Performance under Pressure – Coping Skills and Mitigation Strategies for Tactical Personnel

by Whitney Tramel, MS, CSCS,*D, TSAC-F,*D, Mark Stephenson, MS, ATC, CSCS,*D, TSAC-F,*D, and Robin Orr, PhD, TSAC-F,*D
TSAC Report November 2023
Vol 70, Issue 1

Available to:
Members only
TSAC Facilitators

This article will discuss specific measures of stress that can be monitored, as well as coping skills to mitigate the negative effects of stress.

Paywall block issue

This article is not configured properly for members or paid content.
isMemberOnly: {{isMemberOnly}} | isPaidContent: {{isPaidContent}}
spc: One or more parts of the product SPC is missing.

Read the full article

View the video

Login to view more

{{discountDesc}} Valid thru {{discountEnds}}

This {{ogType == 'video.other' ? 'video':'article'}} is available with a NSCA membership

This {{ogType == 'video.other' ? 'video':'article'}} can be purchased for {{prices}}
Price includes membership pricing and promotions

Purchase this {{ogType == 'video.other' ? 'video':'article'}}. Price range: {{prices}}
Price range includes membership pricing and promotions

Become a Member Add to Cart Login

This article originally appeared in TSAC Report, the NSCA’s quarterly, online-only publication geared toward the training of tactical athletes, operators, and facilitators. It provides research-based articles, performance drills, and conditioning techniques for operational, tactical athletes. The TSAC Report is only available for NSCA Members. Read more articles from TSAC Report 

Related Reading



  1. Anderson, GS, Di Nota, PM, Metz, GAS, and Anderson, JP. The impact of acute stress physiology on skilled motor performance: Implications for policing. Frontiers in Physiology 10: 2019.
  2. Andersen, JP, Di Nota, PM, Beston, D, Boychuk, EC, Gustafsberg, H, Poplawki, S, and Arpaia, J. Reducing lethal force errors by modulating police physiology. Journal of Occupational and Environmental Medicine 60(10): 867-874, 2018.
  3. Andersen, J, Pitel, M, Weerasinghe, A, and Papazpglou, K. Highly realistic scenario based training simulates the psychophysiology of real world use of force encounters: Implications for improved police officer performance. Journal of Law Enforcement 5: 1-13, 2016.
  4. Andrew, ME, Violanti, JM, Gu, JK, Fekedulegn, D, Li, S, Hartley, TA, et al. Police work stressors and cardiac vagal control. American Journal of Human Biology 29, 2017.
  5. Baldwin, S, Bennell, C, Andersen, JP, Semple, T, and Jenkins, B. Stress-activity mapping: Physiological responses during general duty police encounters. Frontiers in Psychology 10: 2216, 2019.
  6. Baldwin, S, Bennell, C, Blaskovits, B, Brown, A, Jenkins, B, Lawrence, C, et al. A reasonable officer: Examining the relationships among stress, training, and performance in a highly realistic lethal force scenario. Frontiers in Psychology 12: 2021.
  7. Balk, YA, Adriaanse, M, de Ridder, D, and Evers, C. Coping under pressure: employing emotion regulation strategies to enhance performance under pressure. Journal of Sport & Exercise Psychology 35(4): 408-418, 2013.
  8. Beatty, GF, and Janelle, CM. Emotion regulation and motor performance: An integrated review and proposal of the Temporal Influence Model of Emotion Regulation (TIMER). International Review of Sport and Exercise Psychology 13(1): 266-296, 2020.
  9. Bertilsson, J, Niehorster, D, Fredriksson, P, Dahl, M, Graner, S, Fredriksson, O, et al. Stress levels escalate when repeatedly performing tasks involving threats. Frontiers in Psychology 10: 1562, 2019.
  10. Borg, G. Percevied exertion as an indicator of somatic stress. Scandanavian Journal of Rehabilitation and Medicine 2: 92-98, 1970.
  11. Brammer, JC, van Peer, J, Michela, A, van Rooij, M, Oostenveld, R, Klumpers, F, et al. Breathing biofeedback for police officers in a stressful virtual environment: Challenges and opportunities. Frontiers in Psychology 12(401): 2021.
  12. Bremner, JD. Traumatic stress: Effects on the brain. Dialogues Clinical Neuroscience 8: 445-461, 2006.
  13. Bustamante-Sanchez, A, and Clemente-Suarez, VJ. Psychophysiological response in night and instrument helicopter flights. Ergonomics 63(4): 399-406, 2020.
  14. Clemente-Suarez, VJ, Palomera, PR, and Robles-Perez, JJ. Psychophysiological response to acute-high-stress combat situations in professional soldiers. Stress Health 34(2): 247-252, 2018.
  15. Cool, J, and Zapperri, D. The physiology of stress. Medical student well-being. Springer 1-15, 2019.
  16. Decker, A, Hilton, B, Dawes, J, Lockie, R, and Orr, R. Physiological demands of law enforcement occupational tasks in Australian police officers. Journal of Australian Strength and Conditioning 24(6): 78-79, 2016.
  17. Gholamrezaei, A, Diest, IV, Aziz, Q, Vlaeyen, J, and Van Oudenhove, L. Psychophysiological responses to various slow, deep breathing techniques. Psychophysiology 58(2): e13712, 2021.
  18. Giessing, L, Frenkel, M, Zinner, C, Rummel, J, Nieuwenhuys, A, Kasperk, C, et al. Effects of coping-related traits and psychophysiological stress responses on police recruits’ shooting behavior in reality-based scenarios. Frontiers in Psychology 10: 1523, 2019.
  19. Gomez-Oliva, E, Robles-Perez, J, Ruiz-Barquin, R, Hidalgo- Bellota, F, de la Vea, R. Psychophysiological response to the use of nuclear, biological and chemical equipment with military tasks. Physiology and Behavior 204: 186-190, 2019.
  20. Goodwin, ML, Harris, J, Hernandez, A, and Gladden, LB. Blood lactate measurements and analysis during exercise: A guide for clinicians. Journal of Diabetes Science and Technology 1: 558-569, 2007.
  21. Hamarsland, H, Paulsen, G, Solberg, P, Slaathaug, O, and Raastad, T. Depressed physical performance outlasts hormonal disturbances after military training. Medicine and Science in Sports and Exercise 50(10): 2076-2084, 2018.
  22. Hinterberger, T, Walter, N, Doliwa, C, and Loew, T. The brain’s resonance with breathing—Decelerated breathing synchronizes heart rate and slow cortical potentials. Journal of Breath Research 13(4): 46003, 2019.
  23. Hood, A, Pulvers, K, Spady, T, Kliebenstein, A, and Bachand, J. Anxiety mediates the effect of acute stress on working memory performance when cortisol levels are high: a moderated mediation analysis. Anxiety, Stress, and Coping 28(5): 545-562, 2015.
  24. Hormeno-Holgado, AJ, and Clemente-Suarez, VJ. Psychophysiological monitorization in a special operation selection course. Journal of Medicine Systems 43(3): 47, 2019.
  25. Hunt, AP, Stewart, IB, and Billing, DC. Indices of physiological strain for firefighters of the Australian Defence Forces. Journal of Occupational and Environmental Hygene 16(11): 727-734, 2019.
  26. Jetelina, K, Beauchamp, A, Gonzalez, J, Molsberry, R, Bishopp, S, and Lee, S. Cumulative, high-stress calls impacting adverse events among law enforcement and the public. BMC Public Health 20(1): 1-9, 2020.
  27. Karaduman, E, Bostanci, O, Karakas, F, Kabadayi, M, Yilma, A, Akyildiz, Z, et al. Pistol shooting performance correlates with respiratory muscle strength and pulmonary function in police cadets. Sustainability 14(12): 7515, 2022.
  28. Kim, JW, Dancy, C, Goldberg, B, and Sottilare, R. A cognitive modeling approach-does tactical breathing in a psychomotor task influence skill development during adaptive instruction? International Conference on Augmented Cognition. Springer Link 162-174, 2017.
  29. Lieberman, HR, Farina, E, Caldwell, J, Williams, K, Thompson, L, Niro, P, et al. Cognitive function, stress hormones, heart rate and nutritional status during simulated captivity in military survival training. Physiology Behaviour 165: 86-97, 2016.
  30. Linderman, JK, O’Hara, R, and Ordway, J. Effect of special operations training on testosterone, lean body mass, and strength and the potential for therapeutic testosterone replacement: A review of the literature. Journal of Special Operations Medicine 20: 94-100, 2020.
  31. Liu, Y, Mao, L, Zhao, y, and Huang, Y. Impact of a simulated stress training program on the tactical shooting performance of SWAT trainees. Research Quarterly for Exercise and Sport 89(4): 482-489, 2018.
  32. Low, WR, SanderCock, G, Freeman, P, Winter, ME, Butt, J, and Maynard, I. Pressure training for performance domains: A meta-analysis. Sport, Exercise, and Performance, Psychology 10(1): 149-163, 2020.
  33. Ma, X, Yue, Z, Gong, Z, Zhang, H, Duan, N, Shi, Y, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in Psychology 8: 874, 2017.
  34. Marcel-Millet, P, Ravier, G, Grospretre, S, Giminez, P, Freidig, S, and Groslambert, A. Physiological responses and parasympathetic reactivation in rescue interventions: The effect of the breathing apparatus. Scandanavian Journal of Medicine and Science in Sports 28(12): 2710-2722, 2018.
  35. Marins, EF, Cabistany, L, Farias, C, Dawes, J, Del Vecchio, FB. Effects of personal protective equipment on metabolism and performance during an occupational physical ability test for federal highway police officers. Journal of Strength and Conditioning Research 34: 1093-1102, 2020.
  36. Mclellan, TM, Cheung, SS, Latzka, WA, Sawka, MN, Pandolf, KB, Millard, CE, et al. Effects of dehydration, hypohydration, and hyperhydration on tolerance during uncompensable heat stress. Canadian Journal of Applied Physiology 24: 349-361, 1999.
  37. Morgan, CA, Wang, S, Mason, J, Southwick, SM, Fox, P, Hazlett, G, et al. Hormone profiles in humans experiencing military survival training. Biological Psychiatry 47: 819-825, 2000.
  38. Michela, A, van Peer, J, Brammer, J, Nies, A, van Rooij, M, Oostenveld, R, et al. Deep-breathing biofeedback trainability in a virtual-reality action game: A single-case design study with police trainers. Frontiers in Psychology 13: 2022.
  39. Munoz, JE, Quintero, L, Stephens, C, and Pope, A. A psychophysiological model of firearms training in police officers: A virtual reality experiment for biocybernetic adaptation. Frontiers in Psychology 11: 2020.
  40. Nieuwenhuys, A. Quantifying police officers’ arrest and self-defence skills: Does performance decrease under pressure? Ergonomics 52(12): 1460-1468, 2009.
  41. Nieuwenhuys, A, and Oudejans, RD. Effects of anxiety on handgun shooting behavior of police officers: a pilot study. Anxiety, Stress & Coping 23(2): 225-233, 2010.
  42. Nindl, BC, Leone, C, Tharion, W, Johnson, R, Castellani, J, Patton, J, and Montain, S. Physical performance responses during 72h of military operational stress. Medicine and Science in Sports and Exercise 34: 1814-1822, 2002.
  43. Nindl, BC, Barnes, B, Alemany, J, Frykman, P, Shippee, R, Friedl, K, et al., Physiological consequences of U.S. Army Ranger training. Medicine and Science in Sports and Exercise 39(8): 1380-1387, 2007.
  44. Ojanen, T, Jalanko, P, and Kyrolainen, H. Physical fitness, hormonal, and immunological responses during prolonged military field training. Physiological Reports 6(17): e13850, 2018.
  45. Oudejans, RR. Reality-based practice under pressure improves handgun shooting performance of police officers. Ergonomics 51(3): 261-73, 2008.
  46. Perroni, F, Tessitore, A, Cibelli, G, Lupo, C, D’Artibale, E, Crotis, C, et al Effects of simulated firefighting on the responses of salivary cortisol, alpha-amylase and psychological variables. Ergonomics 52(4): 484-491, 2009.
  47. Petruzzello, SJ. Physiological, perceptual and psychological responses of career versus volunteer firefighters to live-fire training drills. Stress Health 32(4): 328-336, 2016.
  48. Potts, J. Virtual reality for law enforcement training: a demonstration and implication for dispatch priming. Police Practice and Research 23(5): 623-632, 2022.
  49. Röttger, S, Theobald, D, Adendroth, J, and Jacobsen, T. The effectiveness of combat tactical breathing as compared with prolonged exhalation. Applied Psychophysiology and Biofeedback 1-10, 2020.
  50. Sanchez-Molina, J, Robles-Perez, JJ, and Clemente-Suarez, VJ. Psychophysiological and specific fine motor skill modifications in a checkpoint action. Journal of Medical Systems 43(4): 90, 2019.
  51. Sanchez-Molina, J, Robles-Perez, JJ, and Clemente- Suarez, VJ. Effect of parachute jump in the psychophysiological response of soldiers in urban combat. Journal of Medical Systems 41(6): 99, 2017.
  52. Smith, GD, Ben-Shlomo, Y, Beswick, A, Yarnell, J, Lightman, S, Elwood, P. Cortisol, testosterone, and coronary heart disease: Prospective evidence from the Caerphilly study. Circulation 14(17): 2005.
  53. Spielberger, CD. State-Trait Anxiety Inventory, Form Y Manual. Palo Alto, CA: Consulting Psychologists Press; 1983.
  54. Stephenson, MD, Tramel, W, and Orr, R. Performance under stress— Implications for tactical personnel. Tactical Strength and Conditioning Report 32-36, 2022.
  55. Stephenson, MD, Schram, B, Canetti, E, and Orr, R. Effects of actue stress on psychophysiology in armed tactical occupations: A narrative review. International Journal of Environmental Research and Public Health 19(3): 1802, 2022.
  56. Szivak, TK, Lee, EC, Saenz, C, Flanagan, S, Focht, B, Volek, J, et al. Adrenal stress and performance during military survival training. Medicine and Science in Sports and Exercise 50: 731, 2018.
  57. Taylor, MK, Sausen, KP, Mujica-Parodi, L, Potterat, E, Yanagi, M, and Kim, H. Neurophysiologic methods to measure stress during survival, evasion, resistance, and escape training. Aviation, Space, and Environmental Medicine 78: B224-B230, 2007.
  58. Taverniers, J. The risk of being shot at: Stress, cortisol secretion, and their impact on memory and perceived learning during reality-based practice for armed officers. International Journal of Stress Management 18(2): 113, 2011.
  59. Tomes, C, Schram, B, and Orr, R. Relationships between heart rate variability, occupational performance, and fitness for tactical personnel: a systematic review. Frontiers in Public Health 8, 2020.
  60. Tornero-Aguilera, JF, and Clemente-Suarez, VJ. Effect of experience, equipment and fire actions in psychophysiological response and memory of soldiers in actual underground operations. International Journal of Psychophysiology 128: 40-46, 2018.
  61. Tornero-Aguilera, JF, Robles-Perez, JJ, and Clemente-Suarez, VJ. Use of psychophysiological portable devices to analyse stress response in different experienced soldiers. Journal of Medical Systems 42(4): 75, 2018.
  62. Vaara, JP, Riikka, K, Petri, H, and Heikki, K. Physical fitness and hormonal profile during an 11-week paratroop training period. Journal of Strength and Conditioning Research 29: 2015.
  63. Vartanian, O. Changes in mood, fatigue, sleep, cognitive performance and stress hormones among instructors conducting stressful military captivity survival training. Physiological Behavior 194: 137-143, 2018.
  64. Vicente-Rodriguez, M, Fuentes-Garcia, JP, and Clemente- Suarez, VJ. Psychophysiological stress response in an underwater evacuation training. International Journal of Environmental Research and Public Health 17(7): 2020.
  65. Voigt, L, Wadsley, C, Frenkel, M, and Nieuwenhuys, A. Response inhibition under emotional and physical stress. Sport, Exercise, and Performance Psychology 11(4): 509-523, 2022.
  66. Walker, A, Pope, R, Schram, B, Forey, R, and Orr, R. The impact of occupational tasks on firefighter hydration during a live structural fire. Safety 5(36): 2019.
  67. Winters, JD, Heebner, N, Johnson, A, Poploski, K, Royer, S, Nagai, T, et al. Altered physical performance following advanced special operations tactical training. Journal of Strength and Conditioning Research 35(7): 1809-1816, 2019.
  68. Young, PM, Gibson, A, Partington, E, Partington, S, and Wetherell. Psychophysiological responses in experienced firefighters undertaking repeated self-contained breathing apparatus tasks. Ergonomics 57(12): 1898-1906, 2014.
  69. Zare, S, Hemmatjo, R, Allahyari, T, Hajaghazadeh, M, Hajivandi, A, Aghabeigi, M, and Kazemi, R. Comparison of the effect of typical firefighting activities, live fire drills and rescue operations at height on firefighters’ physiological responses and cognitive function. Ergonomics 61(10): 1334-1344, 2018.
About the author

Whitney Nicole Tramel, CSCS, TSAC-F

Contact Whitney Tramel

Contact Whitney Tramel

Your first name is required.
Your last name is required.
Your email is required.
Your message is required.
Your reCaptcha is required.

Your email was successfully sent to Whitney Tramel

Whitney Tramel is a strength and conditioning coach and PhD candidate. Tramel has worked with a variety of athletes at the high school and collegiate ...

View full biography
About the author

Mark Stephenson, MS, ATC, CSCS,*D, TSAC-F,*D

Contact Mark Stephenson

Contact Mark Stephenson

Your first name is required.
Your last name is required.
Your email is required.
Your message is required.
Your reCaptcha is required.

Your email was successfully sent to Mark Stephenson

Mark Stephenson serves as the Director of Sports Performance for Mass General Brighams Center for Sports Performance and Research and is a PhD student ...

View full biography
About the author

Robin M. Orr, PhD, TSAC-F,*D

Contact Robin Orr

Contact Robin Orr

Your first name is required.
Your last name is required.
Your email is required.
Your message is required.
Your reCaptcha is required.

Your email was successfully sent to Robin Orr

Rob Orr is an Associate Professor of Physiotherapy at Bond University in Australia. He is the Director of the Tactical Research Unit, a multidisciplin ...

View full biography
Available to:
Members only
TSAC Facilitators
#NSCAStrong #NSCAStrong

has been added to your shopping cart!

Continue Shopping Checkout Now