Appendix D

Acronyms and Glossary of Terms

Glossary

“above and below the skin” – refers to observed behavior as well as physiological and biological processes that are the effect of or correlated with one’s experience of an adverse event or ongoing adverse events or maltreatment

Adaptome – a proposed set of approaches, processes, and infrastructure needed to advance the science of intervention adaptation; implementation provides a methodology that can support the integration of evidence that includes both traditional standards of evidence and phases of evidence-based practice development and validation as well as addressing the need for locally acceptable prevention programs that sometimes leads local providers to design and deliver their own programs ahead of evidence for effectiveness

Affective – emotional

Agender – describes an individual whose personal identity is genderless

Amygdala – one of the four basal ganglia; part of the limbic system; key role in processing emotions

Asexual – lacking sexual feelings, associations, or behaviors

Autonomic nervous system – controls bodily functions (e.g. heartrate, respiratory rate or volume, and digestion) unconsciously; protects the body against perceived threat(s)

Bigender – describes an individual whose personal identity encompasses both male and female gender

Child maltreatment – physical, emotional, or sexual abuse or educational or health neglect of a child by an adult, often a caregiver

Chronosystem - the fifth level of Bronfenbrenner’s Ecological Systems Theory; inclusive of the environmental events (e.g. sociohistorical) and transitions that impact the development or functioning of the microsystem (e.g., individual or child)

Cisgender – describes individuals whose gender identity aligns with their biological sex

Cognitive processing therapy (CPT) – an empirically based therapy for the treatment of posttraumatic stress disorder, designed for the amelioration of adverse subjective experiences of trauma; usually 12 clinical sessions (individual or group)

Compendiums – a brief collection of information or knowledge

Contextual moderators – variables, elements, or aspects of the environment, or beyond the individual or group, that impact the functioning and/or perspectives of an individual or group

Continuous quality improvement (CQI) – ongoing process(es) for proactive technical assistance for an established system or program; provides actionable data linked to various outcomes

Continuous quality improvement (CQI) system – a necessary component to ensure that programs are data-driven with a clear direction toward cultivating adaptations and adjustments within services, programs, and resources. The goal of a CQI system is to provide actionable data that enables the system to address various outcomes (i.e., implementation, service, and client or customer outcomes) through specific identifiable adaptations or innovations.

Cortisol – known as the stress hormone, a steroid hormone that regulates a range of physiological processes (i.e. metabolism, immune response, and stress response)

Cultural adaptations – changes, often subtle, to the content of an intervention that are critical for perceived acceptability, relevance, and credibility of the intervention for the target population; include changes to culture-specific nomenclature of intervention materials (or vernacular) that may vary by geographic region or sub-populations essential to the implementation process

Dating violence – physical, sexual, or psychological violence within a dating relationship

Deployment – a short- or long-term relocation of an individual or group and required resources for the purpose of a military mission (i.e. war, conflict, humanitarian effort); can be domestic or international

Developmental stage – describes the physiological, psychological, and/or emotional phase of one’s growth; usually refers to children

Diathesis-stress model – a model that suggests that some youth are more vulnerable to their caregiving environments and that some youth fare worse in stressful circumstances, but do as well as others in routine, low-risk environments

Donabedian framework – a method of assessing the quality of care; includes obtaining data on performance, analyzing patterns, generating a hypothesis for the pattern analysis, taking action based upon the hypothesis, and assessing the subsequent consequences

Dynamic Sustainability Framework (DSF) – describes how the adaptation of interventions may occur over time and their role in facilitating the integration and sustainability of interventions to adapt to the ever-changing context in which they are delivered, including changes to the delivery setting, target population, evidence base, political context, and other key variables that are known to occur over time

Dynamism – vitality

Dysregulation – disrupted ability to regulate metabolic, physiological, and/or psychological processes

Ecological approach – a way of thinking that focuses on intervention from the micro (individual) to macro (population) level via direct (e.g. psychotherapy) and indirect strategies (e.g., policy development)

Ecological framework – framework for constructing practice, policy, and research based on the impact of reciprocal relational factors on human functioning, processes, and outcomes

Ecological model – a theoretical design used to inform implementation that enables providers, installation services, and leaders to build on local capacities, strengths, and resources and to incorporate the local knowledge within the selection, adaptation, adoption and implementation of support services

Epigenetic – related environmental impacts on gene expression

Epinephrine (adrenaline) – a neurotransmitter that acts on alpha and beta receptors in the arteries; epinephrine increases blood sugar levels, heart rate, and heart contractility while also relaxing smooth muscle in the airways to improve breathing

Equifinality – refers to the obverse of multifinality, namely that the same outcome (e.g., anxiety, social challenges or poor academic functioning) can be evident following exposure to disparate stressor events (i.e., prolonged parental separation, relocation, and bullying)

Etiology – cause(s) of a disease or condition

Evidence-based – in reference to knowledge, programs, or practices: derived from systematic empirical research

Evidence-based intervention – deliberate efforts (clinical or nonclinical), based on empirical research and/or literature, designed to ameliorate the effects of a maladaptive process(es), problem(s), or event(s) after occurrence

Evidence-based practice (EBP) – practice designed from empirical research and/or literature

Evidence-based program – a (human service) program designed from empirical research and/or literature

Exosystem – the third level of Bronfenbrenner’s Ecological Systems Theory; inclusive of the environmental elements which impact the development or functioning of the microsystem (e.g. individual or child)

Family diversity – refers to the variety of make-ups of families (e.g., nuclear, blended, single-parent, extended, same-sex)

Family integration – the reunification and reconnection of a military family upon the return of the military member(s) from a deployment of long-term, temporary duty away from the home station; includes events and processes associated with reunification and reconnection

Family stress model – a model that provides a conceptual framework for understanding how stressful contexts such as psychopathology, marital transitions, and socioeconomic conditions reverberate in the family and create complex effects among individuals (adults and children) in dyadic relationships (marital and parent-child), and more broadly within families

Family wellness – a measure of family health that includes interpersonal interactions, bonds, trust, resiliency, and functioning

Fraternization – relationships (e.g., romantic, sexual, friendship, business) between service members, which compromise or appear to compromise

the chain of command, occupational environment, and/or mission execution or success; refers to DoD and service component-level policies prohibiting such relationships

Frontal cortex – cortex of the frontal lobe of the cerebral hemisphere of the brain; associated with aggression and impulse control

Gender-fluid – describes an individual whose personal identity is not fixed to either a male or a female gender

Gender identity – one’s personal sense of identity and/or gender expression or lack thereof

Glucocorticoids – used to treat conditions leading to inflammation (e.g., asthma, arthritis, allergies)

Heteronormative – describes a perspective or worldview based upon heterosexual norms

Hippocampus – brain region located in the medial temporal lobe as part of the limbic system; assists with short-term, long-term, and spatial memory

Homeostasis – the tendency towards internal equilibrium

Hyperarousal – defined by Merriam-Webster’s dictionary as “an abnormal state of increased responsiveness to stimuli that is marked by various physiological and psychological symptoms (such as increased levels of alertness and anxiety and elevated heart rate and respiration).” In addition, to be diagnosed with PTSD, “a person has to have been exposed to an extreme stressor or traumatic event to which he or she responded with fear, helplessness, or horror and to have three distinct types of symptoms consisting of reexperiencing of the event, avoidance of reminders of the event, and hyperarousal for at least one month.”

Hypocortisolism – acute adrenal insuffiency; also referred to adrenocortical hypofunction; symptoms include decreased stress response, fatigue, joint and/or muscle pain or weakness, hypotension, and gastrointestinal problems

Hypothalamic-pituitary-adrenal (HPA) axis – the biological system most closely linked to stress, which releases the hormone cortisol when an individual experiences stress

Intersectionality – the interconnectedness of social categorization and/or grouping (e.g., gender, socioeconomic status, race)

Intervention – deliberate efforts (clinical or nonclinical) to ameliorate the effects of a maladaptive process(es), problem(s), or event(s) after occurrence

Intrafamilial – occurring within a family system

Just-in-time adaptive interventions (JITAIs) – form of an adaptive intervention that aims to address in real time the rapidly changing needs of individuals or families

Life course – refers to the entirety of developmental and life stages throughout the duration of a life span

Life-course model – an organized concept that in the aggregate describes the cycle of developmental processes and life stages throughout the duration of a life span

Lived experience – the subjective perspective and associated functioning of an individual or group; includes contextual factors and interpersonal relations

Longitudinal – a form of scientific research (to seek knowledge through examination, observation, or inference) which studies subjects or populations over a long period of time

Macrosystem – the fifth level (cultural environment) of Bronfenbrenner’s Ecological Systems Theory

Maltreatment – physical, emotional, or sexual abuse or educational, financial or health care neglect of an individual by another, usually a caregiver

Mastery-motivation – the drive to persist to achieve a difficult task or goal

Mesosystem – the second level of Bronfenbrenner’s Ecological Systems Theory; inclusive of the family, peers, and surrounding community

mHealth interventions – mobile technology-based efforts, usually clinical, designed or organized to ameliorate the negative health effects of a maladaptive process(es), problem(s), or event(s) after occurrence

Microaggression – subtle overt or covert acts by an individual or group that cause distress to another individual or group

Microsystem – the first level (individual level) of Bronfenbrenner’s Ecological Systems Theory

Military dependent – a family member for whom a military service member is financially responsible and who is a recipient of military benefits (e.g., health care, base access, and services)

Military Family Fitness Model (MFFM) – a comprehensive model aimed at enhancing family fitness and resilience across the life span. The MFFM has three core components: (1) family demands, (2) resources (including individual resources, family resources, and external resources), and (3) family outcomes (including related metrics)

Military family readiness – the capacity of a family to manage military lifestyle and functions (e.g., deployment, relocation, military trauma and/or strain)

Military Family Readiness System (MFRS) – the network of programs, services, people and agencies, and the collaboration among them, that promotes the readiness and quality of life of service members and their families

Minority stress theory – a theory that describes minority group members’ unique experiences of chronic stresses stemming from social institutions in addition to everyday experiences of racial bias. When applied to sexual minorities, analysis tends to focus on stresses related to heteronormative bias and anti-LGBT experiences

Multifinality – refers to the finding that one stressor (e.g., physical abuse) can have many different negative effects on neurodevelopmental conditions – intellectual and/or psychological conditions that develop in early childhood (e.g., autism, learning disabilities)

Norepinephrine – a neurotransmitter that acts on alpha receptors in the arteries; increases blood sugar levels, heart rate, and heart contractility

Operational tempo – the pace of military operations and/missions; descriptive of the demands on personnel to achieve operational or/or mission objectives

Oxytocin – a neurotransmitter (hormone) produced by the hypothalamus and secreted by the pituitary gland

Oxytocin receptor (OXTR) – a protein that acts as a receptor for the neurotransmitter (hormone) oxytocin; can buffer the adverse impacts of social environments, events, or processes

Pathogenesis – the development of events leading to a disease or pattern of disease

Permanent change of station (PCS) – permanent relocation of a military member and/or family from one military installation to another

Personnel tempo (perstempo) – refers to the amount of time individuals serve away from their home duty station, whether for deployments, sea duty, exercises, unit training or individual training.

Population health framework – a conceptual, practice, or policy framework in which health, disease, and/or health risks are examined, treated, or mitigated based upon community or group health trends and needs

Prolonged exposure (PE) – an empirically-based therapy for the treatment of posttraumatic stress disorder, designed for the amelioration of adverse subjective experiences of trauma; focuses on guided and graduated exposure to trauma-related events, details, fears, and/or avoided triggers

Prosociality – the quality of prosocial behavior (e.g., donating, sharing, helping, caregiving, cooperating)

Psychopathology – the study or presence of mental health disorder(s)

Questioning – may refer to the status of an individual who questions his/her/their own gender status and/or sexual orientation

Readiness – state of preparedness for military-related actions or defense (e.g. deployment, antiterrorism, installation defense)

Resilience – the capacity of an individual or group to endure and/or overcome adversity; functions of intra-individual characteristics and associated with characteristics of the outside environment

Self-efficacy – one’s personal sense of competence in general or in a given area

Self-regulation – an individual’s ability to manage emotions, behaviors, and interactions for optimal functioning

Sexual violence – the use of physical force to compel a person to witness or engage in a sexual act against his or her will. Sexual violence includes attempted or completed nonconsensual sex, unwanted sexual contact, and sexual harassment.

Stress regulatory systems – most commonly the nervous system and endocrine system

Systems principle of homeostasis – principle of Bronfenbrenner’s Ecological Systems Theory; idea that the whole system, inclusive of five levels, remains relative stable and/or seeks equilibrium upon disruption

Taxonomy – classification or organization of individuals or groups

Third gender – describes an individual whose personal identity is neither male nor female, not both male and female, and not any combination of male and female

Total Force Fitness – a holistic concept for building and maintaining health, readiness, and optimal performance of the U.S. Armed Forces using the connection between mind, body, spirit, environment, and relationships (see https://www.hprc-online.org/page/total-force-fitness)

Transgender – describes individuals whose gender expression or identity does not match or is not limited to their biological sex

Trauma-informed – health care, programs, or practices developed from and responsive to all types of trauma (e.g. military-related trauma, domestic or interpersonal violence, health crisis, threat to life or well-being)