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Flashcards in Chapter-18 Deck (427):

How do physical fitness and an active lifestyle supportthe Air Force mission? (425)

They increase productivity, optimize health and decreaseabsenteeism while maintaining a higher level of readiness.


What five elements should your year-round totalfitness conditioning program consider? (425)

1) Cardiorespiratory fitness; 2) strength and endurance; 3)flexibility conditioning; 4) body composition; and 5) healthyeating habits.


Why must commanders and supervisors incorporatefitness into the Air Force culture? (425)

To establish an environment where members maintain physicalfitness and health to meet expeditionary mission requirementsand deliver a fit-and-ready force.


What tool helps commanders determine the overallfitness of their personnel? (425)

The annual Fitness Assessment (FA).


hy is being physically fit more than just passingthe Air Force Fitness Assessment (FA)? (425)

Being physically fit ensures every Airman can properly supportthe Air Force mission while performing at optimal capacity.


The fitness program's goal is to motivate year-roundphysical conditioning. What does the program emphasize?(425)

Total fitness. (This includes proper aerobic conditioning,muscular fitness training and healthy eating.)


What are the five major components of fitness? (425)

1) Cardiorespiratory endurance; 2) body composition; 3)muscular strength; 4) muscular endurance; and 5) flexibility.(Warm-up and cool-down are also essential components of acomplete physical fitness program.)


What is cardiorespiratory endurance? (425)

Sometimes called aerobic fitness, it is the ability to performlarge muscle, dynamic, moderate-to-high intensity exercisefor prolonged periods.


Body __ measures your relative amounts of fatand fat-free tissue. (425)



What is muscular strength? (425)

The maximum force generated by a specific muscle or musclegroup.


What is muscular endurance? (425)

A muscle group's ability to contract repeatedly over a periodof time to cause muscular fatigue.


__ is the maximum ability to move a joint freely,without pain, through a range of motion. (425)



What four principles should a successful cardiovascularexercise program employ? (425)

The principles of 1) frequency; 2) intensity; 3) duration; and4) mode.


Effective cardiorespiratory conditioning is best accomplishedwith __ to __ adequately intenseworkouts per week. (425)

Three to five.


Fitness leaders must be aware of the dangers of__ since the risk of injury increases with increasingworkout duration and intensity. (425)



Improvements in cardiovascular fitness are directlyrelated to the __ of the exercise performed. (425)



What is the minimum training intensity required inan exercise session? (425)

50% of Volume of Oxygen (V02) max, sometimes referredto as the "training threshold."


The Target Heart Rate (THR) corresponds to anintensity sufficient to achieve cardiorespiratory improvement.T/F (425-426)



In cardiovascular training, how do you calculateyour Target Heart Rate (THR)? (426-Fig)

Subtract your age from 220. Then multiply by .7 to find thebottom THR and by .9 to find the top THR.


A Target Heart Rate (THR) of 70 to 90% of one'stheoretical Maximum Heart Rate (MHR) is equivalent to__ to __ % of one's Volume of Oxygen (V02) max.(426)

50 to 85%.


__ is the time spent exercising with the most benefitoccurring in the Target Heart Rate (THR) zone. (426)

Duration. (The more intense the activity, the shorter the timeneeded to produce or maintain the training effect.)


Only sustained activities requiring a large amount ofexercise using large muscle groups will improve cardiovascularfitness. Give several examples. (426)

Running, rowing, jogging, vigorous walking, jumping rope,stationary cycling, swimming and stair climbing.


Successful muscular strength and endurance programsemploy what five principles? (426)

he principles of I) specificity; 2) regularity; 3) recovery; 4)balance; and 5) variety.


The principle of ___ dictates you provide resistanceto the muscle groups that need to be strengthened.(426)

Specificity. (Strengthening muscles used m work-relatedmovements can improve job performance.)


The principle of specificity states: if an Airman wishesto improve performance for a work-related task, thenstrengthening the identified muscles will ensure maximumcarryover value for his or her __ tasks. (426)

Warrior tasks.


Exercise must be done regularly to produce a trainingeffect. How many workouts per week produce optimalgains in strength? (426)

Three workouts per week.


Can an Airman maintain a moderate level ofstrength by doing proper strength workouts only once aweek? (426)

Yes, for a short period of time, if he or she has already establisheda strong baseline level of muscular fitness.


An Airman who exercises three times per weekachieves optimal muscle strength gains when exercising different muscle groups at each workout. T/F (426)

False. (Gains will be minimal as the principle ofregularity is violated.)


How many times a week should an Airman exercisethe same muscle group? (426)

A minimum of two times a week.


Why should there be at least a 48-hour recovery periodbetween working the same muscle groups? (426)

So the muscles have time to adapt.


Consecutive days of hard resistance training for thesame muscle group can be __ . (426)

Detrimental. (Strength training can be done every day, butonly if muscle groups are rotated so the same muscles are nottrained consecutively.)


Normally, the recovery time between sets in muscularstrength training should be between __ to __seconds. (427)

30 to 180.


The principle of __ states that a strength-trainingprogram should work all major muscle groups in boththe upper and lower body. (427)



The principle of balance indicates that you shouldwork opposing muscle groups during strength training.Why? (427)

It ensures good muscle strength balance and may reduce therisk of injury. (For example, follow an overhead press with alat pull down exercise.)


In a strength-training program, exercises shouldtarget larger muscle groups first. T/F (427)

True. (If smaller muscle groups are worked first, they will beexhausted and too weak to handle the resistance needed tooverload the larger muscle groups.)


What is the principle of variety in strength and enduranceprograms? (427)

Enhance results by using different types of equipment andexercises and altering volume and intensity.


To enhance variety, change your muscular conditioningto __ -resisted exercises or another form ofresistance training. (427)



While adding variety to a strength-training programcan be beneficial, why should Airmen avoid frequentwholesale changes? (427)

They may become frustrated if they do not have enough time to adapt or see improvements in strength.


Prevent injury and muscle soreness with a good__ at the beginning and __ at the end of exercise.(427)

Warm-up and cool down.


During the warm-up, perform slow joint rotationexercises. This will help increase the joint's __ of__ .(427)

Range of motion. (Work each major joint for 5 to 10 seconds.)


The preferred time for flexibility stretching is beforethe exercise session. T/F (427)

False. (Overstretching prior to the session can compromisejoint integrity.)


When is the best time to improve your flexibility bystretching? (427)

After exercising, when your muscles are warmest.


Hold stretching positions forconds during cool-down. (427)

10 to 15 seconds. (Relax the stretch, then repeat for maximumbenefit.)


What are the two most important factors in maintaininga positive body composition and losing excessivebody fat? (427)

Exercise and diet.


A realistic weight loss goal is one to two pounds aweek. How is this best accomplished? (427)

By reducing caloric intake and increasing energy expenditure.


Why is dieting without exercise an ineffective way tolose weight? (427)

Your body may believe it is being starved and attempt toconserve its fat reserves by slowing its metabolism.


Airmen should minimize their daily caloric intakeyet consume all major food groups. What is the minimumcaloric intake for Airmen not under medical supervision?(428)

At least 1,500 calories for men or 1,200 for women.


Why don't fad diets and devices or skipping mealsproduce long-term fat loss? (428)

Most weight lost is water and lean muscle tissue, not fat.(Safely losing fat takes time and patience.)


In addition to burning calories, exercise helps thebody maintain muscle mass. T/F (428)

True. (It may also keep the body's metabolic rate high.)


__ exercise, which uses lots of oxygen, is the bestto burn fat. (428)

Aerobic. (Anaerobic act1v1t1es like sprinting and liftingheavy weights bum little, if any, fat.)


Why is exercise alone ineffective for losing weight?(428)

Exercise does not bum enough fat on its own to cause significantweight loss.


What activities are included in a good dynamicwarm-up before vigorous exercise? (428)

Airmen should take five to seven minutes slowly 1) joggingor walking; 2) rotating joints; and 3) mimicking the activitiesto be performed.


Why is it important to slowly return the body to itsresting state after exercise? (428)

Stopping suddenly after vigorous exercise can potentiallylead to health complications.


How should you cool-down after exercising? (428)

1) Repeat the dynamic warm-up activities; 2) be careful notto overstretch; and 3) hold stretches for 15-30 seconds ormore to improve flexibility.


Do not limit __ training to cool-down periodsonly. (428)

Flexibility. (Stretching takes very little time relative to thebenefits gained and can easily be done at home or work.)


A job that requires repetitive movements, or is moresedentary, decreases tension in specific muscle groups.T/F (428)

False. (Tension increases in the specific muscle groups andmild stretching throughout the day can help.)


Commander-driven physical fitness training is thebackbone of the Air Force physical fitness program.What does it promote? (429)

1) Aerobic and muscular fitness; 2) flexibility; and 3) optimalbody composition.


__ is crucial during PT and testing. (429)



A PT program must exceed members' current fitnesslevel to encourage and promote progress to a higher one. T/F (429)

False. (The PT program must meet members' current fitnesslevel.)


How is the PT program's effectiveness measured?(429)

With the 1) 1.5-mile timed run; 2) I-mile walk; 3) AbdominalCircumference (AC); 4) pushup and situp tests. (Donot limit training to these tests.)


The unit fitness program develops general fitness,prevents __ and decreases repetitive strain injuries.(429)



How can the unit PT program ensure a safe trainingenvironment? (429)

By assessing I) traffic patterns; 2) temperature; 3) wateravailability; 4) first aid availability; 5) awareness of emergencyprocedures; 6) individual medical limitations and abilitylevels; and 7) use of headphones or other personal equipment.


What are the three components of the compositefitness score, used to determine overall fitness based on?(429)

1) Aerobic fitness; 2) muscular strength/endurance; and 3)body composition using Abdominal Circumference (AC)measurements.


A composite fitness score of __ , in addition tomeeting the minimum component scores, represents theminimum acceptable health, fitness and readiness levels.(429)

75 or greater. (Though health and readiness benefits continueto accrue with increasing fitness levels.)


__ - and gender-specific fitness score charts areprovided in AFI 36-2905, Fitness Program. (429)



Scoring the minimum component values in all componentswill generate enough points to earn a compositescore of 75 or greater. T/F (429-Note)

False. (The minimum components are established to ensuremembers avoid "asymmetrical fitness.")


The fitness composite score (ranging from 0 to 100)is calculated from what four component scores? (429)

1) Aerobic Fitness Assessment (FA) (60 points maximum);2) body composition (20 points maximum); 3) pushups (10points maximum); and 4) situps (I 0 points maximum).


How do you calculate a member's fitness compositescore when their medical profile prohibits them fromcompleting one or more of the fitness test components?(429)

Based on the remaining components. (Multiply total componentpoints by 100, then divide by total possible points.)


Members complete a composite Fitness Assessment(FA) every three months. T/F (429)

False. (They must complete it biannually.)


__ to the composite Fitness Assessment (FA)temporarily categorize members as unable or unavailableto train or test for reasons beyond their or their commander'scontrol. (429)



Who grants PT component exemptions based onmedical recommendations? (429)

The commander, in consultation with the Exercise Physiologist/Fitness Program Managers (EP/FPM).


How do increased fitness levels optimize performancein the deployed environment? (429)

They allow Airmen to tolerate extremes in temperature, fatigueand stress.


Identify the four fitness levels and the score rangefor each. ( 430-Tbl)

I) Excellent (all four components) - composite score equalsor exceeds 90; 2) Excellent (three or less components) -composite score equals or exceeds 90; 3) Satisfactory- compositescore between 75 and 89.99; and 4) Unsatisfactory -composite score below 75 and/or one component minimumnot met.


74. When do Airmen who receive an excellent in all fourcomponents retest? (430-Tbl)

Within 12 months.


When do Airmen with unsatisfactory fitness levelsretest? (430-Tbl)

Within 90 days of their initial assessment.


Members must have a current fitness score on filebefore deployment. T/F (429)



When is the only time "exempt" should be markedon an Airman's Fitness Assessment (FA)? (429)

The Airman's current FA expires while deployed where testingis not possible or did not volunteer to test at a locationwhere F As are available.


Any Fitness Assessment (FA) __ is annotated inthe Air Force Fitness Management System (AFFMS) andconsidered against the Airman. (429)



Airmen who reach days after rece1vmg anUnsatisfactory Fitness Assessment (FA) score, but beforethe evaluation closes out, will no longer have a currentevaluation and will be marked "exempt." (429)

91 days.


What is marked on the Fitness Assessment (FA) if anAirman has a current/passing score before deploying andhis or her evaluation closes out after the deploymentstarts? (429-430)

Meets Standards.


Deployed Airmen with Satisfactory or Excellentscores become "exempt" when they reach the __ dayof the month, seven/thirteen calendar months followingthe previous official Fitness Assessment (FA) rating. (430)



Who appoints PT Leaders (PTL) to augment theFitness Assessment Cell (F AC)? (430)

Unit Commanders. (Installations develop a local Fitness Assessment(FA) plan that is signed by the installation commander.)


Fitness Assessment Cell (FAC) augmentees conductthe Fitness Assessments (FA), but do not test membersfrom their own unit. T/F (430)



The Fitness Assessment Cell (F AC) will conduct theFitness Assessment (FA) for all Airmen. If no FAC exists,who should conduct the FA? (430, 430-Note)

A certified PT Leader (PTL) from another unit.


The Fitness Screening Questionnaire (FSQ) shouldbe completed no earlier than __ calendar days, or__ days for Air Reserve Component (ARC), but nolater than 7 days prior to Fitness Assessment (FA). (430,430-Note)

30; 90.


Failure to complete the Fitness Screening Questionnaire(FSQ) invalidates the Fitness Assessment (FA). T/F(430-Note)



Medical providers may recommend __ exemptionsfrom specific physical conditioning programs or acomponent of the Fitness Assessment (FA). (430)



Pregnant members will engage in PT and receivenutrition counseling throughout the pregnancy and postpartum period. However, they are exempt from fitnesstesting during pregnancy and for __ days after delivery.(430)

180 days.


All Fitness Assessment (FA) test components must becompleted within a 3-hour window on the same day orwithin __ duty days in extenuating circumstances.(430)

Five duty days.


Assess muscular fitness after the 1-mile walk, restingat least __ minutes between components. (430)

Three minutes. (The 1.5-mile run can be done before or afterthe muscular fitness components.)


Schedule Fitness Assessment (FA) components toallow adequate __ for members with irregular or shiftwork hours. (430)



Which component of the Fitness Assessment (FA)must be assessed first? (430)

The body composition component.


What does the body composition assessment measure?(430)

Your height, weight and Abdominal Circumference (AC).


Where will Fitness Assessment Cell (F AC) membersor trained augmentees take the Abdominal Circumference(AC) measurement? (430)

In a private room or partitioned area.


The __ assessment is a 1.5-mile timed run or, ifmedically exempt, 1-mile walk. (430-431)

Aerobic. ( 1-mile walk is the only authorized alternate assessmentfor Regular Air Force or Air Reserve Component(ARC) members.)


How are upper body and abdominal muscularstrength/endurance measured? (431)

With a one-minute timed pushup test for the upper body anda one-minute timed sit-up test for the abdominals.


Physical fitness education will be incorporated intotraining programs and unit PT. T/F (431)



Ongoing __ emphasis and a supportive environmentare essential to maintaining force health and fitness. (431)



What program is managed by the Health and WellnessCenter (HA WC) and is mandatory for all Air Forcemembers with an unsatisfactory score? (431)

The Balanced Eating, Work Out Effectively, Living Longer(BE WELL) Program.


The installation must promote a healthy lifestyleand optimal nutrition, body composition and fitnessfor all members. (431)



Who makes the unit PT program a success? (431)

The unit commander, Unit Fitness Program Manager(UFPM), PT Leader (PTL), immediate supervisor and eachindividual.


What is the unit commander's role in the PT program?(431)

He or she 1) promotes, supports and ensures the integrity ofthe fitness program; and 2) provides an environment conduciveto healthy lifestyle choices; 3) encourages participationin physical fitness during the duty day; and 4) implementsand maintains the PT program.


What is the Unit Fitness Program Manager's(UFPM) role in the PT program? (431)

To 1) oversee the administration of the unit fitness program;2) notify the unit commander of members who fail to attendscheduled fitness appointments; and 3) provide monthly fitnessmetrics and unit status reports to the unit commander.


How frequently does the PT Leader (PTL) attend aPTL refresher course? (431)

Annually, or upon change in duty station.


Air Reserve Component (ARC) PT Leaders (PTL)receive initial and refresher training from Regular AirForce Exercise Physiologist/Fitness Program Managers(EP/FPM) at co-located bases. How do ARC PTLs completetraining when in-person training is not feasible?(431)

They complete distance learning training, coordinatedthrough the Air Force Medical Operations Agency and thesupporting base EP/FPM.


The PT Leader (PTL) must complete Basic LifeSupport (BLS) and Automated External Defibrillator(AED) training prior to attending the PTL certificationcourse. T IF ( 431)

True. (They must maintain currency while serving as PTLs.)


What is each individual's role in the PT program?(432)

Each Air Force member must 1) maintain year-round physicalfitness through self-directed and unit-based fitness programsand proper nutrition standards according to AFI 36-2905; 2) meet minimum Air Force fitness standards; and 3)attend all required fitness program appointments.


What are the three main types of macronutrients?(432)

The essential calorie-containing nutrients are 1) carbohydrates;2) protein; and 3) fats.


__ are also known as the "energy powerhouse"because they fuel our bodies, especially the brain andmuscles. (432)



Simple carbohydrates take longer to convert to glucose,keeping blood sugar levels consistent and preventingan energy crash during a workout. T/F (432)

False. (Complex carbohydrates take longer to convert toglucose.)


Most sports nutritionists recommend that carbohydratesmake up __ to __ of the calories in a diet.(432)

One-half to two-thirds.


What are the building blocks of protein, necessary tobuild and repair muscle tissue, grow hair and fingernails,produce hormones, boost your immune system and replacered blood cells? (432)

Amino acids.


rotein is needed for the development of muscles,but "more" protein will not build bigger muscles. T/F(432)



General nutrition guidelines for healthy individualsare between __ and __ grams of protein per poundof body weight, depending on activity level. (432)

0.5 and 0.8 grams. (Airmen should consult with the installation'sregistered dietitian or diet technician.)


What can excessive intake of the macronutrient, fat,lead to? (432)

I) Weight gain; 2) heart disease; and 3) cancer.


What foods contain less healthy fats, such as transfats and saturated fats? (432)

Commercially baked foods and animal products.


Healthier fats are __ and __ unsaturated fats, found mostly in plant foods, nuts and fatty fish. (432)

Mono- and poly-unsaturated fats.


Fats are recommended as part of a pre-exercisesnack. T/F (432)

False. (Fats digest slowly and may cause digestive distress.)


What percentage of water is the human body madeup of? (432)

Over 50 percent.


Why is proper hydration critical before, during andafter intense workouts? (433)

Exercise places great demands on fluid replacement.


The simplest way to tell if you're adequately hydratedis the __ test (433)

Urine test. (Drink enough water so that your urine is consistentlypale yellow or clear, and weakly scented.)


What information does the US Department of Agricultureprovide at (433)

A food guidance system that offers many options to helpmake healthy food and activity choices every day.


For -based advice on healthy food and physicalactivity choices, read the Dietary Guidelines for Americansat the US Department of Agriculture's website. (433)

Science-based. (


With regard to nutrition, maintaining a healthy__ is one of the keys to a long, successful career. (433)

Weight. (Start by making small and gradual changes in eatingbehavior and physical activity.)


What risks increase when overweight or obese? (433)

Increased risk of high blood pressure, high blood cholesterol,heart disease, stroke, diabetes, arthritis, breathing problemsand certain types of cancers.


What is the essence of nutritional fitness? (433)

What nutrition you put into your body impacts what physicalabilities come out of your body.


What is nutritional fitness? (433)

Having a safe and appropriate quantity, quality, choice andtiming of fuels, nutrients and fluids to sustain and optimizephysical and cognitive performance, wellness and health,support environmental adaptations, accelerate healing andprotect against disease.


What helps promote nutritional fitness and a resilientand fit force? (433)

Performance-based nutrition education and an eating environmentthat makes healthy choices the easy choice.


What is the purpose of a pre-exercise meal or snack?(434)

To provide enough carbohydrates to maintain proper bloodsugar levels and enough fluid to maintain hydration duringthe activity.


Eat a pre-exercise meal __ to __ hours beforethe activity starts. ( 434)

3 to 4 hours. (Meal should include carbohydrates, fats andprotein.)


Eat a pre-exercise snack that contains mostly __30 to 60 minutes before activity. (434)

Carbohydrates. (They are digested quickly and tum into energy-giving glucose.)


Depending on the time and intensity of the workout,a post-activity snack or light meal will help with recovery.When should you eat a recovery snack? (434)

When an exercise routine is rigorous and lasts more than 45minutes.


In regard to nutrition, avoid __ diet changes beforea fitness test. (434)

Drastic. (Experiment with new food during training.)


Supplements are regulated by the Food and DrugAdministration (FDA). T/F (434)

False. (This lack of oversight means there is no guaranteethat what you purchase is what you get.)


Who created the Human Performance ResourceCenter website that has updates on supplements and performancenutrition? (434)



Who must an Airman consult if he or she wantsclearance to take a dietary supplement? (434)

His or her primary care physician or flight surgeon.


Which treatment programs include substance abuseprevention, education, treatment and urinalysis testing?(434)

The Air Force Alcohol and Drug Abuse Prevention andTreatment (ADAPT) and Demand Reduction (DR) programs.


What assistance will individuals with substanceabuse problems receive? (434)

Counseling and treatment, as needed.


Air Force members are not responsible for unacceptablebehavior resulting from substance abuse. T/F(434)



What are the four objectives of the Alcohol and DrugAbuse Prevention and Treatment (ADAPT) program?(434)

To 1) promote readiness, health and wellness by preventingand treating substance abuse; 2) minimize the negative consequencesof substance abuse; 3) provide comprehensivesubstance abuse education and treatment; and 4) return identifiedsubstance abusers to unrestricted duty status or assistthem in their transition to civilian life.


What is the DoD policy on drug abuse? (434)

To prevent and eliminate drug and alcohol abuse and dependencefrom the DoD.


Drug and alcohol abuse and dependence are incompatiblewith __ , high performance standards and militarydiscipline. ( 434)



Define drug abuse. (434)

The wrongful, illegal or improper use, possession, sale,transfer or introduction onto a military installation of anydrug as defined in AFI 44-121, Alcohol and Drug AbusePrevention and Treatment (ADAPT) Program.


__ use of substances is use without legal justificationor excuse. (434)



To ensure military readiness, Air Force policy prohibitsingestion of products containing or derived fromhemp seed or hemp seed oil. Why? (435)

These products may contain THC, the active ingredient ofmarijuana.


Products made with hemp seed or hemp seed oil maycontain THC, the active ingredient of marijuana, andtherefore their ingestion is prohibited. Failure to complyviolates Article 92, UCMJ. T/F (435)



Other than the lawful use of alcohol or tobacco, the__ use of any intoxicating substance that is inhaled,injected, consumed or introduced into the body in anymanner that alters mood or function is prohibited. (435)

Knowing. (Failure to comply by military personnel violatesArticle 92, UCMJ.)


Knowing. (Failure to comply by military personnel violatesArticle 92, UCMJ.)



Air Force policy recognizes that __ negativelyaffects public behavior, duty performance, and/or physicaland mental health. (435)

Alcohol abuse.


AFI __ provides guidance for the identification,treatment and management of personnel with substanceabuse problems and describes Air Force policy regardingalcohol and drug abuse. (435)

AFI 44-12 I.


AFMAN 31-116, Air Force Motor Vehicle TrafficSupervision, establishes guidance on court hearing procedures,convictions, nonjudicial punishment (NJP), civilianadministrative action or appropriate punishment forviolation of __ and intoxicated driving policies. (435)



Military members are presumed to be impaired withwhat blood-alcohol percentage? (435)

At least 0.05 but less than 0. 10.


Intoxicated driving is operating a motor vehicle underalcohol intoxication only. T/F (435)

False. (Drugs also qualify.)


Driving or being in physical control of a motor vehiclewith a blood alcohol percentage __ or greater resultsin a one-year driving privilege suspension. (435)

0. I 0. (If more stringent, the state limit applies.)


What is the blood alcohol limit for intoxicated drivingoverseas? (435)

0.10. (The SecDefmay set a lower limit.)


Under what circumstances does the Air Force reviewmembers' drinking habits? (435)

When they affect public behavior, duty performance or physicaland mental health.


What is the supervisor's role in assessing potentialdrug- and alcohol-related problems? (435)

To identify subordinates with problems early and motivatethem to seek and accept help.


Name at least five of the 15 signs and symptoms of substance abuse. (436-Fig)

Any five of the following: 1) deteriorating duty performance;2) unexplained or frequent absences; 3) frequent errors injudgment; 4) financial irresponsibility; 5) arrests or legalproblems; 6) increased alcohol use; 7) memory loss; 8)morning drinking and hangovers; 9) health problems relatedto drinking; 10) violent behavior; 11) suicidal thoughts orbehaviors; 12) dramatic mood swings; 13) denial or dishonestyabout use; 14) failed attempts to stop or cut down; and15) concerns expressed by family or friends.


The presence of the signs and symptoms of substanceabuse substantiates a substance abuse problem. T/F (435)

False. (Although they are common indicators, do not usethem to make a conclusive diagnosis.)


What should you do if you are concerned that an AirForce member has a substance abuse problem? (435)

Talk with him or her and explain your concern. Also documentand discuss specific instances of unusual behavior withthe supervisor, first sergeant or unit commander. Do nothesitate to document and refer troubled subordinates to theAlcohol and Drug Abuse Prevention and Treatment(ADAPT) program.


Help must be offered to every individual with substanceabuse problems. T/F (435-436-Note)



What are the five basic substance abuse identificationmethods? (436-437)

1) Medical care referrals; 2) commander's identification; 3)drug testing; 4) results of a medical examination; and 5) selfidentification.


When must medical personnel notify the unit commanderand the Alcohol and Drug Abuse Prevention andTreatment Program Manager (ADAPTPM) about suspectedsubstance abuse? (436)

When a member 1) is observed, identified or suspected to beunder the influence of alcohol or drugs while seeking medicalcare; 2) receives treatment for an injury or illness thatmay be the result of substance abuse; 3) is suspected of abusingsubstances; or 4) is admitted as a patient for alcohol ordrug detoxification.


List some examples of incidents that require unitcommanders to refer servicemembers for assessmentbecause substance use is suspected to be a contributingfactor. (436)

1) DUI; 2) public intoxication; 3) drunk and disorderly; 4)spouse and/or child abuse and maltreatment; 5) underagedrinking; 6) positive drug test; and 7) when notified by medicalpersonnel.


Why must commanders and supervisors refer memberswith suspected or identified substance abuse prollems for treatment? 436)

Failure to refer increases the risk for developing more severesubstance abuse problems and may jeopardize others' safetyand, ultimately, mission accomplishment.


What AFI governs Air Force drug testing of personnel?(436)

AFI 44-120, Military Drug Demand Reduction Program.


Military personnel are subject to drug testing dependingon their grade, status and position. T/F (436)

False. (All personnel are subject to testing.)


__ testing is the best deterrent against drug abusepresently available. (436)



Military members may be ordered or voluntarilyconsent to provide urine samples at any time. What happensto members who fail to comply? (436)

They are subject to punitive action under the UCMJ.


Commander-directed drug testing should only beused as a last resort. Why? (436)

The results cannot be used in actions under the UCMJ or tocharacterize a member's service as either general or underother than honorable conditions if they are separated.


What two adjectives best describe inspection testingunder Military Rule of Evidence (MRE) 313? (436)

Random and unpredictable.


How are individuals selected for inspection testingfor drug abuse? (436)

At random, using a nonbiased selection process. Commandersmay also select work sections, units or segments of themilitary population to provide urine samples.


After inspection under Military Rule of Evidence(MRE) 313, how may commanders use a positive result ofa urine drug test? (436)

) To refer a member for substance abuse evaluation; 2) asevidence to support disciplinary action under the UCMJ oradministrative discharge action; and 3) as a consideration forcharacterization of discharge in administrative discharges.


When does probable cause exist in regards to drugtesting? (436)

When there is reasonable belief that drugs will be found inthe member's system.


Consult with the __ regarding appropriate proceduresto establish probable cause for substance abuse.(436)

Staff Judge Advocate (SJA).


May the results of any examination conducted for avalid medical purpose (including emergency medicaltreatment, periodic physical examinations and other examinationsfor diagnostic or treatment purposes) be usedto identify drug abusers? (437)



Results of any examination conducted for valid medicalpurposes that identifies a drug abuser may be used asevidence to support disciplinary action under the UCMJor administrative discharge action. T/F (437)



Air Force members with substance abuse problemsare encouraged to seek assistance from the unit commander,first sergeant, substance abuse counselor or amilitary medical professional. T/F (437)

True. (Following the assessment, the Alcohol and DrugAbuse Prevention and Treatment Program Manager(ADAPTPM) will consult with the Treatment Team (TT) anddetermine an appropriate clinical course of action.)


Self-identification for substance abuse is reserved forwhom? (437)

Members not currently under investigation or pending actionas a result of an alcohol-related incident.


Commanders will grant unlimited protection for AirForce members who voluntarily disclose evidence of personaldrug use or possession with the intention of enteringtreatment. T/F (437)

False. (Limited protection will be granted; however, commandersmay not use voluntary disclosure against a memberin an action under the UCMJ or when weighing characterizationof service in a separation.)


When is disclosure of evidence of personal drug useor possession not considered voluntary? (437)

If the Air Force member has previously been 1) apprehendedfor drug involvement; 2) placed under investigation for drugabuse; 3) ordered to give a urine sample as part of the drugtesting program whose results are still pending or have beenreturned as positive; 4) advised of a recommendation foradministrative separation for drug abuse; or 5) entered intotreatment for drug abuse.


When is a member considered under investigationfor drug abuse? (437)

When 1) an entry is made in the security forces blotter; 2) thesecurity forces investigator's log shows an initial case entry;3) the Air Force OSI opens a case file; 4) he or she has beenquestioned about drug use by investigative authorities or hisor her commander; or 5) an allegation of drug use has beenmade against the member.


Commanders must provide sufficient incentive toencourage members to seek help for problems with alcoholwithout fear of negative consequences. T/F (437)



Self-identified members enter the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) assessment process and are held to what standards? (437)

The same standards as others entering substance abuse education,counseling and treatment programs.


The supervisor's role in the drug abuse treatmentprocess is limited to identifying and referring members.T/F (437)

False. (Although the supervisor does not provide treatment,his or her daily interaction with personnel and the TreatmentTeam (TT) can significantly impact the success of treatmentefforts.)


What is one of the most critical components of amember's substance abuse treatment program? (437)

The Treatment Team Meeting (TTM).


When must the commander and/or first sergeant andthe supervisor be involved in the Treatment Team Meeting(TTM)? (437)

At program entry, termination and any time there are significanttreatment difficulties with the patient.


What is the primary objective of the TreatmentTeam (TT) in drug abuse treatment? (437)

To guide the clinical course of the patient's treatment afterexamining all the facts.


The substance abuse Treatment Team (TT) consistsof whom? (437)

The commander, supervisor, member's counselor, medicalconsultants, other appropriate helping agencies and themember.


What is the central purpose of the substance abuseassessment? (437)

To determine the patient's need for treatment and the level ofcare required.


Alcohol and Drug Abuse Prevention and Treatment(ADAPT) staff members conduct the substance abuseassessment within how many calendar days of notification?(437)



Alcohol and Drug Abuse Prevention and TreatmentProgram Managers (ADAPTPM) conduct required reviewsof what materials on a priority basis? (437)

The patient's medical records and all documentation providedby the substance abuse staff


What two services is substance abuse treatment dividedinto? (438)

Nonclinical and clinical.


All active duty members involved in alcohol-relatedmisconduct will be referred for substance abuse assessment.T/F (438)



What nonclinical substance abuse services do membersnot meeting the diagnostic criteria for alcohol abuseor dependence receive? (438)

Counseling targeted (secondary) prevention and educationand at least one followup visit to reassess risk, assess progressand review educational components.


How are the length and number of targeted preventionand education visits determined for members referredfor substance abuse who do not meet the diagnosticcriteria for alcoholism or alcohol abuse? (438)

Based on a thorough assessment, determination of risk andtailored to the individual.


Individuals diagnosed with a moderate or higher riskfor alcohol abuse or dependence receive at least __ 30-minute followups with progress updates. (438)

Two. (The focus of these meetings are not treatment. Theyare targeted (individual) prevention, education and reassessment.)


Two. (The focus of these meetings are not treatment. Theyare targeted (individual) prevention, education and reassessment.)

Information on 1) Air Force policy; 2) the relationship betweenconsumption, metabolism and intoxication; and 3) thephysiological effects of alcohol on the brain and body.


What determines the length of involvement in nonclinicalsubstance abuse treatment? (438)

The patient's presenting problems and agreements upontreatment or in the behavioral contract.


Individuals being processed for separation will beprovided appropriate medical care (detoxification) priorto separation. Will separation be postponed due to participationin the Alcohol and Drug Abuse Prevention andTreatment (ADAPT) program? (438)



Which substance abuse patients are entered intoclinical substance abuse services with a level and intensityof care determined by the Alcohol and Drug Abuse Preventionand Treatment Program Manager (ADAPTPM)?(438)

Those meeting the Diagnostic Statistical Manual (DSM) IVdiagnostic criteria for alcohol abuse or dependence.


What is the Air Force's philosophy regarding placingpersonnel with substance abuse problems in treatmentprograms? (438)

They are placed in the least intensive or restrictive treatmentenvironment that is appropriate to their therapeutic needs.


Treatment plans are individually tailored to eachpatient's needs; __ involvement is strongly encouraged.(438)

Family. (Depending on the needs of the patient, variablelengths of stay or duration of treatment are provided withinan array of treatment settings.)


Are individuals diagnosed with alcohol abuse or dependencerequired to refrain from drinking during theinitial phase of substance abuse treatment? (438)

Yes. (They are strongly encouraged to continue to abstainduring aftercare.)


A relapse into unacceptable drinking behavior impliesfailure of the substance abuse treatment process.T/F (438)

False. (Because of the nature of alcoholism, a relapse shouldbe anticipated.)


Involvement in self-help recovery groups is encouragedas an adjunct to substance abuse treatment. How isthe frequency of attendance determined? (438)

It is determined by the Treatment Team (TT) with the patient.


Substance abuse detoxification should be managedon an outpatient basis prior to inpatient treatment.Where are patients requiring medically managed detoxificationplaced? (438)

An appropriate medical facility.


When are patients considered to have successfullycompleted the Alcohol and Drug Abuse Prevention andTreatment (ADAPT) program? (438)

When they meet the Diagnostic Statistical Manual (DSM)criteria for early full remission.


When are patients considered to have failed the Alcoholand Drug Abuse Prevention and Treatment(ADAPT) program? (439)

When the Treatment Team (TT) observes patterns of unacceptablebehavior, inability or unwillingness to comply withtheir treatment plan or involvement in alcohol or drug-relatedincidents after initial treatment.


Individuals who have failed the Alcohol and DrugAbuse Prevention and Treatment (ADAPT) program willbe considered for administrative __ by their commander.(439)



Decisions regarding substance abuse aftercare serviceswill be based on treatment history. T/F (439)

False. (They will be based on an assessment of current status.)


What does the substance abuse aftercare treatmentplan identify? (439)

Specific goals, interventions and means to assess them.


The commander is responsible for all personnel andadministrative actions pertaining to patients involved inthe Alcohol and Drug Abuse Prevention and Treatment(ADAPT) program. What does this include? (439)

1) Assignment availability; 2) promotion eligibility; 3) reenlistmenteligibility; 4) Personnel Reliability Program; and 5)security clearances.


What should administrative restrictions for substanceabuse be based on? (439)

The establishment of an Unfavorable Information File (UIF)or control roster resulting from the member's unacceptablebehavior, not solely on their involvement in the Alcohol andDrug Abuse Prevention and Treatment (ADAPT) program.


What is a Line of Duty (LOD) determination? (439)

A finding made after an investigation into the circumstancesof a member's illness, injury, disease or death to determinewhether it 1) Existed Prior to Service (EPTS) (and if EPTS,whether it was aggravated by military service); 2) occurredwhile the member was absent from duty; and 3) was due tothe member's own misconduct.


Can a member's substance abuse misconduct lead toa Line of Duty (LOD) determination? ( 439)



What entitlements may a Line of Duty (LOD) determinationimpact? (439)

I) Disability retirement and severance pay; 2) forfeiture ofpay; and 3) period of enlistment; and 4) veteran benefits.(Additional guidance may be found in AFI 36-2910, Line ofDuty (Misconduct) Determination.)


What is the single most preventable cause of disease236and death in the US?

Tobacco use. (Approximately 443,000 Americans die eachyear from tobacco-related diseases; an estimated 49,000 diefrom secondhand smoke.)


What is the Air Force's goal regarding tobacco use?(439)

To be a tobacco-free force.


Tobacco use, including but not limited to cigarettes,cigars, spit tobacco and electronic cigarettes, is __with the Air Force's goal of a mission-ready, healthy andfit force. ( 439)



Tobacco use only affects the mouth and lungs. T/F(439)

False. (It affects all body systems.)


What medical problems have been linked to members'tobacco use? (439)

Types of cancer, cardiovascular diseases and many otherdiseases; decreased endurance, night vision and fine motorcoordination; increased risk of injuries and post-operativerespiratory complications; and impaired (or slow) woundhealing.


The Environmental Protection Agency (EPA) classifiestobacco smoke as a class "A" carcinogen. What doesthis mean? (439)

Smoking causes cancer and contributes to cardiovasculardisease. (For both the smoker and those who breathe environmental(exhaled) tobacco smoke.)


Cigarette smoking has declined but the use of smokelesstobacco has increased, based on the faulty assumptionthat it is less hazardous than smoking. What is theevidence against this assumption? (439)

1) Smokeless tobacco contains 28 different cancer-causingagents (carcinogens); 2) oral cancers affect 30,000 peopleannually, killing one per hour; and 3) the 5-year survival rateafter diagnosis is only 50%.


How can you best prevent nicotine addiction? (439-440)

By never using tobacco products. (Quitting is challenging.)


Who found that nearly 100 percent of adults whosmoke daily started when they were 26 or younger? (440)

The US Surgeon General.


TRICARE estimates tobacco use costs the DoD$ _ per year because of increased health care use anddecreased work productivity (due to smoking breaks and illness). (440)

$1.6 billion per year.


How much will an AB spend each year if he or shesmokes a pack of cigarettes each day? (440)

One month's base pay.


Which AFI expands tobacco-free environments.(440)

AFI 40-102, Tobacco Use in the Air Force.


Tobacco use on military installations is restricted towhat areas? (440)

Designated Tobacco Areas (DTA).


Tobacco use is prohibited on all recreational facilities,including athletic complexes, golf courses and beaches.T/F (440)

True. (Unless the installation commander assigns a DesignatedTobacco Area (DTA).)


Not using tobacco should be the Air Force norm topromote mission readiness, health and productivity. T/F(440)



What do installation health promotion programs(offered through the Health and Wellness Center(HA WC)) provide to discourage tobacco use? (440)

Strategies for education, motivation and intervention. (TheHA WC also provides formal, structured tobacco cessationprograms.)


What is the Military Health System (MHS)? (440)

A unique partnership of medical educators, medical researchers,health care providers and their support personnelworldwide.


The Military Health System (MHS) is a DoD enterprise.Who does it consist of? (440)

The 1) Office of the Assistant Sec Def for Health Affairs; 2)medical departments of the Army, Navy, Marine Corps, AirForce, Coast Guard and Joint Chiefs of Staff (JCS); 3) CombatantCommand (COCOM) surgeons; and 4) TRICAREproviders (including private sector health care providers,hospitals and pharmacies).


The Military Health System (MHS) is prepared torespond with comprehensive medical capability to militaryoperations, natural disasters and humanitarian crisesin the US alone. T/F (440)

False. (It is prepared to respond anytime, anywhere aroundthe globe.)


How does the Military Health System (MHS) promotea fit, healthy and protected force? (440)

By reducing noncombat losses, optimizing healthy behaviorand physical performance and providing casualty care.


What are the key mission elements of the MilitaryHealth System (MHS)? (440)

1) Casualty care and humanitarian assistance; 2) fit, healthyand protected force; 3) healthy, resilient individuals, familiesand communities; and 4) education, research and performanceimprovement.


What does the v1s10n statement of the MilitaryHealth System (MHS) focus on? (440)

1) Providing premier care for warriors and their families; 2)creating an integrated team ready to go in harm's way; 3)leading in health education, training, research and technology;4) becoming a nationally recognized leader in preventionand health promotion; and 5) building a bridge to peacethrough humanitarian support.


TRICARE is the health care program serving activeduty servicemembers and retired members of the uniformedservices, their families, survivors and certainformer spouses (those who are registered in Defense EnrollmentEligibility Reporting System (DEERS)). Whoelse does it serve? (441)

Air Reserve Component (ARC) members and their families.(Benefits will vary depending on sponsor's military status.)


TRICARE brings together the health resources ofthe Army, Navy, Air Force, Coast Guard and commissionedcorps of the public health service, and supplementsthis capability with networks of civilian healthprofessionals, institutions, pharmacies and suppliers. T/F(441)



The mission of is to enhance DoD and nationalsecurity by providing health support for the full range ofmilitary operations. (441)



What is the vision ofTRICARE? (441)

To be a world-class health care system that supports the militarymission by fostering, protecting, sustaining and restoringhealth.


Name several ways TRICARE enhances medicalreadiness. (441)

I) Promoting our forces' health and well-being; 2) providingpreventive care and excellent medical care; 3) enabling medicsto maintain skills during peacetime for ultimate medicalreadiness in wartime; 4) ensuring the Air Reserve Component(ARC) has access to quality medical care; 5) providingaccess to medical care for members and their families stationedaway from Military Treatment Facilities (MTF); and6) taking care of family members at home so members cantake care of the mission.


TRI CARE is available worldwide and is managed in__ separate regions. ( 441)

Four. (Three in the US and one OS.)


The three US regions of TRICARE include North,South and West. What does the OS region include? (441)

TRICARE Eurasia-Africa, TRICARE Latin America andCanada and TRICARE Pacific.


What three plans does TRICARE offer to eligiblebeneficiaries? (441)

I) Prime; 2) Standard; and 3) Extra.


TRICARE availability depends on the beneficiary'sstatus and residence. Who can help you decide whichoption is best? (441)

Local TRICARE service centers or the beneficiary counselingand assistance coordinators in the Military TreatmentFacilities (MTF).


TRICARE Prime is a managed care option offeringthe most affordable and comprehensive coverage. Whatimportant points should you know about this plan? (441)

1) lt is the only option available to active dutyservicemembers; 2) enrollment is not automatic; 3) there isno enrollment fee, annual deductible or co-payments for carein the network; 4) most care is received from providers in theTRICARE network; 5) a Primary Care Manager (PCM) providesmost of the member's care; 6) it includes enhancedvision and preventive service; and 7) it offers travel reimbursementfor some specialty care.


What TRI CARE program extends TRI CARE Primebenefits to active duty servicemembers and Active DutyFamily Members (ADFM) in designated ZIP codes wholive and work at least 50 miles or an hour's drive from aMilitary Treatment Facility (MTF)? (442)

TRICARE Prime Remote (TPR). (Active dutyservicemembers are required to enroll. Those living closerthan 50 miles may be eligible when geographic boundariescreate undue travel hardship.)


Active Duty Family Members (ADFM) residing withtheir TRICARE Prime Remote (TPR)-enrolled sponsorsare eligible for TPR for Active Duty Family Members(TPRADFM). T/F (442)

True. (They may remain enrolled even if their sponsor receivesunaccompanied PCS orders, as long as they remain inthe same TPR location.)


TRI CARE _____ is used when visiting a nonnetworkprovider. (442)



What should you know about the TRICARE Standardand Extra fee-for-service plan? (442)

It I) is available to all nonactive duty beneficiaries in the US;2) does not require enrollment; 3) gives automatic coverageas long as information is current in the Defense EnrollmentEligibility Reporting System (DEERS); 4) allows membersto visit any TRICARE-authorized provider, network or nonnetwork;5) may require prior authorization for some services;and 6) provides care at Military Treatment Facilities(MTF) on a space-available basis.


TRICARE __ is used if visiting a network providerallowing the beneficiary to pay less out-of-pocket.(442)



What medical services does TRICARE Prime provideat no cost to participants? (442-Fig)

I) Civilian inpatient admission; 2) civilian outpatient visits; 3) civilian inpatient mental health; and 4) civilian inpatientskilled nursing facility care.


TRICARE Extra and Standard members rankedSSgt and above pay an annual deductible of $150 perindividual or $300 per family. What are the deductiblesfor Sr A and below? (442-Fig)

$50 per individual or $100 per family.


There is no annual enrollment fee for TRICAREExtra, Standard or Prime. T/F (442-Fig)



The civilian inpatient admission fee for TRICAREExtra and Standard participants is the greater of $25 or$15.65 per day. What is the civilian inpatient mentalhealth fee? (442-Fig)

The greater of$20 per day or $25 per admission.


With TRICARE Extra and Standard, civilian inpatientskilled nursing facility care costs $15.65 per daywith a minimum$ __ charge per admission. (442-Fig)



The TRICARE catastrophic cap on out-of-pocketexpenses for TRICARE-covered services is __ per active duty family per FY. (442-Fig)



Who qualifies to purchase TRI CARE Young Adult(TY A), a premium-based coverage plan that offersTRICARE Prime and TRICARE Standard worldwide?(443)

Unmarried, 21- to 25-year-old dependents of TRICAREeligibleuniformed service sponsors.


What two eligibilities would disqualify you frompurchasing TRICARE Young Adult (TYA)? (443)

Eligibility for either TRICARE program coverage or enrollmentin an employer-sponsored health plan as defined inTY A regulations.


The TRICARE Dental Program (TDP) offers dentalcare with __ dentists. (443)

Civilian. (It is managed by United Concordia Companies,Inc. (UCCI).)


Who is eligible for TRICARE Dental Program(TDP)? (443)

Active Duty Family Members (ADFM), selected Reserveand Individual Ready Reserve (IRR) members and their eligiblefamily members.


Active duty servicemembers and Reservists called toactive duty for more than __ days are not eligible forTRI CARE Dental Program (TDP). (443)

30 days.


Suicide is the act of __ killing oneself, based onthe victim's intent and understanding of the probableconsequences of his or her actions. ( 443)



Roughly how many Americans commit suicide eachyear? (443)

30,000. (Almost twice the number killed by homicide.)


During 2011, the Air Force suffered __ RegularAir Force suicides. (443)

42. (A rate of 12. 8 suicides for every I 00,000 Airmen.)


Suicide is the __ leading cause of death amongRegular Air Force personnel. (443)

Third. (Death by accidents is second.)


During 2011, 27 Air Reserve Component (ARC) and__ civilian employee suicides occurred. (443)



Within the Air Force, what are the most commonstressors among those who commit suicide? (443)

Relationship, legal, mental health, financial hardship andwork problems.


Within the Air Force, those over 35 are at less riskfor suicide than those under 24 years old. T/F (443)

False. (These groups are at equal risk.)


Is any particular ethnic, racial, age, or rank groupspared from suicide? (443)

No. (However, men do commit suicide at a rate four timesgreater than women.)


What serious problems may Air Force suicides create?(443)

1) An unnecessary loss of human life; 2) distress in the victim'sfamily and Air Force community; 3) direct impact onmission sustainability (loss of skills, experience and productivity);and 4) loss of the economic value invested in thevictim (anticipated services, training costs and replacementcosts).


What are the two personal perceptions that placesomeone at risk for suicide? (443-444)

I) Feeling like they don't belong or fit in anywhere; and 2)feeling like a burden to others.


What is the third important piece in the dynamics ofsuicide? (444)

Acquiring the capability to take one's own life. (For Airmen,the most common step is acquisition ofa firearm.)


Among Airmen feeling suicidal, which ones may beat more risk for suicide? (444)

Those who already possess the means or have training in theuse oflethal means.


All military suicides are preventable. T/F (444)

False. (However, definite steps can be taken to reduce thenumber of suicides.)


Suicide prevention efforts should be __ with allthe force and effectiveness of other command initiatives.(444)



At what stage may individuals considering suicide bemost open to assistance and support from a wingman,friend or professional? (444)

After other efforts to cope with or manage their problemshave failed and they feel there are no other options.


Name three suicide risk factors. (444)

Any three of the following: 1) severe, prolonged or unmanageablestress; 2) difficulty coping or functioning; 3) lack ofsocial support or social isolation; 4) escalating alcohol ordrug use; 5) difficulty sleeping; and 6) feelings of hopelessnessor depression.


Through CY 2009 to CY 2011, more than __ 0/oof Airmen who died by suicide were receiving treatmentfor mental health concerns. (444)



Depression is a significant risk factor associated withsuicide. Name five signs that can help you determine ifsomeone may be suffering from depression and distress.( 444, 444-Fig)

Any five of the following: agitation, alcohol misuse, anxiety,apathy, avoiding recreation, constant fatigue, decreased appetite,decreased libido, depression, difficulty coping, disciplinaryproblems, excessive sleeping, feeling "blah," feelingguilty, feeling overwhelmed, feeling worthless, financialproblems, hopelessness, increased appetite, indecisiveness,insomnia, irritability, loss of interest, low energy, low selfesteem,poor concentration, poor personal hygiene, poorwork performance, relationship difficulties, restlessness,sadness, social isolation, social withdrawal, suicidal ideation,weight gain or weight loss.


Since CY09, __ % of Airmen who died by suicidefaced legal problems at the time of their deaths. (444)



Why is being under investigation for a suspectedcriminal offense stressful, especially if it is highly embarrassing?( 444-445)

There is stress in not knowing the final outcome of the investigation,the threat to one's career and/or ability to find workafter separation, and rejection by loved ones


Many Air Force suicide victims were experiencingsignificant financial problems at the time of their deaths.T/F (445)



Why should commanders recognize financial probIems as symptomatic of ineffective coping behavior or poor decisionmaking that might lead to suicide? (445)

It is another potential point of intervention that might reducethe overall Air Force suicide rate.


Since CY09, __ % of Airmen who died by suicideexperienced a failed relationship in the months prior totheir death and __ % experienced work-related problems.(445)

54%; 25%.


Many suicide victims experienced simultaneous workand relationship problems at the time of their deaths. T/F(445)



Why is a combination of work-related problems andpersonal problems particularly dangerous for suicidevictims? (445)

Because it leaves the victim with no safe haven. (A healthy,happy relationship can serve an important protective functionagainst many other kinds of stress.)


When a fellow Airman, friend or family memberdemonstrates observable signs of distress, what actionshould you take? (445)

Ask them what may be troubling them.


Most suicides are impulsive. T/F (445)

False. (Typically, individuals come to focus on suicide astheir only solution over a period of time.)


List five examples of verbal and behavioral hints ofsuicidal ideation. (445)

1) Acquiring the means to commit suicide; 2) making suicidalremarks; 3) giving away cherished possessions; 4) writinga will; and 5) preoccupation with death.


Some communications of suicidal intentions are direct(i.e., "I'm going to get a rifle from a pawnshop andkill myself."); others are indirect. Give examples of indirectstatements of suicidal intention. (445)

Goodbye statements, making preparations such as writing awill or increasing life insurance, or comments that everyonewould be better offifhe or she was dead.


Why are vague allusions to suicide easy to dismiss?(445)

Because of their passive nature and because many people mistakenly believe that those who talk about suicide are not likely to actually do it. Every suicidal remark must be takenseriously.


Any self-injury intended to end one's life should betreated as a suicide attempt, regardless of its severity. T /F(445)



ls the severity of injury during a suicide attempt anaccurate indicator of the lethality of the intent? (445-446)

No. (Any level of self-injury is serious and should be addressedby mental health professionals.)


Actual suicides combine high __ in the selectedmethod and a low probability of __ . (445)

Lethality; rescue.


Do suicides increase during the holidays? (446)

No. (Despite widespread belief, no such relationship hasbeen noted in the Air Force.)


After deciding upon suicide and acquiring the capability,many victims become __ . (446)

Tranquil. (Always question this change in behavior or attitude.Do not assume the victim's solution is positive.)


Extreme __ can limit a person's ability to problem-solve effectively, and lead them to focus on suicidewithout being able to clearly see alternatives. (446)



Suicide is a permanent solution to an often temporaryproblem. T/F (446)

True. (The Air Force has many resources to help people resolveproblems in more constructive ways.)


Effectively addressing suicide requires a carefullyintegrated and systematic community approach that doeswhat two things? (446)

1) Prevents the factors contributing to suicide; and 2) identifies,diagnoses and treats those at risk.


What does the community approach to suicide preventionrely on? (446)

1) Active leadership involvement in the full range of AirForce suicide prevention activities; and 2) the engagement ofconcerned wingmen.


Military commanders have the authority to compelbehavior, but they are also responsible for the health,well-being and morale of their subordinates. T/F (446)

True. (This applies from four-star generals to the frontlinesupervisor.)


May the obligations of leadership in regards to suicideprevention be transferred to specialists such as psychiatrists,psychologists, social workers or chaplains?(446)

No. (Specialists provide services m support of commandresponsibilities.)


Since CY09, what percentage of Airmen who died bysuicide were seen by Air Force mental health services inthe month prior to their deaths? (446)

30%. (However, I 00% were seen by their supervisors andpeers.)


Why is the supervisor a central player in suicideprevention? (446)

He or she is in a position to see any changes in performanceor behavior that may signal a problem.


What are some typical reasons front-line supervisorsfail at suicide prevention? (446

I) Not paying enough attention to their subordinates' personalneeds; 2) not recognizing warning signs; 3) trying to "protect"subordinates from the Air Force; and 4) failing to takethe proper action when needed.


How can supervisors best help subordinates limit thenegative impact of personal problems on their careers?(447)

Engage in problems early to ensure subordinates get the helpthey need to improve or maintain peak performance.


What should happen when suicide risk has beenidentified? (447)

Appropriate professional resources should be obtained andapplied to the problem.


Appropriate treatment requires commitment andassumption of responsibility at the __ level, and dedicatedcompetence at the __ level. (447)

Command level; support level.


What resource helps supervisors and wingmen identifyappropriate helping agencies for suicide prevention?(447)

The Airman's Guide for Assisting Personnel in Distress.


Who owns the Air Force Suicide Prevention Program(AFSPP)? (447)

The ChiefofStaff, US Air Force (CSAF).


Who serves as the Office of Primary Responsibility(OPR) for the Air Force Suicide Prevention Program(AFSPP)? (447)

The Air Force Surgeon General (AF/SG).


What helping agencies typically evaluate and treatpotential suicide victims at the installation level? (447)

Installation mental health clinics


What major shortcoming do helping agencies such asmental health clinics have in regard to suicide prevention?(447)

They can only act when they are aware of the problem. (Individualsat risk must either seek help themselves or bebrought into the healthcare system by others.)


What is the common fear many have with regard toseeking help at the mental health clinic? (447)

That it will negatively impact their career.


The vast majority of Airmen who receive mentalhealth care in Air Force clinics suffer no adverse careeroutcomes. T/F (447)

True. (97% do not.)


Mental health providers must disclose what informationto commanders? (447)

Safety issues (such as suicidal or violent thoughts) and fitnessfor duty issues. (All other information is private.)


If you visit a mental health provider, will your commanderbe contacted? (447)

No, unless there is a safety-related issue or mission impairment.


What program did the Air Force institute to promotehelp-seeking for suicidal Airmen with legal or administrativeproblems? (447)

The Limited Privilege Suicide Prevention (LPSP) program,according to AFI 44-109.


What does the Limited Privilege Suicide Prevention(LPSP) program allow suicidal Airmen to receive withoutrisk of further incriminating themselves? (447)

Mental health care.


Who is most likely to spot a potential suicide victim?(447)

Friends, coworkers and immediate supervisors. (They aremost likely to notice signs of depression and hear suicidalcomments.)


__ concerns of a potential suicide victim with thechain of command. (447)

Communicate. (Post-suicide reviews often find that no one person had "the whole picture.")


To help prevent suicide, Air Force members should ~encourage use of professional services for personalproblems. (447)

Support. (Encouraging early help-seeking behavior is animportant part of supervision, leadership and friendship.)


The Air Force Suicide Prevention Program (AFSPP)is founded upon what concept? (448)

That decreasing suicides requires a community approach inwhich prevention and assistance are offered long beforesomeone becomes suicidal.


The suicide prevention Integrated Product Team(IPT) published 1 I Air Force Suicide Prevention Program(AFSPP) initiatives in AFPAM 44-160, The AirForce Suicide Prevention Program. Name eight. (448-449)

Any of the following: I) leadership involvement; 2) addressingsuicide prevention through PME; 3) guidelines for commanders(use of mental health services); 4) unit-based preventiveservices; 5) wingman culture; 6) investigative interviewpolicy (hand-off policy); 7) post-suicide response(postvention); 8) Community Action Information Board(CAIB) and Integrated Delivery System (IDS); 9) LimitedPrivilege Suicide Prevention (LPSP) program; 10) commanderconsultation tools; and 11) suicide event tracking and Vanalysis.


What type of environment do leaders build to preventsuicide? (448)

One that promotes healthy/adaptive behaviors, fosters thewingman culture and encourages responsible help-seeking.


PME provides periodic and __ suicide preventiontraining for Airmen. (448)

Targeted. (Specifically oriented to the individual's rank andlevel ofresponsibility.)


PME suicide prevention teaches leaders about policiesand practices that promote or discourage helpseeking.What skills do the leaders develop? (448)

How to detect at-risk individuals and intervene with Airmenunder stress.


Why are commanders encouraged to partner andconsult with mental health staff about the health of theirAirmen? (448)

To improve their Airmen's duty performance. (Early selfreferralyields the best outcome for the individual and unit.)


When must a commander order an Airman to theMedical Treatment Facility (MTF)? (448)

For I) a mental health evaluation (per AF! 44-109); 2) a substanceabuse assessment (per AFI 44-121 ); or 3) family advocacy issues (per AFI 40-301).


Unit leaders and helping agency professionals providesuicide prevention services at the worksite to increaseaccess, encourage help-seeking and promote familiarity,rapport and trust with Airmen and families. T/F(448)

True. (Unit-based preventive services also improve unit cohesionand effectiveness.)


How do Wingmen help with suicide prevention?(448)

Wingmen l) foster a culture of early help-seeking; 2) recognizethe signs and symptoms of distress in themselves andothers and take protective action; and 3) practice healthybehaviors, make responsible choices and encourage others todo the same.


Airmen facing __ or __ action are at greaterrisk of suicide. (448)

Criminal or administrative action. (They can easily feel isolatedfrom family, friends and other social supports whenneeding them most.)


Following an investigative interview, Air Force investigatorsmust hand off the accused directly to themember's commander or through person-topersondocumented contact. (448)

First sergeant. (The investigator will notify the unit representative.)


Who manages post-suicide responses? (448)

Unit leaders. (They support affected personnel through thegrieving process, consulting with chaplains and mentalhealth staff as needed.)


In post-suicide responses, what should be carefullyavoided? (448)

Sensationalizing, glamorizing, romanticizing or giving undueprominence to suicide. (These practices are associated withsuicide clusters, copycat suicides and increased suiciderates.)


According to AFI __ , Community Action InformationBoard (CAIB) and Integrated Delivery System(IDS) coordinate the activities of the various base helpingagencies to achieve a synergistic impact on communityproblems and reduce suicide risk. (448-449)

AFI 90-501, Community Action Information Board and IntegratedDelivery System.


According to AFI 44-109, the Limited Privilege SuicidePrevention (LPSP) program offers increased legalprotections and confidentiality for members. Informationin the LPSP mental health file may be disclosed only to(449)

1) Other medical personnel for treatment purposes; 2) amember's confinement military commander for legal proceedingsagainst third parties; and 3) other authorized personnelwith an official need to know.


Validated unit climate assessment tools can tap intothe strengths and challenges of an organization and assistin choosing strategies that enhance the well-beingand resilience of their Airmen. ( 449)

Commanders. (Some tools available to commanders, at nocost to the unit, include the equal opportunity's unit climateassessment, the Airman and Family Readiness Center's(A&FRC) support and resilience inventory and the Air Forceculture assessment safety tool.)


What information is entered into the DoD SuicideEvent Report (DoDSER)? (449)

Information on all Air Force suicides and suicide attempts.(It identifies suicide risk factors and trends.)


DoD Suicide Event Report (DoDSER) statisticalsummary data may be provided to federal, state and localgovernments for health surveillance and research. T/F(449)

True. (The report cannot contain personally identifiable information.)


A DoD Suicide Event Report (DoDSER) is submittedwhen active duty or federalized status Air Reserve Component(ARC) members attempt suicide. A DoDSER issubmitted for what other populations? (449)

For suspected suicides by active duty or equivalent ARCmembers, or active, full-time ANG members.


Basic DoD Suicide Event Report (DoDSER) demographicdata from data fields 1-9 is tracked for whichpopulations? (449)

All 1) Department of Air Force civilian employee personnelsuspected of dying by suicide; and 2) Selected Reserve(SELRES) and traditional Air Reserve Component (ARC)members suspected of dying by suicide while in civilianstatus or during a unit training assembly.


Who has the authority to conduct additional reviewsof suicides by civilians and reserve members not in Title10 status within their commands? (450)

MAJCOMs, Field Operating Agencies (FOA), Direct ReportingUnits (DRU) and the ANG.


A DoD Suicide Event Report (DoDSER) is completedwithin 30 days of the hospitalization or evacuation date,or within ___ days from the date the event was determinedto be a suicide for active duty servicemembers,and __ days for activated guardsmen and reservists.(450)

60 days; 90 days.


For reportable events that occur in a deployed setting, the DoD Suicide Event Report (DoDSER) is completed at the servicemember's deployed station. T/F (450)

False. (DoDSER is completed at the servicemember's homestation.)


Suicide prevention is whose responsibility? ( 450)



To effectively prevent suicide, create a(n) __ thatencourages early help-seeking behavior. (450)



What is the simple acronym the Air Force developedto help facilitate personal engagement in suicide prevention?(450)

ACE - Ask, Care, Escort.


When working with suicide prevention and the Ask,Care, Escort (ACE) model, why is it important to askquestions if you see or hear any of the warning signs ofsuicide? (450)

To give people permission to talk about a subject that may bedifficult to bring up.


When working with suicide prevention and the Ask,Care, Escort (ACE) model, what are some importantways to show you care? (450)

I) Listen and allow them to share; 2) avoid judgmentalstatements or immediately trying to solve their problems; 3)accept they are in distress; 4) begin the process of gettingthem help; and 5) try to remove any means of self-harm,such as weapons or medications.


When working with suicide prevention and the Ask,Care, Escort (ACE) model, the final step is to escort theindividual to the person or agency that can help. Why isthis important? (450)

If you leave them alone or send them alone to a chaplain ormental health clinic, they may change their mind on the way.


If someone is suicidal and won't agree to go with youto a helping agency, what action is appropriate? (450)

Contact your chain of command or emergency services forhelp ensuring the person's safety.


What does the acronym PTSD stand for? (450)

Posttraumatic stress disorder.


PTSD is comprised of what six components? (450)

I) Exposure to a traumatic event; 2) re-experiencing theevent (nightmares and/or flashbacks); 3) avoidance or emotionalnumbing; 4) persistent arousal symptoms(hypervigilance); 5) symptoms lasting more than one month; and 6) significant distress or impairment.


PTSD symptoms are four to five times more frequentwith what type of exposure? (450)

Combat exposure.


Occupations more likely to be exposed to traumahave a higher incidence of PTSD. T/F (450)



How is PTSD prevention achieved? (451)

Through screening and training.


Airmen are screened before and after eachassess mental health. (451)



What types of training do deploying Airmen receiveto prevent PTSD? (451)

Airmen resilience training before and after deployment, andtraining on PTSD recognition, intervention and treatment.


What type of training might the installation traumaticstress response team provide for mission sets that havea high probability of exposure to PTSD? (451)

Pre-exposure preparation training.


The deployment transition center is a two-day reintegrationprogram, completed en route from the deployedlocation to home station. Who participates? (451)

Airmen in high PTSD exposure mission sets.


Units at moderate or high risk of exposure to atraumatic event can enhance their psychological __through preventive preparation. (451)



What are the two preparation principles for preventingPTSD? (451)

I) Engage in realistic training; and 2) strengthen your perceivedability to cope.


What types of realistic training simulations are effectivein PTSD prevention? (451)

Body handling, survival training and mock captivity training.


What is the purpose of teaching coping mechanismsduring PTSD prevention training? (451)

To strengthen coping skills before actual trauma. (Discuss the reasoning behind realistic training.)


What appears to be the most effective type of counselingfor PTSD? (451)

Cognitive behavioral therapy.


What two types of cognitive behavioral therapy doesthe Air Force provide? (451)

Cognitive processing and prolonged exposure therapy.


Name two other types of PTSD treatment besidescognitive behavioral therapy. (451)

1) Eye movement desensitization and reprocessing therapy;and 2) medication (e.g., a drug known as a Selective SerotoninReuptake Inhibitor (SSRI)).


What percent of PTSD patients never require a medicalboard? (451)

75 percent.


Why are organizational and personal stress both major concerns for enlisted leaders at all levels? (451)

At the organizational level, it can negatively affect performance,effectiveness and mission accomplishment. At thepersonal level, experiencing stress over an extended periodof time can lead to health problems and affect overall qualityoflife.


Name the two individuals who defined the concept ofstress. ( 451)

Physiologist Walter Cannon and endocrinologist Hans Selye;Selye is widely regarded as the father of stress research.


How did Cannon describe the body's reaction tostress? (450)

As a response to a perceived threat that prepares the body forflight or fight.


What conclusion did Selye draw about the body'sreaction to stress? (451)

The reaction is the same regardless of whether the sourcewas good or bad, positive or negative.


What is Selye's definition of stress? (451)

"The nonspecific response of the body to any demand madeupon it." (This demand is commonly called a stressor.)


What terms did Selye use to identify the stresses experiencedfrom positive or negative factors? (451-452)

1) Eustress (exhilarating experiences, the stress of winning and achieving); and 2) distress (negative factors, losing, failing,overworking, not coping effectively).


Stressors can be categorized into what two majorareas? (452)

1) Organizational stressors, which occur in the work environment;and 2) extra-organizational stressors, which occuroutside the work environment, such as family, marital andfinancial issues.


Stress indicators may be isolated reactions or combinationsamong what three categories? (452)

Emotional, behavioral and physical.


The duration, __ and intensity of the symptomscan indicate the level of difficulty in dealing with stress.(452)



Apathy, irritability and job dissatisfaction are __symptoms of stress. (452-Fig)



Frequent illness, weight gain/loss and headaches are__ symptoms of stress. (452-Fig)



Social withdrawal, substance abuse and neglectingself-care are __ symptoms of stress. ( 452-Fig)



What does individual stress management attempt tostrengthen? (452)

Your ability to manage stressors and your stress response.


Organizational stress management methods attemptto alter potential stressors themselves. Why are both vitallyimportant? (452)

They are interrelated and influence each other.


ldentify the five individual stress management methods.(452-453)

1) Planning; 2) time management; 3) overload avoidance; 4)relaxation; and 5) exercise and good nutrition.


How can planning help you manage stress? (452)

It can help you look for ways to achieve your goals whileavoiding the effects of known stressors.


How can time management help you manage stress?(452)

If time management is an issue for you, it will help to use effective time management skills and tools, like developingtask lists and prioritizing tasks.


How can overload avoidance help you managestress? (453)

It can help you identify and avoid busy work, and delegateand empower others.


How can relaxation methods help you managestress? (453)

By reducing mind and body tension in your daily routines,you can train your body to respond differently to stress andreduce the negative effects of stress on your health.


How can exercise and good nutrition help you managestress? (453)

Exercise provides an outlet for excess energy and tensioncaused by stress, and nutritious foods nourish your body.Both help you build resistance to the negative physical resultsof stress.


How can supervisors reduce organizational stresslevels? (453)

By identifying potential stressors and developing strategiesto remove or reduce them.


Name the five organizational stress managementmethods identified in the PDG. (453)

1) Job design; 2) improving the work environment; 3) improvingorganizational communication; 4) personnel selectionand job placement; and 5) substance abuse programs.


What should you consider when examining job designas a potential stressor in the organizational workenvironment? (453)

Ask yourself if the task is needed and feasible, or ifit shouldbe eliminated or restructured to better accommodate the individualneeds and abilities of your Airmen.


What physical factors should you consider whentrying to reduce stress by improving the organization'swork environment? ( 453)

Examine factors such as temperature, noise and light levels,and make necessary improvements.


What is the best way to improve organizationalcommunication and thus reduce stress in the work environment?(453)

Do your best to keep your subordinates informed about anythingthat can impact their lives. (Any attempts at improvementscan help lower individual stress levels.)


How can your efforts to improve personnel selectionfor job placement help reduce organizational stress in the work environment? (453)

Though difficult to do, carefully matching the right person to each position will result in satisfied workers.


In the organizational environment, why are all supervisorsresponsible and accountable for managing substanceabusers in accordance with applicable directives?(453)

Substance abuse can have a dramatic negative effect on mission,morale and readiness, and people's health and wellbeing.


What is the purpose of the redeployment supportprocess? (453-454)

The positive and sustained care, control and discipline ofeach Airman.


How does the redeployment support process ensurepersonnel readiness throughout the Air and Space ExpeditionaryForce (AEF) cycle? (453-454)

By providing timely support for members and their families.(It is an ongoing process, not a homecoming event.)


The redeployment support process provides continuous,integrated support from the __ to home station toassist the transition from the deployed environment tofamily life and the work site. (454)

Area of responsibility (AOR).


How does a lengthy break from the deployment environmenthelp members? (454)

It improves their psychological and physical status and providestime to tend to personal needs.


Each __ establishes and publishes personnel recoverypolicies (leave, passes, attribution and retention)for returning combat forces. (454)



The redeployment support process requires quicklyreconstituting forces to their full combat capabilities. T/F(454)



In the redeployment support process, levels of consumablesare restored and lost __ is recovered duringreconstitution. (454)



408. What variables do bases and units consider whenplanning their reconstitution needs? (454)

1) The magnitude, duration and intensity of the crisis; 2)consumption rates; and 3) the type of deployment location(fixed versus austere base).


Which personnel are considered in the redeploymentsupport process? (454)

All those deployed to a(n) 1) area of responsibility (AOR); 2)CONUS location in support of contingencies; and 3) remoteassignment.


What key factors determine redeployment supportprocess participation? (454)

1) Lengthy family separation; and 2) significant familyrelatedstressors prior to redeployment.


What helping agencies support redeployed RegularAir Force, ANG, AFR, civilian personnel, family membersand units during the Air and Space ExpeditionaryForce (AEF) cycle? (454)

Community Action Information Board (CAIB) and IntegratedDelivery System (IDS).


Readjustment from duty in the Area of Responsibility(AOR) requires structured __ time and activitiesfor members and their families prior to leave or TDY.(454)



What does the redeployment support process timelineprovide? (454, 454-Fig)

A template for commander responses and actions, andCommunity Action Information Board (CAIB) and IntegratedDelivery System (IDS) members' activities at the criticalredeployment, recovery, reconstitution and spinup/deployment junctions. (Refer to Figure 18. 7 for moreinformation.)


With regard to Community Action InformationBoard (CAIB) and Integrated Delivery System (IDS)agencies, the online( is your critical source ofdeployment information, and education and training.(454)

Air and Space Expeditionary Force (AEF).


In the Air and Space Expeditionary Force (AEF)cycle, personal readiness begins __ and develops thereception station. (455)



Personnel readiness establishes procedures that ensuremembers returning from deployment are incorporatedinto what? (455)

Installation reconstitution planning and the installation deploymentplan.


When do returning units and individuals inprocesswith the personnel readiness function? (455)

Within two duty days ofredeployment day.


When will the personnel readiness function updatethe date of return to home station for all deployed individualsin the deliberate and crisis action planning andexecution segments? (455)

On the date ofnotification ofretum.


At the home station post-deployment, ___ servicemembers provide followup support, reintegration andreunion ministries, and other programs to strengthenfamily and individual spiritual health. (455)

Chaplain. (Services at AFR command wings are coordinatedwith the reserve wing deployment support program Point ofContact (POC).)


What does the Airman and Family Readiness Center(A&FRC) provide? (455)

Mobility and deployment assistance to single and marriedDoD personnel and families to reduce stress, deal with separationand reintegration, increase morale and unit cohesion,and support operational readiness.


What document describes Airman and Family ReadinessCenter (A&FRC) services? (455)

AFI 36-3009, Airman and Family Readiness Centers.


Airman and Family Readiness Centers (A&FRC) useelectronic media and hard copies to help develop __educational material. (455)

Reintegration. (They also provide materials support to chaplainand mental health services in the Area of Responsibility(AOR).)


In addition to providing one-on-one counseling andsupport for families of single Airmen, what does the Airmanand Family Readiness Center (A&FRC) staff doduring deployment? (455)

They 1) Provide tailored support to commanders, units andfamilies; 2) help local school authorities and teachers understandthe unique stress on children of deployed militarymembers; 3) provide deployment support programs; and 4)distribute commercial, printed materials addressing deployment.


Post-deployment assistance and pre-deployment activitiesare linked. T IF ( 455)

True. (Particularly early intervention to educate families,single members and units on concerns related to reintegrationand reunion.)


The Airman and Family Readiness Center (A&FRC)staff operates independently from the Community ActionInformation Board (CAIB) and Integrated Delivery System(IDS) agencies. T/F (455)

False. (They collaborate to ensure smooth family reunions.)


What needs do the force support squadron and fami-248ly member program protocols fill? (455)

Increased childcare needs during contingencies and the Airand Space Expeditionary Force (AEF) cycle.


Members and their families must be physically fitand of __ mind and body to enhance mission accomplishment.( 455)