Psychological inflexibility, stress, and burnout among U.S. Air Force military training instructors: Insights from a health surveillance program.

Military Training Instructors (MTIs) shape over 40,000 U.S. Air Force recruits annually, making instructor well-being critical to training effectiveness and safety. This study examined predictors of stress and burnout among 565 MTIs who completed an annual health survey in 2024. Measures included perceived stress, burnout, psychological inflexibility, sleep-related impairment, emotional support, alcohol use, physical activity, and personal characteristics. Hierarchical multivariable linear regression models assessed associations with perceived stress and burnout. In fully adjusted models, psychological inflexibility (β = 0.49; 95% CI: 0.41, 0.57), sleep-related impairment (β = 0.54; 95% CI: 0.43, 0.66), and line squadron assignment (β = 0.78; 95% CI: 0.01, 1.55) were associated with higher perceived stress, while emotional support was associated with lower stress (β = -0.38; 95% CI: -0.51, -0.24). Burnout was associated with psychological inflexibility (β = 0.09; 95% CI: 0.04, 0.13), sleep-related impairment (β = 0.40; 95% CI: 0.36, 0.46), alcohol use (β = 0.22; 95% CI: 0.06, 0.37), line squadron assignment (β = 0.62; 95% CI: 0.22, 1.01), female sex (β = 0.64; 95% CI: 0.20, 1.07), emotional support (β = -0.14; 95% CI: -0.21, -0.07), and longer time in role (all p-values < .05). Results indicate that psychological inflexibility and sleep-related impairment were the most consistent correlates of MTI strain, with emotional support and occupational factors also contributing. Interventions that increase psychological flexibility, strengthen support networks, improve sleep, and reduce alcohol use may help mitigate risk. Findings provide guidance on sustaining MTI health and performance that may generalize to similar high-demand occupations.