explained here

with textual examples; in Chapter 5 they are discussed in detail and applied to the larger

scientific literature. The first theme that comes up is emotionality.

Marines who overcome CSE positively understand that positive and negative emotions

associated with combat must be managed in combat and when they return from war.

Emotionality in the context of coping with CSE can range from numbness to feeling

good/justified for killing an enemy, to extreme anger and complicated sadness and guilt.

In the war participants, one stated with respect to emotionality:

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Yes, so many emotions, things change from the beginning until after the 3rd

spread. During the first placement, there weren't many questions for emotional

tension about the mission we were undergoing. I don't know if it's from training

or from reading or from a standard storyline or what but... it is... We believe in

what we do and we try to do it ethically. Most of the emotions in the first

placement and most of the second as well, have to do with friendships, loss, and

frustration in working with people but it's all pretty normal. Then some emotions

from the battle scenario. I don't think we're talking about... We don't... I think we

all love adrenaline but we're not going to talk about it.

Participants two concluded how they felt when the air mission went badly:

Most of my problems that I thought I had during that time were guilt. Guilt for

possibly not choosing the right path. Do the right planning.

Participant five shared that he is currently struggling to express positive emotions when

he comments:

I think it numbs me. Like I find it difficult to feel sorry for things. Likes to have

any emotions. Now I don't know if it's because of the battle or if that's all I did. I

don't know. It's like gradually over time. I don't really feel sorry for others or

emotionally like when my wife cries, I can't bring tears to my eyes. No matter

how hard I try.

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Participant six commented that one emotion that gripped him in battle was:

afraid of the unknown to me. It was very scary because I didn't know what the

bad guys were doing. I don't know where they will come from. I don't know what

pile of garbage is going to explode behind me. That... You are not afraid of too

many things. Like, I'm not afraid of the darkness anymore. But the only reason

people are afraid of the dark is that they can't see the darkness.

Participants 12 identified emotions that were difficult to manage, namely:

Disgust! Every time it is usually disgusting. They will... We bring dead women

and children, and men and it indiscriminately. They don't care. At the same time

ANP and ANA they were killed.

Finally, participant 12 summed it up well after an intense firefight by stating: You

have excitement, because this is over; You have sadness, because you have

3.2

Marines and an Englishman you know they died. You have all these good and

bad emotions simultaneously flooding you.

The second theme that emerged from the interview was a dilemma/moral injury.

Marines who deal with CSE positively often think deeply about the morality of war.

Marines are trained to be ethical and moral warriors. The Law of Armed Conflict and the

rules of engagement were drilled into their minds. However, due to the fog, friction,

uncertainty, and chaos of war, the Marines faced many moral dilemmas and could be

morally injured as a result of the battle.

Participant one commented in connection with how he felt about the mission

during his third combat deployment when he stated:

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The third ... Third, there have been some disenfranchisements with missions and

especially in Afghanistan. It's much harder to lead the Marines when they don't

believe in what we're doing and you can't hide the fact of what seems useless

from what we're doing.

He goes on to state that this moral dilemma challenges then and now:

But in relation to God; Killing someone doesn't satisfy you or just doing the job

whether you think it makes sense. Reasonable is the wrong word. Do you think

it's a good policy, do you think it's morally wrong or do you think it's ridiculous

to be there. Unsatisfactory. But there's a tension between you saying it's

unsatisfying and looking back and saying "Yes, I made it." And I'm not sure how

I'm going to discuss that with my son.

Participant four was very good at articulating when he explained in detail how the

mission he had planned was the worse day of his life and caused extreme moral injury.

He stated:

Like I had an episode where I dropped a bomb and it didn't kill the bad guys but

it killed eight women and children. It was the worst day of my life. It devastated

me like I was a psychological victim when it happened. The lie I bought was

'You have committed an unforgivable sin' like at that time I didn't even care if I

went to jail... I was only concerned, as to where I would spend eternity quite

honestly.

Participant 12 commented that his real struggle came when he returned home from the

war when he declared:

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Yes, the first thing when you come back from a placement is to go back to the

routine. Realizing that I can rest. I didn't have to worry about waking up at 3:00

a.m. when the Afghans decided to fire a .50 caliber machine gun at us. Just such

stupid things. But coming back from Afghanistan tried to wrap my mind around

what it was like to actually live in a world where everything I believed before

religiously, philosophically, morally, society is now destroyed. So it's a lot harder.

The third theme that emerged from the interview was self-awareness. Marines

who overcome CSE are positively aware of the potential for death and the morality of the

mission and how different they are once they go home. Participant six stated with respect

to self-awareness and combat:

It made me realize that there was something more important than me... thinking

of the Marines who couldn't come home alive and thinking of their families and

so thankful to the people who protected me...

Participant two noted that being self-aware every day was very important when he

commented:

I think it just depends on you. You have to understand your situation and get up

every day to exert your best efforts. Some things you can control and some things

you can't control and as long as you make the right effort to control things with

your end of control, you will at least leave with a good taste in your own mouth.

Enjoy a delicious last bite of steak. When you don't, that's when I think

everything will probably creep up on you and maybe be too much of a burden to

handle.

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Participant four summed it up well when he stated

You don't prove who you are in battle, you learn about who is in battle.

Six participants stated:

It made me realize that there was something more important than me... Thinking

of the Marines who couldn't come home alive and thinking of their families and

being so grateful to the people who protected me...

Participant seven only commented that because he was fighting: I

know who I am as a person.

The fourth theme identified in this study is training. Marines train like they fight

and fight like they train. Marines train from the day they enter military service to the day

they leave. Training is essential for success in battle. Participant five captures the essence

of battle and training when he states that the battle is:

Move fast. Confusion. But I used to wonder why we did all the things we did in

training. When you're in battle, you really see them come together. It all makes

sense. Like the simplest things you know. You see a man get off when you

hurry... Fire brigade maneuvers and difficult things. Machine guns lay such a

base shot. Everything came together. I mean afterwards, as long as you don't

think about it.

16 participants briefly stated in connection with the training:

I mean, you know there are some things that are like if it gets really busy, it's not

just a smooth ride. Like we always know what to do but in the end always change

the way we train.

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78 participants eloquently summarized the importance of the training as follows:

Right, no matter how small, no matter what the details are, I mean you're thinking

back to the boot camp even. There is a purpose for everything. To do something

that is embedded in you, so that it is embedded in you, we will do 5 seconds and

25 seconds until you want to scream at the top of your lungs. Until you beg to

stop because it's important. I really explored why things mattered.

It has always been attached to; If we do this wrong, someone can die. Even worse

if we make this mistake, someone could die and it will be your conscience. We

always say that it's like killing someone worse than you dying yourself. When

you get somebody killed, it will happen, it's because of something you didn't do,

something you don't know, something you ignore, get dismissed in training,

something we could have done more thoroughly. It may even go so far as to

report after the action about heat washing that talks about what happened during

the evolution of our training. If you don't do it right and a little bit of detail and

discuss it so that from the senior guys to the PFC until they nod their heads from

north to south 'yes, I understand that.'

The fifth theme that appears in this study is work. In the context of duty, Marines

can make positive meanings of often very adverse experiences involving killing, death,

and destruction. This is what makes being a Marine soldier different from most daily life

experiences and jobs such as being a postal worker, factory worker, or other earning job.

The nearest nonmilitary call that Marines can identify is first responders such as police

officers, emergency medical technicians,

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nurses, or doctors because this civilian vocation is related to life and death. Doing your

job in the military is often associated with a deep sense of duty and loyalty that goes

beyond oneself. Participant one summed it up well when he stated:

There are several things. There is a sense of satisfaction in having done the work

that your superiors asked for, by the Marines you lead, and by the country.

Fulfillment of the contract you registered. There is something in what American

society and most male society define as a warrior image. About someone who is

not afraid to fight or if he is afraid to fight, he still fights. I'm not sure if some of

this might be related to pride.

Participant 12 provided an interesting perspective when he commented:

Honestly, I wish I would never go through it. I don't know what other people

think but I don't... There's a sense of pride in having gone to the worst places in

the world and done the worst job in the world and having some of the worst

experiences in the world locked in your mind so that no one else has to do it. But

I don't know... what all my brothers are fighting for here but I am fighting for

peace. I have a picture on my wall with NY and early September 2001 where the

World Trade Center Tower stands. That's what I want back is peace. So the way I

see it is that unfortunately it is something that I have to experience as an

obligation to my country.

110 participants put their experiences in a historical context:

6800 died in Iwo Jima. So it's very difficult to complain too much. I mean,

everyone brings their own challenges, I guess. I try to be positive about it.

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You have a job and we are professional and this is what we do. We do the bidding

of nations. They said do this and we do that. Really just try really hard just to

'okay this is the chapter in your life' and you move on. That's not something...

what I found were those who talked a lot about murder; they have done very little.

Usually some people talk about, 'Yes, I killed all these people.' Usually he is like

a mechanic and he doesn't do that. I don't understand why people do that.

The sixth theme that emerged in this study was shared experience. Marines who

cope well with CSE often do so with those on duty with them or other service members

who have similar combat experience. Overcoming meant more in relation to other

soldiers because they only understood. Participant 78 summed it up well when he stated:

yes, I mean and I think it's an important thing how do you deal with it? How do

you deal with it? You are bound together. You're there with the guy to your left

and right and you carry each other through it... It's very aware that you're with the

Marines and you're there doing this together.

Six participants commented in relation to the shared experience:

Shared difficulties make bonds with people. So, if you are going through difficult

things and you are going through the same thing as your Marines are going

through. You automatically earn their trust.

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The Marine Corps had long considered the nature of their human relationship as a group

of brothers and the three participants summed it up briefly about how he felt after he

returned from the war:

I'm glad to be back but you still miss the high brotherhood. Finally, the

seventh and perhaps most critical theme with respect to addressing CSE positively is

social support. Marines who positively overcome CSE assessments

the existential nature of battles as meaningful and often beneficial; especially when a

Marine returns from war to experience family, friends, love, and support. Coping

positively with CSE is reciprocal and involves positive relationships; Coping positively

is a social phenomenon. 16 participants stated the following with respect to social

support:

I probably give most of the credit to my wife. I knew there would be many nights

for a while I could have a very bad night terror. He would be the one to wake me

up or calm me down, until I woke up.

Participant one noted how important family support is to her:

I mean... I don't have as much family stress coming home as anyone else does

because there's never been a question about infidelity, there's never a question

about his care of the kids or you know a frivolous finance or anything like that. I

really had an easy homecoming compared to some of the others. Several other

Marines. It makes the desire to go home very, very good. There are a few months

of transition time when we get back to where we have to think

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out who is each other again. But by the grace of God we have worked through

most of it and we work through it.

Participant seven summarized his experience of social support when he noted:

There with me, right next to me. I have a tough wife; I guess that's the word for

it. He... I guess I can go crazy sometimes... I think it was he said... not physically

only emotionally non-existent. He must have been by my side the whole time...

Finally, the whole family system is important for positive social support. Participant78

stated in relation to social support:

I think that's pretty good. I think it started... First, you have family and

everything and most of the time it just matters no matter what. Be it wives and

children. Parents are amazing. My brothers... For me they are very supportive.

Chapter Summary

This chapter presents the findings of QUAN and QUAL data. Tests on endurance,

social support, and neuroticism revealed that these variables had a moderating effect on

the relationship between CSE and SWB. Less adaptive coping has a mediating effect on

the relationship between CSE and SWB. Also, this chapter provides an eicadic

description of the seven themes that emerged from phenomenological interviews. Chapter

5 will present a discussion and interpretation of the findings, implications for social

change, recommendations, and future research.

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Chapter 5: Discussion, Conclusions, and Recommendations

Introduction

The purpose of this study was to examine quantitatively and qualitatively the

phenomenon of coping with the effects of combat stress exposure in a group of U.S.

Marines who served in the OEF/OIF or both, and who self-reported that they coped

positively with their combat experience. These findings help fill the literature gap

between psychological and health illnesses; They added resilience, stress, and coping

literature, with the aim of influencing researchers to conduct more resilience studies to

develop prevention, intervention, and post-prevention programs and policies that will

help reduce the negative impacts of CSE on service members, their families and

communities.

There are three research questions and five directional hypotheses for this study.

1. What was the effect of the moderation variables of resilience, hope, social

support, and personality on the effects of CSE on U.S. Marines in this study

who subjectively self-reported that they positively coped with their combat

experience?

The following directional hypotheses were tested during this study:

H01: U.S. Marines who scored average or higher on PVSIII-R® (Maddi &

Khoshaba, 2001) outperformed CSE positively (H01: μ 40).

H02: U.S. Marines who scored average or higher on the Adult Disposition

Expectancy Scale (Snyder, Rand, & Sigmon, 2005) outperformed CSE

positively

(H02: μ  49).

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H03: U.S. Marines who scored average or higher on the Post-Deployment

Social Support Scale (King, King, & Vogt, 2003) positively

outperformed CSE (H03: μ  56.69).

H04: U.S. Marines scored average or higher on extraversion, openness,

thoroughness, and pleasure and low on neuroticism based on the NEO-

Five-Factor™ Inventory-3 (NEO-FFI-3™; McCrae & Costa, 2010)

positively coped with CSE (H04: μ  45 for EOAC; μ 4 5 f o r N ) .

2. What mediation effect did coping have on the effects of CSE on U.S. Marines

who participated in this study and subjectively self-reported that they coped

positively with their combat experience? The following directional

hypotheses were tested during this study to examine these hypotheses:

H05: U.S. Marines who subjectively self-report that they are coping positively

CSE report adaptive coping strategies and styles based on a Short COPE

Inventory (Carver, 1997).

3. How and why did the U.S. Marines in this study positively address their

experience of combat stress exposure? The third question is explored in

the qualitative strand of research and has no hypothesis.

The goals of the Marine Corps are: to create Marines, win the nation's battles,

and develop qualified citizens (Marines, 2013). Understanding the objectives of the

Marine Corps is essential for the link to the application of the study discussed at the end

of the chapter. As conceptually defined in Chapter 1, "War is a clash of wills and

interests that often results in military force and violence involving combat." Also, the

war is

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unique human efforts (MCDP 1, 1997). The essence of being a Marine is to be a war fighter.

According to the 1st Marine Corps Doctrine Publication (MCDP 1, 1997):

Since war is a clash between opposing human wills, the human dimension is

central in war. It is the human dimension that instills war with its intangible

moral factors. War is shaped by human nature and is subject to the complexity,

inconsistency, and peculiarities that characterize human behavior. (p. 13)

The Marine Corps often turned to the classic book Clausewitz On War (1989) to

understand war theory and the human dimension of war, as well as to develop the

doctrine of war battles that directly influenced the training and education of Marines. For

Clausewitz, war involves rational and irrational factors, material and immaterial, and

simple and complex factors. Irrational, immaterial, and complex factors of war can be

characterized as the moral elements of war. Clausewitz wrote, "The moral elements are

one of the most important in war" (p. 184). The moral elements of war help leaders and

fighters overcome the uncertainty of war: fog, friction, and chance.

Further, Clausewitz concludes that moral forces:

It is a spirit that permeates the war as a whole, and at an early stage they establish

a close affinity with the will that drives and directs the whole mass of power,

practically joining it, because the will itself is a moral quality. (p. 184)

Since war is largely a human endeavor, the moral factor is essential to wage and

win the war regardless of technological superiority. In addition, Clausewitz noted that

the "national feeling of the army (enthusiasm, fanatical spirit, faith, and general

temperament)" was

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moral factors are especially in a fierce fighting environment (p. 184). Michael Handel

(2001) commented that Clausewitz's moral factors include:

the personality, creativity, experience, intuition of the leaders; the spirit and

character of the people; military training and motivation; the quality of military

doctrine; and the behavior of the troops under fire and their continued resistance

after defeat. (p. 82)

The moral factor in war involves emotions, cognition, the human will (will), spirits, and

spiritual, cultural, and religious elements. Clausewitz asserts that moral factors cannot be

fully known, nor can they be easily categorized or measured. Moral elements are

subjective to individuals but should not be ignored objectively by leaders.

The current study takes place in the context of the Marines in war and in many

ways is the study of the moral factors of war. Morality in the context of war theory is not

only morality but is widely applied as an invisible and intangible human personal factor

of a soldier as described above. The findings of this study are intended to promote

resilience in the Marine Corps through training and education; Thus, the interpretation of

these findings is seen through the lens of soldiers and war battles.

Interpretation of Findings

There are three interpretations of the findings: (a) qualitative interpretation, (b)

quantitative interpretation, and (c) synthesis interpretation. As explained in Chapter 3, I

used a single concurrent triangulation strategy (Figure 1). This strategy places equal

priority on both methods by collecting data simultaneously and then comparing or

mixing

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(integrate) data to "confirm, cross-validate, or corroborate findings in a single study"

(Creswell, Clark, Gutman, & Hanson, 2003, p. 229). The integration (triangulation) of

data during analysis leads to metainference (Creswell & Clark, 2011).

In addition, in Chapter 3, it is noted that Erzberger and Kelle (2003) comment

that when integrating mixed-method data, researchers should use solid "logical reasoning

and inference" (p. 466). Erzberger and Kelle define and describe three forms of logical

reasoning and inference: (a) deduction, (b) induction, and (c) abduction. Deduction uses

hypothesis testing to draw conclusions, while induction makes general statements about

empirical facts (Erzberger & Kelle). Abduction is applied when the data is mixed. If the

findings in a study do not have logical reasoning through deduction and induction, then

kidnapping is applied (Erzberger & Kelle).

Abductive reasoning seeks to discover new or unknown ideas. The following three

sections provide logical reasoning and analysis of the data results presented in Chapter 4.

Qualitative Interpretation

Chapter 1 introduces the Husserlian transcendental phenomenological conceptual

framework used in this study; Chapter 2 provides an in-depth literature review of the

framework; Chapter 3 describes the methodology for using phenomenology through

interviews and analysis; and Chapter 4 presents seven themes that emerged during the

interview along with 13 textural and structural descriptions, which are contained in

Appendix D. The following sections interpret the findings. Themes that emerge from

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The 13 interviews were (a) emotionality, (b) moral dilemmas/injuries, (c) self-awareness, (d)

training, (e) work, (f) shared experiences, and (g) social support.

The seven themes are related to combat experience, returning from war, and

overcoming CSE. Each of the following thematic discussions ends with a description of

the essence of the theme by answering the following question: What is the essence of the

experience of a tough warrior that makes his life experience different from others?

Emotionality. Each of the interviewees was able to describe and discuss the

emotions associated with fighting, going home, and overcoming CSE—as expected, the

range of combat-related emotions went from very negative to very positive. The soldiers

depicted a variety of emotions such as terror, anger, guilt, disgust, fear, and joy. An

emotion theory is presented in Chapter 2 in the context of hope as an emotion as opposed

to fear. Emotions and cognition are equally important when dealing with stress. As noted

in Chapter 2, Lazarus' metatheory (1999) views stress and emotions as "combined" (p.

86). Without emotions, stress assessment is impossible.

The transactionalist theory of coping applied to this study is based on the balance

of cognitive and emotional assessment of stress, coping, stress management and control.

As noted in Chapter 2, Lazarus (1999) developed a transactionalist model with the

cognitive-motivational-emotional relational theory as a basis. Throughout the history of

psychology, emotions have often been analyzed from a negative perspective; However,

healthy expressions of negative and positive emotions are essential to overcome them. As

before

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discussed in Chapter 2, emotion-focused coping is just as important as problem-focused

coping. Although the Marines in this study coped positively, they continued to

experience negative emotions related to the war.

For example, two interviewees had difficulty expressing a variety of emotions—

one still felt numb, and the other felt less empathetic. One of the negative criticisms of

positive psychology is the lack of emphasis on negative emotions. Positive psychology is

not a negation of negative emotionality; It is a healthy expression of all emotions in a

positive way. This means that anger can be expressed in a healthy way. For example,

there are times when confiding in "comrades-in-arms" is the best coping strategy. Even

denial for a while can be healthy, especially when in battle. The soldier has a job to do,

and he cannot get caught up in the complicated grief when another soldier is killed;

Soldiers must stay in the fight to protect their combat companions on the left and right.

Thus, rejection in battle was necessary to numb the soldier's senses. However, sooner or

later, the Marines will have to strive to overcome the negative effects of war positively.

Soldiers cannot live in a state of denial and numbness and cope with CSE positively.

Emotionality is poorly studied in military research. However, there is a growing

amount of theoretical and practical research on the importance of positive emotions and

positive influences, especially in the domain of positive psychology (Fredrickson, 2002;

Fredrickson & Losada, 2005). Positive emotions have been associated with positive

psychological adjustment and ego resilience associated with service members serving

under traumatic war conditions. Riolli, Savicki, and Spain (2010) conducted a study with

632

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U.S. troops stationed in Baghdad, Iraq during OIF. The researchers tested five

hypotheses related to ego resilience, positive influence, stress assessment, and mood

states. The researchers concluded from their study that even in traumatic conditions,

resilience was prevalent among Soldiers and was positively associated with positive

emotionality. Positive emotions mediate stress assessments in traumatic conditions,

resulting in positive ego resilience.

Finally, what is the essence of the tough warrior's emotionality that makes his life

experience different from others? With regard to emotionality, war peels off layers of

emotion and exposes raw human primordial emotions. In battle, emotions are more

intense and can cause a wide range of expressions ranging from numbness to anger to

excitement and excitement. Often, the numbing effect is crucial in combat to help the

soldier cope, but if the numbness and denial persist after the soldier returns home, it can

contribute to negative outcomes, as in the case of a third participant, who self-reported

that a lack of emotional expression eroded his marriage and resulted in a divorce. Anger

that can result in anger or tantrums should be controlled positively. Thus, a formidable

warrior is able to express a variety of emotions accordingly and has self-control over

these emotions.

Moral/injury dilemma. Marines in this study are faced with life and death in

war. Young men and women who join the military are raised in a culture that makes

murder a federal crime. United States Marines are trained to respect human life and

protect it; However, when given a mission, they are often asked to take their lives.

When faced with murder, many began to think about the moral implications of war and

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killing, especially when they encounter an enemy who does not fight with the Law of

Armed Conflict, the Geneva Conventions, or other just ethics and virtues of war.

Combat can put soldiers in circumstances that lead to moral dilemmas and contribute to

moral injury.

Maguen et al. (2010) found in a study of 2,797 OIF veterans that about 40% of

members of this service reported having killed someone in battle. These researchers

found that being directly involved in murder is a contributing factor to PTSD or other

negative symptoms such as depression or behaviors such as alcohol abuse. So, thinking

about the morality of war and murder in a way that helps service members cope

positively is essential to their well-being. If a person experiences moral conflict, this can

lead to distress, which limits the individual's ability to actively cope, use positive

reframing, and accept the dramatic and traumatic experience of war. Addressing CSE

positively requires fighters to be able to process internal moral conflicts through adaptive

and active coping.

The concept of moral injury is complex and is a subject that deserves attention in

the literature. Drescher et al. (2011) define and describe moral injury as

disturbances in the individual's confidence and expectations about their own or

others' motivation or capacity to behave fairly and ethically. These injuries are

caused by testimony to immoral acts, failure to stop such acts, or committing

immoral acts, in particular acts that are inhuman, cruel, violent, causing pain,

suffering, or death of others. (p. 2)

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Nancy Sherman (2010) commented on moral injury when she stated:

But what we miss in fear of talking about a soldier's emotions is that

psychological anguish in war is also moral anguish. Soldiers grapple with what

they see and do in uniform, even when their conflict does not rise to the level of

acute psychological trauma. And they felt guilty and ashamed even when they

didn't make a mistake by the best standards of war. (p. 1)

Moral injuries are invisible war injuries and are directly related to combat stress

injuries, as discussed in Chapter 2. To overcome moral injury, one must be able to

process negative and often traumatic combat experiences in a positive way similar to that

described in moral dilemmas. Not all moral injuries associated with combat occur in

combat. Two of the participants in my study experienced drama and trauma at home

through failed marriages and the death or illness of a loved one which made coping with

CSE more challenging especially with their moral reasoning. Interestingly, these two

Marines sought mental health services and the help of a priest.

They adapt and cope with it positively. In the study, it was found that those who coped

with CSE positively were less likely to use self-blame and rejection coping strategies and

were more likely to use positive reframing and acceptance when coping.

There are very few peer-reviewed articles and studies on moral dilemmas and

injuries. In the Academic Search Complete (EBSCO) search for moral injury, there were

70 citations found; most of these entries were articles published in the last decade and

are related to the current GWOT. Also, Nash et al. (2013) developed the Moral Injury

Event Scale, which is intended to measure moral injury in combatants. This scale

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developed as part of a larger longitudinal study titled the Marine Resiliency Study. The

moral injuries associated with being in combat need to be the subject of future research.

Finally, what is the essence of the moral processing of a tough warrior that makes

his life experience different from others? Facing moral dilemmas and being morally

wounded can happen to anyone anywhere; However, the battle puts a person in a very

risky environment that most people will never experience. The moral decisions of a

formidable warrior require him to instantly make life and death choices. Often, these

soldiers were only 18 or 19 years old; At this age, the prefrontal cortex and executive

decision-making system are not yet fully developed. Wrong decisions can destroy lives

and take human lives, which can result in PTSD and moral injuries that can haunt a

person for life. Tough warriors are trained to make the best moral decisions in the most

difficult environments.

Thus, a tough fighter is able to make quick moral decisions that protect lives and

accomplish missions without suffering moral injury; If moral injuries are suffered, they

are able to overcome their combat experience and bounce back positively.

Self-awareness. Throughout the interviews, the participants were very reflective

and introspective about their combat experiences, coming home from the war and

coping with CSE positively. This awareness includes understanding their emotionality

associated with war and the awareness that war has changed them, mostly in a positive

way. Self-awareness is an emerging topic in positive psychology research and part of

the Master Resilience Training conducted by the Army in conjunction with the Penn

Resilience Program (Reivich, Seligman, & McBride, 2011).

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Self-awareness is one of the six core resilience competencies of the

Comprehensive Solider Fitness Master Resiliency Training program The six core

competencies are: (a) self-awareness, (b) self-regulation, (c) optimism, (d) mental

agility,

(e) character strength, and (f) connections. Griffith and West (2013) conducted a

resilience study with the Army's 611 National Guard and civilians. The researchers found

in the self-report measure of six core competencies of resilience that increased self-

awareness and character strength were positively correlated with resilience that allowed

them to better cope with the stress associated with military service.

Finally, what is the essence of the self-awareness of tough warriors that

makes their life experiences different from others? When you realize your death,

especially in battle, soldiers come face-to-face with their existence or absence.

Existence is the core of our essence. Stallard (2004) commented that

Sartre fundamentally expresses this in his popular phrase "existence precedes essence."

Formidable warriors who experienced combat were faced with the reality of their own

existence and the existence of others. Thus, a formidable warrior is aware of their

existence and is able to face the possibility of non-existence and cope with this experience

positively.

Training. The Marine Corps is notorious for its difficult and rigorous training.

The Marine Corps saying "train like you fight and fight like you train" and "if it doesn't

rain, we don't train" or "the more you sweat in peacetime, the less you bleed in war" are

the reality of becoming a Marine. Resilience is directly related to training and education

which will be discussed later. In combat, Marines in this study often stated that they

were capable of

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coping with them better is simply doing what they are trained to do. The same is true

about returning home from war. The Marine Corps trains Marines in Combat

Operational Stress Control which helps them when deployed, during returns and

reunions, and as they adjust and adapt to being at home or in the garrison. In addition,

the warrior spouses received training on how to cope with the effects and stresses of war.

Training is discussed in recommendations for action; however, one of the

common discussions in the military today is how to institute resilience training. Many

people believe that resilience is a trait for some people but can be strengthened to a large

extent through training and education such as those offered by the Hardiness Institute. In

June 2013 Sinclair and Britt edited a published work Building Psychological Resilience

in Military Personnel: Theory and Practice. In this text there is a strong emphasis or

training in the military, leadership, and environment regarding resilience. Proven by the

full implementation of the U.S. Comprehensive Soldier Fitness Program, the DoD Total

Force Fitness concept, and the emphasis on institutionalizing resilience training in the

Marine Corps, the DoD and VA are trying to stem the tide on the negative effects of

CSE by focusing on strengthening service members holistically.

Finally, what is the essence of a tough warrior training experience that makes

their life experience different from others? From the day a Marine sets foot in a training

camp or Officer Candidate School, they begin the training and education process that

lasts throughout their time in the Marine Corps. Training is an important aspect of

becoming a Marine. Training is part of the Marine Corps' first goal of creating the

Marines. As discussed in Chapter 3 in the section on military culture

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and the soldier's ethos that training is essential to make a fighter. Thus, a formidable

soldier is well trained who can protect lives in battle and win the nation's war; also

because of their training, they are better equipped to overcome CSE positively during

battle and when they return from war.

Work. Doing my job is a recurring theme in my interviews. Often the pride of

serving the country is associated with doing my job. As noted in Chapter 2, Shaw and

Hector (2010) conducted a phenomenological study of OEF/OIF veterans that revealed

that work was a fundamental theme for their studies and that doing their work gave a

positive meaning to their combat experience. Military service can be understood as a call

in the weapons profession. Chairman of the Joint Chiefs of Staff General Dempsey

(2010) commented in "White Paper—The American Military: The Weapons Profession"

that

After September 11, 2001, the All-Volunteer Force of America embarked on a

campaign that exceeded any limits imagined as the era of conflict unfolded, its

resilience arguably exceeded the expectations of its architects. As we reflect on a

decade of war, American Service men and women are fighting as a Selfless

Combined Forces serving our Nation, answering the call to duty repeatedly,

constantly adapting. The sacred element of faith allows them to

endure. (p. 1)

Finally, what is the essence of a tough warrior's understanding of doing their job

or duties that makes their life experience different from others? In the context of military

service as a noble profession, our service members overcome CSE. As a military

profession, service members are trained and educated to struggle with a set of values

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which includes honor, courage, and commitment. Doing my job as a member of the

service is directly related to doing my duties. Service members who embody these values

and perform their duties are more likely to cope with CSE positively as evidenced in the

positive psychology literature on character strengths and virtues. Thus, a resilient soldier

lives with a set of positive core values that allow them to do their job and perform their

duties with honor; doing one's duty can enable a fighter to overcome CSE positively.

Shared experiences. The Marine Corps was founded on November 10, 1775 and

for 239 years developed an ethos built on leadership, esprit de corps, and knowledge.

Henry V, Shakespeare's St. Crispen's Day Speech which includes "We are few, we are

happy a little, we are a group of brothers; for he who today shed his blood with me will

be my brother" was common knowledge to Marines. The Marine Corps was built on a

bond of trust among the fighters. War is a continuation of policy in another way; The

other way is fighting and fighting is violence. Marines are usually not caught up in the

politics of war, so in battle they fight for their Marines left and right. The words of the

two participants captured the essence of the shared experience and overcoming CSE.

Participant six stated"

Shared difficulties make bonds with people. So, if you are going through difficult

things and you are going through the same thing as your Marines are going

through. You automatically earn their trust.

78 participants commented:

yes, I mean and I think it's an important thing how do you deal with it? How do

you deal with it? You are bound together. You're there with the guy to your left

and

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your rights and you carry each other through it... It's very aware that you're with

the Marines and you're there doing this together.

Finally, what is the essence of a tough warrior training experience that makes

their life experience different from others? The Marine Corps is an amazing organization,

the Marine title is earned and lasts a lifetime, the friendship of being in the Marines is

transcendent. Esprit de corps formed in battle is the essence of being a Marine. Thus, a

formidable soldier is not an individual alone in battle; a soldier is part of a corps of

warriors who share the difficulties of battle; thus this shared experience is crucial in

overcoming CSE positively.

Social support. As discussed throughout this dissertation, positive social

support, whether perceived or received, is essential in coping with CSE positively.

Hourani et al. (2012) studied resilience and mental health in 475 active-duty Marines

leaving military service by examining mental health risks and protective factors after

combat exposure. Social support was found to be one of the main protective factors that

promote resilience and positive well-being.

Finally, what is the essence of the social support experience of resilient warriors

that makes their life experience different from others? Social support is enhanced by

lasting and meaningful love relationships. Throughout the interview, couples were most

often given credit for helping their soldiers adapt to being at home and coping with CSE

positively. Social support in a military context is based on strong bonds due to the

existential nature of military life. Family separation is a way of life in the military. Thus,

positive social support is essential for overcoming military stress

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service especially when deployed for battle. In addition, the Marine Corps has a strong

Marine Corps Family Readiness Program, Ombudsman, and Community Service

resources that support family readiness. Family readiness is a resilience factor. Thus, a

resilient fighter has positive social relationships that support the entire family system to

cope with the stress of military service at home and abroad; positive social support

empowers the fighter to cope positively with CSE.

Quantitative Interpretation

Chapter 1 introduces positive psychology as the theoretical basis used in this

study; Chapter 2 provides an in-depth literature review of the theoretical basis; Chapter 3

describes the methodology for using positive psychology for empirical research; Chapter

4 presents the results in Table 1-19 of statistical tests conducted during this study—the

following sections interpret these findings. The explanation of these results will be

shown by analyzing five direction hypotheses.

Hypothesis 1. The first hypothesis predicts and expects that the Marines in this

study will score average or higher on PVSIII-R® (Maddi & Khoshaba, 2001) with H01:μ

≥40. This hypothesis is not supported by the findings. The t-test of one sample showed

that the difference in the participant's score for resilience (N = 132, M = 39.80, SD =

6.47) and the hypothesis test value of 40.00 was not statistically significant, t (131) =

-.350, p = .05, 95% CI [-1.31, .92], d = -0.03. As noted in Table 5 there are two hardy

outliers revealed in the box-plot; even by removing these two scores, M rises slightly to

40.09 which seems to validate the hypothesis; however running a test of one more

sample t hypothesis is not correct based on insignificant statistics

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t score .158 which is included in the critical value ± 1.65. However, hardiness is strongly

correlated with SWB with r (131) = 0.509, p = 0.01. In addition, resilience moderates the

SWB and explains 32.1% of the variance in the model. Two reasons why these findings

can be mixed are because of the highly homogeneous nature of the samples and their

multicollinearity. Also, according to the literature Maddi and Khoshaba estimate that

with a military sample, the percentile of resilience should be around 60% which is

significantly higher than in my study. Further analysis is recommended using abductive

reasoning which will be discussed in future research.

Hypothesis 2. The second hypothesis predicts and expects that Marines in this

study will score average or higher on the Adult Disposition Expectancy Scale (Snyder,

Rand, & Sigmon, 2005) with an H02: μ  49. This hypothesis is supported by the

findings. The t-test of one sample showed that the difference in participant scores for

expectations in the current sample (N = 132, M = 55.42, SD = 5.63) and hypothesis test

value of 49.00 was statistically significant, t(131) = 13.12, p = 05, 95% CI [5.46, 7.93], d

= 1.14. Hope was moderately and significantly correlated with SWB with r (131) = 0.23,

p = 0.01. Although this sample appears to be very hopeful and SWB is high, there is no

moderation effect between CSE, expectation and SWB. Further analysis is recommended

using abductive reasoning which will be discussed in future research.

Hypothesis 3. The third hypothesis predicts and expects that Marines in this

study will score average or higher on the Post-Placement Social Support Scale (King,

King, & Vogt, 2003) with an H03: μ  56.69. This hypothesis is supported by the

findings. The test of one sample showed that the difference in participant scores for

social

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support (N = 132, M = 61.55.42, SD = 6.29) and hypothesis test value of 56.69 were

statistically significant, t (131) = 8.87, p = 0.05, 95% CI [3.77, 5.94], d = 0.77. Social

support was moderately and significantly correlated with SWB with r (131) = 0.21,

p = 0.01. In addition, social support moderated the SWB and accounted for 12.3% of the

variance in the model. The results of this study for social support are strongly supported

by the research literature discussed in Chapter 2.

Hypothesis 4. The fourth hypothesis predicts and expects that Marines in this

study will score average or higher on extraversion, openness, agreement, rigor, and low

on neuroticism based on NEO-FFI-3™ (McCrae & Costa, 2010) with H04: μ  45 for

EOAC; μ 4 5 f o r N . T e s t i n g t h e h y p o t h e s i s f o r e a c h

f a c t o r y i e l d e d m i x e d f i n d i n g s f o r p e r s o n a l i t y .

Neuroticism. The single-sample t-test showed that the difference in participant

scores for neuroticism (N = 132, M = 45.99, SD = 10.50) and hypothesis test values of 45

was not statistically significant, with t (131) = 1.08, p = 0.05, 95% CI [-.83, 2.79], d =

0.09.

However, neuroticism strongly and significantly correlates with SWB with r (131) =

-.411, p = .01. Also, neuroticism moderated CSE in SWB and explained 26.1% variance

in the model. So, when neuroticism goes down, SWB goes up.

Extraversion. The t-test of one sample showed that the difference in participant

scores for extraversion (N = 132, M = 56.90, SD = 10.40) and hypothesis test value of 45

was statistically significant, with t (131) = 7.20, p = 0.05, 95% CI [10.08, 13.72], d =

1.14.

Extraversion is moderately and significantly correlated with SWB with r (131) = 0.21, p

= 0.01. However, extraversion does not moderate the effect of CSE on SWB.

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Openness. The t-test of one sample showed that the difference in participant scores

for openness (N = 132, M = 51.52, SD = 10.40) and hypothesis test scores of 45 was

statistically significant, with t (131) = 7.20, p = 0.05, 95% CI [-.83, 2.79], d = 0.63.

Openness was not significantly correlated with SWB with r (131) = 0.099, p = 0.01.

However, openness moderated the effect of CSE on SWB and accounted for 8.4% of the

variance in the model.

Pleasure. The t-test of one sample showed that the difference in participant

scores for openness (N = 132, M = 45.67, SD = 10.19) and hypothesis test values of 45

was statistically significant, with t (131) = 12.22, p = 0.05, 95% CI [9.08, 12.58], d =

0.06. Agreement is moderately and significantly correlated with SWB with r (131) =

.214, p = .01. The agreement does not moderate the effect of CSE on the SWB.

Accuracy. The single-sample t-test showed that the difference in participant

scores for rigor (N = 132, M = 55.83, SD = 11.30) and hypothesis test scores of 45 was

not statistically significant, with t (131) = 0.678, p = 0.05, 95% CI [-1.28, 2.61], d = 0.96.

The accuracy was slight but significant correlated with SWB with r (131) = 0.183, p =

0.01. Accuracy did not moderate the effect of CSE on SWB.

Sinclair, Waitsman, Oliver, and Deese (2013) comment that "most service

members exposed to traumatic events do not report severe mental health problems" (p.

21) and although mental health problems are a common problem in the military, most

service members "appear to be resilient" (p. 22). Sinclair, Waitsman, Oliver, and Deese

base their conclusions on the FFM personality theory. There is broad support from FFM

in the stress and coping literature and especially in some militaries today

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studies on resilience. Overall, the statistical trends in current studies using FFM are

supported by findings with lower neuroticism and higher other factors. Although the

moderation effect is inconsistent among personality variables, it appears that all five

factors influence how Marines cope with CSE positively; however, like Hardiness, the

homogeneous nature of the sample may have contributed to the findings of this mixture.

Further analysis is recommended using abductive reasoning which will be discussed in

future research.

Hypothesis 5. The fifth hypothesis predicts and expects that Marines in this study

will report adaptive coping strategies and styles based on the Brief COPE Inventory

(Carver, 1997). First, this hypothesis is poorly written because it is clear that if you

administer a BCI that measures adaptive and less adaptive coping strategies then the

Marines in this study will report adaptive coping strategies. The hypothesis should be

readable

H05: U.S. Marines who subjectively self-report that they positively address CSE

reports using more adaptive coping strategies and less adaptive coping

strategies based on the Short COPE Inventory (Carver, 1997).

Using this revised hypothesis, the research findings support the hypothesis. Table

15 presents two categories of coping strategies and M for adaptive coping as

36.95 and M for less adaptive coping as 18.72. Thus, it appears that Marines in this study

are more likely to use adaptive coping strategies than less adaptive coping strategies.

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However, adaptive coping strategies did not correlate significantly with SWB

with r (131) = -0.043, p = 0.01; while less adaptive coping was significantly and

strongly correlated with SWB with r (131) = -.533, p = 0.01. These findings further

support that adaptive coping is not a mediator; while less adaptive are mediators. A less

adaptive coping strategy explains 28% of the variance in the model. However, the

effect is a negative relationship—which means that the less adaptive score rises, the

lower the SWB. Thus, the opposite was true for this study—a sample of Marines who

reported themselves coping positively used fewer less adaptive coping strategies and

more adaptive coping strategies.

Synthetic Interpretation

In Chapter 2 it is noted that Erzberger and Kelle (2003) explain the origin of

mathematical triangulation techniques used in surveys to determine distances between

various fixed points; Then they explain how triangulation is transformed into a

validation method for social science research. Erzberger and Kelle developed the

triangulation theory into the model "Between the Theoretical Level and the Empirical

Reasoning Level" (p. 462). This triangulation model shows how QUAN and QUAL data

are integrated and interpreted (synthesized). They describe three possible outcomes

(meta-inferences) when integrating (triangulating) QUAN and QAL data: (a)

convergence, (b) complementary, or (c) contradictory. Convergence means that the

QUAN and QUAL data arrive at the same conclusion through separate analysis.

Complementarity means that the QUAN and QUAL data "relate to different objects or

phenomena" but complement each other without contradicting the results (p. 466).

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Conflicting results mean the data is different; However, different and conflicting

results can actually lead to new knowledge and are not necessarily the result of poorly

designed studies (p. 466).

The findings from the current study are largely complementary and the following

is a synthetic description of "A Tough Soldier." Notice this is not a description of

"Formidable Warriors." No study or theory can capture everything there is to know about

being human, no elemental science can describe the totality of being human, so my

studies describe the characteristics of a formidable warrior. The following is a sketch of a

tough warrior as I depict based on the QUAL and QUAN data found in this study.

A formidable fighter. In the context of this study, the formidable soldiers were

Marines from 20-52 years old with an average age of 30 years who had been on active

duty for an average of 10 years with some Marines still serving in their first enlistment

and one who had served for 30 years. Half of the Marines in the study were deployed to

the OEF or OIF with 47% participating in both operations with all being awarded CAR

or equivalent. The average number of deployments for the Marines was 2.43 with several

deployments as many as six times.

When deployed, a formidable soldier relies on his training to help him fight better

and overcome CSE. A formidable soldier relies on his brothers for support during and

after battle; along with family and fellow soldiers at home. A formidable warrior is

generally proactive, sociable, and willing to seek help when needed.

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Connecting with others through social support is essential for these tough warriors to

positively overcome the effects of combat.

In addition, the experience of fighting together with fellow Marines inspires

soldiers in battle; They fought against each other, side by side. The death of a fellow

Marine is sad for the formidable soldier but motivates them to fight harder, and become

better people and the Marines to honor the sacrifices of their brother and the family left

behind to mourn the loss of a loved one. Serving with other soldiers helps to give a

positive meaning to the combat experience. This shared experience allows for a positive

reframing after the battle and being accepted with the reality of war. A formidable

soldier understands what they do in battle is their job in the weapons profession to serve

their country. Doing their work creates a sense of pride, duty, and professional

satisfaction.

A formidable soldier is tough. A resilient warrior has the ability to control or

influence stressful events, the ability to have a deep sense of commitment to life, and the

acceptance of change as challenging and good. A formidable fighter is full of hope and

they tend to be optimistic. Because they expect them to have the ability to plan for the

future, organize resources to achieve their goals, and motivation to achieve their goals

even when side effects disrupt their flow in life.

Finally, the personality of a formidable soldier is inferior in neuroticism, average

or higher in extraversion, openness, fun and thoroughness that allows them to cope with

stress positively. Extraversion helps them relate positively to others; pleasure helps them

get along with others. Being in agreement means that a formidable fighter tends to be

altruistic, sympathetic, and empathetic. A very formidable soldier

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to become a Marine. Being meticulous means stronger character potential, self-control,

and driven to succeed or achieve a mission. A formidable fighter is more likely to use

adaptive coping strategies and fewer less adaptive coping strategies. A formidable

warrior faces adverse life events with existential courage; they may have TBI, PTSD, or

moral injuries but they are adaptive and capable of getting back up, recovering even

when life has reconfigured them by the wounds of war—they are formidable fighters—

they are United States Marines.

Implications of Positive Social Change

As noted in Chapter 1 unless there is world peace; War will continue to cause

harm to individuals, institutions, communities, cities, states, and nations. The negative

effects of war can have immediate generational consequences and last a lifetime. If

The U.S. military knows why and how military members cope with combat stress

positively so positive psychological tools, training, and education can be developed to

mitigate the negative effects of war. What is inherent in this research is social change;

Because overcoming combat stress positively can reduce the negative effects of combat

on many soldiers by strengthening resilience in individuals, families, institutions, and

communities.

As mentioned earlier, the Invisible Wounds of War study (Rand, 2008) predicted

that more than 300,000 service members suffered from PTSD or other

psychopathological problems related to trauma. The social and economic costs of trauma-

related injuries from war are significant and will have systemic social consequences for

decades to come. The U.S. government has a national and moral responsibility to care for

veterans and their

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Family; especially those who are wounded, sick, or injured by war. In addition, good

policies, programs, and funding are needed to produce positive social change as a result of

war.

The social costs of trauma-related health problems are widespread, and will

negatively impact individuals, families, institutions, and communities. Behavioral health

outcomes such as divorce, suicide, poor job performance, loss of time at work,

unemployment, homelessness, domestic violence, childcare problems, substance abuse,

and poor health due to lifestyle decisions will all have a negative impact on society

(Rand, 2009). The economic and social costs for this problem are incalculable. In

addition, the economic costs that flow to treat invisible war wounds are difficult to

calculate; However, there are some estimates based on economic modeling; along with

the VA's current and future health care budgets that can provide an idea of potential costs.

The RAND study (2009) and testimony to the U.S. Congressional committee on

veterans affairs shed light on the social and economic costs of invisible war wounds using

a two-year post-deployment model that takes into account a variety of factors. The report

concludes that using 2007 dollar values, the costs associated with PTSD treatment and

major depression found in service members participating in OEF/OIF can range from

$4.0 to $6.2 billion per year. The report estimates the cost of a post-placement individual

service member for PTSD alone will range from $5,904 to $10,298 per year. To this end,

the VA's annual health care budget has increased by 9% each year since 2004; with a

2011 budget of $52 billion and a projected budget increase of 50% by 2020

(Congressional Budget Office, October 2010).

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How can these costs be reduced? Tough soldiers who positively cope with

exposure to combat stress can help reduce the costs and outcomes associated with the

negative effects of war—not only the economic cost but also the psychological taxes

imposed on individuals, families, institutions, and society. What tangible improvements

can be applied to bring about positive social change due to the negative effects of war?

The following action recommendations are presented for consideration.

Recommendations for Action

Positive psychology focuses on a well-lived life, a thriving life, a good life.

Resilience and coping with life stress positively are essential for positive well-being in

individuals, families, institutions, and communities. Based on my studies, I made the

following conclusions.

1. Most Marines who go to war and return home can cope positively with their

combat experience.

2. Marines with positive social support from family, friends, and the Marine

Corps can better cope with CSE.

3. Marines with positive attitude and personality factors such as resilience,

hope, self-awareness, lower neuroticism, and higher extraversion are more

likely to cope with CSE positively.

4. Marines who use adaptive coping strategies and less adaptive

coping strategies tend to cope with CSE positively.

5. The Marine Corps is a positive institution that fosters resilience.

6. The Marine Corps is a formidable institution.

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7. Marines are formidable fighters.

8. When Marines leave service and return to society, they can return as better

human beings and positive citizens.

The following actions are recommended. This recommendation is in line with the

35th Marine Corps Commander's planning guidelines (Amos, 2010) which states:

Institutionalize resilience training. The Assistant Commander of the Marine Corps

will lead efforts to develop policies and programs to improve individual

resilience training during the unit formation, training, deployment, and post-

deployment phases. The goal is to provide the best skills and tools available to

Marines and their leaders so that they can overcome the challenges of combat and

the rigors of life as Marines both deployed and in the garrison. (p. 12)

1. Recommends the findings from my research be given to the United States

Marine Corps to support the institutionalization of resilience training

throughout the Marine Corps and support the Marine Corps Command

(MCO) Combat Operational Stress Control Program (COSC) 5351.1 (Feb,

2013). Program COSC

Enable a cohesive ready force and promote long-term health and well-being

among Marines, Connected Marines, and their family members. The

COSC program assists commanders, Marines and Attached Marines, in

maintaining combat capability by preventing, identifying, and

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manage combat impacts and operational pressures on Marines and Sailors.

2. Recommends the findings of this study are given to the commander of the

Marine Corps Training and Education Command to improve the

implementation of Marine Total Fitness (MTF) which is a holistic approach to

health that addresses body, mind, soul, and relationship fitness. The goal of

the MTF is to make Marines more resilient and ready for duty by:

a. Improve, maintain, and when necessary, restore physical, mental,

spiritual, and social fitness.

b. Supporting fitness through the relationships that Marines form

with other Marines, their leaders, and families.

c. To win battles, preserve troops, and protect Marines.

Marine Total Fitness is understood as four individual fitness straps that are

woven together to form an integrated strap. Marine Total Fitness takes the

existing program and brings it together to achieve and maintain total fitness

as best as possible. All levels of leadership are responsible for hiring MTF

across Marine Corps companies. The final state of the MTF is "A Marine

who is ready to successfully operate and respond to the harsh, demanding,

and stressful demands of combat and garrison."

3. Recommends providing the findings of this study to the Commander General,

Marine Corps Combat Development Command for use in doctrine

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integration and development of Combat Operational Stress Control (MCRP 6-11C).

4. Recommends that the Marine Corps consider using resilience training

to strengthen resilience in individuals and institutions.

5. Recommend the findings of this study to be disseminated to the scientific

community through:

a. peer-reviewed articles.

b. poster sessions at psychological conferences such as the 2014 APA

convention in Washington, DC.

c. presentation of scientific papers to various APA divisions and academic

institutions such as Marine Corps University, Quantico, VA.

d. Post the findings to www.resilient-warrior.org's website, which will be a

forum for research discussions and a resource page for soldier resilience.

e. presented the findings of this study to the Center of Defense Excellence

for Psychological Well-being and Traumatic Brain Injury.

f. provide post-study briefings for commands that support the study and

send secure emails of findings to each participant in the study.

Recommendations for Further Study

The purpose of this study was to examine and explore the phenomenon of coping

with the effects of combat stress exposure in a group of U.S. Marines serving in the

OEF/OIF, and who self-reported that they coped positively with their combat experience.

The current study helps me fill the literature gap between psychology

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disease and health; it adds resilience, stress, and coping literature; and hopes to influence

researchers to conduct more resilience studies to develop prevention, interventions, post-

weir programs, and policies that will help reduce the negative impacts of CSE on service

members and their families.

The findings of this study generate many new questions related to stress, coping,

and resilience. The following questions were not answered in this study:

1. What is the influence of age (maturity) in overcoming CSE?

2. What are the effects of being single or married in coping with CSE?

3. What is the impact of education in coping with CSE?

Recommendations for further study include:

1. Post-traumatic growth is a growing field of study and further research needs to

be done with the fighters and their families related to personal psychological

growth.

2. Post-traumatic stress disorder does not have to be a debilitating disorder

and more research needs to be done on how to help those with PTSD to

meet the challenges associated with the negative effects of CSE. For

example, the Hardiness Institute offers resilience training that can assist

soldiers in strengthening resilience.

3. Examine and explore resilience among U.S. Marines from a trait and country

perspective to find out if there are any tough personalities based on FFM or

other personal variable groups.

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4. Explore resilience among U.S. Marines using the framework of Bolger and

Zuckerman (1995) to examine personality, stress, and coping.

5. The analysis of all variables in this study uses the guidebook of Nathans,

Oswald, and Nimon (2012) to interpret multiple linear regression.

Finally, this study is a personal journey for me. As mentioned in Chapter 1— I

started this research to earn a PhD in Health Psychology by helping to close a gap in the

research literature on stress, coping, and resilience related to CSE. The mixed

methodology is an ideal model for me because it allows me to learn about positive

psychology and how to use phenomenology. As noted in Chapter 1 under Assumptions

and Limitations, there are inherent biases that I have to manage in this study. As a former

Marine enlisted and OIF veteran as a Navy chaplain, I was exposed to combat stress, but

not to the size of the participants in this study. Also, I am positively biased towards

Marines who have served in combat, which requires me to exercise discipline not to let

my bias interfere with my data collection and analysis. This is why transcendental

phenomenology is a good qualitative framework because of the times or the bracket of

my knowledge and experience that allowed me to manage my biases.

Finally, Grinker and Spiegel (1945) stated in the introduction to their classic work

on combat stress that

War tests humans as another test they face in civilized life. Like a cruel

experiment, it exposes physiological and

human psychological mechanisms. Cruel, destructive and extravagant

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Although such experiments are possible, a very valuable lesson can be learned

from them regarding the methods by which humans adapt to all forms of

pressure, both in war and in peace. (p. vii)

One key lesson I learned from this study is this: soldiers can endure combat

difficulties and overcome their experiences positively. Throughout this study it was

shown that dramatic and traumatic experiences associated with combat can have

positive outcomes. Finally, as mentioned above the Marine Corps' goals are to: create

Marines, win the nation's battles, and develop qualified citizens (Marines, 2013). I

believe the findings from this study can improve the Marine Corps' goals.

The legacy of the Marine Corps is a storied history from 1775 to the present.

From the revolutionary battles of Nassau Bay to the Fallujah urban war and the battle of

the mountain fires in Afghanistan, the Marines continue to tell their stories with blood,

sweat and tears. Being a Marine changes lives and being a Marine is meaningful.

Meaning-making is the main motivation and need of human beings (Seligman, 2011).

Finding meaning and purpose in life is essential for human development and optimal life

(Seligman). The Marine Corps promotes a thriving and optimal life by fostering a

warrior ethos that fosters the creation of individual and collective meaning. Meaningful

phrases such as Semper Fidelis, Esprit de Corps or Teufelshunde describe the essence of

being a Marine.

How do Marines make meaning when faced with the difficult and harsh life of a

fighter? How do they turn adversity into strength? Battle of Iwo Jima presents

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a timeless example of how more than 60,000 Marines and Sailors face insurmountable

challenges; and after 36 days of fierce fighting against 22,000 trained and fortified

Japanese soldiers, the Marines defeated the enemy. This was the only battle during World

War II in which Marine casualties outnumbered enemy losses. After the battle there were

more than 26,000 US casualties, including 6,800 KIAs. The Marine Corps turned this

tragedy into victory by turning the flag-raising on Mount Suribachi into an iconic image

of the Marine Corps' tenacity, resilience, and heroism; where "Unusual Courage Is a

Common Virtue."

In our generation, meaning-making involves empowering Marines through

Marine Total Fitness. Meaning-making is enhanced by being part of something greater

than oneself and for the greater good of humanity. Important personal and institutional

factors that empower and enhance meaning-making include: character development,

positive relationships, high morals and morals, as well as being completely fit: mind,

body, soul and in all relationships. A formidable soldier is a truly fit soldier who can

positively cope with exposure to combat stress.

COPING WITH COMBAT STRESS INSIGHTS INTO RESILIENCE AND POSITIVE ADAPTATION.

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