In physically and cognitively demanding professions, individuals face heightened risks of injury, illness, and attrition due to various physical and psychological stressors. A recent longitudinal study published in the journal Stress and Health explored these risks among candidates enrolled in the United States Army Special Forces Assessment and Selection (SFAS) course.
The study followed 792 candidates over a two-year period, examining the cumulative incidence of injuries, illnesses, and attrition. It aimed to identify modifiable factors at the time of enrollment that could influence these outcomes. Candidates completed surveys assessing psychological, sleep, and nutrition status, while anthropometric measurements and physical performance tests were conducted. Additionally, fasted blood samples were collected for physiological and nutritional biomarker analyses.
Logistic regression analyses were employed to determine baseline factors associated with the two-year incidence of injury, illness, or attrition. The findings revealed several key associations:
- Slower road march times were linked to a 25%-66% increase in the odds of experiencing injury, mental or behavioral illness, sleep disorders, and separation from service.
- Conversely, greater resistance training, improved sleep quality, and higher protein intake correlated with an 18%-45% reduction in the odds of injury.
- Interestingly, elevated morning cortisol levels at enrollment were associated with a 23% decrease in the odds of mental or behavioral illness.
- Negative mood, poor sleep quality, and lack of social support were each linked to a 28%-31% increase in the odds of separation from service.
These findings underscore the importance of addressing modifiable factors such as physical fitness, nutritional intake, sleep quality, and social support to mitigate risks associated with demanding military roles. By targeting these areas, it may be possible to enhance resilience and retention among Special Forces candidates.
What this study does not show
This study does not establish causation between the identified factors and the outcomes of injury, illness, or attrition, as it is observational in nature.
Evidence scorecard
- Analytic validity: established
- Clinical validity: partial
- Clinical utility: not established
The evidence is based on primary research involving human participants.