Stress Resilience Training System
Condition: Stress; Anxiety; Depression; PTSD
MeSH terms: Depression
Study type: Interventional

Summary: 
      The Stress Resilience Training System (SRTS) program is a stress reduction and resilience
      building system that blends cognitive training to anticipate the effects of stress with
      advanced biofeedback to mitigate stress effects and aftereffects, using a game-based learning
      framework on an iPad platform.

      The proposed study will evaluate the effectiveness of the SRTS program at reducing perceived
      stress, PTSD symptoms, depression, anxiety, sleep quality, coping, attrition and
      class/operational performance among United States Navy service members.
    

Detailed description: 
      Military operations and training situations present many physical and psychological
      challenges for service members to adapt to and overcome. The challenges of these changing
      conditions necessitate having to cope with stress, which is seen as the negative perceptions,
      feelings, and emotions that manifest from the subjective physical and/or mental strain on
      life processes. In addition, service members are returning from deployments having gone
      through traumatic experiences that can develop into posttraumatic stress disorder (PTSD),
      depression or other serious conditions.

      In an increasing number of military personnel, the adverse effects of service and
      particularly of stressful combat exposure are significant, long lasting and possibly fatal.
      Most stress research is focused on treatment, but because stress effects are liable to appear
      years after exposure, it is imperative that methodologies be developed to mitigate the
      adverse effects of military-related stress and prevent its post-exposure effects.

      It has long been accepted that warfighters adapt to combat stress after the first few
      experiences and that training can help duplicate this process, with recent studies showing
      that experienced military personnel are able to control and even utilize stress productively.
      A key part of what experienced personnel learn is self-awareness of their stress state and
      self-regulation of stress energy in order to maintain or even improve performance. These
      skills can be greatly enhanced by combining cognitive learning methodologies grounded in
      learning theory and biofeedback techniques based on Heart Rate Variability (HRV) with
      innovative simulation and game-based training tools.

      The Stress Resilience Training System (SRTS) program is a stress reduction and resilience
      building system that blends cognitive training to anticipate the effects of stress with
      advanced biofeedback to mitigate stress effects and aftereffects, using a game-based learning
      framework on an iPad platform.

      The proposed study will evaluate the effectiveness of the SRTS program at reducing perceived
      stress, PTSD symptoms, depression, anxiety, sleep quality, coping, attrition and
      class/operational performance among United States Navy service members.
    

Intervention name(s): Stress Resilience Training System (SRTS); Progressive Muscle Relaxation (PMR)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): SRTS training provides both cognitive learning and training in a scientifically-designed stress resilience training approach designed to minimize the adverse effects of stress and also enhance its positive effects. In summary, the SRTS training comprises: (1) Cognitive rules and mental exercises based on expert knowledge and research; (2) Biofeedback stress control exercises based on proven HRV (Heart Rate Variability) algorithms developed by the Institute of HeartMath; and (3) E-Learning presentation of games and simulations to motivate younger trainees. The training is designed to familiarize participants with the iPad and the SRTS program. Participants will be told how to use the system and how often to use the system. SRTS program participants will each be assigned an iPad to take home with them and practice the techniques for a period of two months.; Progressive muscle relaxation is the systematic tensing and relaxing of 16 different muscle groups, starting with one's toes and ending with one's head (Jacobson, 1938; Conrad & Roth, 2007). PMR users are instructed to inhale as they tense the muscles and exhale as they release the tension. Participants will participate in a two-hour PMR training. PMR participants will be given iPADs with a video recording that guides the user through working each muscle group while instructing them to focus on positive thoughts and feelings and breathing techniques. PMR program participants will each be assigned an iPad to take home with them and practice the techniques for a period of two months.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Resilience; Perceived stress; PTSD symptoms; Depression; Anxiety; Sleep quality; United States Navy service members