ENDURE: Executive Functioning and Decision-Making Under Stress in Realistic Environments

Introduction

Military personnel that engage in military operations are increasingly faced with acute stress by means of physical, environmental, social, and psychological stressors. These stressors have an impact on hormonal balance and overall performance (e.g., cognition). The relationship between acute stress and cognitive performance has been described as an inverted U; meaning that there is an optimal stress level at which cognitive functioning is maximally enhanced. In contrast, at both ends of the curve (too low or too high stress), cognition seems to be impaired. In a military setting, cognitive functioning, or rather executive functioning is of great importance to adequate performance and decisions. Specifically, decision-making relies heavily on prefrontal executive functions, which have been shown to be impaired by acute stress. How decision-making and cognition is affected by realistically induced acute stress has not yet been researched extensively in a laboratory setting.
For that reason, we started the ENDURE project. To investigate whether acute stress has an enhancing or impairing effect on cognition and decision-making we will inoculate a stress response in healthy military personnel using multiple realistic military scenarios in Virtual Reality (VR). These scenarios will include external factors which induce stress. During the VR sessions we will monitor heart rate and respiration rate to acquire information on the stress response of the participant. Moreover, we will take saliva samples to analyze the stress hormones.
The benefit of using VR is the immersion in the virtual world creating more realistic and engaging environments, as well as the possibility to train more individually and effectively compared to real-life military training. Training in VR can, thus, result in more individual attention, tailored training packages, and lower costs. 
ENDURE is an intervention study which requires 68 participants between the age of 18 and 40. Participants will partake in a single research session which will take approximately 2.5 hours. During this session they will perform cognitive tasks and VR tasks and will fill in multiple questionnaires. 

Project overview

Objective:

1. Researching the effect of acute stress on cognitive functioning and decision-making.
2. Investigating the differences in cognitive test scores and decision-making between participants being exposed to different forms of stress.

Study population:

Healthy military personnel (18 – 40 years old).

Timeframe:

The research will start in 2023. The expected duration is 3 years.

Results:

Results are expected at the end of 2025.