Psychological and Spiritual Factors Affecting Well-Being Among Military Personnel Engaged in Remote Combat

Introduction: Remotely piloted aircraft (RPA) require multiple crewmembers to successfully operate the aircraft. RPAs shape modern warfare and pose challenges for the spiritual-emotional health of RPA personnel. This study explored whether (a) RPA crewmembers could be separated into groups based on their experiences, (b) the groups differed in psychological health outcomes, and (c) they differed in aspects of spiritual well-being. Method: Participants included 354 United States Air Force personnel involved in RPA duty. Participants provided demographic information and completed the Work Role Strain Scale as a predictor. Outcome measures included job satisfaction, the Maslach Burnout Inventory, Outcome Questionnaire-45.2, Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), and medical complaints and psychosocial services indices. The Spiritual Well-Being Scale and Unit Cohesion Scale were assessed as moderating factors. Results: Cluster analysis identified two groups of crewmembers. Psychologically healthy participants included 73.4% of crewmembers (n = 260); the remaining 26.6% (n = 94) were distressed. The distressed group included more imagery analysts, weapon-strike pilots, and females, and fewer sensor operators and males compared with the healthy group. Symptoms among the distressed group included more psychological difficulties and PTSD symptoms, more medical complaints, and greater use of psychosocial services. The distressed group reported greater work-role conflict, role ambiguity, work overload, relationship stress, emotional exhaustion, and cynicism as well as lower job satisfaction, unit cohesion, professional efficacy, and existential well-being. Discussion: The strongest predictors of distress were lack of meaning and feeling overextended at work. Emotional exhaustion and low existential well-being identified distressed crewmembers. Clinical Impact StatementAbout one quarter of remotely piloted aircraft (RPA) crewmembers reported high distress. They could be identified by their emotional exhaustion and low existential well-being. Primary stressors were work-role conflict, ambiguity, overload, and relationship stress. Greater attention to psychological wellness among RPA personnel seems essential given these findings. Successful intervention may require attention to religious/spiritual struggles, loss of meaning and purpose, guilt and shame, interpersonal alienation, anxiety,