Resiliency Program R. Davis U10A1

Running Head: RESILIENCY PROGRAM 1
Military Resiliency Program based around the Prevention of Trauma Induced Stress
Rachel R. Davis
Capella University
A Paper Presented in Partial Fulfillment
Of the Requirements of
PSY 5201 Integrative Project
U10a1
Summer, 2015

RESILIENCY PROGRAM 2
Table of Contents
Abstract 3
Chapter I: Introduction 4
Chapter II: Literature Review 9
Resiliency Programs 9
Lazarus' Model of Coping and Stress 10
Military Application 11
Chapter III: Methodology Description 13
Purpose 13
Sample 13
Instruments 14
Study Design 17
Program Evaluation 17
Chapter IV: Expected Findings 21
Chapter V: Discussion 24
Appendix A 26
Appendix B 29
References 31

Abstract
The purpose of this study is to propose and evaluate a resiliency program based on
the Lazarus Transactional Model of Stress and Coping, targeted at a military population
and designed to focus on trauma induced stress. PTSD is a serious condition effecting
many of our military service members. While treatment is available, building resiliency
against such trauma has been less of a priority. Lazarus' model of Stress and Coping
provides the cognitive aspect to resiliency programs that most are lacking. This theory
emphasized the “importance of cognition in the determination of behavior” (Benness,
1989, p. 17). By adding cognitive training to resiliency programs, the mind may be
trained to better withstand the trauma that comes with combat.

Chapter I
Introduction
PTSD is a serious condition whose symptoms can significantly effect someone's
quality of life. More than a depressive disorder, PTSD is caused by trauma and is
characterized by its intrusive symptoms and cognitive alterations. “PTSD can cause
substantial distress and interfere with personal and social functioning, subsequently
leading to social withdrawal, anger, and aggression. Furthermore, PTSD in military
populations has a pervasive impact on military readiness and the accomplishment of
military goals” (Xue, Ge, Tang, Liu, Kang, Wang, & Zhang, 2015, p. 2). The military has
a long history of researching PTSD and its relationship with combat trauma because of
the significant effect on its members. With some estimates ranging as high as 34%,
combat related PTSD is a prevalent problem for combat veterans (Xue et al., 2015).
While there are many different treatment programs and support groups for those suffering
from PTSD, less work has been done to fortify people against it.
While current treatment programs help with learning to cope with PTSD and
manage symptoms, the truth is that the person has already reached the point where PTSD
had already caused, “a serious mental health injury described by anxious and depressive
features ” (Dunkley, Sedge, Diesburg, Grodecki, Jetly, Shek, & Pang, 2015, p. 1) By
reaching this state, a person is left more vulnerable in the future. Kleiman, Liu, and
Riskind (2013) in their study on depressogenic stress, emphasize the elevated risk.

“Individuals with such vulnerabilities may behave in ways that generate future stressful
events” (Kleiman, et al., 2013, p. 468). They go on to explore attributes in those that are
more resilient to these symptoms with the thought that enhancing these attributes in
others will cause resiliency. “The logic could be extended where individuals with the
enhancing attributional style may act in ways that increase hopefulness that not only
reduces depression symptoms but also predicts less negative life events” (Kleiman et al.,
2013, p. 468). Fostering resiliency in high risk populations should lead to a reduction of
the impact of stressful life events. The military population is especially at risk for
multiple and prolonged exposure to these types of negative life events, and the need for
this enhanced attributional style is among them that much more pronounced.
Resiliency programs are not a new thought. Many programs exist for children in
high risk environments in order to have on hand the resources for coping with significant
threats. These programs focus on fostering, “various interpersonal protective factors;
cognitive skills as well as emotional and behavioral regulation skills” (De Villiers & Van
Den Berg, 2012, p. 94). By being able to identify attributes of those who more readily
adapt to adversity and working to foster those attributes in anticipation for encounters in
high risk environments, service members may be able to minimize the prevalence of
PTSD or the impact of its symptoms. These are the two main focuses of current resiliency
programs. “To date, however, identification of these individual resiliency constructs has
yielded few theoretical guidelines for improving post trauma outcomes” (Whealin,
Ruzek, & Southwick, 2008, p. 101). Despite the prevalence of this type of resiliency
program, its overall effectiveness is clearly lacking.

The Department of Defense (DoD) began specifically developing its own
resiliency training consistent with military culture. In 2007 the DOD introduced the
Battlemind training system. Their training system also had a two part focus, “(1)
enhancing battle preparedness by increasing individual and unit skills, teamwork, and
confidence and (2) mitigating adverse combat stressors by stress inoculation” (Bowles &
Bates, 2010, p. 383). Their program still maintained a large emphasis on fostering
certain attributes. In these programs the focus was on teamwork and leadership. There
was a secondary focus on mitigation, but it was not as emphasized. This move in the last
few years has shown a recognition from the DoD of the importance of more than a focus
on attributes alone. These attributes are tools that can be used during a traumatic event,
but will not be as effective unless given a cognitive context in which a person can use
them.
Aspects of cognitive- behavioral theory provide a context for how these tools may
be used more effectively. “The theory maintains that people’s appraisals about their own
capabilities to manage events (referred to as coping self-efficacy) are central determinants
of behavioral and affective responses to situations” (Whealin, Ruzek, & Southwick, 2008,
p. 103). Lazarus' Model of Stress and Coping breaks down the process of how
individuals appraises a perceived threat and their response by using a balance system of
threat versus resources. This theory emphasized the “importance of cognition in the
determination of behavior” (Benness, 1989, p. 17). By fostering resiliency factors and
using them in cognitive training of threat appraisal, the scale may be tipped toward
resources and lessen the impact of the stressful life event.

Cognitive training in a resiliency program is key because PTSD causes not only
depressive symptoms, but actual cognitive alterations. Proper cognition must be
maintained if threat appraisal is to happen appropriately. “Many studies report functional
deficits in a number of domains, including short-term working memory, sustained
attention, inhibition, memory recall, executive function and emotional processing”
(Dunkley et al. 2015, p. 2). Trauma actually changes the way the brain functions. PTSD
is the mind caught in a traumatic loop of cognitive and behavioral responses to such an
extent that ordinary events can begin the traumatic response cycle. “Once activated, the
perception of current threat is accompanied by intrusions and other re experiencing
symptoms, symptoms of arousal, anxiety and other emotional responses” (Ehlers &
Clark, 1999, p. 320). The mind has the habit of creating thought patterns, but it does not
always have to work against someone. Resiliency thought patterning may help prevent
the formation of this cycle.
In a 2008 study on recruit training it was found that attribute cognitive behavioral
training was effective. Cohn and Pakenham (2008) focused on a positive versus an
avoidance emotional coping style and a problem solving coping style. These two coping
styles represented the behavioral (emotional coping) and the cognitive (problem solving
coping) aspects used in early resiliency training for recruits. The key to this particular
intervention was its dual nature. “Studies have demonstrated the efficiency of brief
interventions incorporating both cognitive and behavioral components for teaching
coping skills” (Cohn & Pakenham, 2008, p. 1152). If resiliency training includes a
cognitive aspect, it can provide context for the attribute training and actually reinforce the

mind into a healthier thought patterns. “In the context of Neuroscience, an example of a
self-reinforcing process may be that correlated firing of two groups of neurons may
strengthen synaptic connections between them” (Pengsheng, Dimitrakakis, & Triesch,
2013, p. 3). Having established neural pathways associated with threat assessment and
coping before a traumatic experience may help prevent the cycle of traumatic cognitive
response forming new neural pathways.

Chapter II
Literature Review
Resiliency Programs
Resiliency programs in the past have largely focused on the idea of resiliency as a
person's ability to overcome adverse life events. It is tied with the idea that several
personal attributes help to bolster this ability, but many past programs have been lacking
in evidence of their effectiveness ( De Villers & Van Den Burg, 2012). The underlying
idea that the ability to adapt to adverse situations will be present if the accompanying
adaptability attributes are also present in that individual seems a sound theory, but has not
been proven long term. These programs focused only on the fostering of certain
behavioral attributes, and not on cognition.
Recent thought on resiliency has added to this basic theory. Resiliency, more than
simply the presence of adaptive attributes, is a process (Rensel, 2015). It is the active
building of the concept of resiliency as a framework of cognition. Building the
underlying structure of resiliency incorporates the ideas of fostering adaptive attributes.
This is the behavioral side of coping and resiliency. These are the tools. The idea of
cognition is the key. Being able to tap into these attributes and using them actively as an
internal resource when faced with adverse events is what will lead to better mental health.
To be able to effectively cope with stressful life events, an individual must not only
possess the tools, but have working knowledge of when and how to use them.

Lazarus' Model of Coping and Stress
The goal is to teach the mind in how to apply the benefits of adaptive attributes.
Resiliency programs including strong cognitive aspects can be used to create or reinforce
the neural pathways associated with positive coping attributes. Lazarus' Model of Coping
and Stress provides a guide for that purpose. The model goes through two basic
cognitive steps. The primary appraisal looks at the threat while the secondary appraisal
looks at the options for coping (Lazarus, 2006). The proposal here is a program that
helps train the mind to actively move through these two types of appraisals instead of
most of it happening subconsciously. Actively going through this process may create a
familiar “pathway” in the mind that can easily be accessed in moments of stress.
Stress is produced when there is an imbalance between what a person perceives to
be the desired outcome, and their perception of their ability to produce that outcome
(Benness, 1989). Once stress is present, the mind's training should begin the familiar
process of threat appraisals. Active cognition during the secondary appraisal, the
assessment of coping resources, gives a person the opportunity for a controlled
assessment. Lazarus' model stipulates that coping potential, positive or negative, stems
from a person's conviction on their ability to shape the situation to their desires (Lazarus,
2006). By fostering attributes that bolster adaptivity and adding cognitive training to
access these attributes when a threat assessment is progressing, an individual should more
readily be able to see these attributes in themselves as resources available to them. These

resources can then actively be used to by an individual to plan on how to address the
adverse situation.
Military Application
The difference in the proposal here lies in its military application and focus on
stress induced trauma. The stressors that military personnel come in contact with are far
beyond what most people would encounter. “Modern warfare is characterized by
demanding missions, extreme climates, sleep deprivation, cultural dissonance, physical
fatigue, prolonged separation from family, and the ever present threat of serious bodily
injury or death (Cornum, Matthews, & Seligman, 2011, p. 4). Due to the unusual and
elevated levels of stress that will be encountered, a program specifically deigned for this
population to meet these challenges is needed. While stress may be thought of as an
imbalance between perceptions and resources, trauma is when that balance is
overwhelmed. In a situation such as combat, stress can easily reach the traumatic level
and stay there for prolonged periods of time. “Intense physiological and emotional
arousal also seems to be associated with fear conditioning in PTSD . Fear conditioning
involves the pairing of a fear-eliciting aversive stimulus with an explicit neutral stimulus
that then comes itself to elicit a conditioned emotional response” (Whealin, Ruzek, &
Southwick, 2008, p. 104). Multiple and prolonged exposures to the negative stimulus
seen in combat situations will condition the mind to automatically respond with fear.
Cornum, Matthews and Seligman (2011) show that the previous approach to this situation
mostly focused on treatment and screenings after the damage had been done. Not only is

there a need for a resiliency program with added steps for cognition, there is a need for a
program designed to deal with the unusual circumstances that lead to trauma induced
stress in military members.

Chapter III
Methodology Description
Purpose
The purpose of this study is to propose and evaluate a resiliency program based on
the Lazarus Transactional Model of Stress and Coping, targeted at a military population
and designed to focus on trauma induced stress. The purpose of the program will be to
foster attributes in soldiers that have been proven to facilitate resiliency. In addition to
this training, soldiers will receive cognitive training to actively recognize those attributes
as coping resources in threat appraisals. By adding active cognitive programming to
universal resiliency programs that focus on behavioral aspects of training, the the trainee
will create familiar neural pathways in the brain to be easily accessed at times of
heightened stress. This study will be evaluating whether or not the program increases the
presence of resiliency attributes, determining whether or not added cognitive training
raises the awareness of these traits as coping mechanisms, and more long term, whether
providing resiliency training before soldiers are exposed to trauma inducing stress lowers
the impact of PTSD.
Sample
A convenience sample of military personnel including recruits and combat
veterans will be used during this program, and selected using a simple random probability
sample. A resiliency program such as the one described here has a clearly targeted

population. This program would be best initiated and evaluated at a facility set up to
work with a specific military population such as Comprehensive Soldier Fitness (CSF).
CSF is a part of the Army's resiliency campaign and has 20 established training
installations located around the country and over seas (Overview, 2015). While these
facilities work with other demographics such as Army family members, these established
installations have access to the target population of the new program. These facilities are
already set up to work with specifically members of the Army who are anticipated to see
combat and with military members that have already seen combat. Participants will be
recruited using the primary data collection sites of the CFS installations. Participants will
also be recruited through the Department of Veteran Affairs. For inclusion in the program
participants must be at least 18 years old, a military member that has completed basic
training, able to participate to completion in the pretest phase, resiliency training
modules and subsequent post test phase, and understand the informed consent. Any
participants deployed during the study and unable to complete the whole program will be
excluded from the final analysis. Any incomplete testing data collected will also be
excluded from final analysis. Outliers will be examined at the time of analysis for
possible inclusion and reasoning presented for in inclusion or exclusion. Study must be
approved by a review board and obtain corresponding military approval before
commencement of recruiting participants.
Instruments
Demographic data, such as age, gender, rank, education, ethnicity, and military

occupation would be gathered by questionnaire. Basic T- tests will be run to determine if
there are significant differences between demographic scores. During analysis
multivariate ordinary least squares liner regression will be used to determine if there may
be a cause and effect relationship between the different demographic data and the
cognitive scores. These distinctions will be important to determine as, for instance,
gender may be a large mitigating factor on how stress is handled.
In order to determine the programs effectiveness two key factors must be
measured. First is a service member's perception of the presence of adaptability
attributes, and the second is their confidence in using those attributes. The Global
Assessment Tool (GAT) is currently used by the military as, “a self awareness tool for
Soldiers by providing a snapshot of their psychological health along four dimensions –
Emotional, Family, Social, and Spiritual fitness” (Lester, Harms, Bulling, Herian, &
Spain, 201, p. 9). The GAT has several established resiliency scales, and was developed
specifically for the military and focus on self awareness. While many see its overarching
nature as a weakness, “findings suggest that the strategy of investigating multiple factors
of psychosocial fitness, rather than a single higher order factor, was appropriate because
it lends granularity to the analysis” (Lester, Harms, Herian, & Sowden, 2014, p. 6). The
fact that this test was designed specifically for the targeted population, and tailored to the
culture makes it ideal.
The Ego-Resiliency Scale assesses the trait of psychological resilience, which is
the capacity to respond effectively to changing situational demands, especially frustrating

or stressful encounters” (Riolli, Savicki, & Spain, 2010, p. 210). The developers of this
scale had a similar idea of resiliency as a framework. Block and Kreman referred to
resiliency as an adaptive system for modifying one's level of control in response to
situational demands (Prince- Embury, 2012). The underlying theory makes this scale
appropriate for use in this program as it includes a resiliency scale and a traumatic stress
scale seen below in Appendix A. Many items from the scale were drawn from the MMPI,
and its validity established in 2005 (Alessandri, Vecchio, Steca, Caprara, & Caprara,
2002, p. 167).
The Combat Exposure Scale (CES) measures the stress experienced by combat
veterans. “The total score ranges from 0 to 41 and can be classified within 1 of 5
categories ranging from 'light' to 'heavy'” (Troyanskaya, Pastorek, Scheibel, Peterson,
McCulloh, Wilde, & Levin, 2015, p 286). Since trauma effects cognition and the
working of the brain, previous traumatic experiences involving combat must be taken
into account when measuring the effectiveness of training for certain paths of cognition.
The Delis-Kaplan Executive Function System( D-KEFS) will be used to establish
the state of the participants cognitive functioning. “The nine D-KEFS tests embrace a
cognitive-process approach to assess the component functions of higher-level cognitive
tasks” (Swanson, 2007, p. 118). Since this is a neural psychological test, the results must
be analyzed specifically by a psychologist with training in neuropsychology.

Study Design
The study design is a quasi experimental pre-test/ post-test with non equivalent
control group. Testing and training would take place at the CSF installations. Both
testing and training components would be overseen by trained personnel. Full testing
analysis must include a psychologist who specializes in neuropsychology. Each
participant would be provided with information on the study including purpose,
procedure, risks, benefits, and informed consent forms. Regression analysis will be used
to analyze results. Once recruitment has taken place, basic demographic data will be
collected. Pre-testing will include all listed measurements and will be completed before
participation in any of the training modules. Once all training modules are completed
post testing will take place with the exclusion of the CES.
Program Evaluation
When evaluating the program as a whole, several steps will need to be taken. It
would be important to identify key players in CSF to begin to trouble shoot and generate
ideas on the existing resiliency program. This discussion can begin to shape what those
involved perceive as the current needs of the program, where it may be lacking and what
the vision of the new program may look like. The implementation of a cognitive aspect
to the existing program is not a simple matter of adding a new module, but a redesign of
all the existing modules currently run by the program. As with any new procedure it will
have to be evaluated and reevaluated as each change is made to assure efficiency and that
the new program is reaching all of its targeted goals. The above psychological analysis

will answer questions about the effect of the modules on its participants, but the new
program implementation will have its own set of issues requiring an evaluation at each
step taken.
Posavac talks about two very important factors when considering implementing
any program evaluation. “First, who are the people whose unmet needs are being
studied? Second, what are the resources currently available to these people” (Posavac,
2012). In this instance care must be taken to make sure that the newly designed modules
are still relevant to the targeted military population, as it is their needs that the program is
trying to meet. Also since the targeted population is of itself diverse in nature, care must
be taken that each module is designed to accommodate these existing differences.
Secondly, as the new program is to be implemented at existing CSF installations, each
installation will have new requirements. To make sure that each test is analyzed properly,
each installation will require access to a neuropsychologist. Due the the cost of extra
testing, it may also need to be determined if a smaller participatory group will go through
the new program to prove its worth before implementing it on a larger scale. Since part
of the goals of this program is of a preparatory nature for the mind, stakeholders may
wish to implement this program using recruits instead of seasoned veterans. This is due
to the possible existing cognitive impairment that may be present in those who are
already seasoned combat veterans. Recruits may be better suited to provide clear
baselines. It will be important to identify key players, generate clear goals based on a
needs, and identify the population that will be the source of future data collection and
analysis.

In theory-driven evaluation the evaluators will be working from an underlying
idea that is meant to guide the program and its goals. In this program the driving theory
has a cognitive-behavioral foundation and focuses on Lazarus' model of Stress and
Coping. A theory-driven evaluation works best here due to the long term nature of the
study. Evidenced-based evaluations of such concepts have limitations on capturing the
long term effects since they can be much more focused on immediate output. Theory
driven evaluations are better designed to take a long view and work well with studies that
will develop more over time. “Often theory-driven evaluators seek to estimate statistical
relationships between the characteristics of participants, the services received, and the
immediate and long-term outcomes achieved” (Posavac, 2009, p. 189). By evaluating
the underlying idea, theory-driven models give evaluators the capacity to look beyond a
straight forward proving of causation. Long term goals of this program include looking at
the impact of receiving cognitive training and the possibility of preventing neurological
cycles based on a trauma response. Since this is clearly a long term outcome, the
evaluation should be theory-driven.
The UCLA model fits well for this beginning of this evaluation. Its creator, Alkin
defined it as, “the process of ascertaining the decision areas of concern, selecting
appropriate information, and collecting and analyzing information in order to report
summary data useful to decision-makers in selecting among alternatives” (Fitzpatrick,
Sanders, & Worthen, 2011, p. 47). The UCLA model is very similar in structure to the
CIPP model but was chosen over CIPP for two reasons. The UCLA model's beginning

assessment looks at the state of a program that is already in existence, not planning for a
program to be implemented. The CSF programs are established and have established
protocol already in place. The redesign here is not an implementation of an entirely new
program, but a redesign of modules in an established setting.
The UCLA model has five major steps in its process. The System's assessment is
figuring out what is actually happening in the program. For this evaluation a major task
will be to outline exactly what it is that the modules contain, and how they teach their
respective constructs. Since the program is already in existence, a clear picture needs to
be painted of what is actually happening so that it can be compared to the stated goals of
the program. An evaluator can then assess where the program is meeting the needs, and
where it is falling short. An evaluation of the existing resiliency modules will be key for
an understanding of where and how the new cognitive-process aspects will be inserted.
The second step to the UCLA model is program planning. This is where the evaluator
works, “to assist in the selection of particular programs likely to be effective in meeting
specific educational needs”(Fitzpatrick, Sanders, & Worthen, 2011, p. 92). Here is where
a consultant should be brought in for the program design to incorporate Lazarus' model
appropriately. It will be imperative for the proper redesign of the modules to have
significant input from a specialist in neuropsychology.
The last steps of the UCLA model are program improvement and program
certification. This part of the model looks at if the goals set in the beginning are actually
being achieved and if the program could be implemented elsewhere. After the redesign
and implementation of the new modules, the analysis of the measurements listed above

should show the effectiveness of the new program. If the new program is meeting the
stated needs of its participants, then considerations can be made for adapting the program
to new populations or installations. While each program will be somewhat uniquely
tailored to the setting in which it is implemented the basic setup and principles, if done
well, should have some ability to cross over into a similar setting.

Chapter IV
Expected Findings
Basic statistical analysis should show the relations between the
demographic data and cognitive functioning. With an alpha set at 0.05 or less, only
scores that met this criteria would be considered significant. Possible adaptations of the
program should be considered if there is significant ties to a certain demographic and any
cognitive impairment. Age, for instance, may be a factor in the performance of cognitive
functioning. Additional cognitive exercises may be beneficial to certain age groups to
maintain peak performance.
The GAT results measure the presence and awareness of various resiliency
aspects. Suspected results would indicate a difference in pre-test and post-test results.
Participants given the GAT at the start of the program would have a lower self assessment
of measured factors as opposed to after they had completed all training modules. Overall
GAT scores could be monitored by factor to see if one or more aspects of training
experienced a disproportional amount of growth compared to others. Discontinuity may
lead to possible redesign of modules to improve GAT post- test scores. It would be
hoped that growth could be seen in all factors and in awareness.
The results following a factor analysis the Ego Resiliency Scale during the pre-
test phase should show basic differences across demographic categories. It is also
expected that lower scores for the Ego Resiliency Scale will be shown with those

participants that also score low on the positive emotionality portion of the GAT.
“Positive emotionality encompasses behavioral and temperamental characteristics
conducive to joy, excitement, and vigor and to states of positive engagement, whereas
negative emotionality is associated with anxiety, anger, and related states of negative
engagement” (Alessandri, Vecchio, Steca, Caprara, & Caprara, 2002, p. 180).
Additionally, if after the program scores in the emotionality portion of the GAT increase,
there should be a correlated increase in the Ego Resiliency Scale scores.
The Trauma Exposure Scale will only be given once, at the start of the program,
as all participants who are deployed and unable to finish the program to its end will not
be included in the final results. It is expected that there will be differences in the results
of those who have significant scores on the Trauma Exposure Scale and the D-KEFS.
“The impact of stress on learning has been widely studied, and research has shown that
cognitive abilities are affected by the physical and psychological manifestations of stress”
(Palmer, Economou, Cruz, Abraham- Cook, Huntington, Maris, Makhija, Welsh, &
Maley, 2014, p. 200). The effects of trauma and combat related stress should be
significant enough to show a difference.
The D-KEFS results should provide a comprehensive evaluation of frontal lobe
integrity. Results will be seen on each individual divided among the nine sub tests that
make up the D-KEFS. Results of an overall multivariate analysis of variance
(MANOVA) should show the relationships between the subsets of functioning and the
dependent variables established in analysis setup. The MANOVA should be able to
compare individual dependent variables for significance. These tests especially should

show if there is a possible connection between high exposure to combat-related trauma
and cognitive functioning. By giving participants the D-KEFS as a pre-test and post- test,
it may be possible to show that cognitive training may be able to reduce the negative
impact of trauma on cognitive functioning.

Chapter V
Discussion
Since this program is specifically designed for members of the military, the
program proposed here has a greater focus on how to deal with trauma induced stress.
“Service members with long-term adjustment difficulties tend to be low in resilience,
have had high exposure to combat, stressful deployment living conditions and/or
additional stressful life events, (Cunningham, Weber, Roberts, Hejmanowski, Griffin, &
Lutz, 2014, p. 979). The universal resiliency programs currently in use are not designed
to deal with this level of stressful environment and may not be reaching their full
potential as a resource for developing coping mechanisms. Basing the new cognitive-
behavioral resiliency program off of Lazarus' model of Stress and Coping adds an active
cognitive role to dealing with a stressor before it takes a mental and physical toll. If stress
is an imbalance between what is happening and a person's perceived ability to handle
what is happening, then perception must be changed. The program described here helps
to balance that perception. The added cognitive aspects of the new program should help
those participating more readily recognize their resiliency aspects as resources that can be
accessed when dealing with stressors. The expected results of this are that members of the
military will feel more actively prepared to deal with the heightened stressful
environments that they will encounter during their service. Their minds will be rewired to
start a healthier coping cycle when presented with these stressful life events. The cycle
of trauma stimulus and an anxious arousal, perpetuated by the mind's tendency to replay

cognitive-processes, may be greatly lessened. If it is the case that PTSD is perpetuated
by a cognitive process that begins at the time of trauma, then cognitive preparation of
threat appraisal before that time may help to interrupt that cycle before it is ever
ingrained in the mind.
This proposal has several limitations. As a new program it will need to be
evaluated over time to make sure it's tailored properly to the needs of the participants.
Also, tracking any long term data on the impact of trauma will be difficult. While this
program may begin a process of training the mind to be resilient against trauma, many
more future studies will have to be conducted to show its value in lessening the impact of
PTSD.
The specific goals of the program and the purpose goal of the program are
different. There are specific questions that the program evaluation must answer. Does
this program foster resiliency attributes? Does the program raise awareness of coping
resources by adding in a cognitive-process? The specific goals of the program are to
foster resiliency attributes and train participants through a cognitive progress to be able to
actively apply those attributes during heightened stress. The evaluation of the program,
and the pre-test/ post-test study design should be able to show if those specific goals are
being met. It should also show weak points in the program that can then be reevaluated.
The overall program purpose has much larger questions. Does active cognition during
threat assessment lessen the impact of trauma induced stress or the effects of PTSD
overall? That will be harder to answer and will take much more time and effort.

Appendix A

Appendix B

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