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Objective: Imagery analysts of the United States Air Force distributed common ground system (DCGS) provide real-time intelligence informing battlefield decision-making processes worldwide. The number of DCGS combat operations personnel has grown along with the demand for their products, but little is known about the emotional impacts of remote warfighting. The current study is a mixed methods analysis of emotional reactions to remote fatality-inducing combat events and of potential demographic, occupational, and mission-specific correlates of negative emotional reactions to these combat operations in DCGS personnel. Method: One-hundred ninety-six active duty analysts with direct exposure to weapon strike operations volunteered to participate in semistructured interviews. Results: Participants were largely enlisted (93.9%), male (75%), and between 18 and 30 years of age (73.0%). Eighty-nine percent reported at least one positive emotion and 71% reported both positive and negative emotions in response to weapon strike events. An underlying current of positive emotions (e.g., pride, camaraderie, patriotism) combined with mission-specific negative emotions (e.g., sadness related to witnessing pain, suffering, and/or loss of life; anxiety and stress related to uncertainty and unforeseeable events) were commonly reported. Twenty-one percent endorsed negative emotions that disrupted their daily functioning, and witnessing a civilian casualty increased risk by 217%. Conclusion: DCGS analysts reported emotional responses similar to other remote warfighters but with proportional distributions that reflect their unique wartime roles and responsibilities. The heightened sense of responsibility associated with their wartime roles may elevate risk for negative emotional outcomes when adverse events, such as the death of a civilian, occur.

Critical Care Air Transport Teams (CCATT) are specialized military medical personnel who provide high-acuity care in an aeromedical environment. The rate of post-traumatic stress disorder (PTSD) symptoms was assessed in CCATT personnel and their rates were compared to general aeromedical evacuation (AE) personnel. As part of a computer-based occupational stress survey, 188 crew members (138 AE nurses and technicians, 50 CCATT nurses and respiratory therapists) completed the PTSD Checklist - Military Version. A categorical MEET/DOES NOT MEET CRITERIA variable was created, and a Fisher's exact test was computed to identify differences between groups. Contingency table analyses were used to assess associations between demographic and occupational variables with meeting criteria. χ or Fisher's exact test results, relative risks, and 95% confidence intervals were obtained, with 4.35% of AE and 14.00% of CCATT crew members meeting PTSD symptom criteria. The CCATT crew members were 3.22 times (95% confidence interval = 1.14-9.12) more likely to meet symptom criteria than AE, and for CCATT meeting criteria, the most commonly endorsed symptoms were arousal and avoidance. The demographic and occupational factors assessed in this study were not associated with meeting PTSD symptom criteria. Current findings are discussed in relation to current research on post-traumatic stress in ground-based critical care personnel.

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