Past research suggests that the negative consequences related to exposure to traumatic events and injury may impact cohesive work relationships. Additionally, trauma and low cohesive relationships independently predict poorer psychological and physical health in service members. The objective of the present study was to examine the interrelationships between exposure to traumatic events, burnout, and cohesion among tri-service medical and support staff. Surveys were administered to 253 U.S. Army, Army Reserve Units, U.S. Air Force, and U.S. Navy personnel upon arrival in Hawaii for participation in a stressful, 2-week training exercise. Results showed that history of trauma was correlated with poorer view of officers and higher levels on two components of burnout. We discuss how findings can apply to prevention and early intervention efforts.

The U.S. military is composed of a variety of units, large and small, that must quickly adapt to perform widely varying missions. Across missions, the success of each group often depends on a cohesive effort among individuals. Typically, individual service members are required to form group alliances quickly and work together effectively. Most individuals are able to form cohesive group bonds with peers and effective relationships with their leaders. These individuals are perceived as helpful to the group effort and tend to be rewarded. However, individuals who have problems working in group settings are often disregarded by peers and superiors. Poor cohesion tends to perpetuate poor performance and ultimately can lead to career advancement difficulty.

Regardless of institution, positive interpersonal relationships are fundamental in achieving organizational goals.1 Several lines of research have indicated that the extent to which group members feel a part of a group and desire to remain in the group predicts stronger performance at the group level.1-5 Additionally, group cohesion is consistently related to perceptions of job satisfaction, a sense of well-being, and lower levels of disciplinary problems.6 Therefore, there is a need to identify factors that correlate with group cohesion and those that may predict which individuals will be most capable of forming cohesive bonds.

Few studies have examined the impact that traumatic stress exposure can have upon group cohesion. However, there is reason to believe that trauma might impair work-related relationships. Among the widely varying correlates of trauma exposure, sequelae may include emotional numbing and chronic anger,7,8 a belief that the world is a malevolent place,9 and impaired interpersonal relationships.10-12 A study of 1,365 U.S. Army soldiers13 showed that soldiers who were sexually and physically/emotionally maltreated as children reported poorer perception of officers, noncommissioned officers (NCOs), and their peers. This group14 also showed that report of trauma and unit cohesion independently predicted poorer psychological and physical health among soldiers. Overall, these findings provide reason to believe that the negative consequences related to trauma may impact cohesive work relationships.

Attachment theory has been used to explain the sequelae of trauma. Attachment refers to one’s set of expectations about relationships, based on expectations developed from previous experiences with relationships.15 When previous relationships are warm and responsive to an individual’s needs, the individual will develop a “secure” attachment style. In secure attachments, future relationships are expected to provide warmth and responsivity, and the individual sees others as trustworthy. When previous relationships are not responsive to the individual’s needs, the individual will develop an “insecure” attachment style. Such an individual tends to see others as untrustworthy, nonresponsive, and in some cases, abusive.

A traumatic experience can have a major impact on attachment ability.12 Insecure adult attachment style is more likely in those who have trauma histories and post-traumatic stress disorder (PTSD) symptoms, including combat veterans and prisoners of war.16-18 McFarlane and Bookless12 propose that interpersonal trauma can become embedded in the memory structure of an individual, leading him/her to avoid other people. Because secure attachment ability is a necessary foundation for healthy interpersonal relationships, trauma exposure may lead individuals to become distrustful of others and avoid social interactions. Moreover, social situations may become associated with the trauma, thus serving as a trigger for intrusive memories of the event and other trauma symptoms. When traumatic events are work related, such events may also lead individuals to feel betrayed by the “system” that they expected to protect them. Such an impact would then likely impact cohesion with peers and leaders.

A second work-related factor that may be impacted by trauma is burnout. Burnout is a particular form of occupational stress that refers to how poorly a person is coping, reflecting both the cumulative amount of job stress a person can handle and the effectiveness of his or her coping style.19 Drawing from extant quantitative and qualitative research, Maslach20 proposed that the burnout construct consists of three separate but interrelated dimensions: emotional exhaustion, depersonalization, and personal accomplishment. The first factor, emotional exhaustion, refers to the depletion or draining of physical, mental, and emotional resources.21 Depersonalization refers to a lack of enthusiasm for one’s work and cynicism that one’s work does not contribute to a meaningful goal.20 The third factor, personal accomplishment, refers to a feeling of productivity and fulfillment related to one’s work role.21 Thus, individuals who suffer burnout tend to feel ineffectual, have cynical attitudes, and have little energy to contribute to their organization.