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Baseline Burnout Symptoms Predict Visuospatial Executive Function During Survival School Training in Special Operations Military Personnel

  • Charles A. Morgan (a1) (a2), Bartlett Russell (a3), Jeff McNeil (a4), Jeff Maxwell (a5), Peter J. Snyder (a6), Steven M. Southwick (a1) (a2) and Robert H. Pietrzak (a1) (a2)...


Burnout symptoms, which are characterized by exhaustion, cynicism, and a reduced sense of professional efficacy, may deleteriously affect cognitive function in military personnel. A total of 32 U.S. Military Special Operations personnel enrolled in Survival School completed measures of trauma history, dissociation, and burnout before training. They then completed the Groton Maze Learning Test (GMLT), a neuropsychological measure of integrative visuospatial executive function during three field-based phases of Survival School—enemy evasion, captivity/interrogation, and escape/release from captivity. Lower pre-training perceptions of professional efficacy were associated with reduced executive function during all of the field-based phases of Survival School, even after adjustment for years of education, cynicism, and baseline GMLT scores. Magnitudes of decrements in executive function in Marines with low efficacy relative to those with high efficacy increased as training progressed and ranged from .58 during enemy evasion to .99 during escape/release from captivity. Pre-training perceptions of burnout may predict visuospatial executive function during naturalistic training-related stress in military personnel. Assessment of burnout symptoms, particularly perceptions of professional efficacy, may help identify military personnel at risk for stress-related executive dysfunction. (JINS, 2011, 17, 494–501)


Corresponding author

Correspondence and reprint requests to: Robert H. Pietrzak, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, and Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue/151E, West Haven, CT 06516. E-mail:


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Ahola, K., Honkonen, T., Kivimaki, M., Virtanen, M., Isometsa, E., Aromaa, A., Lönnqvist, J. (2006). Contribution of burnout to the association between job strain and depression: The health 2000 study. Journal of Occupational and Environmental Medicine, 48, 10231030.
Benight, C.C., Bandura, A. (2004). Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behaviour Research and Therapy, 42, 11291148.
Bremner, J.D., Krystal, J.H., Putnam, F.W., Southwick, S.M., Marmar, C., Charney, D.S., Mazure, C.M. (1998). Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS). Journal of Traumatic Stress, 11, 125136.
Chen, K.H., Chuah, L.Y., Sim, S.K., Chee, M.W. (2010). Hippocampal region-specific contributions to memory performance in normal elderly. Brain and Cognition, 72, 400407.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Connor, K.M., Davidson, J.R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 7682.
De Vente, W., Olff, M., Van Amsterdam, J.G., Kamphuis, J.H., Emmelkamp, P.M. (2003). Physiological differences between burnout patients and healthy controls: Blood pressure, heart rate, and cortisol responses. Occupational and Environmental Medicine, 60(Suppl. 1), i54i61.
Gaab, J., Blattler, N., Menzi, T., Pabst, B., Stoyer, S., Ehlert, U. (2003). Randomized controlled evaluation of the effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects. Psychoneuroendocrinology, 28, 767779.
Horner, M.D., Hamner, M.B. (2002). Neurocognitive functioning in posttraumatic stress disorder. Neuropsychology Review, 12, 1530.
Johnson, D.C., Polusny, M.A., Erbes, C.R., King, D., King, L., Litz, B.T., Southwick, S.M. (in press). Development and initial validation of the Response to Stressful Experiences Scale (RSES). Military Medicine.
Lieberman, H.R., Bathalon, G.P., Falco, C.M., Kramer, F.M., Morgan, C.A. 3rd, Niro, P. (2005). Severe decrements in cognition function and mood induced by sleep loss, heat, dehydration, and undernutrition during simulated combat. Biological Psychiatry, 57, 422429.
Lieberman, H.R., Bathalon, G.P., Falco, C.M., Morgan, C.A. 3rd, Niro, P.J., Tharion, W.J. (2005). The fog of war: Decrements in cognitive performance and mood associated with combat-like stress. Aviation, Space, and Environmental Medicine, 76(7 Suppl.), C7C14.
Maslach, C., Jackson, S.E., Leiter, M.P. (1996). Maslach Burnout Inventory manual. Palo Alto, CA: Consulting Psychologist Press.
Maslach, C., Schaufeli, W.B., Leiter, M.P. (2001). Job burnout. Annual Review of Psychology, 52, 397422.
Mathewson, K.J., Dywan, J., Snyder, P.J., Tays, W.J., Segalowitz, S.J. (2008). Aging and electrocortical response to error feedback during a spatial learning task. Psychophysiology, 45, 936948.
Morgan, C.A. 3rd, Cho, T., Hazlett, G., Coric, V., Morgan, J. (2002). The impact of burnout on human physiology and on operational performance: A prospective study of soldiers enrolled in the combat diver qualification course. Yale Journal of Biology and Medicine, 75, 199205.
Morgan, C.A. 3rd, Doran, A., Steffian, G., Hazlett, G., Southwick, S.M. (2006). Stress-induced deficits in working memory and visuo-constructive abilities in Special Operations soldiers. Biological Psychiatry, 60, 722729.
Morgan, C.A. 3rd, Hazlett, G., Wang, S., Richardson, E.G. Jr., Schnurr, P., Southwick, S.M. (2001). Symptoms of dissociation in humans experiencing acute, uncontrollable stress: A prospective investigation. American Journal of Psychiatry, 158, 12391247.
Morgan, C.A. 3rd, Krystal, J.H., Southwick, S.M. (2003). Toward early pharmacological posttraumatic stress intervention. Biological Psychiatry, 53, 834843.
Morgan, C.A. 3rd, Rasmusson, A., Pietrzak, R.H., Coric, V., Southwick, S.M. (2009). Relationships among plasma dehydroepiandrosterone and dehydroepiandrosterone sulfate, cortisol, symptoms of dissociation, and objective performance in humans exposed to underwater navigation stress. Biological Psychiatry, 66, 334340.
Morgan, C.A., Southwick, S.M., Hazlett, G., Dial-Ward, M. (2008). Baseline dissociation and prospective success in special forces assessment and selection. Psychiatry, 5, 5358.
Morgan, C.A. 3rd, Wang, S., Mason, J., Southwick, S.M., Fox, P., Hazlett, G., Greenfield, G. (2000) (Hormone profiles in humans experiencing military survival training. Biological Psychiatry, 47, 891901.
Ohman, L., Nordin, S., Bergdahl, J., Slunga Birgander, L., Stigsdotter Neely, A. (2007). Cognitive function in outpatients with perceived chronic stress. Scandinavian Journal of Work and Environmental Health, 33, 223232.
Onen Sertoz, O., Tolga Binbay, I., Koylu, E., Noyan, A., Yildirim, E., Elbi Mete, H. (2008). The role of BDNF and HPA axis in the neurobiology of burnout syndrome. Progress in Neuropsychopharmacology and Biological Psychiatry, 32, 14591465.
Paulus, M.P., Potterat, E.G., Taylor, M.K., Van Orden, K.F., Bauman, J., Momen, N., Swain, J.L. (2009) A neuroscience approach to optimizing brain resources for human performance in extreme environments. Neuroscience and Biobehavioral Reviews, 33, 10801088.
Pickering, M.A., Hammermeister, J., Ohlson, C., Holliday, B., Ulmer, G. (2010). An exploratory investigation of relationships among mental skills and resilience in Warrior Transition Unit cadre members. Military Medicine, 175, 213219.
Pietrzak, R.H., Fredrickson, A., Snyder, P.J., Maruff, P. (2010). A comparison of statistical approaches used to evaluate change in cognitive function following pharmacologic challenge: An example with lorazepam. Human Psychopharmacology, 25, 335341.
Pietrzak, R.H., Maruff, P., Mayes, L.C., Roman, S.A., Sosa, J.A., Snyder, P.J. (2008). An examination of the construct validity and factor structure of the Groton Maze Learning Test, a new measure of spatial working memory, learning efficiency, and error monitoring. Archives of Clinical Neuropsychology, 23, 433445.
Pietrzak, R.H., Maruff, P., Snyder, P.J. (2009b). Convergent validity and effect of instruction modification on the Groton Maze Learning Test, a new measure of spatial working memory and error monitoring. International Journal of Neuroscience, 119, 11371149.
Pietrzak, R.H., Maruff, P., Snyder, P.J. (2009a). Methodological improvements in quantifying cognitive change in clinical trials: An example with single-dose administration of donepezil. Journal of Nutrition, Health, and Aging, 13, 268273.
Robbins, T.W., Arnsten, A.F. (2009). The neuropsychopharmacology of fronto-executive function: Monoaminergic modulation. Annual Review of Neuroscience, 32, 267287.
Roelofs, J., Verbraak, M., Keijsers, G.P.J., de Bruin, M.B.N., Schmidt, A.J.M. (2005). Psychometric properties of a Dutch version of the Maslach Burnout Inventory General Survey (MBI-DV) in individuals with and without clinical burnout. Stress and Health, 21, 1725.
Sandstrom, A., Rhodin, I.N., Lundberg, M., Olsson, T., Nyberg, L. (2005). Impaired cognitive performance in patients with chronic burnout syndrome. Biological Psychology, 69, 271279.
Schnurr, P., Vielhauer, M., Weathers, F., Findler, M. (1999). The Brief Trauma Questionnaire. White River Junction, VT: National Center for Posttraumatic Stress Disorder.
Snyder, P.J., Bednar, M.M., Cromer, J.R., Maruff, P. (2005). Reversal of scopolamine-induced deficits with a single dose of donepezil, an acetylcholinesterase inhibitor. Alzheimer's & Dementia, 1, 126135.
Snyder, P.J., Werth, J., Giordani, B., Caveney, A.F., Feltner, D., Maruff, P. (2005). A method for determining the magnitude of change across different cognitive functions in clinical trials: The effects of acute administration of two different doses alprazolam. Human Psychopharmacology, 20, 263273.
Ursin, H., Eriksen, H. (2010). Cognitive activation theory of stress (CATS). Neuroscience and Biobehavioral Reviews, 34, 877891.
Whealin, J.M., Batzer, W.B., Morgan, C.A. 3rd, Detwiler, H.F. Jr., Schnurr, P.P., Friedman, M.J. (2007). Cohesion, burnout, and past trauma in tri-service medical and support personnel. Military Medicine, 172, 266272.
Wingenfeld, K., Schulz, M., Damkroeger, A., Rose, M., Driessen, M. (2009). Elevated diurnal salivary cortisol in nurses is associated with burnout but not with vital exhaustion. Psychoneuroendocrinology, 34, 11441151.
Wingo, A.P., Fani, N., Bradley, B., Ressler, K.J. (2010). Psychological resilience and neurocognitive performance in a traumatized community sample. Depression and Anxiety, 27, 768774.


Baseline Burnout Symptoms Predict Visuospatial Executive Function During Survival School Training in Special Operations Military Personnel

  • Charles A. Morgan (a1) (a2), Bartlett Russell (a3), Jeff McNeil (a4), Jeff Maxwell (a5), Peter J. Snyder (a6), Steven M. Southwick (a1) (a2) and Robert H. Pietrzak (a1) (a2)...


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