J R Army Med Corps 2004; 150: 179-181 J R Army Med Corps: first published as 10.1136/jramc-150-03-04 on 1 September 2004. Downloaded from

Issues In Temperamental Unsuitability Re-Examining Concepts And Current Practice In The British Army

N Deu, M Srinivasan, P Srinivasan

ABSTRACT regardless of environment or time, or Currently, in the UK military, and indeed, is TU a "state", i.e. reactive to the particularly in the Army, a significant presenting circumstances and only number of personnel are regularly applicable to military environment? Does discharged on the grounds of being the existence of such a category infer a mis- assessed as "Temperamentally Unsuitable match between personality characteristics (TU) for military duties", under and military generally? Or is it, as is more Queen’s Regulations (QRs): (Army) often the case, a reactive incompatibility 9.414 and 9.434 (1). In the last two years between the individual, for example, failed (2001-2003), preliminary figures suggest expectations, and the demands of military that approximately 700 serving personnel life e.g. postings, deployments and were recommended for discharge under unconditional acceptance of authority and this category by only four psychiatrists hierarchy? in the south of .The regulations governing TU have been in existence Historical Perspective and essentially unchanged since their The history of (temperament) personality development long before the 1960s assessment in the military dates back to albeit subject to parliamentary WW2. In the US, psychologists’ roles quinquennial review.The Army General developed from basic personnel selection and Administrative Instructions through to utilising clinical expertise in the (AGAI) (2) standards also remain field of personality assessment in 1941, with unchanged over this period. This paper a keen focus on developing procedures to raises questions about the current predict behaviour in typical Army conditions validity and relevance of existing TU and on differential diagnosis of neuro- concepts and regulations with psychiatric conditions Rath & McCarroll (3). Post WW2, the focus of activity

suggestions as to what is being proposed http://militaryhealth.bmj.com/ in the context of changing roles, remained primarily in psychological technology and advances in the modern assessment and personality specifically, but armed forces. between the early 60’s and late 80’s there is Dr N Deu, BSc(Hons), a relative gap in the literature on personality MSc, PsychD. CPsychol assessment in the military.The basis for this Consultant Clinical and Introduction Temperamental Unsuitability (TU) is unclear but may be related to debates and Forensic Psychologist controversies in the field of personality DCMH , There are a number of problems with the TU concept and regulations as they exist measurement at this time. Duchess of Kent Milgram (4) highlights that whilst there is Barracks, Maida Road, today; a lack of academic and clinical Aldershot, Hants. consensus on the definition and operational a general acknowledgement in the military on October 2, 2021 by guest. Protected copyright. GU11 2DW criteria of "temperamental unsuitability", field of the importance of personality and the variable application of the variables in all phases of military life, there is Dr (Lt Col Retd) M psychiatric opinion, for what would appear a paucity of military psychology literature Srinivasan, MBBS, to amount to a mis-match between dedicated to this area. The majority of MRCS, LRCP, activity had been undertaken in the MRCPsych individual and military environment or role. Yet, in practice, TU is widely used as a occupational domain i.e. personality Consultant Psychiatrist assessment for selection, with research DCMH , legitimate, expeditious exit -route for disaffected, inefficient or non-effective focusing on recruitment and attrition. It 3-4 Napier Road, would seem that the areas of retention, Flagstaff Compound, service personnel, often as an alternative to , more appropriate administrative procedures, resilience, recovery and adaptability have CO2 7SW which would otherwise be protracted, been somewhat neglected. thereby burdening units. Most importantly there appears to be no Dr P Srinivasan, BSc The existing criteria for TU are vague and established scientific background to the MBBS DPM intangible, and raise several questions; how research of TU as it has not, to our FRCPsych knowledge, been studied within the British Consultant Psychiatrist do we define "temperament" - personality traits, behaviour or attitude?; is the Army before. A review of international and DCMH Donnington, reputed literature databases in the public Parsons Barracks, "unsuitable temperament" reflecting a definable pathological diagnosis?; is TU domain, and internal restricted databases Donnington, Telford, has not elicited any previous research.There TF2 8LS considered to be enduring and intractable 180 Temperamental Unsuitability J R Army Med Corps: first published as 10.1136/jramc-150-03-04 on 1 September 2004. Downloaded from

has been, however, internal unpublished identified risk factors, rather than screening correspondence on the issue of TU, which of out of cases, would aim to inform more course has a potential for bias. The only productive monitoring of potentially article obtained relating specifically to the vulnerable recruits and hopefully inform concept of TU is a 1947 article from better preventative and management USA/Canada entitled "Signs of Temper- strategies when difficulties arise. amental Unsuitability in Aircrew under The susceptibility to amelioration of such Training", Air Ministry, Air Publication "unsuitable" characteristics via management 3139 (5). The emphasis of this article is on or treatment could be a key aspect of the fearfulness in relation to flying and therefore decision making process, and the offer of not reflective of the broader concept of TU appropriate evidence-based interventions, for the military. the thrust of the organisation’s retention strategy.The Navy has moved forward in this TU Today respect, so that the Temperamentally In all three military services, TU is seen as a Unsuited sailor is likely to be classified by a non-medical, but administrative discharge. Psychiatrist according to a system of However, it necessitates a psychiatric establishing severity of personality or opinion to exclude any mental illness albeit behavioural disturbance based on its that this opinion is sought at the discretion amenability to intervention. This allows for of the Medical Officer. retention in the service if the disorder is mild Where the QRs for the three armed forces or moderate. However, there are no suggest a need for a recommendation from a guidelines or recommendations on the Service Psychiatrist for TU, broad nature of such interventions, rendering guidelines are offered for this. The evaluation of successful strategies difficult. operationalistion of these regulations in the single service instructions (in this case What Research Is Necessary AGAI) varies considerably, with resultant The study of temperament or personality variations in the interpretation of TU traits and social/situational factors in concepts and practice. For example, the relation to suitability, psychological fitness Army, unlike the Navy, adopts an all-or- and adaptability for the military nothing approach and does not consider environment seems key to the concept of categories of TU severity, nor see it as TU. Anecdotal evidence from service amenable to treatment. The problem with psychiatrists, suggests that the assessment this being the obvious loss of potentially for TU is multidimensional i.e. the interplay redeemable trained personnel. between personality characteristics and It could be argued that, even in the face of contextual factors. presenting problems with "temperament" in However, there is a need for the specific

the soldier, that the presence of these should discriminative analysis of those factors that http://militaryhealth.bmj.com/ not be the focus of a clinical or may not only be predictive of `best fit for administrative decision. Rather, the role’ but also those that may later interfere assessment should focus on what factors with optimal performance in specific roles or helped to generate the (unsuitable) environments. Such factors may include "temperament" now or what factors personality traits, social or situational factors protected against its expression earlier. In or stress tolerance and adaptability other words, what has occurred to trigger characteristics. In this respect, it seems we latent traits, otherwise controlled prior to the should concern ourselves with the referral? As Wickenden (6) argues, that in identification and resolution of key factors cases where the soldier has consistently that may serve as risk and protective factors struggled to perform adequately, it begs the in adaptation to the demands of (un)familiar on October 2, 2021 by guest. Protected copyright. question - could the selection process have operational environments and resilience identified these factors? In observing within and recovery from enduring stress selection procedures locally, the authors situations. identified a number of points where changes In our experience the assessment process could be made in this regard. The gathering reveals that the TU situation arises as a of historical information could be more result of breakdown in adaptation to the comprehensive and areas of concern environment, resulting in disaffection and highlighted and explored further before lack of motivation for military life. This selection. More importantly the subjective breakdown can be caused by a number of and often brief process of advising on factors including; work related issues, for "suitable roles or trades" following British example failed expectations, dislike of trade, Army Recruitment Battery (BARB) conflict with authority, or to changes in assessments, means that the match between personal circumstances, for example new the person and trade is frequently informed relationship, family demands, children, by interviewer bias or simply recruit divorce/separation. Whilst personality "interest". Whilst "screening" methods are characteristics are rarely formally assessed, inherently problematic with respect to 100% there is an informal acknowledgement accuracy, the process of highlighting within the psychiatric profession that certain N Deu, M Srinivasan, P Srinivasan 181 J R Army Med Corps: first published as 10.1136/jramc-150-03-04 on 1 September 2004. Downloaded from

traits, for example, obsessive-compulsive, 2. A prospective research study - following antisocial, dependant or paranoid, may recruits through training, to vocational interfere with some soldiers’ resilience employment, and tracking those who within operational situations. become "TU".The aim would be to assess There is a lack of information on the the reliability and validity of those factors relevance of currently available standardised identified at stage 1. Given the likelihood personality assessment measures to the of undisclosed risk factors at selection, it military and moreover, British military would also allow for identification of population. The use of commonly used emerging and previously unidentified risk measures in the Armed forces in the absence and protective factors. It is hoped that of appropriate military norms would be long term follow-up would allow for questionable, since they are not a investigation of any associated representative cross section of society and relationship with later mental illness and therefore can not be readily compared to adjustment to civilian life. normative student, psychiatric or general Longer-term implications of the research populations typically used as standardisation would be in the use of reliable and valid samples. Indeed, where measures are assessment of Personality and "TU", aiming to available, these tend to have been validated inform management strategies during training on non-British populations rendering direct where possible. Given the limitations of comparisons difficult. The military rationale predictive risk assessment and emergence of for a comprehensive research and false negative cases, it would seem more development strategy in the area of beneficial to use risk factors to identify and temperament and suitability would appear manage vulnerable soldiers from the point of necessary. The cross-cultural differences in selection than risk screening out potentially military selection, training and roles would malleable and successful recruits. Further indicate a clear need for a British development of the research is hoped to contribution to the development of inform standardised protocols for specific or appropriate assessment tools, norms and specialist sub-groups of military personnel, evidence-based practice. whose roles may require specific characteristics to enhance performance for, or recovery, from Our Study specialist deployments. We hope to explore the relevance of a range of factors in TU, in particular those References characteristics and circumstances that may 1. Queen’s Regulations for the Army (QR (Army)). render individuals as suited or unsuited to 1975, reprinted 1996 (amendments 1-19), Dec 2003 (amendments 20-26); Chapter 9 Manning; military service including (though not Section 3 " Discharge from the colours admin- exclusively) social, situational, personality istrative instructions"(includes 9.414) and

and stress tolerance/adaptability factors. Section 5 " Soldiers Mentally or Tempera- http://militaryhealth.bmj.com/ The current operational concept of TU is mentally Unsuitable" (includes 9.434). 2. Army General and Administrative Instructions however, a vague, broad and multifaceted (AGAI) Vol. 2, Ch 49 ANNEX E "Common one and which varies across the three causes for discharge under QR (Army)". Para 5: branches of the military services. There is a Temperamental Unsuitability. need to examine the concept of TU as laid 3. Rath, F.H Jr., & McCarroll, J.E (1991) " Clinical out in the current AGAI, and its relationship Psychology Assessment". In Gal, R. & Mangelsdorff, D.A (Eds). Handbook of Military with modern views of Personality Psychology. John Wiley & Sons. England. development and exploration of the possible 4. Milgram, N.A. (1991) "Personality Factors in impact of multiple military deployments. Military Psychology". In Gal, R. & Mangelsdorff, The aim of the proposal is to identify risk D.A (Eds). Handbook of Military Psychology. John Wiley & Sons. England. on October 2, 2021 by guest. Protected copyright. and protective factors (including personality 5. Symonds, C.P., & Williams, D.J (1947). "Signs of variables) for TU in military personnel, with Temperamental Unsuitability in Aircrew under a view to informing strategic developments Training". In Psychological Disorders in Flying at the stages of recruitment, selection and Personnel of the RAF investigated during the war retention. It is envisaged that this research 1939-1945. Air Ministry, Air Publication 3139. 6. Wickenden, D. (1999) "Definition of process will involve two stages: Temperamental Unsuitability". Internal Discussion Paper. Ministry of Defence 1. A retrospective case file audit of a cohort Psychiatric Services, Aldershot, Hants. UK of personnel who have already been recommended for (and/or discharged by) TU. This would identify commonalities in factors currently assessed and considered to be associated with TU.