Evaluating the Impact of a High-Intensity Cognitive Agility Optimization Intervention in Special Operations Forces: A Randomized Comparative Effectiveness Trial

Objectives and Rationale: Members of the United States (U.S.) Special Operations Forces (SOF) face frequent deployments, changes in station, and relocation for training duties, and they must often make decisions under pressure and uncertainty. Increasingly complex and unpredictable operational demands require SOF members to be flexible and adaptable in the midst of ever-changing circumstances, both operationally and in the home environment. The overarching goal of this study is to assess whether an intervention designed to improve cognitive agility and dynamic decision-making, called Special Operations Cognitive Agility Training (SOCAT), does, in fact, positively affect SOF members' cognitive agility, cognitive flexibility, social problem-solving, and overall functioning. The SOCAT program is a 4-hour interactive, culturally relevant, and evidence-informed training curriculum designed to enhance the three domains of cognitive agility: (1) focused attention, the capacity to zoom in and to avoid distraction; (2) openness, the ability to zoom out, search for, and process new information; and (3) cognitive flexibility, the capacity to switch from focus to openness depending upon which attentional strategy is more adaptive. SOCAT has been commissioned by the United States Special Operations Command (USSOCOM), and desired outcomes are in psychological, spiritual, social, and human performance functional domains in accordance with the Preservation of the Force and Family (POTFF) mission. A highly trained sports or cognitive-behavior-oriented psychologist with SOF-relevant experience will serve as the SOCAT instructor at four study sites selected by USSOCOM. We will determine the extent to which receiving SOCAT is associated with improved cognitive flexibility, cognitive agility, social problem-solving, and overall functioning 3 and 6 months following program completion. We will also conduct interviews with individuals who complete the SOCAT program to explore factors they perceive as contributing to their cognitive agility, factors they found helpful or not helpful, and identify examples of how SOF members apply the SOCAT training to their personal lives and military careers.

Focus Area to Be Addressed: This study responds to the Fiscal Year 2018 (FY18) Defense Medical Research and Development Program (DMRDP) Clinical Research Intramural Initiative (CRII) Military Performance Optimization Research Award (MPORA) Focus Area of Cognitive Performance Optimization to: 'Develop and validate interventions to assess, preserve, and optimize Service member cognitive performance and resilience throughout the military lifecycle.' SOCAT emphasizes optimal and stable cognitive performance across different contexts – as well as across various stages of the military lifecycle – to serve as a buffer against biopsychosocial vulnerabilities, environmental stressors, military operational demands, and mental health problems, including suicide. The current funding mechanism provides a timely and strategic opportunity to conduct a program evaluation of SOCAT prior to its broad dissemination. Quantitative and qualitative results of the proposed study will be used to inform future dissemination, implementation, and sustainability of the SOCAT program.

Potential Applications, Benefits, and Risks: If the proposed study finds positive effects of SOCAT on cognitive flexibility, cognitive agility, social problem-solving, and overall functioning, widespread dissemination of the program to the entire SOF community, including both Service members and spouses, has the potential to enhance functioning in psychological, spiritual, social, and human performance domains. Specifically, by optimizing cognitive performance, one can enhance operational performance, have a more satisfying military service experience and career, and bring added value to family dynamics. The study is expected to involve minimal risk to participants, the primary area of concern being possible breach of confidentiality regarding individuals' demographic and assessment information. However, the research team will ensure protection of data collected using multiple Department of Defense-approved security measures. Benefits associated with the proposed study include the potential for improving SOF members' cognitive flexibility, cognitive agility, social problem-solving, and overall functioning, the potential for subsequent widespread dissemination across the SOF community, to include SOF spouses, and adding to the body of knowledge about cognitive agility and dynamic decision-making.