Evaluating the Relationship between Psychological Traits and Resilience to Musculoskeletal Injuries in Combat Control Graduates by Mendelian Randomization

U.S. Air Force combat control (CCT) personnel are a group of highly trained personnel performing a wide range of aviation-related tasks in contested combat environments. Certified by the U.S. Federal Aviation Administration to conduct air traffic control operations, CCTs are required to maintain high levels of alertness and perform complex tasks in high stress, high threat environments. Those CCTs who complete training are in exceptional physical, psychological, and cognitive fitness, however nearly 70% of CCT candidates will develop some form of musculoskeletal injury (MSI) during training. Using only open-source summary statistics results of genome-wide association studies (GWAS) on civilian populations, we report our findings from two-sample Mendelian randomization (MR) estimates evaluating the causal relationships between personality and psychological strengths associated with success in the CCT training program and MSI. We used the TwoSampleMR R-package and GWAS statistics obtained from the IEU OpenGWAS project with instrumental variables extracted at GWAS-significant and suggestive thresholds (P < 5x10-8 and 5x10-5, respectively). Back pain and dislocations were the most common outcomes caused by personality and psychological traits. Altogether more than 150 MSI outcomes were identified with causes related to psychological traits associated with successfully completing combat control training. The implications of our results suggest that the combat control training program, and by extension other special operations training programs, could encounter fewer injuries by encouraging utilization of embedded psychological assets.