Relationship between Mindfulness and Psychological Adjustment in Soldiers According to Their Confrontation with Repeated Deployments and Stressors

doi:10.4236/psych.2012.31016

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Psychology

2012. Vol.3, No.1, 100-115

Published Online January 2012 in SciRes (http://www.SciRP.org/journal/psych) http://dx.doi.org/10.4236/psych.2012.31016

100

Relationship between Mindfulness and Psychological Adjustment

in Soldiers According to Their Confrontation with Repeated

Deployments and Stressors

Marion Trousselard1*, Dominique Steiler2, Damien Claverie1, Frédéric Canini1

1Département des Facteurs Humains, Institut de Recherches Biomédicales des Armées,

La Tronche, France

2Département Management et Comportements, Grenoble Ecole de Management, Grenoble, France

Email: *marion.trousselard@gmail.com

Received October 9th, 2011; revised November 11th, 2011; accepted December 16th, 2011

Although interest in incorporating mindfulness into medical interventions is growing, data on the rela-

tionships between mindfulness, stress and coping in military personnel is still scarce. This report investi-

gates the relationship between psychological adjustment and mindfulness in soldiers according to their

repeated deployments and confrontations with stressors. Our findings indicate that soldiers’ mindfulness

levels were in the range of the middle-aged civilian working population, and were negatively correlated

with emotional disturbance measures, and positively correlated with their subjective assessments of their

own well-being. Individuals confronted with conflict deployments and stressors recorded lower mindful-

ness scores, and appeared high in emotional disturbance measures.

Keywords: Coping; Mindfulness; Personality; Stress

Introduction

Repeated deployments in unsecure places and exposure to

war-related stressors lead increasing numbers of soldiers to

experience stress-related symptoms—either acute such as Acute

Stress Disorder (ASD) or chronic such as Post-Traumatic Stress

Disorder (PTSD)—and other mental disturbances which affect

their moods, thoughts and behaviours. In fact, history has con-

sistently shown that exposure to combat environments can im-

pair the mental health of everyone in these environments (Red

Cross), as well as negatively impacting moral engagement

processes, leading to possible violations of international law.

Anxiety symptoms are the most frequently reported in such

circumstances and environments, but the rates of depression,

addiction, suicide, alexithymia (or emotional numbing) are also

high (Ginzburg, Ein-Dor, & Solomon, 2010). Studies using

psychological constructs have clearly shown relationships be-

tween combat exposure (duration and/or severity) and psycho-

logical casualties (Juster, McEwen, & Lupien, 2010, Sapolsky,

2001). Current literature on the effects of chronic stress in gen-

eral health converges around the concept of allostatic load (AL),

and the AL model expands the stress-disease literature by pro-

posing a temporal cascade of multi-systemic physiological

dysregulations that contribute to disease trajectories. AL refers

to the cumulative wear and tear on body systems caused by too

much stress and/or inefficient management of the systems that

promote adaptation through allostasis. AL offers important

clues as to why individuals who have previously adapted suc-

cessfully to repeated stressors suddenly can succumb to psy-

chological distress and maladjusted behaviours (Mc Ewen &

Stellar, 1993).

However, the relationship among observed elements of psy-

chological distress is not yet understood (Berthoz, Consoli,

perez-Diaz, & Jouvent, 1999; Endler & Kocovski, 2001; Miko-

lajczak & Luminet, 2006). A pertinent example concerns

alexithymia, a clinically derived concept that refers to a cogni-

tive-affective disorder characterized by having difficulty ex-

periencing and expressing emotions (Taylor, 1984) which is

considered as a vulnerability factor regarding mental disorders

(see Corcos & Sperenza, 2003, for overviews). A high state-

alexithymia level is understood as a response to anxiety or

stress that serves to counter negative affectivity in the face of

stressors (Hendryx, Haviland, & Shaw, 1991, Mikolajczak &

Luminet, 2006). Two main linked questions arise. The first

concerns the nature of the association between alexithymia and

other psychological distress, such as anxiety and depression

(Berthoz, et al., 1999), psychosomatic disorders (Porcelli, Leoci,

Guerra, Taylor, & Bagby, 1996), and PTSD (Frewen, Lanius,

Dozois, Neufeld, Pain, Hopper, Densmore, & Stevens, 2008)

with controversial results. On the one hand, taking into account

the relationship between alexithymia, anxiety, and depression,

studies have found causal links between anxiety and depression

and alexithymia, and also between depression and alexithymia

(Hendryx, Haviland, Shaw, & Henry, 1994). On the other hand,

Berthoz, et al. (1999) showed a tighter relationship between

trait anxiety and alexithymia than between state anxiety and

alexithymia, and also that controlling anxiety broke the rela-

tionship between alexithymia and depression (Berthoz, et al,

1999). Some authors have argued that investigation is needed to

understand this relationship, to determine whether alexithymia

might be secondary to psychological disorders (i.e., a conse-

quence of psychological distress), or whether it constituted a

vulnerability factor towards mental disorders (and is thus a

cause of psychological distress). This approach raises a second

*Corresponding author.

M. TROUSSELARD ET AL.

question concerning the stability of alexithymia—is it a stable

personality trait (Martinez-Sanchez, Ato-Garcia, & Ortiz-Soria,

2003; Mikolajczak & Luminet, 2006) or a state-dependant

phenomenon (Corcos & Speranza, 2003; Haviland, Shaw,

Cumming, & MacMurray, 1988; Honkalampi, Hintikka, Saari-

nen, Lehtonen, & Viinamaki, 2000)? Recent data suggest that

although alexithymia level is described as having a high degree

of relative stability, it increases in psychological distress (Mi-

kolajczak & Luminet, 2006).

This debate is not simply limited to alexithymia, but occurs

in other psychological assessment areas. Even if they were

stable, psychological human dimensions, types or attributes

would be of little interest if they did not predict some important

real life outcomes (Alport, 1961), such as disease, lifestyle or

social (mal)adjustment. Furthermore, the debate about the sta-

bility or instability of the conventional psychological constructs

must take into account the question as to whether they should

be conceived as lying on a continuum or as being divisible into

two (or more) specific categories. While the “categorical” ap-

proach—where a patient either does or does not have a certain

disorder—is both familiar and traditional in psychiatry and

helpful in communication, a growing of literature in the field of

psychological constructs seems to suggest that psychological

dimensions—especially anxiety, depression and alexithymia—

should be conceived as lying along a continuum if the full

spectrum of studied psychological variables is to be taken into

account (Cox, Endler, & Swinson, 1991; Endler & Kocovski,

2001; Mikolajczak & Luminet, 2006). This quantitative ap-

proach also implies the need to define agreed cut off points that

can determine pertinent differences between illnesses that

aligns with observed types of behaviour or distress.

While it is imperative to move swiftly to understand fully the

tremendous challenges involved if the psychological conse-

quences of repeated deployments are to be limited, the most

urgent challenge for military health services is to improve their

ability to detect, before deployment, which soldiers are likely to

be at risk of developing mental diseases when facing new

stressors. Such a preventive strategy implies the need to be able

to detect quickly soldiers who present even very slightest signs

of stress-related psychological disturbances, so as to reveal any

potential psychological disorders before the soldiers’ psycho-

logical adaptation break-points are reached, so they can be kept

away from confronting deleterious new stressors. The medical

challenge implied here involves first the defining what “invisi-

ble” psychological sign(s) could predict where a soldier’s psy-

chological break-point might be, beyond which he risks devel-

oping mental health wounds, and secondly developing a sensi-

tive tool to diagnose such signs. In fact, a possible psychologi-

cal tool for detecting individual intolerance to new stressors

comes from the literature on human mindfulness, and can be

assessed easily by questionnaire.

Mindfulness is described as a non-elaborative, non judg-

mental present-centred awareness in which each thought, feel-

ing or sensation arising in a subject’s field of attention is ac-

knowledged and accepted for what it is (Kabat-Zinn, 1990;

Segal, Williams, & Teasdale, 2002; Shapiro & Schwartz, 1999).

High levels of mindfulness are believed to be associated with

well-being (Brown & Ryan, 2003), higher body satisfaction

(Body Cathexis Scale; Secord & Jouard, 1953) and better iden-

tification and description of feelings (Toronto Alexithymia

Scale-20; Bagby, Parker, & Taylor, 1994; Bagby, Taylor, &

Parker, 1994), while low mindfulness is associated with anxiety

(Walach, Buchheld, Buttenmüller, Kleinknecht, & Schmidt,

2006), including social anxiety (Scale for Interpersonal Behav-

iour; Arrindell, Sanavio, & Sica, 2002), and depression (Wa-

lach, et al., 2006). Mindfulness therefore shows positive corre-

lations with positive personality traits and well-being indicators,

and negative correlations with neuroticism and emotional dis-

turbance measures (Baer, Smith, & Allen, 2004; Brown &

Ryan, 2003; Walach, et al., 2006).

Strozzi-Heckler (2003) reports that the samurais of ancient

Japan practiced mindfulness to reduce fear and stay focused,

even in very stressful situations, so—from that psychological

perspective—a state of high mindfulness is the opposite of a

state of mental distress. Individuals with high mindfulness

scores have also been shown as exhibiting greater ability to

tolerate uncomfortable sensations (Eifert & Heffner, 2003;

Levitt, Brown, Orsillo, & Barlow, 2004) and emotions (Hayes,

Strosahl, & Wilson, 1999; Linehan, 1993; Segal, et al., 2002).

So mindfulness appears to reduce negative appraisals (i.e., fear)

of challenging or threatening events (Trousselard, Steiler, Ra-

phel, Cian, Duymedjian, Claverie, & Canini, 2010). Stress ap-

praisals concern the cognitive processes through which an indi-

vidual evaluates events. Since “mindful” individuals view on-

going events and experiences in a receptive manner, it could be

suggested that a high mindful disposition alters the stress pro-

ducing process by attenuating negative appraisals, which would

therefore tend to protect individuals who have to cope with the

psychological impact of a traumatic event (Weinstein, Brown,

& Ryan, 2009).

Mindfulness training has been shown to improve psycho-

logical and physiological outcomes in subjects facing stressors

(Davidson, 2004; Walache, et al., 2006) and even to treat vari-

ous anxiety disorders (Germer, Siegel, & Fulton, 2005; Orsillo,

Roemer, Lerner, & Tull, 2004). High scores in mindfulness

questionnaire seem therefore related to subjects’ abilities to

regulate their day-to-day behaviors and adapt to stressful events,

and may therefore be a psychological feature that representing

subjects’ resilience.

Whether mindfulness scores would allow the detection of the

slight psychological perturbations induced by previous combat

exposure remains a question, but reductions in psychological

stress and/or mindfulness training have proved that mindfulness

is a relevant measure for indicating a decrease of mental dis-

tress. However, whether a mindfulness measurement could be

used to detect vulnerable soldiers a priori so as to protect them

from encountering repeated stressors has yet to be examined.

It is important for understanding how mindfulness deals with

stress to assess this psychological dimension before a trauma

(prospective design) rather than after a trauma (retrospective

design). However, increasing proofs before introducing a pro-

spective study is necessary as data on mindfulness in the mili-

tary population are scarce. In this context, an exploratory retro-

spective design first can be proposed to retrospectively assess

differences between soldiers according to their distress status,

as correlations between mindfulness and other psychological

variables known to influence how a person deals with stress.

In accordance, this study aims to observe mindfulness levels

among French military personnel according the nature of their

previous operational missions, namely repeated deployments in

conflict situations or on patrol and surveillance activities. The

first goal is to measure mindfulness levels of among a military

population from the French Armed Forces, and the second is to

evaluate the relationships, first between mindfulness and those

M. TROUSSELARD ET AL.

psychological dimensions already known to be predictors of

psychological protective dimensions (personality and coping

features), and second between mindfulness and emotional dis-

turbances (anxiety and alexithymia) according to the nature of

stressors’ being confronted. It is supposed that mindfulness

levels for soldiers are in the same range that those described in

the French population (Trousselard, et al., 2010). Moreover,

similar relationships must be found; that is both negative corre-

lations between mindfulness and emotional disturbances scores,

and positive correlations between mindfulness and protective

dimensions scores. The final aim is to investigate the relation-

ship between mindfulness and stress responses by taking into

account individual histories of exposure to stressors, in terms of

their intensity and their psychological sequels. This relationship

is also examined in terms of its sensitivity to the numbers and

severity of the stress situations encountered. It is postulated that

the relationships between mindfulness and the assessed psy-

chological dimensions are modulated by the number and the

importance of the encountered stress.

Method

Participants and Procedure

Two military units—a mountain infantry unit and a subma-

rine unit—were contacted for the study, chosen because their

operational missions differed (combat and stress vs. peaceful

submarine patrol) but they also shared some strains in common

(long durations, promiscuity, distance from family, inability to

cope with family’s home problems, etc.). Individuals in each

unit received a letter (supported by a covering letter from their

respective headquarters) inviting them to participate in the

study, which contained two types of information. First, the

main aim of the study was noted as a psychological investiga-

tion, conducted within the Armed Forces, based on a question-

naire about mindfulness, together with guidance for the instru-

ments’ completion. Second, respondents were told of the two

criteria for being included in the study: 1) that they were not

undergoing treatment and 2) that they had no personal interest

in the concept of “mindfulness”. The set of self-report ques-

tionnaires, including common socio-demographic data and five

psychological measurement tools for studying the promotion of

adaptability to stress, was presented online on each unit’s

intranet between September and December 2009. The guide-

lines for internet-based experimenting proposed by Reips (2002)

were followed to ensure data quality, and answers were coded

to ensure confidentiality. Volunteers—who had all given writ-

ten informed consent before participation—completed the

questionnaires (anonymously) online and at a single session.

After excluding incomplete sets of answers, our final sample

consisted of 167 French servicemen soldiers—108 infantrymen

and 59 submariners. The study was conducted in accordance

with all applicable regulatory requirements, including the 1996

version of the Helsinki Declaration, and approved by the

French Military Health Service’s ethics committee.

Measures

The socio-demographic data collected included age, ethnicity,

gender, educational level, matrimonial status, duty service,

usual activities, rank and number of deployments. Duration of

mission was not required. Age data was requested in the three

divisions (under 21; 22 - 36; over 36), while educational level

data was also requested in two categories - undergraduate level

(one or two years at military school) and graduate level (two to

five years of more specialized technical courses). Subjects were

also questioned about whether they had experienced stressful

events in the last two years in their private or professional lives

(respondents were only asked to answer Yes or No, to indicate

whether the stressful events mainly concerned their private or

professional lives, and to indicate the total number of events

where their response was positive) and about whether or not they

had concerns about their health (again, only on a Yes/No basis).

Respondents’ mindfulness levels were assessed using the

French version of the Freiburg Mindfulness Inventory-14 (FMI),

which is a short form with 14 items developed for people with

no background knowledge about mindfulness (Trousselard, et

al., 2010; Walach, et al., 2006). It constitutes a consistent and

reliable scale evaluating several important aspects of mindful-

ness (internal consistency of the scale based on the one-factor

solution was .74, and test-retest reliability was good with an

intra-class correlation coefficient of .80 (p < .01); Trousselard,

et al., 2010). It is considered as one-dimensional for practical

purposes (Kohls, Sauer, & Walach, 2009; Walach, et al., 2006).

Each item is evaluated on a four-point Likert scale from 1

(strongly disagree) to 4 (strongly agree) and, depending on the

suggested time frame, can be used to assess state- or trait-like

components. For the purposes of this study, this short form was

used for measuring respondents’ state of mindfulness.

The personality assessments were conducted by means of the

French (Rolland, 1998) version of the NEO Personality Inven-

tory-Revised (NEO-PIR; Costa & McCrae, 1992). This ques-

tionnaire is a hierarchically structured instrument based on the

Five Factor Model (FFM—Cattell, Cattell, Cattell and Kelly,

1999) measuring five personality domains—Neurotiscism (N),

Extraversion (E), Openness to experience (O), Agreeableness

(A) and Conscientiousness (C)—with each factor having six

subscales for individual facets. Individuals who score high on

Neuroticism are more likely than average to experience feelings

such as anxiety, anger, guilt and depressed moods, and neuroti-

cism scales were expected to have negative correlations with

mindfulness scores (Brown & Ryan, 2003). Individuals with

high Extraversion scores are considered as sociable, active and

more likely to experience positive emotions (Costa & McCrae,

1992), and the association between extraversion and positive

attitudes, optimism, and well-being (Löckenhoff, Sutin, Ferruci,

& Costa, 2008) means it has been predicted to be positively

linked with mindfulness (Baer, Smith, Hopkins, Krietemeyer,

Toney, et al., 2006; Brown & Ryan, 2003). Openness to ex-

perience includes receptivity to novel experiences, actions, and

greater than average interest in imaginative and reflective

thought, so this scale was expected to be positively correlated

with mindfulness scores (Brown & Ryan, 2003). In contrast to

the three domains, studies on the psychological implications of

Agreeableness and Conscientiousness are rather scarce. Agree-

ableness primarily describes interpersonal tendencies: agreeable

individuals are more likely able to gain social support (Hoth,

Christensen, Ehlers, Raichle, & Lawton, 2007), but this proso-

cial orientation has not led researchers to predict any significant

correlation with mindfulness. Conscientiousness has been asso-

ciated with better objective and subjective health, greater vital-

ity and emotional stability (Friedman, 2000; Jerram & Coleman,

1999). Since this factor promotes individuals to act in a delib-

erate fashion and to exercise self-control (Costa & McCrae,

1992), it could conflict with the acceptance of all thoughts—as

102

M. TROUSSELARD ET AL.

characterised by mindfulness—again, therefore, scholars have

not felt able to predict any correlation between conscientious-

ness and mindfulness.

Coping refers to the set of cognitive and behavioural strate-

gies used by individuals to manage the demands of their stress-

ful situations (Folkman & Moskowitz, 2004), and we analysed

the construct using the French version of the Coping Inventory

of Stressful Situation (CISS; Endler & Parker, 1999), a 48-item

self-report questionnaire assessing three general coping styles:

task-oriented, emotion-oriented and avoidance-oriented. Mind-

fulness was predicted to correlate positively with task-oriented

coping, which has been considered to promote effective recov-

ery from many types of stressful situations (Penley, Tomaka, &

Wiebe, 2002; Zeidner & Saklofske, 1996), while task oriented

strategies have been shown to promote mindfulness training

(Baer, et al., 2006, Dobkin, 2008). Conversely, mindfulness

was predicted to correlate negatively with emotion-oriented

coping, since mindfulness training seems to decrease the use of

emotional coping strategies (Baer, et al., 2006, Dobkin, 2008).

Anxiety was checked using the French version of the Spiel-

berger State-Trait-Anxiety Inventory (S-STAI; Spielberger,

1972), a 40-item self-reporting questionnaire divided into 2

subscales. 20 items on the state subscale ask subjects to report

the extent of their anxiety at particular moments, while the

remaining 20 (on the trait subscale) ask respondents to indicate

the intensity of their anxiety in general: both scores were com-

puted in this study. Since mindfulness levels correlate nega-

tively with the anxiety subscale of the 9-item Profile of Mood

states (POMS; McNair, Lorr, & droppleman, 1971), the state

S-STAI level (Brown & Ryan, 2003), and Neuroticism (Baer,

et al., 2006), we predicted negative correlations between mind-

fulness scores and both state and trait anxiety scores.

Alexithymia was assessed using the French version of the

Toronto Alexithymia Scale-20, a 20-item self-reporting ques-

tionnaire (TAS-20, Bagby, et al., 1994) developed from the

original 26-item self-reporting scale (Taylor, Ryan, & Bagby,

1985) which is considered as the standard self-report instrument

for studying three factors that correspond to three of the four

theoretical dimensions of the alexithymia construct (Taylor, et

al., 1985). The first dimension reflects the ability to identify

and describe feelings, and to distinguish between feelings and

bodily sensations, the second reflects the ability to communi-

cate feelings to other people, while the third deals with exter-

nally oriented thinking. (The fourth factor—daydreaming—is

not assessed in the 20-item form.) Both the total score and

those of three individual subscales were computed in this study.

The overall alexithymia score was predicted to correlate nega-

tively with mindfulness, as has been previously reported (Baer,

et al., 2006; Brown & Ryan, 2003; Walach, et al., 2006). In

terms of the individual dimensions, negative correlations were

also expected between the first two and mindfulness—which is

described as the ability to observe and describe feelings—but

we made no prediction as to its association with externally ori-

ented thinking.

Statistical Analysis

All analyses were performed using the SPSS 17.0 software

package. Student’s “t”-test or chi-square were used to study

inter-sample differences, and Pearson correlation coefficients to

analyse relationships between FMI scores and those for other

psychological variables. A linear regression of the correlated

psychological variables on the FMI scores was applied to pro-

vide a context for interpreting the relationships between mind-

fulness and the psychological constructs. Variables are expres-

sed as mean (M) ± standard deviation (SD, square roots of vari-

ance). The effect sizes were estimated, using Cohen’s d (Cohen,

1988). According to Cohen (1988), values above .80 were taken

to indicate large effects and .50 - .80 as moderate effects.

Results

Socio-Demographic Sample (See Table 1)

The descriptive findings for the full sample of 167 respon-

dents showed that more than 98% were men, 91.02% were

between 18 and 36 years (11.37% between 18 and 21, 79.64%

between 21 and 36) and 8.98% were between 37 and 55 . They

were predominantly Caucasian (>75%), 41.31% were married

or living as couples and 35.93% were smokers. They had

served 7.76 ± 6.67 years on active duty. The mean (standard

deviation) number of missions was 3.1 (M = 3.49) ranging from

0 to 15. As might be expected, length of active duty was posi-

tively correlated the number of missions (r = .55; p < .01).

Of the sample population, 108 (64.7%) were from the moun-

tain infantry unit (sub sample 1) and the remaining 59 (35.3%)

served as submariners (sub sample 2). More than 98% of the

mountain infantrymen were men, and all had been engaged in

more than two operational deployments (2.6 ± 2.36). More than

44% (n = 48) reported experience of a recent stressful event in

last years, experiencing a stressful event in recent years, and

more than 16% reported health concerns. All the submariners

were men, and all had engaged in more than five submarine

patrols (5.71 ± 4.14). More than 32% (n = 19) reported experi-

ence of a recent stressful event, but none reported being con-

cerned about their health. No significant differences were ob-

served in terms of educational background, age or matrimonial

status between the two sub samples, although infantrymen

smoked more than submariners. The positive correlation be-

tween length of active duty and the number of missions held in

both samples (r = .72; p < .01 and r = .51; p < .01 for subma-

riners and infantrymen respectively). Infantrymen reported

fewer years of active service, and significantly fewer numbers

of missions than submariners. They also reported a higher rate

of health concerns, and a lower total number of stressful events,

but a higher number of professional stressful events. In terms of

the nature of the stressful events respondents reported for each

sample separately, our results showed that submariners report-

ing slightly more private than professional stressful events

(47.5% to 46.3%; with 6.1% making no response) whereas the

great majority of stressful events reported by infantrymen were

professional (83.4% against 12.4%, with 4.2% no responses).

Psychological Assessments According to the Sub

Samples (See Table 2)

Comparing the two sub samples, significant differences were

observed for state- and trait-anxiety, for task- and avoidance-

oriented coping subscales, and for Neuroticism, Agreeableness,

and Openness to experience scales and subscales scores. The

mountain infantrymen recorded lower mindfulness scores,

higher state- and trait-anxiety scores, lower task-oriented cop-

ing scores, higher avoidance-oriented coping scores, higher

Neuroticism scores, lower Agreeableness scores, and lower

Openness to experience scores. All these effects are strong (d >

.8) as showed in Table 2. 0

M. TROUSSELARD ET AL.

104

Table 1.

Characteristics of respondents: For active duty, and numbers of missions, the sample was divided into two groups according to the respective medians.

Full sample

(n = 167)

Infantry men subsample

(n = 108)

Submariners subsample

(n = 59) Χ2 values p

Qualitative Variables n % n % n %

<36 years 152 91.02 99 91.67 53 89.83

Age

>37 years 15 8.98 9 9.33 6 10.17

.16 p > .05

Married or as couple 69 41.32 46 42.6 23 38.98

Marital status

Divorced or Single 98 58.68 62 57.4 36 61.02

.49 p > .05

No 94 56.29 55 50.93 39 66.1

Yes 60 35.93 53 49.07 7 11.87 Tobacco use

No response 13 7.78 0 0 13 22.03

−2.94 p < .05

No 97 58.08 60 55.55 40 67.8

Stressful

event reported Yes 70 41.92 48 44.44 19 32.2

−.89 p > .05

No 26 37.14 14 29.17 12 54.55

Professional

Stressful event Yes 44 62.86 34 70.83 10 45.45

4.16 p < .05

Undergra-duate studies 81 48.5 57 52.78 24 40.67

Educational

background Graduate studies 86 51.5 51 47.22 35 59.33

1.49 p > .05

No 18 10.78 0 0 18 16.67

Yes 135 85.02 54 91.52 91 83.33 Good health

No response 7 4.19 5 8.48 0 0

8.77 p < .05

Quantitative Variables Mean SD Mean SD Mean SD t values p

Active duty 7.76 6.67 7.09 7.04 9.75 5.01 2.09 p < .05

Number of missions 3.1 3.49 2.6 2.36 5.71 4.14 7.02 p < .05

In terms of the self-reporting of stressful events across the

total sample, those who reported such events were prone to

higher emotional state anxiety, and to task- and emotion-related

coping. Individuals reporting stressful events also recorded

significantly higher scores for some subscales scores of Con-

sciousness, Openness to experience, and Extraversion.

Mindfulness Q u es tionnaire

Psychometric properties: As showed in Table 3, the normal-

ity assumption in both samples was acceptable (p = .17). The

“normal” range (i.e., between −1 and +1 standard deviations

from the mean) is between 34 and 47, and contains about 74%

of the population. In the infantry sub sample, more than 21%

scored below 34 and more than 5% above 47; in the submarin-

ers sub sample, more than 10% scored below 34 and more than

13% above 47.

Dependence of mindfulness scores on demographic variables

(see Table 4, for demographic data): In terms of the mindful-

ness scores in the full sample, the FMI score appeared inde-

pendent of matrimonial status, tobacco use, educational back-

ground, length of active duty, and number of missions, and did

not differ according to the reported experience of stressful

event(s). However, taking into account subjects who reported

stress events only, results showed lower FMI levels for subjects

reporting professional stress experience that for those reporting

private stressful events or reporting neither. Older individuals

tended to record higher levels of mindfulness. Higher rates of

concern for health were associated with lower FMI levels,

while submariners appeared to be more prone than infantrymen

to higher FMI levels. Two separate Pearson correlation analy-

ses—applied between FMI scores and each quantitative vari-

able (active duty and number of missions)—showed no signifi-

cant correlation.

Considering the mindfulness score of each subsample sepa-

rately, similar results were observed for the assessed socio-

demographic variables, except for the relationships with re-

ported stressful events. We observed a tendency for lower

mindfulness levels to be associated with stressful event reports

for submariners ((X2 = 1.79, p = .07) whereas no difference was

observed for infantrymen (X2 = .02, p > .05). Pearson correla-

tion analyses applied separately to each sub-sample for each

quantitative variable (active duty and mission numbers) showed

no significant correlations.

When comparing demographic features according to the

range distribution (below, normal, above), results showed no

significant difference for age, mtrimonial status, reported ex- a

M. TROUSSELARD ET AL.

Table 2.

Scores (Standard Deviations) of the French FMI version and others psychological constructs for the sample according to the military group.

Sample t-test p Effet Size (Cohen’s d)

Variables Full sample

(n = 167)

Infantrymen

(n = 108)

Submariners

(n = 59) MD PV ES

1-State-FMI 39.62 (6.59) 38.77 (5.9) 41.2 (7.5) 2.31 <.05 1.43 1.13 2.15

2-State-anxiety 33.73 (11.61) 35.25 (12.55) 30.96 (9.14) −2.30<.05 −4.78 1.81 −2.64

2-Trait-anxiety 36.96 (10.74) 38.69 (11.19) 33.79 (9.13) −2.88<.01 −4.89 1.6 −3.05

3-TAT 39.6 (6.62) 40.2 (6.79) 38.2 (6.05) −1.72.08

3-Feelings’ identification 10.48 (3.14) 10.76 (3.29) 9.8 (2.66) −1.75.08

3-Feelings’ communication 10.88 (3.13) 11.02 (3.27) 10.55 (2.78) −0.84>.05

3-Externally oriented thinking 18.24 (3.22) 18.42 (3.24) 17.85 (3.18) −1 >.05

4-Task-oriented coping 58.75 (13.97) 57.12 (16.34) 61.67 (7.44) 2 <.05 4.55 1.87 2.42

4-Emotion-oriented coping 40.14 (13.69) 40.49 (14.58) 39.52 (12.05) −0.43>.05

4-Avoidance-oriented coping 41.22 (14.48) 43.43 (16.1) 37.26 (9.92) −2.65<.05 −6.17 2.05 −3.01

5-Openness 105.26 (19.14) 102.45 (16.21) 109.93 (22.59) 2.38 <.01 7.48 3.39 2.2

5-Neuroticism 84.5 (20.36) 88.22 (19.7) 78.34 (20.1) −2.99<.01 −9.87 3.32 −2.97

N1 Anxiety 14.63 (5.12) 14.93 (4.84) 14.15 (5.54) −0.91>.05

N2 Hostility 14.52 (5) 15.63 (4.69) 12.67 (4.99) −3.71<.05 −2.96 0.8 −3.65

N3 Depression 14.08 (5.14) 15.28 (5.11) 12.1 (4.6) −3.88<.05 −3.18 0.79 −3.98

N4 Self-consciousness 15.11 (4.3) 15.28 (4.51) 14.83 (3.96) −0.63>.05

N5 Impulsiveness 16.69 (4.46) 17.26 (4.7) 15.74 (3.9) −2.06<.05 −1.52 0.7 −2.16

N6 Vulnerability 9.46 (4.21) 9.83 (4.36) 8.84 (3.91) −1.41>.05

5-Extraversion 110.43 (17.01) 110.14 (16.75) 110.9 (17.54) 0.26 >.05

E6 Positive emotions 19.25 (4.64) 18.88 (4.75) 19.84 (4.43) 1.24 >.05

5-Agreeableness 112.40 (24.82) 109.18 (26.42) 117.72 (21.06) 2.09 <.05 8.53 3.86 2.21

5-Conscientiousness 122.86 (21.73) 121.27 (19.29) 125.5 (25.3) 1.16 >.05

SD: standard difference, MD: mean difference, PV: pooled variance, ES: effect size (Cohen’s d); Effect sizes > 0.8 were judged as indicators of large effects, and thus

highlighted.

Table 3.

Statistical properties of the French FMI version for the civilian and military working middle-aged sample.

Form French civilian workers Military sample Infantrymen Submariners

Mean 38.98 39.63 38.76 41.2

SD 5.43 6.59 5.91 7.49

Range (theoretical) 14 - 56 (14 - 88) 25 - 62 (14 - 88) 25 - 54 (14 - 88) 30 - 62 (14 - 88)

Kolmogorov-Smirnov (Z) p = .01 (1.57) p = .17 (1.11) p = .74 (.68) p = .71 (1.29)

Kurtosis −.28 .61 −.21 1.88

Skewness 1.12 .30 .11 .31

M. TROUSSELARD ET AL.

Table 4.

Scores (Standard Deviations) of the French FMI version for the full military sample (n = 167) according to the age, marital status, tobacco use,

stressful event reported, educational background, active duty, numbers of missions and nature of missions (units). For educational background, active

duty, and numbers of missions, the sample was divided into two groups according to the respective median.

Variables n % FMI t or Χ2 values* p

<36 years 152 91.02 39.05 (6.61)

Age

>37 years 15 8.98 40.27 (5.99)

−1.63 p = .10

Married or as couple 69 41.32 39.09 (6.15)

Marital status

Divorced or Single 98 58.68 40.04 (6.92)

0.91 p > .05

No 94 56.29 40.15 (7.7)

Yes 60 35.93 38.52 (5.77)

Tobacco use

No response 13 7.78 41 (5.32)

1.48 p = .14

No 97 58.08 40.11 (7.76)

Stressful event reported

Yes 70 41.92 38.95 (5.69)

1.11 p > .05

No 26 37.14 36.72 (5.26)

Professional Stressful event

Yes 44 62.86 42.73 (4.28)

16.23 p = .001

No 18 10.78 39.72 (6.86)

Yes 135 85.02 37.78 (5.23) Good health

No response 7 4.19 41.32 (5.32)

8.77 p = .003

Undergraduate studies 81 48.5 39.28 (7.09)

Educational background

Graduate studies 86 51.5 39.95 (6.11)

−0.65 p > .05

≤6 years 85 50.89 39.39 (7.25)

Active duty

>6 years 82 49.11 39.89 (5.36)

−0.48 p > .05

≤2 69 41.32 39.36 (5.79)

Number of missions

>2 98 58.68 39.81 (7.12)

−0.43 p > .05

Conflict deployment 108 64.67 38.76 (5.91)

Nature of missions (unit)

Surveillance patrol 59 35.33 41.2 (7.49)

2.31 p = .02

Note: Because of the small sample size for the group ranged above 37 years, we used Kruskal-Wallis tests, non-parametric tests, to compare the effect of age on FMI level.

perience of stressful event(s), and tobacco use (X2, p > .05), as

for active duty, educational background, and number of mis-

sions (t; p > .05). For individuals in the lower age range, a ten-

dency to report more concerns about health was observed com-

pare to those in the higher range (X2 = 4.63, p = .09). Moreover,

they reported a significantly higher rate of professional stressful

events that those in the higher range (X2 = 12.55, p = .001).

Psychological Assessments According to the FMI

Score Range (See Table 5)

Kruskal-Wallis tests and non-parametric tests applied to

compare the effects of FMI range groups on the psychological

constructs showed significant differences in all the assessed

questionnaires except for the E, A, and O facets of the NEO-

PIR. Subjects above the normal range were prone to lower state

and trait anxiety, alexithymia, emotion-oriented coping, avoid-

ance-oriented coping, Neuroticism (N1, N2, N3, N6), and

higher task-oriented coping, Conscientiousness and Extraver-

sion that those in and below the normal range. As far as the

TAT and its factor assessments were concerned, no differences

were observed between individuals in the normal range and

those above it. For Extraversion, no difference was observed

between individuals in and below the normal range, nor was

any difference observed between individuals in and above the

normal range for the Positive Emotion (E6) subscale.

Relationship between Mindfulness and Psychological

Assessments (See Table 6)

All the expected negative correlations with mindfulness

(anxiety-state and -trait, alexithymia and its factors, emotion-

and avoidance-oriented coping, N and N-subscales) were ob-

served, as were the predictive positive correlations for Open-

ness, and Task-oriented coping. For the predicted non signifi-

cant correlations (Extraversion and its subscale E6 Positive

106

M. TROUSSELARD ET AL.

Table 5.

Scores (standard deviations) of the psychological constructs for the sample according to the FMI range group.

Variables FMI score < 34

n = 29 (Gr1)

34 < FMI score < 47

n = 129 (Gr2)

FMI score > 47

n = 15 (Gr3) Χ2 values Range group

differences

1-State-anxiety 43.68 (14.08) 32.39 (10.03) 25.07 (4.93) 15.57*** G3 < Gr2 < Gr1

2-Trait-anxiety 45.48 (11.52) 36.02 (9.72) 27.64 (5.39) 18.17*** G3 < Gr2 < Gr1

3-TAT 44.7 (6.16) 38.77 (6.20) 36.17 (6.13) 13.71*** G3 = Gr2 < Gr1

3-Feelings’ identification 12.67 (4.11) 10.15 (2.73) 8.66 (1.77) 13.97*** G3 = Gr2 < Gr1

3-Feelings’ communication 12.85 (3.57) 10.5 (2.87) 10.08 (2.88) 6.33* G3 = Gr2 < Gr1

3-Externally oriented thinking 18.18 (3) 18.11 (3.23) 17.42 (3.39) 6.49* G3 = Gr2 < Gr1

4-Task-oriented coping 53.32 (12.56) 59.02 (14.31) 68 (7.38) 12.78*** G3 > Gr2 > Gr1

4-Emotion-oriented coping 49.42 (13.69) 38.79 (13.22) 32.6 (8.11) 19.45*** G3 < Gr2 < Gr1

4-Avoidance-oriented coping 42.89 (13.07) 40.51 (14.96) 44.23 (13) 3.83

5-Openness 107.48 (18.31) 103.51 (19.01) 116.69 (18.9) 2.24

5-Neuroticism 102.44 (17.17) 83 (18.28) 68.38 (17.79) 18.96*** G3 < Gr2 < Gr1

N1 Anxiety 18.4 (4.37) 14.28 (4.92) 10.53 (3.84) 13.13*** G3 < Gr2 < Gr1

N2 Hostility 17.4 (4.49) 14.37 (4.86) 10.31 (3.9) 8.16** G3 < Gr2 < Gr1

N3 Depression 17.28 (4.74) 13.82 (4.94) 10.23 (4.49) 8.22** G3 < Gr2 < Gr1

N4 Self-consciousness 17 (4.27) 14.94 (4.26) 12.92 (3.59) 8.4** G3 = Gr2 < Gr1

N5 Impulsiveness 19.24 (4.57) 16.46 (4.25) 13.77 (3.98) 3.99

N6 Vulnerability 13.12 (4.04) 9.1 (3.76) 5.61 (3.59) 13.18*** G3 < Gr2 < Gr1

5-Extraversion 103.08 (15.67) 110.51 (16.79) 123.84 (13.69) 6.94* G3 > Gr2 = Gr1

E6 Positive emotions 16.44 (3.84) 19.54 (4.58) 22 (4.38) 8.19** G3 = Gr2 > Gr1

5-Agreeableness 114.08 (23.01) 111.35 (19.52) 118.54 (21) 5.17

5-Conscientiousness 113.68 (17.67) 122.96 (22.09) 139.69 (15.94) 17.38*** G3 > Gr2 > Gr1

emotions), results showed positive correlations. In terms of

those factors where no correlations were predicted—Agree-

ableness and Conscientiousness—a positive correlation was

found between conscientiousness and mindfulness scores.

These correlations remained significant after controlling ei-

ther for the nature of missions (conflict deployment or surveil-

lance/patrol) or the reported experience of stressful event(s),

except that the negative significant correlation between mind-

fulness and the communication of feelings subscale of the TAT

scores disappeared after controlling for the number of missions.

Anxiety-trait, and the Hostility, Depression, Vulnerability

facets of Neurotiscism scores exhibited the highest Pearson

correlation coefficient psychological constructs with Mindful-

ness (r ≥ .04). To examine the extent to which mindfulness

scores might be accounted for by these four psychological con-

structs, a multiple analysis regression (Table 7) was applied to

mindfulness, which showed that more than 29% of the variance

in Mindfulness scores could be accounted for by variance in

these psychological constructs. Results differed considerably

between the three ranges of FMI scores. For the group with

mindfulness scores above the normal range, results showed that

more than 40% of the variance in Mindfulness scores could be

accounted for by variance in these psychological. But for the

normal range, results showed this variance accounted for 16%

of the Mindfulness score variance, while for the group below

the normal range, that figure dropped further to less than 6%.

Furthermore, as shown in Table 7, Vulnerability was the best

predictor for the mindfulness score for the full sample, albeit

with weak predictive power. It was followed by the Hostility

dimension. When regarding individuals in the normal range of

mindfulness range, Hostility was the best predictor for the

mindfulness score for the full sample.

Discussion

The main aim of the study was to analyse the potential of as-

sessing mindfulness for the detection of soldiers’ adaptation

break-points. This problem was studied following the hypothe-

sis, that soldiers with longer deployment histories are more

likely to exhibit subsequent incidents of psychological stress, or

even to develop chronic stress (Juster, et al., 2010; Mc Ewen &

Stellar, 1993; Sapolsky, 2001). To achieve this, we assessed

both psychological variables and the state-mindfulness levels of

subjects from a military populatiassessed by the French on, as

M. TROUSSELARD ET AL.

Table 6.

Pearson’s correlation coefficients between mindfulness and the selected psychological constructs according to the predictions. Pearson’s partial cor-

relation coefficients (grey columns) between mindfulness and the selected psychological constructs controlled by self-report of events and nature of

missions (conflict deployment or surveillance patrol).

Scales and subscales Correlations Controlled by nature of mission Controlled by self-report of event

Predicted negative correlat ions

Neuroticism −.52*** −.52*** −.52***

N1 Anxiety −.38*** −.37*** −.38***

N2 Hostility −.41*** −.32*** −.41***

N3 Depression −.35*** −.37*** −.34***

N4 Self-consciousness −.30** −.29** −.29**

N5 Impulsiveness −.37*** −.35*** −.37***

N6 Vulnerability −.44*** −.42*** −.44**

STAI State Anxiety −.39** −.35*** −.38***

STAI Trait Anxiety −.40** −.37*** −.40***

TAT −.25** −.23** −.25**

Feelings’ identification −.33*** −.30*** −.33***

Feelings’ communication −.18* −.16 −.18*

Externally oriented thinking −.02 −.03 −.02

Emotion-oriented coping −.36*** −.32*** −.36***

Predicted posi tive correlations

Openness .35*** .36*** .36***

Task-oriented coping style .28** .30*** .28**

Predicted non s ignificant cor relations

Extravers ion .32*** .31*** .32***

E6 Positive emotions .37*** .35*** .37***

Non Predicted correlations

Agreeablenes s .13 .16 .13

Conscientiousness .35*** .36*** .36***

Note: * p < .05; ** p < .001; *** p < .0001.

version of the 14-item FMI, according to their levels of expo-

sure to repeated deployment and stressors.

Mindfulness Characteristics of the Military Sample

The first step of the study was to measure the mindfulness

levels of our military population sample to check for any

methodological bias which might have confused the relation-

ships between mindfulness assessments and stress history. The

majority of previous studies have been conducted on students

or patients, so little is known about how mindfulness operates

in a general working population. First, no population selection

bias was observed, since our results showed: 1) the mindfulness

level of our sample soldiers (from either unit), was within the

range observed in middle-aged working French individuals, and

2) presented an acceptable normal distribution (Trousselard, et

al., 2010), given that the normal range contained about 74% of

the military population. Concerning the interaction between

mindfulness measures and matrimonial status, educational

background, and tobacco use, no effect on FMI level was ob-

served in either sub sample as described with the French civil-

ian working population (Trousselard, et al., 2010).

Such results conflict with the well-known epidemiologic data

highlighting loneliness, low educational background and

smoking as risk factors in developing health distress (Engelhard,

van den Hout, & Schouten; 2006; Bjelland, Krokstad, Mykletun,

Dahl, Tell, & Tambs, 2008). One explanation may be supported

by the strong group cohesion which is usually developed in

military units for operating efficiently, especially in infantry

units under extreme stress (Ingraham & Manning, 1981; Shils

108

M. TROUSSELARD ET AL.

Table 7.

Predictors of Mindfulness (stepwise regression model).

Population Predictors R2* R2* adjusted Beta B Std. Err. T Sign. T

Constant 0.31 0.29 52.38 1.75 29.78 <.001

Anxiety-trait −0.18 −0.11 0.06 −1.88 .06

Vulnerability −0.37 −0.58 0.13 −4.17 <.001

Depression 0.12 0.15 0.14 1.05 .29

Full sample

Hostility −0.27 −0.36 0.1 −3.42 <.001

Constant 0.62 0.43 37.53 12.72 2.95 .01

Anxiety-trait 0.53 0.87 0.4 2.16 .06

Vulnerability −0.31 −0.79 0.72 −1.1 .30

Depression 0.67 1.36 0.83 1.62 .14

High mindfulness group

Hostility −0.75 −1.77 0.86 −2.06 .07

Constant 0.18 0.16 45.47 1.27 35.73 <.001

Anxiety-trait −0.07 −0.02 0.03 −0.68 .49

Vulnerability −0.28 −0.24 0.09 −2.58 <.001

Depression −0.06 −0.04 0.09 −0.48 .62

Middle mindfulness group

Hostility −0.14 −0.1 0.07 −1.51 .13

Constant 0.21 0.05 30.23 1.82 16.58 <.001

Anxiety-trait −0.59 −0.1 0.05 −1.93 .06

Vulnerability 0.12 0.05 0.1 À.53 .6

Depression 0.6 0.23 0.11 1.99 .06

Low mindfulness group

Hostility 0.08 0.03 0.09 0.31 .75

B, factor B; Beta, beta coefficient; Std. Err., Standard error of B; T, t-test; Sign. T, significance (T).

& Janowitz, 1948), or to counter the problems of living to-

gether shut away in an isolated environment on a long subma-

rine mission. Indeed, it is well-known that cohesion creates a

sense of commonality and shared experience, creating a social

support mechanism (Griffith, 2002) that both protects against

stressful conditions by helping members adjust to military

situations and promotes further supportive interpersonal rela-

tionships (Griffith & Vaitkus, 1999).

Relationsh i ps be t ween Mindfu l ne ss and the Assessed

Psychologi cal Variabl e s

The second aim of the study was to analyse the relationship

between mindfulness and various psychological dimensions,

independently of the nature of mission and of self-reported

stressful events (i.e., the stress levels experienced). Most of the

studies evaluated the relationship between mindfulness and few

psychological variables. Furthermore, psychological variables

were only used to assess a psychological state or a psychologi-

cal trait. One of the interests of our results was to allow brush-

ing a more general psychological picture, associating both posi-

tive and negative states and traits, of an individual according to

its mindfulness level.

With regard to the whole military sample, the correlations

between FMI scores and those for measures of psychological

variables showed a coherent picture. Low mindfulness is re-

lated with high emotional disturbance levels (Neuroticism,

Depression, Hostility, Impulsiveness, Anxiety, Alexithymia,

emotion-oriented coping, and avoidance-oriented coping) and

high mindfulness is related with positive emotions, (Extraver-

sion, task-oriented coping and, at lesser extent, Openness).

Considering only the highest Pearson correlation coefficients,

we observed that low mindfulness was associated with high

emotional disturbance, which agrees which complements oth-

ers’ findings that high levels of mindfulness indicate a psycho-

logical disposition associated with reduced negative appraisals

of challenging or threatening events (Weinstein, et al., 2009).

Whether or not mindfulness is related to introversion or extra-

version (Baer, et al., 2006), individuals high in Extraversion are

considered as sociable, active, experiencing positive emotions

(Costa & McCrae, 1992) and to be associated with positive

affects, optimism and well-being (Löckenhoff, et al, 2008), so

the links observed among our soldiers between FMI and Extra-

version and between FMI and positive emotions (E6) appear to

be coherent, and to echo the strong positive links that have been

observed between Extraversion and positive emotion with re-

M. TROUSSELARD ET AL.

silience (Campbell-sills, Cohan, & stein, 2006).

Although data on the relationship between mindfulness and

Conscientiousness are scarce, Conscientiousness has been

found to serve as a protection against stress through its influ-

ence on coping strategy selection leading to the greater use of

Problem-Focused coping strategies among peacekeepers (Dir-

kzwager, Bramsen, & van der Ploeg, 2003). Taken together

with the previous correlations, the relationship between high

mindfulness and high Conscientiousness suggests that mind-

fulness is linked with a cognitive way of managing problems,

and with optimism about the self, which is related to self-es-

teem, which has been defined as a perception of oneself as

having strong coping skills, persistence in the face of chal-

lenges, happiness, and longevity (Bandura, 1982; Bauermeister,

Campbell, Krueger, & Vohs, 2003; Chunping, Xiwen, Qian-

zhen, Aili, Bo, & Yongping, 2010; Pruessner, Hellhammer, &

Kirschbaum, 1999).

Thus, a mindful individual appears as an achieving person

with stable (C) and positive (E6) emotions, with a seeking ex-

perience of the world (E), with a task-oriented coping attitude

to adversity, a psychological pattern that suggests such indi-

viduals may experience stress situations as less threatening to

themselves and thus as less stressful. Finally, a high mindful-

ness level may be viewed as an indicator of good adjustment

following adversity—the more mindful individuals have less

stressed brains and so recover from exposure to stressors more

quickly. Such a psychological pattern of mindfulness raises the

question of an overlap between it and resilience.

Resilience has been negatively associated with Neuroticism,

and positively related to Extraversion, Conscientiousness and

optimism. Task-oriented coping has been positively related to

resilience, and has been argued as mediating the relationship

between Conscientiousness and resilience (Campbell-Sills, et

al., 2006; Waugh, Fredrickson, & Taylor, 2008). Such a per-

sonality pattern has been associated with more complete affec-

tive recovery after aversive laboratory stress, suggesting that

people are deemed resilient if they maintain psychological sta-

bility and display an ability to recover effectively from daily

stress experiences with fewer mental health problems (Waugh,

et al., 2008), and these same adaptive outcomes in the face of

adversity have also been observed in mindful individuals.

Mindfulness level, therefore, may constitute a measure of resil-

ience in our military sample—a score over 47 may indicate

protective adaptation and highly resilient individuals, and one

below 34 low resilient subjects who are maladapted to dealing

with distress.

Mindfulness and Stress Experience

The third step was to analyse the sensitivity of the mindful-

ness score to the stress experienced by our sample soldiers. One

view is to consider stress experience as being objective, ana-

lysable using four main variables: the number of missions

linked to overall duration of active service, the operational dif-

ference between populations, the rate of concern of health, and

the rate of reported stress events. The results (which held for

our full military population, i.e., both infantrymen and subma-

riners) show that the FMI scores depended neither on the num-

ber of missions, nor on active duty duration, nor on the reported

total number of stressful events. However the psychological

questionnaires showed that submariners had higher numbers of

missions, a higher rate of stressful events, higher mindfulness

levels, but were less stressed. Compared to mountain infantry-

men, they tended to have lower trait-anxiety, avoidance-ori-

ented coping, lower Neuroticism and alexithymia scores, and

higher task-oriented coping, Agreeableness, and Openness to

experience scores. Higher levels of stressful event reports may

be due to higher numbers of submarine patrols (Corrigan &

Penn, 1999, Reger, Gahm, Swanson, & Duma, 2009), but these

findings not only conflict amongst themselves, but also with

both the well-known association between mental distress rate

and both mission durations and the ratio of deployments (Cor-

rigan & Penn, 1999, Reger, et al., 2009) and the association

previously observed between lower mindfulness scores and

higher experience of stressful events in a non-military middle-

aged population (Trousselard, et al, 2010).

A first explanation for our data may come from a population

selection bias based on personality differences between subma-

riners and infantrymen, in that the choice of serving as subma-

riner requires the ability to live within small groups isolated

from the outside world. Although descriptions in the literature

of submariners’ personality characteristics are scarce, studies

have described them as highly homogeneous groups (van Wilk

& Waters, 2000) but the specific personality factors observed

depended on the dimensional outcomes measurements that

were used. Similar problems exist for military personnel in

general, but, again, since different studies have not used the

same tests findings have differed according to the purpose of

different studies. Psychologists have labelled and developed

tests to understand personality correlates, to profile the person-

ality styles of the successful professional soldier or successful

military leaders, or even to help recruit people more likely to

stay in military service for longer periods, so data are hetero-

geneous between different armed forces and different military

groups. In terms of the psychological dimensions assessed in

our sample on the NEO-PIR scale (Carter, Herbst, Stoller, King,

Kidorf, Costa, & Brooner, 2001; Marshall, De Fruyt, Rolland,

Bagby, 2005), the Alexithymia scale (de Timary, Luts, Hers, &

Luminet, 2008; Stingl, Bausch, Walter, Kagerer, Leichsenring,

& Leweke, 2008), the CISS (Gaudreau & Miranda, 2010) and

the anxiety trait scale (Endler & Kocovski, 2001), they can be

considered as being relatively stable over time for non-clinical

samples. Nevertheless, changes in scores have been described

when subjects suffer distress, as in NEO-PI-R scores for the

Neuroticism (Wilberg, Karterud, Pedersen, Urnes, & Costa,

2009).

Whether the differences in psychological dimensions as-

sessed in this study constitute a selection bias cannot be entirely

refuted, but this must be qualified given the level of distress

outcomes observed among infantrymen, as indicated by their

higher rates of both health concerns and of stressful profes-

sional events reported. As these data clearly depend on the

effects of the job on individuals, another explanation may come

from the nature of the missions themselves. Submariners are

part of a nuclear deterrence force whereas infantrymen are de-

ployed in conflict areas. While some stressors are common to

both populations (extended separation from family members,

working day and night, sleep debt, etc.), others differ: in par-

ticular, infantry deployments carry the risks related to combat

situations—being attacked or ambushed, confronting dead bod-

ies, having someone you know seriously injured or killed, all of

which are known to create a high level of stress, and to lead to

infantrymen experiencing higher numbers of stressful events

than submariners. Consequently, our objective stress experience

110

M. TROUSSELARD ET AL.

analyses highlighted two different patterns of relationships

between mindfulness and stress experience, one for submarin-

ers (characterized by high numbers of patrols, high rates of

private stressful events, low rates of health concerns and higher

mindfulness levels), and the other for infantrymen (less patrols,

more professional stressful events, greater health concerns and

lower mindfulness levels). The first is similar to previous data

from a middle-aged non clinical civilian population (Trousse-

lard, et al., 2010) and may be considered as adaptive, whereas

the second represents a different professional stress context,

which is more associated with distress.

In order to understand better how stress and mindfulness may

interact, the subjective stress experience point of view was also

taken into account. Indeed, it is common assumption among

health studies that the impact of events that are “objectively”

stressful is, to some degree, determined by individuals’ percep-

tions of their stressfulness (see, e.g., Lazarus, 1966; Lazarus &

Folkman, 1984). This approach can involve questionnaires to

check anxiety-state, alexithymia, and coping style, which are

known to reflect individuals’ psychological states at the mo-

ment of the measures, and thus the subjective effect of the “ob-

jective” stress they are experiencing. Anxiety, the outcome

most frequently observed in stressor-exposed men, has been

identified as the primary phenomenon of stress and to have

strong correlations with objective stress in various populations

(Cerclé, Gadea, Hartmann, & Lourel, 2008; Cohen, Kamarck,

& Mermelstein, 1983; Bergdahl & Bergdahl, 2002; Fliege,

Rose, Arck, Walter, Kocalevent, Weber et al, 2005). Our find-

ings of higher anxiety-state levels in infantrymen than in sub-

mariners indicate their higher stress-experience. Alexithymia

characteristics mediate cognitive and affective appraisal be-

tween stressors and stress responses (Berthoz, et al., 1999;

Espina-Eizaguirre, Saenz de Cabezon, Ochoa de Alda, Olariaga,

& Juaniz, 2004; Karukivi, Hautala, Kaleva, Haapasalo-Pesu,

Liuksila, Joukamaa, & Saarijärvi, 2010; Mikolajczak & Lumi-

net, 2006). Alexithymia is also known to contribute to acute

stress disorder, and the TAT score is known to be modified by

encountering stress (Martinez-Sanchez, Ato-Garcia, Corcoles,

Huedo, & Selva, 1998, 2003; Mikolajczak & Luminet, 2006).

Although the difference between the two military units was not

very great, the infantry groups tended to report higher TAT

levels. This was mainly observed for the “identification of

feelings” factor, suggesting a difference in emotional

self-aware- ness. This difficulty in distinguishing between feel-

ings and the bodily sensations of emotional arousal is closely

related to sensitivity to the emotions of others (Lane, 2000;

Lane & Schwartz, 1987). An individual’s capacity to perceive

and to differentiate their own emotions from those of another

person in a given context appears to be crucial for their ability

to manage a variety of emotional states (Bydlowski, Corcos,

Jeammet, Paterniti, Berthoz, Laurier, Chambry, & Consoli,

2005). For those unable to perceive this differentiation, emo-

tions remain global and undifferentiated, reducing their ability

to use their own emotions to guide their selection of adaptive

behaviour. This suggests that infantrymen’s deployments may

disturb their emotional self-awareness and thus lead to their non

optimal adaptation to their environment.

As the effects of stress are directly linked to coping styles,

coping is a useful concept in understanding an individual’s

adaptive capacity and their vulnerability to stress-related dis-

ease. Coping styles have been characterized (in both humans

and animals) as presenting consistent behavioural and neuro-

endocrine characteristics (Hori, Ozeki, Teraishi, Matsuo, Ka-

wamoto, Kinoshita, Suto, Terada, Higuchi, & Kunugi, 2010;

Koolhaas, Korte, De Boer, Van Der Vegt, Van Reenen, Hopster,

De Jong, Ruis, Blokhuis, 1999; Salvador & Costa, 2009). Re-

silience is viewed as an important coping style, which allows an

individual to recover from or avoid the negative outcomes of

stressor conditions and which follows a pattern of high task-

oriented coping and low emotionally-oriented and low avoid-

ance-coping styles, more use of problem solving and social

support-seeking strategies, and so being related to lower PTSD

symptom severity (Dirkzwager, et al., 2003). Longitudinal

studies have shown that individuals’ styles of coping change

over time (Kammeyer-Mueller, Judge, Scott, 2009; Stewart &

Schwarzer, 1996). Intensive and inappropriate emotional reac-

tions show the greatest cross-situational stability and problem

solving efforts the least (Stewart & Schwarzer, 1996), and re-

search has described a tendency to shift toward a more emo-

tional- and/or avoidance-coping style when confronting intense

stressors (Foa & Kozak, 1986; Horowitz, 1986).

However, which coping styles are the most or least sensitive

to changing according to the stressful situations encountered is

still matter of debate (Dirkzwager, et al., 2003; Kammeyer-

Mueller, Judge, Scott, 2009). Different coping patterns were

observed between the two military units: while no differences

in emotion-oriented coping levels were noticed, we found the

infantrymen used fewer task-oriented and more avoidance-

oriented strategies than did the submariners. The data from the

alexithymia literature indicates that, while no difference was

observed between the two units in emotion-oriented coping,

this coping strategy could be disturbed in the less mindful in-

fantrymen (Bydlowski, et al., 2005; Lane, et al., 2000; Lane &

Schwartz, 1987). Low mindfulness levels, which clearly appear

to be associated with less efficient adaptation towards coping

with emotions, could induce a possible shift toward more dis-

turbed emotional relationships with the environment. In line

with the suggestions in the literature that lower mindfulness

levels are linked to higher stressful situations encountered, this

pattern was observed in infantrymen confronted with highly

stressful situations.

The difference in natures of the two units’ missions may ac-

count for the discrepancy in the distribution of their FMI scores,

with twice as many infantrymen as submariners recording

scores below the “normal” range, and only half as many regis-

tering sores above normal. On the basis of subjective stress

experience, and referring to the FMI score distribution we ob-

served, we can propose a descriptive dual model of the extent to

which mindfulness score might be accounted for by the four

psychological constructs (anxiety, vulnerability, hostility, de-

pression, neuroticism). The highest negative association be-

tween mindfulness and the assessed psychological constructs

was observed for subjects at the highest extreme of the mind-

fulness range. This association was less important for the sub-

jects in the normal range. While this model was very good or

acceptable for 79% of the military sample, it was not acceptable

for the 21% who exhibited the lowest mindfulness scores.

The observations that both the percentage of individuals in

the lower range of mindfulness distribution was higher for in-

fantrymen (21%) than for submariners (10%), and that that in

the higher range was lower for infantrymen (5%) than for sub-

mariners (13%) raises a final question as to whether mindful-

ness measures may be altered by exposure to stressors. In our

study, the difference in mindfulness measurements between

M. TROUSSELARD ET AL.

both groups is viewed as the consequence of stress exposure,

rather than of selection bias in the assessed population. Al-

though no difference was observed in terms of relationship

between mindfulness and socio-demographic features between

civilian and military populations, a selection bias from the dif-

ferent personality profiles of individuals entering the different

armed forces cannot be discounted, given the lack of common

assessments of such recruits. Independent of the possibility of a

selection bias between submariners and infantrymen, this aspect

focuses on the stability of the mindfulness dimension. Whether

an individual’s mindfulness score remains exactly the same

across time and situation (i.e., is absolutely stable) is not known:

no studies have measured mindfulness changes when individu-

als face the fluctuating situations encountered in life, nor have

any investigated whether mindfulness changes after the chronic

or acute increases in psychological distress that might be en-

countered by infantrymen on deployment.

However many studies have examined mindfulness after

chronic reductions in psychological distress: indeed, mindful-

ness training - a two hour a week intervention over eight weeks

for reduction in psychological distress—has clearly been shown

to increase mindfulness level in both clinical and non clinical

subjects (Hayes, et al., 1999; Germer, et al., 2005; Grossman,

Niemann, Schmidt, & Walach, 2004; Weinstein, et al., 2009;

Lau, Bishop, Segal, Buis, Anderson, Carlson, Shapiro, & Car-

mody, 2006), although none give information to investigate

whether the mindfulness scores possess arithmetical properties

indicating partial stability. Specifically, it would be interesting

to know whether the relative differences between individual

scores remain the same during the mindfulness training, and

whether, even if they do, the relative positions of individuals

within a group remains the same. Such data could assist in the

investigation of mindfulness as a personality trait, or as a

state-dependant phenomenon, or as an interaction between trait

and state. It could also help to conceptualize categories of

mindfulness or continuous dimensions for analysing it.

More interesting in clinical terms, is that the few studies in-

vestigating long term benefits of meditation have shown sus-

tainable effects on cognitive functions, brain plasticity and

mental health (Aftanas & Golosheykine, 2005; Jha, Kromp-

inger, & Baime, 2007; Lazar, Kerr, Wasserman, Gray, Greve,

Treadway, McGarvey, et al., 2005; Slagter, Lutz, Greischar,

Francis, Nieuwenhuis, Davis, & Davidson, 2007). Although

these findings provide neurophysiological evidence to support

claims of the long-term effects of meditation on emotional sta-

bility, detachment and resilience to stressful events, other stud-

ies have also shown experience-dependent “dose”-effects of

meditation on these neurofunctional networks (Aftanas &

Golocheikine, 2001, 2002; Brefczynski-Lewis, Lutz, Schaefer,

Levinson, & Davidson, 2007; Farb, Segal, Mayberg, Bean,

McKeon, Fatima, & Anderson, 2007). These data from mind-

fulness training suggest that it works by changing the way

mental events are experienced as they arise, on a continuum

according to the time for achieving long term change in the

neurophysiology for practitioners of Mindfulness Meditation,

although these studies do not reveal whether or not individuals

remain in the same category after completing the mindfulness

training programs.

However, our findings may indicate a continuum in the

mindfulness level of individuals which could shape the brain, in

terms of learning and experience-dependent plasticity, allowing

it to govern the functional cerebral networks when the individ-

ual is faced with stress experiences. On this continuum, the

stress encountered could induce three separate patterns of func-

tioning, according to the intensity of the stressors and the level

of mindfulness. Above the normal range could be well adapted

individuals, with a high level of mindfulness who we can con-

sider resilient, and associated with lower psychological distress

and psychopathology costs when facing the allostatic load of a

stress experience (Seeman, Singer, Rowe, Horowitz, & McE-

wen, 1997). The normal range may defined as containing indi-

viduals who adapt themselves to face the stress experiences

they encounter by using responses that are graded in relation to

the allostatic load involved. The lower range category displays

a pathological adaptation, with no assessed relationship be-

tween mindfulness and distress—for such individuals, mind-

fulness may have no reality, so a mindfulness questionnaire is

unfruitful.

These propositions should be considered in light of all of this

study’s limitations: no recruiting data, no baseline for the levels

of mindfulness, no PTSD scale, or for other pathologies derived

from stress. The proposed hypotheses imply the need to con-

duct longitudinal epidemiologic studies evaluating the epige-

netic development of mindfulness levels to investigate whether

the properties of mindfulness can be thought of as being on a

continuum. Further studies are also required to evaluate

whether individual differences in mindfulness scores as meas-

ured after stress experiences may be accounted for by individ-

ual differences in baseline mindfulness scores. Neurophysi-

ological studies to test functional and structural changes before

and after stress experiences could help evaluate the categories

of individuals’ responses, and so help understand the neuro-

physiological functioning of individuals below the normal

range after a high stress experience.

To sum up, our results first have contributed to build a psy-

chological picture of psychological functioning for military

according to the mindfulness level. Second, they have allowed

evaluating how mindfulness may help to deal with stress for

individuals confronted with realistic stressors. Finally, because

mindfulness has to be seen in the context of stress and suffering,

these results are of outstanding importance for health care and

health care research.

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