Background: Alcohol use disorder (AUD) has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting of cognitive training. The advent of computer-based interventions may leverage these improvements, but randomized controlled trials (RCTs) of digital interactive-based interventions are still scarce. Objective: The aim of this study is to explore whether a cognitive training approach using VR exercises based on activities of daily living is feasible for improving the cognitive function of patients with AUD undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs. Methods: This study consisted of a two-arm pilot RCT with a sample of 36 individuals recovering from AUD in a therapeutic community; experimental group participants received a therapist-guided, VR-based cognitive training intervention combined with treatment as usual, and control group participants received treatment as usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre- and postassessments, including measurement of global cognition, executive functions, attention, visual memory, and cognitive flexibility. Results: In order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled for in the statistical analysis for each individual outcome. Results indicate intervention effects on attention in two out of five outcomes and on cognitive flexibility in two out of six outcomes, with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies. Conclusions: Overall, the data suggest that VR-based cognitive training results in specific contributions to improving attention ability and cognitive flexibility of patients recovering from AUD. Trial Registration: ClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Burnout, characterized by Emotional Exhaustion (EE), Depersonalization (DP), and Reduced Personal Accomplishment (PA), is a significant occupational hazard. Although extensively studied in other contexts, its prevalence and predictors among Portuguese military personnel have not been explored. This study investigates burnout prevalence and its sociodemographic and organizational predictors within the Portuguese Army. A total of 437 active-duty personnel completed the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) alongside sociodemographic and organizational questionnaires. Results revealed that 2.3% of participants exhibited burnout across all dimensions, while 25.2% demonstrated engagement (low scores in all dimensions). High EE, DP, and PA were reported by 35.7%, 13.7%, and 45.5% of respondents, respectively. Logistic regression identified key burnout predictors: feeling undervalued by superiors, being enlisted, and being single significantly increased burnout risk. These findings align with the Job Demands-Resources model, highlighting how low support, high workload, and job insecurity exacerbate burnout, while marital support and stability mitigate it. Despite relatively low burnout prevalence, the study emphasizes the need for targeted interventions. Promoting supportive leadership, recognition, and preventive strategies is essential to improve well-being and operational performance in the military.

Previous research has reported a low prevalence of burnout syndrome in the Portuguese Army. However, it did not explore the internal heterogeneity within the army. Since burnout can manifest in qualitatively different ways among army personnel, overall averages may conceal distinct profiles. This study employed latent profile analysis to identify distinct person-centered profiles along the burnout–engagement continuum based on the three dimensions of the Maslach Burnout Inventory–Human Services Survey. A total of 430 active-duty military personnel completed the instrument and a sociodemographic-organizational questionnaire. Results revealed three profiles: ineffective (33%), engagement (45.6%), and burnout (21.4%). Multinomial logistic regression identified significant predictors of profile membership. Feeling valued by the unit commander strongly increased the likelihood of being in the Engagement profile. Performing ≥ 9 monthly duty shifts significantly raised the odds of being in the Ineffective profile. Older age was a protective factor. These findings highlight the role of recognition, workload, and age in shaping burnout vulnerability in military settings. Public Significance Statement : Nearly one in three Portuguese Army personnel exhibit moderate to high levels of burnout symptoms. This is closely linked to feeling undervalued by leadership, high monthly duty shifts, and younger age. Promoting supportive leadership, recognizing individual contributions, and adjusting workload intensity may help reduce burnout. These actions can foster mental well-being, increase morale, and support long-term operational effectiveness and retention within the military.

BACKGROUND Alcohol use disorder (AUD) has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting of cognitive training. The advent of computer-based interventions may leverage these improvements, but randomized controlled trials (RCTs) of digital interactive-based interventions are still scarce. OBJECTIVE The aim of this study is to explore whether a cognitive training approach using VR exercises based on activities of daily living is feasible for improving the cognitive function of patients with AUD undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs. METHODS This study consisted of a two-arm pilot RCT with a sample of 36 individuals recovering from AUD in a therapeutic community; experimental group participants received a therapist-guided, VR-based cognitive training intervention combined with treatment as usual, and control group participants received treatment as usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre- and postassessments, including measurement of global cognition, executive functions, attention, visual memory, and cognitive flexibility. RESULTS In order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled for in the statistical analysis for each individual outcome. Results indicate intervention effects on attention in two out of five outcomes and on cognitive flexibility in two out of six outcomes, with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies. CONCLUSIONS Overall, the data suggest that VR-based cognitive training results in specific contributions to improving attention ability and cognitive flexibility of patients recovering from AUD. CLINICALTRIAL ClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345

Burnout constitutes a critical psychological and operational challenge in military environments, with potential implications for well-being and occupational functioning. Mindfulness-Based Cognitive Therapy has shown beneficial effects on stress and burnout across different populations; however, little is known about how brief online adaptations are perceived by active-duty military personnel prior to implementation. This qualitative study explored the prospective acceptability of a proposed brief online Mindfulness-Based Cognitive Therapy program and identified perceived implementation considerations within the Portuguese Army. Fifteen participants (11 men and 4 women) took part in semi-structured interviews, which were analyzed using reflexive thematic analysis within a constructivist framework. Five themes were identified: previous experiences with psychological services, prospective acceptability of the proposed program, practical and cultural barriers, conditions for implementation, and preferences regarding format and facilitation. Participants generally viewed the proposed program favorably and identified brevity, confidentiality, scheduling flexibility, digital access, leadership support, and facilitator credibility as potentially important for future implementation, while stigma and workload were perceived as relevant barriers. These findings reflect prospective perceptions rather than actual intervention feasibility or effectiveness. Public Significance Statement: This study identifies key factors influencing how active-duty military personnel perceive a proposed brief online mindfulness-based intervention before implementation.