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criteria were (1) peer-reviewed research articles written or FIGURE 1 Preferred Reporting Items for Systematic Reviews and
translated into English; (2) titles indicating resilience was the Meta-Analyses flow diagram.
main topic; (3) articles with titles indicating military popula-
tions’ resilience, or resilience in veteran, military, or combat CINAHL, PsycInfo, Mil/Gov, PubMed, Google Scholar
situations was specifically studied; and (4) published within 138 Citation(s)
the past 20 years (up to mid-2018). Exclusion criteria were (1)
resilience studied solely in civilian children and adolescents; 134 Non-Duplicate
(2) resilience in civilian organizations separate from the mil- Citations Screened
itary or armed conflicts; (3) articles that were in a language
other than English; (4) works on resilience in textbooks, man- Inclusion/Exclusion 101 Articles Excluded
uals, and/or self-help books without clear empirical basis; (5) Criteria Applied After Title/Abstract Screen
resilience in populations with a chronic physiological disease;
and (6) resilience in populations caring for a loved one with
a chronic disease or special needs. Quantitative, qualitative, 33 Articles Retrieved
mixed-methods, and concept analyses were included for re-
view. Data evaluation commenced via constructing an evi- Inclusion/Exclusion
1 Article Excluded
2 Articles Excluded
dence table by which final samples of literature were included Criteria Applied After Full Text Screen During Data Extrraction
and examined (see online Appendix).
32 Total Articles Included, Plus 2 found from hand-searches
Results
Ultimately, 32 articles met inclusion criteria. Of those, 27 were
based in quantitative methods, one was mixed methods (e.g., Canadian Forces Recruit Health Questionnaire, resilience was
researchers combined quantitative and qualitative methods), captured through elements of conscientiousness, emotional
and four qualitative articles were examined. We found resil- stability, and mastery (e.g., “I can accomplish anything I set
ience is implemented programmatically throughout the mili- my mind to”), which were associated with constructs of men-
tary intended as a salutogenic (i.e., a curative) method used tal health—not psychopathology, such as PTSD—after de-
to ward off deleterious effects of traumatic stress. Overall, re- ployments. In fact, Lee et al. found lengths of service and
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silience remained mostly couched as an elemental trait versus deployment experiences actually decreased neuroticism and
a contextual response, elicited in reaction to environmental increased resilience. Combat experiences did have an effect
stress or threats. Quantitative resilience research mostly used on post-deployment mental health, though main effects of
instruments of measurement to capture participants’ self- deployments and combat experiences were small, and agree-
reported resilience, yet no recent studies critically examined ableness was the main personality trait that moderated associ-
variables and underlying concepts constructing the instru- ations between the two. 40
ments they used.
In contrast, American military resilience researchers’ cross-
Most quantitative research of resilience in the military used sectional results deviate from longitudinal findings of Lee et al.
operationalized variables in psychometric instruments, though of deployments’ effects on resilience. In 2011, Peterson et al.
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none was notably critical in examining resilience as a con- attributed poor mental health (e.g., PTSD) to “deployments
struct. Detailed analysis of accepted articles’ evidence rating that are repeated, extended, and at a fast tempo.” In 8,000
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is found in the evidence table (see Appendix); article selection US Army Soldiers of multiple ranks, Peterson et al. measured
is noted in Figure 1 within a Preferred Reporting Items for resilience within the Global Assessment Tool (GAT), which
Systematic Reviews and Meta-Analyses (healthcare) diagram measures resilience within overall psychosocial well-being.
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to visually represent the flow of accepted evidence into the The GAT is used to evaluate the success of the Comprehensive
integrative review. 38 Soldier Fitness (CSF) program, designed to improve Soldiers’
emotional, social, family, and spiritual fitness, all considered
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Quantitative Studies: Resilience Measurement Literature by those investigators as resilience domains.
Resilience measured in military populations (i.e., resilience
quantified via operationalized variables in an instrument of Programs such as CSF center on resilience building in mili-
measurement) revealed additional variation in definitions and tary populations and are typically compulsory for US Army
use of proxy measures. Meadows et al. explains that the De- Servicemembers. Results from the GAT are given to Soldiers’
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partment of Defense (United States; DoD) does not have an of- commanders: “[the] GAT provide[s] a way to articulate the
ficial, force-wide, consistent definition of resilience. Lee et al. strengths and assets of an individual soldier’s own self as well
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likewise indicated resilience in the military is defined vaguely as those with whom [they] work . . . when a soldier com-
and definitions imply there are multiple cognitive and behav- pletes the GAT, immediate feedback about his or her profile
ioral elements. Lack of clear conceptual definition is reflected of strengths is provided.” Soldiers’ results are compared with
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in variances in studies’ particular measurements and methods. those of their peers. For example, if a Soldier scores a 3.9 out
of 5 in resilience but everyone else in their unit scores a 4.2, the
Resilience measured within broader military assessments Soldier with a 3.9 could be flagged as deficient. Developers of
In contrast to most cross-sectional quantitative studies of resil- the GAT cite α coefficients greater than .80 in their description
ience in the American military, Lee et al. studied the resilience of GAT psychometrics but note that none of the initial 180
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of Canadian Forces personnel longitudinally: at baseline and GAT questions inquire about Soldiers’ depression or suicide
then approximately 4 years later. All participants had com- risk: “To avoid legal issues, we did not include questions ask-
bat experience. In 1,315 Servicemembers using the broader ing explicitly about suicidal or violent thoughts and actions.” 41
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