Listed below are the article abstracts only. For the full text article, please contact the publishing journal.
2011

December
09/12/2011
The influence of posttraumatic stress disorder numbing and hyperarousal symptom clusters in the prediction of physical health status in veterans with chronic tobacco dependence and posttraumatic stress disorder.
Harder LH, Chen S, Baker DG, Chow B, McFall M, Saxon A, & Smith MW.
J Nerv Ment Dis. 2011 Dec;199(12):940-945 PMID: 22134452 [PubMed - as supplied by publisher]

Abstract: Smoking and PTSD are predictors of poor physical health status. This study examined the unique contribution of PTSD symptoms in the prediction of the SF-36 physical health status subscales accounting for cigarette smoking, chronic medical conditions, alcohol and drug use disorders, and depression. Read more . . .
09/12/2011
Glucocorticoid receptor pathway components predict posttraumatic stress disorder symptom development: A prospective study.
van Zuiden M, Geuze E, Willemen HL, Vermetten E, Maas M, Amarouchi K, Kavelaars A, & Heijnen CJ.
Biol Psychiatry. 2011 Nov 30; [epub ahead of print] PMID: 22137507 [PubMed - as supplied by publisher]

Abstract: BACKGROUND: Biological correlates of posttraumatic stress disorder (PTSD) have mostly been studied using cross-sectional or posttrauma prospective designs. Therefore, it remains largely unknown whether previously observed biological correlates of PTSD precede trauma exposure. We investigated whether glucocorticoid receptor (GR) pathway components assessed in leukocytes before military deployment represent preexisting vulnerability factors for development of PTSD symptoms. Read more . . .
02/12/2011
Prevalence, correlates, and clinical features of delayed-onset posttraumatic stress disorder in a nationally representative military sample.
Fikretoglu D, & Liu A.
Soc Psychiatry Psychiatr Epidemiol. 2011 Nov 29; [epub ahead of print] PMID: 22124662 [PubMed - as supplied by publisher]

Abstract: PURPOSE: Since its inclusion in the Diagnostic and Statistical Manual of Mental Disorders, there has been skepticism over the validity of delayed-onset posttraumatic stress disorder (PTSD). Paucity of research on the correlates and the clinical consequences of delayed-onset PTSD have historically added to this skepticism. The objective of this study was to address an important gap in the literature by examining the prevalence, the correlates, and the clinical consequences of delayed-onset PTSD using data from a large epidemiological survey. Read more . . .
02/12/2011
Disengagement coping as a mediator between trauma-related guilt and PTSD severity.
Held P, Owens GP, Schumm JA, Chard KM, & Hansel JE.
J Trauma Stress. 2011 Nov 30; [epub ahead of print] PMID: 22131291 [PubMed - as supplied by publisher]

Abstract: This study examined disengagement coping as a partial mediator between trauma-related guilt and severity of posttraumatic stress disorder (PTSD) in a sample of veterans (N = 175) entering residential PTSD treatment with either PTSD or subthreshold PTSD.
Disengagement coping partially mediated the relationship between guilt and self-reported PTSD severity (b = .07; 95% CI = [-.003, .13]; p = .06), but did not mediate the relationship when PTSD severity was based on clinicians' ratings.
These findings bolster Street, Gibson, and Holohan's (2005) contention that higher guilt-related cognitions are related to increases in the use of disengagement coping strategies, which can interfere with PTSD recovery. The findings support the importance of PTSD treatments that target reductions in guilt-related cognitions and disengagement coping strategies.
02/12/2011
Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample.
Kearney DJ, McDermott K, Malte C, Martinez M, & Simpson TL.
J Clin Psychol. 2011 Nov 28; [epub ahead of print] PMID: 22125187 [PubMed - as supplied by publisher]

Abstract: Objectives: To assess outcomes of veterans who participated in mindfulness-based stress reduction (MBSR). Read more . . .
02/12/2011
Approaches to the primary prevention of posttraumatic stress disorder in the military: a review of the stress control literature.
Hourani LL, Council CL, Hubal RC, & Strange LB.
Mil Med. 2011 Jul;176(7):721-30 PMID: 22128712 [PubMed - in process]

Abstract: Numerous studies are underway, using data collected from clinical studies and data collected from surveys of combat troops, to determine the most efficacious treatment options for those diagnosed with posttraumatic stress disorder (PTSD). In contrast, little is known about the effectiveness of predeployment training in preventing or mitigating the impact of combat-related stressors on the development of PTSD.
We conducted a comprehensive review of literature pertaining to primary prevention efforts to stem the advent of PTSD and other combat and operational stress injuries in military populations using databases from the peer-reviewed literature as well as online searches and colleague referrals.
Results show that, as with treatment for PTSD, the most promising preventive approaches appear to utilize exposure strategies, especially those in conjunction with education and stress reduction skills training.
02/12/2011
Personality traits as moderators of the associations between deployment experiences and PTSD symptoms in OEF/OIF service members.
Caska CM, & Renshaw KD.
Anxiety Stress Coping. 2011 Nov 9; [epub ahead of print] PMID: 22129461 [PubMed - as supplied by publisher]

Abstract: This investigation examined traits from the five-factor model of personality as moderators of the associations of combat and aftermath of battle experiences with symptoms of posttraumatic stress disorder (PTSD) in 214 National Guard/Reserve service members deployed to operations enduring and Iraqi freedom.
Extraversion significantly moderated the associations of both combat experiences and aftermath of battle experiences with PTSD severity, with associations weakening as levels of extraversion increased. The relation between aftermath of battle experiences and PTSD was also moderated by the other four personality factors, with the relation being weaker at higher levels of agreeableness, conscientiousness, and openness, and lower levels of neuroticism.
These results suggest that personality traits may impact individual responses to war trauma, particularly war-related experiences that are not directly threatening to one's safety (i.e., aftermath of battle events vs. actual combat events). Although this investigation was cross-sectional, these findings indicate that personality traits are an important risk/resiliency factor to consider in people's responses to traumatic events.
02/12/2011
Awareness of posttraumatic stress disorder in veterans: a female spouse/intimate partner perspective.
Buchanan C, Kemppainen J, Smith S, MacKain S, & Cox CW.
Mil Med. 2011 Jul;176(7):743-51 PMID: 22128714 [PubMed - in process]

Abstract: The purpose of this qualitative study was to identify perspectives of female spouses/intimate partners regarding posttraumatic stress disorder (PTSD) in returning Iraq and Afghanistan combat Veterans.
Through the use of a self-administered questionnaire based on Flanagan's critical incident technique, reports were obtained from a purposive sample of 34 spouses/intimate partners of Veterans recruited through a social group for military spouses and a university in southeastern North Carolina.
Two-thirds of the participants reported not having received formal education about PTSD. The main perceived barriers to PTSD treatment seeking were denial of symptoms, fear, and stigma about disclosing PTSD symptoms. Spouses/intimate partners observed Veterans for changes in behavior and routines, disturbed sleep patterns, and nightmares. In the event of PTSD treatment resistance, spouses/intimate partners reported they would suggest the need for treatment, issue an ultimatum, take action, or offer patience and support without taking any action.
November
25/11/2011
Psychiatric lessons learned in Kandahar.
Jetly R.
Can J Surg. 2011 Dec;54(6):S142-4 PMID: 22099328 [PubMed - in process ]

Abstract: Not since the Korean War have the Canadian Forces engaged in combat missions like those in Afghanistan. Combat, asymmetric warfare, violent insurgency and the constant threat of improvised explosive devices all contribute to the psychological stressors experienced by Canadian soldiers.
Mental health teams deployed with the soldiers and provided assessment, treatment and education.
Lessons learned included refuting the myth that all psychological disorders would be related to trauma; confirming that most patients do well after exposure to trauma; confirming that treating disorders in a war zone requires flexible and creative adaptation of civilian treatment guidelines; and confirming that in a combat mission mental health practice is not limited to the clinical setting.
25/11/2011
A qualitative study of U.S. veterans' reasons for seeking Department of Veterans Affairs disability benefits for posttraumatic stress disorder.
Sayer NA, Spoont M, Murdoch M, Parker LE, Hintz S, & Rosenheck R.
J Trauma Stress. 2011 Nov 22; [epub ahead of print] PMID: 22109077 [PubMed - as supplied by publisher]

Abstract: Posttraumatic stress disorder (PTSD) is the most prevalent compensable mental disorder within the U.S. Department of Veterans Affairs disability system and the number of veterans with PTSD service-connected disability has increased steadily over the past decade. An understanding of the reasons veterans apply for PTSD disability status may inform interpretation of this increase and policies and interventions to assist veterans with military-related PTSD. Read more . . .
25/11/2011
Home-based telehealth to deliver evidence-based psychotherapy in veterans with PTSD.
Strachan M, Gros DF, Yuen E, Ruggiero KJ, Foa EB, & Acierno R.
Contemp Clin Trials. 2011 Nov 11; [epub ahead of print] PMID: 22101225 [PubMed - as supplied by publisher]

Abstract: Although medical service delivery via home-based telehealth technology (HBT) is gaining wider acceptance in managing chronic illnesses such as diabetes or chronic obstructive pulmonary disease, few studies have tested HBT applications of psychotherapy. Clinicians, administrators, and researchers question whether delivering psychotherapeutic services to patients in their homes via video-conferencing technology compromises patient safety, potency of treatment, or data security.
Despite these concerns, HBT service delivery may increase access to evidence-based psychotherapies for veterans with posttraumatic stress disorder (PTSD), who may be less willing or less able to receive weekly treatment at a VA medical center or outpatient clinic due to symptom severity or other similar barriers to care. Indeed, although combat-exposed service members endorse high rates of psychiatric disorders, few appear to initiate mental health services or receive an adequate dose of treatment.
Thus, using HBT technologies to administer evidence-based therapies remains uncharted territory in both the clinical and research arenas. This manuscript describes an ongoing four year randomized controlled trial comparing in-person Prolonged Exposure (PE) - a specialized evidence-based psychotherapy for PTSD - and PE delivered via HBT, with a particular focus on the selection, application, and strengths/weaknesses of HBT procedures.
25/11/2011
Main and interactive effects of social support in predicting mental health symptoms in men and women following military stressor exposure.
Smith BN, Vaughn RA, Vogt D, King DW, King LA, & Shipherd JC.
Anxiety Stress Coping. 2011 Oct 24; [epub ahead of print] PMID: 22098413 [PubMed - as supplied by publisher]

Abstract: Evidence across a multitude of contexts indicates that social support is associated with reduced risk for mental health symptoms. More information is needed on the effectiveness of different sources of support, as well as sex differences in support. Associations between social support from two sources - the military unit and friends and family - and mental health symptoms were examined in a study of 1571 Marine recruits assessed at the beginning and end of a highly stressful 13-week training program.
Military social support buffered the stressor exposure-posttraumatic stress symptomatology (PTSS) relationship, whereas the relationship between stressor exposure and PTSS was highest when civilian social support was high. Further inspection of the interactions revealed that military support was most important at high levels of stressor exposure.
Sex differences in the relationship between social support and symptoms were found, such that support from military peers was associated with lower levels of PTSS for men, whereas civilian support was associated with lower PTSS for women. While civilian social support was associated with lower levels of depression symptom severity in both women and men, the relationship was stronger for women. Reviewed implications focus on the importance of considering the recipient, source, and context of social support.
25/11/2011
Physical rehabilitation following polytrauma. The Canadian Forces Physical Rehabilitation Program 2008-2011.
Besemann M.
Can J Surg. 2011 Dec;54(6):S135-41 PMID: 22099327 [PubMed - in process]

Abstract: As a consequence of Canada's involvement in the war in Afghanistan, many members of the Canadian Forces have experienced debilitating injuries. Despite the Canadian Forces Health Services (CFHS) having outstanding relationships with many civilian care providers for the rehabilitation of injured soldiers, it became apparent early on that the high-level goals and aspirations of these returning soldiers were sometimes beyond the capability of these centres to facilitate. From this reality grew the need to develop a Physical Rehabilitation Program within the CFHS. This article describes the lessons learned since the creation of the program and outlines the future vision in terms of unique challenges and opportunities. The primary purpose of this article is to describe a hybrid model of civilian-military rehabilitation for injured soldiers and dis-cuss the benefits and challenges of such a model of care.
25/11/2011
Project VALOR: design and methods of a longitudinal registry of post-traumatic stress disorder (PTSD) in combat-exposed Veterans in the Afghanistan and Iraqi military theaters of operations.
Rosen RC, Marx BP, Maserejian NN, Holowka DW, Gates MA, Sleeper LA, Vasterling JJ, Kang HK, & Keane TM.
Int J Methods Psychiatr Res. 2011 Nov 16; [epub ahead of print] PMID: 22095917 [PubMed - as supplied by publisher]

Abstract: Few studies have investigated the natural history of post-traumatic stress disorder (PTSD). Project VALOR (Veterans' After-discharge Longitudinal Registry) was designed as a longitudinal patient registry assessing the course of combat-related PTSD among 1600 male and female Veterans who served in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF). Aims of the study include investigating patterns and predictors of progression or remission of PTSD and treatment utilization. Read more . . .
18/11/2011
Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans.
Wright KM, Britt TW, Bliese PD, Adler AB, Picchioni D, & Moore D.
J Clin Psychol. 2011 Nov 7; [epub ahead of print] PMID: 22065464 [PubMed - as supplied by publisher]

Abstract: Objectives: The study conducted a longitudinal assessment of insomnia as an antecedent versus consequence of posttraumatic stress disorder (PTSD) and depression symptoms among combat veterans. Read more . . .
18/11/2011
Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services.
Hassija CM, Luterek JA, Naragon-Gainey K, Moore SA, & Simpson T.
Anxiety Stress Coping. 2011 Sep 14; [epub ahead of print] PMID: 22059938 [PubMed - as supplied by publisher]

Abstract: The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Read more . . .
18/11/2011
Noradrenergic vs serotonergic antidepressant with or without naltrexone for veterans with PTSD and comorbid alcohol dependence.
Petrakis IL, Ralevski E, Desai N, Trevisan L, Gueorguieva R, Rounsaville B, & Krystal JH.
Neuropsychopharmacology. 2011 Nov 16; [epub ahead of print] PMID: 22089316 [PubMed - as supplied by publisher]

Abstract: The wars in Iraq and Afghanistan are associated with high rates of post-traumatic stress disorder (PTSD) and comorbid alcohol use disorders. The pharmacotherapy of these comorbid conditions has received relatively little study. The current study compared the serotonin uptake inhibitor, paroxetine, to the norepinephrine uptake inhibitor, desipramine. It also evaluated the adjunctive efficacy of the Food and Drug Administration (FDA)-approved alcoholism pharmacotherapy, naltrexone, relative to placebo. Read more . . .
18/11/2011
Posttraumatic stress disorder from Vietnam to today: the evolution of understanding during Eugene Brody's tenure at the journal of nervous and mental disease.
Benedek DM.
J Nerv Ment Dis. 2011 Aug;199(8):544-52 PMID: 21814076 [PubMed - indexed for MEDLINE]

Abstract: The psychological and behavioral consequences of exposure to traumatic events have been described throughout our history. However, the term posttraumatic stress disorder (PTSD) was not formally introduced into the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, until after Dr Eugene Brody--whose broad interests included refugee populations and victims of trauma--had already served as editor-in-chief of the Journal of Nervous and Mental Disease (JNMD) for 15 years.
Advances in molecular biology, genetics, and imaging that occurred during Brody's tenure at the JNMD contributed significantly to our current understanding of the human fear response and the neurobiology of PTSD. Comprehensive treatment guidelines summarizing evidence-based treatment were published during his tenure, and the most recent American Psychiatric Association update to practice standards was published in the year before his passing. Thus, this review of the history and present state of the science of PTSD summarizes the lessons learned while Dr Brody dedicated his life to teaching us.
18/11/2011
Trauma, identity and mental health in UK military veterans.
Brewin CR, Garnett R, & Andrews B.
Psychol Med. 2011 Aug;41(8):1733-40 PMID: 21144125 [PubMed - indexed for MEDLINE ]

Abstract: BACKGROUND: Military service can lead to profound changes in identity, both in servicemen's perception of themselves and in their relationship to the world, but the significance of these changes for psychopathology is unclear. We investigated whether the extent and valence of identity change was related to the degree of military trauma exposure or to post-traumatic stress disorder (PTSD) and suicide attempts. We further sought to describe the nature of such changes using qualitative analysis. Read more . . .
04/11/2011
Mental health of Special Forces personnel deployed in battle.
Hanwella R & de Silva V.
Soc Psychiatry Psychiatr Epidemiol. 2011 Oct 29; [epub ahead of print] PMID: 22038567 [PubMed - as supplied by publisher]

Abstract: PURPOSE: To compare the mental health problems of Special Forces with regular forces engaged in combat in the Sri Lanka Navy (SLN). Read more . . .
04/11/2011
Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder.
Brenner LA.
Dialogues Clin Neurosci. 2011;13(3):311-23 PMID: 22034217 [PubMed - in process]

Abstract: Advances in imaging technology, coupled with military personnel returning home from Iraq and Afghanistan with traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD), have increased interest in the neuropsychology and neurobiology of these two conditions. There has been a particular focus on differential diagnosis. This paper provides an overview of findings regarding the neuropsychological and neurobiological underpinnings of TBI and for PTSD.
A specific focus is on assessment using neuropsychological measures and imaging techniques. Challenges associated with the assessment of individuals with one or both conditions are also discussed. Although use of neuropsychological and neuroimaging test results may assist with diagnosis and treatment planning, further work is needed to identify objective biomarkers for each condition. Such advances would be expected to facilitate differential diagnosis and implementation of best treatment practices.
04/11/2011
Stigma, help-seeking attitudes, and use of psychotherapy in veterans with diagnoses of posttraumatic stress disorder.
Rosen CS, Greenbaum MA, Fitt JE, Laffaye C, Norris VA, & Kimerling R.
J Nerv Ment Dis. 2011 Nov;199(11):879-85 PMID: 22048141 [PubMed - in process]

Abstract: Survey and medical record data from 482 Veterans Affairs (VA) patients who recently received diagnoses of posttraumatic stress disorder (PTSD) were examined to determine need and predisposing factors associated with utilization of psychotherapy and counseling. More than half (58%) of participants initiated VA psychotherapy for PTSD within a year of diagnosis. Of those, one third completed eight or more sessions. Roughly two thirds of participants initiated counseling at a Vet Center.
Initiating PTSD psychotherapy was associated with greater impairment but not with stigma, concerns about fitting in, or satisfaction with care. The use of Vet Center counseling was associated with desire for help, concerns about fitting in, and satisfaction with care. Unexpectedly, veterans with greater stigma concerns completed more psychotherapy visits and Vet Center counseling. Negative attitudes about mental health treatment did not seem to be substantial barriers to engaging in psychotherapy among these VA patients. Future research should consider enabling treatment system factors in addition to predisposing patient characteristics.
04/11/2011
The structure of posttraumatic psychopathology in veterans attending primary care.
Forbes D, Elhai JD, Lockwood E, Creamer M, Frueh BC, & Magruder KM.
J Anxiety Disord. 2011 Oct 1; [epub ahead of print] PMID: 22036064 [PubMed - as supplied by publisher]

Abstract: This study attempted to extend research indicating that posttraumatic stress disorder (PTSD) factors of Re-experiencing, Avoidance and Hyperarousal are more related to Fear/phobic disorders, while PTSD Dysphoria is more related to Anxious-Misery disorders.
Trauma exposure, PTSD and comorbidity data for 668 veteran patients were analysed using confirmatory factor analyses and relative strengths of the relationships between PTSD factors and the Fear and Anxious-Misery factors were assessed. Combining Simms, Watson, and Doebbeling's (2002) model of PTSD symptoms and Krueger's (1999) Fear/Anxious Misery model of mood and anxiety disorders fit the data well.
Contrary to previous research, PTSD Re-experiencing, Avoidance and Hyperarousal did not correlate more with the Fear factor; nor did PTSD Dysphoria correlate more with Anxious-Misery. Hyperarousal was more closely related to Fear than was Re-experiencing; however, Avoidance was not. Dysphoria was more closely related to the Anxious-Misery factor than all other PTSD factors.
October
28/10/2011
A Phase I study of low pressure Hyperbaric Oxygen Therapy for blast-induced post concussion syndrome and post traumatic stress disorder.
Harch P, Andrews SR, Fogarty E, Amen DG, Pezzullo JC, Lucarini J, Aubrey C, Taylor DV, Staab P, & Van Meter K.
J Neurotrauma. 2011 Oct 25; [epub ahead of print] PMID: 22026588 [PubMed - as supplied by publisher]

Abstract: This is a preliminary report on the safety and efficacy of 1.5 ATA HBOT in military subjects with chronic blast-induced mild-moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD). Read more . . .
28/10/2011
Posttraumatic growth among Operation Enduring Freedom and Operation Iraqi Freedom amputees.
Benetato BB.
J Nurs Scholarsh. 2011 Oct 20; [epub ahead of print] PMID: 22018141 [PubMed - as supplied by publisher]

Abstract: Purpose: Posttraumatic growth (PTG) is a positive psychological change experienced as a result of struggle with highly challenging life circumstances. This study tested the PTG Model in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans following a major combat-related amputation. Specifically, the relationships among social support, rumination, length of time since amputation, and PTG among these veterans were examined. Read more . . .
28/10/2011
Stress and mental disorders in female military personnel: Comparisons between the sexes in a male dominated profession.
Mota NP, Medved M, Wang J, Asmundson GJ, Whitney D, & Sareen J.
J Psychiatr Res. 2011 Oct 22; [epub ahead of print] PMID: 22024487 [PubMed - as supplied by publisher]

Abstract: The proportion of women in militaries is growing; however, many studies in the area of military mental health have been conducted with majority male samples. The present study examined sex differences in trauma exposure, work stress, and mental disorders in the Canadian Community Health Survey - Canadian Forces Supplement, a representative sample of 5155 regular force personnel and 3286 reservists ages 16-54. Read more . . .
21/10/2011
Unit cohesion and mental health in the UK armed forces.
Du Preez J, Sundin J, Wessely S, & Fear NT.
Occup Med (Lond). 2011 Oct 14; [epub ahead of print] PMID: 22003060 [PubMed - as supplied by publisher]

Abstract: BACKGROUND: Unit cohesion is recognized as a potentially modifiable factor in the aetiology of mental illness among military personnel. AIMS: To examine the association between unit cohesion and probable post-traumatic stress disorder (PTSD), common mental disorder and alcohol misuse, in UK armed forces personnel deployed to Iraq. Read more . . .
14/10/2011
Combat veterans' symptoms of PTSD and partners' distress: The role of partners' perceptions of veterans' deployment experiences.
Renshaw KD, Campbell SB.
J Fam Psychol. 2011 Oct 10; [epub ahead of print] PMID: 21988078 [PubMed - as supplied by publisher]

Abstract: Romantic partners of combat veterans with posttraumatic stress disorder (PTSD) report elevated relationship and psychological distress. One recent study suggests that this association may be weaker when partners perceive that veterans experienced higher levels of traumatic deployment events, but such results have not yet been replicated. We replicated and extended these findings in a sample of 206 National Guard service members who deployed overseas since 2001 and their partners. Read more . . .
07/10/2011
Abnormal ECG patterns in chronic post-war PTSD patients: A pilot study.
Khazaie H, Saidi MR, Sepehry AA, Knight DC, Ahmadi M, Najafi F, Parvizi AA, Samadzadeh S, & Tahmasian M.
Int J Behav Med. 2011 Sep 30;[epub ahead of print] PMID: 21960258 [PubMed - as supplied by publisher]

Abstract: BACKGROUND: Posttraumatic stress disorder (PTSD) is a psychiatric syndrome associated with high levels of sympathetic activation of the autonomic nervous system. Individuals diagnosed with PTSD have a high propensity for electrocardiogram (ECG) abnormalities, atrioventricular conductive defects, and cerebrovascular incidents. Read more . . .
07/10/2011
Factors associated with interest in receiving help for mental health problems in combat veterans returning from deployment to Iraq.
Brown MC, Creel AH, Engel CC, Herrell RK, & Hoge CW.
J Nerv Ment Dis. 2011 Oct;199(10):797-801 PMID: 21964275 [PubMed - in process]

Abstract: ABSTRACT: Mental health problems in service members often go untreated. This study focused on factors related to interest in receiving help in a survey sample of 577 combat veterans who were screened positive for posttraumatic stress disorder, depression, or generalized anxiety disorder 3 months after returning from Iraq. Over three quarters of respondents recognized that they had a current problem, but only 40% were interested in receiving help. Interest in receiving help was associated with recognizing a problem and receiving mental health services in the past year. More negative attitudes toward mental health care were associated with lower interest in receiving help; paradoxically, more negative perceptions of unit stigma were associated with increased interest in receiving help. Further studies are needed to better define the relationship between stigma perceptions, interest in receiving care, and actual care utilization and to determine whether attitudes toward mental health care can be modified through changes in how care is delivered. Attitudes toward mental health care should be considered in treatment interventions.
07/10/2011
Help a buddy take a knee: Creating persuasive messages for military service members to encourage others to seek mental health help.
Clark-Hitt R, Smith SW, & Broderick JS.
Health Commun. 2011 Oct 4;[epub ahead of print] PMID: 21970672 [PubMed - as supplied by publisher]

Abstract: Helping service members returning from the wars in Iraq and Afghanistan who need mental health help is an important problem for the United States military. Tanielian and Jaycox (2008 ) estimated that approximately 14%, or 300,000, of the service members returning from the wars have posttraumatic stress disorder (PTSD), yet just over half of those needing psychological help seek it despite the availability of effective treatments.
This article reports the focus group responses of military personnel about message factors associated with persuading individuals to encourage others to seek mental health help. The results have theoretical and practical implications for future message design for promoting increased usage of mental health services among members of this population. Responses are presented in terms of the communication variables of source, message, channel, and receiver factors.
07/10/2011
Long-term outcomes of disability benefits in US veterans with posttraumatic stress disorder.
Murdoch M, Sayer NA, Spoont MR, Rosenheck R, Noorbaloochi S, Griffin JM, Arbisi PA, & Hagel EM.
Arch Gen Psychiatry. 2011 Oct;68(10):1072-80 PMID: 21969464 [PubMed - in process]

Abstract: CONTEXT: Most studies examining the clinical impact of disability benefits have compared aid recipients with people who never applied for benefits. Such practices may bias findings against recipients because disability applicants tend to be much sicker than never-applicants. Furthermore, these studies ignore the outcomes of denied claimants. Read more . . .
07/10/2011
Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual.
Nacasch N, Foa EB, Huppert JD, Tzur D, Fostick L, Dinstein Y, Polliack M, & Zohar J.
J Clin Psychiatry. 2011 Sep;72(9):1174-80 PMID: 21208581 [PubMed - in process]

Abstract: OBJECTIVE: Empirically based studies have demonstrated that prolonged exposure therapy effectively reduces posttraumatic stress disorder (PTSD) symptoms in a vast range of traumas, yet reports of the efficacy of such therapies in combat- and terror-related PTSD are scarce. In this article, we examine the efficacy of prolonged exposure therapy in combat- and terror-related PTSD in comparison to treatment as usual (TAU). Read more . . .
07/10/2011
Tianeptine in the combined treatment of combat related posttraumatic stress disorder.
Fran?iškovi? T, Sukovi? Z, Janovi? S, Stevanovi? A, Nem?i?-Moro I, Ron?evi?-Gržeta I, & Letica-Crepulja M.
Psychiatr Danub. 2011 Sep;23(3):257-63 PMID: 21963693 [PubMed - in process]

Abstract: BACKGROUND: The aim of this study was to evaluate the efficacy of tianeptine, an antidepressant that acts by increasing serotonin reuptake, in the treatment of posttraumatic stress disorder and to compare the effects of tianeptine and fluoxetine, an antidepressant from the selective serotonin reuptake inhibitors class. Read more . . .
September
23/09/2011
Evaluating transdiagnostic treatment for distress and impairment in veterans: A multi-site randomized controlled trial of Acceptance and Commitment Therapy.
Lang AJ, Schnurr PP, Jain S, Raman R, Walser R, Bolton E, Chabot A, & Benedek D.
Contemp Clin Trials. 2011 Sep 6. [Epub ahead of print]

Abstract: Military personnel who engaged in the conflicts in Afghanistan and Iraq frequently present for mental health care because of the stresses of service and readjustment. Although excellent treatments are available to treat the typical presenting problems, there is a need for additional empirically supported treatment approaches for this population.
Because these veterans have high levels of comorbidity, transdiagnostic treatment - treatment that applies to more than one diagnosis - may be an efficient approach for this group. Acceptance and Commitment Therapy (ACT) is one such approach that is well-known and has high face validity for veterans, but it has not been rigorously evaluated as a treatment for trauma-related mental health problems.
Described herein is an ongoing multi-site randomized clinical trial of ACT as compared to a psychotherapy control. Challenges in designing an RCT to evaluate transdiagnostic treatment and in executing a multi-site psychotherapy trial are discussed. Published by Elsevier Inc. PMID:21920461[PubMed - as supplied by publisher]
23/09/2011
Factor structure of posttraumatic stress disorder symptoms in OEF/OIF veterans presenting to a polytrauma clinic.
Maestas KL, Benge JF, Pastorek NJ, Lemaire A, & Darrow R.
Rehabil Psychol. 2011 Sep 19

Abstract: Objective: A significant number of Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) veterans are returning from deployment and presenting to Veterans Health Administration (VHA) polytrauma clinics with elevated rates of posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI).
Inherent to the accurate assessment and treatment of this diagnostically complex group of veterans is the assumption that the construct of PTSD is the same in this population as in other trauma groups.
To our knowledge, no previous study has examined the structure of PTSD in this relevant and fast-growing population of treatment-seeking OEF/OIF veterans. Evidence suggests that the latent structure of PTSD symptoms is best represented by a four-factor model, rather than the three-factor model found in the current DSM-IV-TR. Thus, we examined the three and four-factor models using the PTSD Check List-Civilian (PCL-C) in a sample of treatment-seeking OEF/OIF veterans seen through a VHA polytrauma clinic. Read more . . .
23/09/2011
Insecure attachment is an independent correlate of objective sleep disturbances in military veterans.
Troxel WM, & Germain A.
Sleep Med. 2011 Sep 16

Abstract: BACKGROUND: Sleep disturbances and interpersonal problems are highly prevalent in military veterans with post-traumatic stress disorder (PTSD) and are associated with substantial comorbidities and increased healthcare costs. This study examines the association between interpersonal attachment styles and sleep in a high-risk cohort of military veterans with PTSD symptoms. Read more . . .
23/09/2011
Insomnia characteristics and clinical correlates in Operation Enduring Freedom/Operation Iraqi Freedom veterans with post-traumatic stress disorder and mild traumatic brain injury: An exploratory study.
Wallace DM, Shafazand S, Ramos AR, Carvalho DZ, Gardener H, Lorenzo D, & Wohlgemuth WK.
Sleep Med. 2011 Sep 16

Abstract: BACKGROUND: There is limited data on chronic insomnia in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, in whom post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) often co-exist. Our aim was to compare sleep characteristics of three groups of OEF/OIF veterans: (1) healthy sleepers (HS), (2) those with insomnia associated with PTSD and mTBI (PTSD-mTBI), and (3) those with insomnia associated with PTSD alone. Read more . . .
23/09/2011
Seeking safety treatment for male veterans with a substance use disorder and PTSD symptomatology.
Boden MT, Kimerling R, Jacobs-Lentz J, Bowman D, Weaver C, Carney D, Walser R, & Trafton JA.
Addiction. 2011 Sep 16

Abstract: Aims: To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and posttraumatic stress disorder (PTSD), for part of treatment as usual (TAU) improves substance use outcomes. Design: Randomized controlled effectiveness trial. Settings: Outpatient Veterans Administration Health Care System SUD clinic. Read more . . .
23/09/2011
The relationship between spiritual distress, PTSD and depression in Vietnam combat veterans.
Berg G.
J. Pastoral Care Counsel. 2011 Spring-Summer;65(1-2):6:1-11

Abstract: Presents empirical data showing the relationship between combat-related posttraumatic stress disorder (PTSD), depression and spiritual distress. Uses spiritual injury scale to measure distress; scale measures guilt, anger or resentment, sadness/grief, lack of meaning, feeling God/life has treated one unfairly, religious doubt, and fear of death. Shows high association between spiritual injuries and both PTSD and depression. Also finds inverse relationship between intrinsic religious faith and these two diagnostic categories. An inverse relationship also exists between religious faith as measured by regular worship with a faith community and both depression and PTSD. [PMID:21919327[PubMed - in process]
16/09/2011
Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder.
Maguen S, Cohen B, Ren L, Bosch J, Kimerling R, & Seal K.
Womens Health Issues. 2011 Sep 8; [epub ahead of print] PMID: 21907590 [PubMed - as supplied by publisher]

Abstract: OBJECTIVE: We examined correlates of posttraumatic stress disorder (PTSD), including military sexual trauma (MST), in Iraq and Afghanistan veterans. We also compared mental health comorbidities by gender among veterans with PTSD, with and without MST. Read more . . .
16/09/2011
PTSD comorbidity and suicidal ideation associated with PTSD within the Ohio Army National Guard.
Calabrese JR, Prescott M, Tamburrino M, Liberzon I, Slembarski R, Goldmann E, Shirley E, Fine T, Goto T, Wilson K, Ganocy S, Chan P, Serrano MB, Sizemore J, & Galea S.
J Clin Psychiatry. 2011 Aug;72(8):1072-8. PMID:21899816[PubMed - in process]

Abstract: OBJECTIVE: To study the relation between posttraumatic stress disorder (PTSD) psychiatric comorbidity and suicidal ideation in a representative sample of Ohio Army National Guard soldiers. Read more . . .
16/09/2011
Type D personality and the development of PTSD symptoms: a prospective study.
Rademaker AR, van Zuiden M, Vermetten E, & Geuze E.
J Abnorm Psychol. 2011 May;120(2):299-307. PMID:21171726[PubMed - indexed for MEDLINE]

Abstract: Psychological trauma and prolonged stress may cause mental disorders such as posttraumatic stress disorder (PTSD). Pretrauma personality is an important determinant of posttraumatic adjustment. Specifically, trait neuroticism has been identified as a risk factor for PTSD. Additionally, the combination of high negative affectivity or neuroticism with marked social inhibition or introversion, also called Type D personality (Denollet, 2000), may compose a risk factor for PTSD. There is no research available that examined pretrauma Type D personality in relation to PTSD.
The present study examined the predictive validity of the Type D personality construct in a sample of Dutch soldiers. Read more . . .
02/09/2011
Functional neuroimaging studies of post-traumatic stress disorder.
Hughes KC, & Shin LM.
Expert Rev Neurother. 2011 Feb;11(2):275-85. PMID:21306214[PubMed - indexed for MEDLINE ]

Abstract: Post-traumatic stress disorder (PTSD) is a significant problem that can affect individuals who have been exposed to a traumatic event or events, such as combat, violent crime or childhood abuse. Over the past several years, neuroimaging studies of PTSD have focused on elucidating the brain circuits that mediate this disorder.
In this article, we will briefly introduce some of the methods used in functional neuroimaging studies of PTSD. We will then review functional neuroimaging studies that have reported significant findings in the amygdala, medial prefrontal cortex, hippocampus and insula.
Finally, we will suggest future directions for research.
02/09/2011
Group cognitive behaviour therapy for military service-related post-traumatic stress disorder: effectiveness, sustainability and repeatability.
Khoo A, Dent MT, & Oei TP.
Aust N Z J Psychiatry. 2011 Aug;45(8):663-72 PMID: 21870924 [PubMed - in process]

Abstract: Objective: The aim of this study was to assess 12 month outcomes of Australian combat veterans with post-traumatic stress disorder (PTSD) who participated in a 6 week group-based CBT programme at the Toowong Private Hospital. The study population included 496 consecutive admissions to the programme between 1999 and 2008. Read more . . .
02/09/2011
Predictors of Treatment Response in Canadian Combat and Peacekeeping Veterans With Military-Related Posttraumatic Stress Disorder.
Richardson JD, Elhai JD, & Sarreen J.
J Nerv Ment Dis. 2011 Sep;199(9):639-645. PMID:21878776[PubMed - as supplied by publisher]

Abstract: Military-related posttraumatic stress disorder (PTSD) is a significant psychiatric condition associated with severe psychosocial dysfunction. This study examined the predictors of treatment outcome in a group of veterans with military-related PTSD.
Participants were 102 Canadian combat and peacekeeping veterans who received treatment at a specialized outpatient clinic for veterans with psychiatric disorders resulting from military operation.
Analysis demonstrated a significant decrease in PTSD severity during the 1-year period (Yuan-Bentler ? [86, N = 99] = 282.45, p < 0.001). We did not find chronicity, alcohol use, and anxiety or depression severity as significant predictors for PTSD symptom decline. However, initial depression significantly predicted anxiety symptom decline, and initial anxiety predicted depression symptom decline. This study demonstrated that, despite considerable comorbidity, significant treatment gains, including remission of PTSD, can be achieved in an outpatient setting in veterans with chronic military-related PTSD.
August
26/08/2011
Family resilience and the fortunes of war.
Chapin M.
Soc Work Health Care. 2011 Aug;50(7):527-42. PMID:21846253[PubMed - in process]

Abstract: Military families have been a subject of concern due to increasing divorce rates and child maltreatment that have been directly linked to the number and length of combat deployments. In contrast many military families show positive resilience in the wake of multiple deployments. This article looks at several special situations where military families are faced with serious challenges after deployment: soldiers returning with post-traumatic stress disorder, soldiers receiving serious injuries, and those killed in action. McCubbin's Family Resilience Model is applied as a theoretical tool for understanding not only the stressors military families face, but other factors that buffer stress and assist in problem solving and coping.
26/08/2011
Perceived burden in spouses of National Guard/Reserve service members deployed during Operations Enduring and Iraqi Freedom.
Caska CM, & Renshaw KD.
J Anxiety Disord. 2011 Apr;25(3):346-51 PMID: 21112182 [PubMed - indexed for MEDLINE]

Abstract: Spouses of combat veterans with posttraumatic stress disorder (PTSD) experience elevated psychological distress. Recent research indicates that spouses' perceptions of burden may be one mechanism of such distress, but there are several gaps in this literature. No research has examined perceived burden in relation to symptoms other than PTSD or subclinical levels of psychological distress, and very little research has focused on characteristics of spouses that may be related to their perceptions of burden. Read more . . .
26/08/2011
Prolonged exposure therapy for combat-related posttraumatic stress disorder: an examination of treatment effectiveness for veterans of the wars in Afghanistan and Iraq.
Tuerk PW, Yoder M, Grubaugh A, Myrick H, Hamner M, & Acierno R.
J Anxiety Disord. 2011 Apr;25(3):397-403 PMID: 21131170 [PubMed - indexed for MEDLINE]

Abstract: The Veteran's Health Administration (VHA) has launched a large-scale initiative to promote prolonged exposure (PE) therapy, an evidence-based treatment for PTSD. While existing randomized controlled trials (RCTs) unambiguously support the efficacy of PE in civilian and some military populations, there is a need to better understand the course of treatment for combat Veterans of the current wars receiving PE in normative mental healthcare settings. Read more . . .
26/08/2011
Trauma-related dreams of Australian veterans with PTSD: content, affect and phenomenology.
Phelps AJ, Forbes D, Hopwood M, & Creamer M.
Aust N Z J Psychiatry. 2011 Aug 22; [epub ahead of print] PMID: 21859279 [PubMed - as supplied by publisher]

Abstract: Objective: Consensus on the parameters of trauma-related dreams required to meet criteria for post-traumatic stress disorder (PTSD) is critical when: (i) the diagnosis requires a single re-experiencing symptom; and (ii) trauma dreams are prevalent in survivors without PTSD. Read more . . .
19/08/2011
The case for treating depression in military spouses.
Verdeli H, Baily C, Vousoura E, Belser A, Singla D, & Manos G.
J Fam Psychol. 2011 Aug;25(4):488-96. PMID:21842994[PubMed - in process]

Abstract: The increased operational tempo associated with current deployments to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) is placing considerable strain on military families. Among other sequelae of OIF and OEF deployment, findings from recent studies suggest high rates of depression in spouses of service members. This review presents a rationale for targeting depression among military spouses. It examines how stressors relating to the deployment cycle may contribute to depression in spouses and outlines the effects of spousal depression on the mental health of service members and their children. Mental health services currently available to military spouses as well as barriers to their care are also described. Considerations for the adaptation of treatment to their unique circumstances and needs are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
12/08/2011
An examination of the relation between combat experiences and combat-related posttraumatic stress disorder in a sample of Connecticut OEF-OIF Veterans.
Pietrzak RH, Whealin JM, Stotzer RL, Goldstein MB, & Southwick SM.
J Psychiatr Res. 2011 Aug 2; [epub ahead of print] PMID: 21816411 [PubMed - as supplied by publisher]

BACKGROUND: Combat exposure is an important risk factor for posttraumatic stress disorder (PTSD). However, little research has examined specific combat experiences associated with PTSD and confirmatory factor analytically (CFA)-derived re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters. Read more . . .
12/08/2011
Cognitive-behavioral coping strategies associated with combat-related PTSD in treatment-seeking OEF-OIF Veterans.
Pietrzak RH, Harpaz-Rotem I, & Southwick SM.
Psychiatry Res. 2011 Aug 1. [Epub ahead of print] PMID:21813184[PubMed - as supplied by publisher]

Abstract: Posttraumatic stress disorder (PTSD) is associated with intrusive trauma-related thoughts and avoidance behaviors that contribute to its severity and chronicity. This study examined thought control and avoidance coping strategies associated with both a probable diagnosis and symptom severity of combat-related PTSD in a sample of 167 treatment-seeking Operations Enduring Freedom and Iraqi Freedom (OEF-OIF) Veterans. Read more . . .
12/08/2011
Female veterans of the OEF/OIF conflict: concordance of PTSD symptoms and substance misuse.
Nunnink SE, Goldwaser G, Heppner PS, Pittman JO, Nievergelt CM, & Baker DG.
Addict Behav. 2010 Jul;35(7):655-9 PMID: 20378259 [PubMed - indexed for MEDLINE]

Abstract: This study examined the post-deployment rates of comorbid PTSD and substance abuse in a cohort of female veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Female OEF/OIF veterans and reservists (N=36) completed a battery of assessments as part of a larger study.
Of the 36 participants, 11 (31%) screened positive for posttraumatic stress disorder (PTSD), 17 (47%) screened positive for high-risk drinking and 2 (6%) screened positive for drug abuse. Higher scores on measures of alcohol and drug use predicted positive PTSD status (p < or = 0.01) and alcohol misuse was significant in explaining unique variance of PTSD status (p < or = 0.05).
Our findings suggest a trend toward increased problematic drinking among female OEF/OIF veterans and reservists and a relationship between substance misuse and PTSD. Future research should investigate needs for gender-specific PTSD and substance-abuse treatment needs.
12/08/2011
Acute stress disorder revisited.
Cardeña E, & Carlson E.
Annu Rev Clin Psychol. 2011 Apr;7:245-67 PMID: 21275643 [PubMed - indexed for MEDLINE]

Abstract: Acute stress disorder (ASD) was introduced into the Diagnostic and Statistical Manual (DSM) taxonomy in 1994 to address the lack of a specific diagnosis for acute pathological reactions to trauma and the role that dissociative phenomena play both in the short- and long-term reactions to trauma.
In this review, we discuss the history and goals of the diagnosis and compare it with the diagnoses of acute stress reaction, combat stress reaction, and posttraumatic stress disorder (PTSD). We also evaluate the research on the validity and limitations of ASD as a diagnosis, the relationship between peritraumatic dissociation and other symptomatology, the extent to which PTSD is predicted by previous ASD or peritraumatic dissociation, and other important issues such as impairment and risk factors related to ASD.
We conclude with our recommendations for changes in DSM-5 criteria and the development of more sophisticated research that considers ASD as but one of two or possibly three common acute posttraumatic syndromes.
12/08/2011
Adjunctive risperidone treatment for antidepressant-resistant symptoms of chronic military service-related PTSD: a randomized trial.
Krystal JH, Rosenheck RA, Cramer JA, Vessicchio JC, Jones KM, Vertrees JE, Horney RA, Huang GD, & Stock C.
Veterans Affairs Cooperative Study No. 504 Group. JAMA. 2011 Aug 3;306(5):493-502. PMID:21813427[PubMed - in process]

Abstract: CONTEXT: Serotonin reuptake-inhibiting (SRI) antidepressants are the only FDA-approved pharmacotherapies for the treatment of posttraumatic stress disorder (PTSD).
OBJECTIVE: To determine efficacy of the second-generation antipsychotic risperidone as an adjunct to ongoing pharmacologic and psychosocial treatments for veterans with chronic military-related PTSD. Read more . . .
12/08/2011
Effect of transition home from combat on risk-taking and health-related behaviors.
Adler AB, Britt TW, Castro CA, McGurk D, & Bliese PD.
J Trauma Stress. 2011 Aug 4; [epub ahead of print] PMID: 21818784 [PubMed - as supplied by publisher]

Abstract: Transition home following a combat deployment involves a period of adjustment. Exploratory and confirmatory factor analyses of a new 16-item transition scale were conducted with 2 samples and resulted in 4 factors (Benefit, Appreciation, Anger/Alienation, and Guilt/Remorse).
In Study 1 (N = 1,651), the number of combat events was positively related to Anger/Alienation 4 months later even after controlling for posttraumatic stress disorder (PTSD) symptoms, partial r = .18, p < .001. In Study 2 (N = 647), after controlling for PTSD symptoms, Anger/Alienation assessed at 4 months postdeployment predicted more risk-taking behaviors 4 months later, partial r = .10, p = .01.
Appreciation predicted fewer unhealthy habits, partial r = -.13, p = .001, whereas Anger/Alienation predicted more unhealthy habits, partial r = .09, p = .024. Results demonstrate the importance of broadening the conceptualization of adjustment in combat veterans.
12/08/2011
Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD).
Ipser JC, & Stein DJ.
Int J Neuropsychopharmacol. 2011 Jul 29;:1-16 PMID: 21798109 [PubMed - as supplied by publisher]

Abstract: Post-traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Recognition of neurobiological abnormalities associated with this condition suggests the potential efficacy of medication in its treatment. Nevertheless, questions regarding the efficacy of medications remain, despite general endorsement by clinical practice guidelines of selective serotonin reuptake inhibitors (SSRIs) as first-line agents in treating PTSD.
This paper reviews evidence from randomized controlled trials (RCTs) for the efficacy of acute and long-term pharmacotherapy for PTSD, including the treatment of refractory PTSD. In addition, we conducted a systematic meta-analysis to compare the efficacy of different medications in treating PTSD. The effects of methodological study features (including year of publication, duration, number of centres) and sample characteristics (proportion of combat veterans, gender composition) were also tested. Read more . . .
12/08/2011
Fear conditioning, synaptic plasticity and the amygdala: implications for posttraumatic stress disorder.
Mahan AL, & Ressler KJ.
Trends Neurosci. 2011 Jul 26; [epub ahead of print] PMID: 21798604 [PubMed - as supplied by publisher]

Abstract: Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after a traumatic experience such as domestic violence, natural disasters or combat-related trauma. The cost of such disorders on society and the individual can be tremendous.
In this article, we review how the neural circuitry implicated in PTSD in humans is related to the neural circuitry of fear. We then discuss how fear conditioning is a suitable model for studying the molecular mechanisms of the fear components that underlie PTSD, and the biology of fear conditioning with a particular focus on the brain-derived neurotrophic factor (BDNF)-tyrosine kinase B (TrkB), GABAergic and glutamatergic ligand-receptor systems. We then summarize how such approaches might help to inform our understanding of PTSD and other stress-related disorders and provide insight to new pharmacological avenues of treatment of PTSD.
12/08/2011
Observations and insights about strengthening our soldiers SOS.
Melamed BG, & Castro C.
J Clin Psychol Med Settings. 2011 Jun;18(2):210-23. PMID:21638114[PubMed - in process]

Abstract: The Special Issue (June 2011) of the Journal of Clinical Psychology in Medical Settings titled Strengthening Our Soldiers (SOS) and Their Families: Contemporary Psychological Advances Applied to Wartime Problems revealed the following important concerns: 1) Who is at risk for psychological sequelae during and following service in the U.S. military? 2) How to deliver the best treatment for our soldiers and veterans with PTSD, Traumatic Brain Injury and Pain? 3) How to train the trainers? and 4) What are the current priorities for service delivery, research and funding? Read more . . .
12/08/2011
Prevalence and features of panic disorder and comparison to posttraumatic stress disorder in VA primary care.
Gros DF, Frueh BC, & Magruder KM.
Gen Hosp Psychiatry. 2011 Aug 2; [epub ahead of print] PMID: 21816481 [PubMed - as supplied by publisher]

OBJECTIVE: Although panic disorder (PD) is a highly prevalent condition in both community and community primary care settings, little is known about PD in veteran populations, especially in comparison to posttraumatic stress disorder (PTSD). The present study investigated prevalence, comorbidity, physical and mental health impairment, and health care utilization of veterans with PD and PTSD. Read more . . .
12/08/2011
Quality of life in Croatian Homeland war (1991-1995) veterans who suffer from post-traumatic stress disorder and chronic pain.
Bras M, Milunovic V, Boban M, Brajkovic L, Benkovic V, Dordevic V, & Polasek O.
Health Qual Life Outcomes. 2011 Jul 29;9(1):56 PMID: 21798076 [PubMed - as supplied by publisher]

ABSTRACT: BACKGROUND: The aim of this study was to investigate the quality of life in Croatian homeland war veterans who suffer from post-traumatic stress disorder (PTSD) and chronic low back pain (LBP). Read More . . .
12/08/2011
War exposure and post-traumatic stress as predictors of Portuguese colonial war veterans' physical health.
Maia A, McIntyre T, Pereira MG, & Ribeiro E.
Anxiety Stress Coping. 2011 May;24(3):309-25 PMID: 20945238 [PubMed - indexed for MEDLINE]

Abstract: The relationship between war exposure and post-traumatic stress disorder (PTSD) has been largely investigated but the impact of the combat experience on physical health has only recently merited attention.
The authors investigated the relationship between war exposure and psychological and physical health among 350 Portuguese colonial war veterans. The role of current PTSD symptoms as a mediator of these relationships was also investigated.
The results showed that 39% of the veterans met criteria for current PTSD diagnosis and psychological distress was present in half of the sample. Pain, fatigue, and sleep problems were the most reported physical symptoms and mental health and gastro-intestinal problems, the most reported illnesses. Combat exposure variables were significant predictors of current health.
The results indicated that veterans with higher exposure to war trauma maintained higher current levels of psychological distress and presented more physical health problems and physical symptoms than those less exposed. Mediation analyses showed that current PTSD was a full mediator of the relationship between war exposure and physical health outcomes.
July
29/07/2011
Case report on the use of cognitive processing therapy-cognitive, enhanced to address heavy alcohol use.
McCarthy E, & Petrakis I.
J Trauma Stress. 2011 Jul 21. doi: 10.1002/jts.20660. [Epub ahead of print] PMID:21780191 [PubMed - as supplied by publisher]

Abstract:There is a high rate of co-occurring alcohol dependence (AD) in individuals with posttraumatic stress disorder (PTSD). Cognitive processing therapy (CPT) is an effective treatment for individuals diagnosed with PTSD. CPT-Cognitive (CPT-C) is a modified form of CPT. This case report describes a 12-week course of CPT-C treatment, enhanced to address heavy alcohol use, in a combat veteran with PTSD and co-occurring AD. By treatment end, the veteran demonstrated clinically significant improvement in both PTSD symptoms and alcohol-related problems and sustained these gains 12-weeks posttreatment. The results indicate promise for the use of CPT-C, enhanced for heavy alcohol use, for individuals diagnosed with PTSD and AD.
29/07/2011
Group cognitive processing therapy delivered to veterans via telehealth: A pilot cohort.
Morland LA, Hynes AK, Mackintosh MA, Resick PA, & Chard KM.
J Trauma Stress. 2011 Jul 25. doi: 10.1002/jts.20661. [Epub ahead of print], PMID:21793047 [PubMed - as supplied by publisher]

Abstract: The authors report clinical findings from the pilot cohort of the first prospective, noninferiority-designed randomized clinical trial evaluating the clinical outcomes of delivering a cognitive-behavioral group intervention for posttraumatic stress disorder (PTSD), cognitive processing therapy (CPT), via video teleconferencing (VT) compared to the in-person modality. The treatment was delivered to 13 veterans with PTSD residing on the Hawaiian Islands. Results support the general feasibility and safety of using VT. Both groups showed clinically meaningful reductions in PTSD symptoms and no significant between-group differences on clinical or process outcome variables. In keeping with treatment manual recommendations, a few changes were made to the CPT protocol to accommodate this population. Novel aspects of this trial and lessons learned are discussed.
22/07/2011
Ending self-stigma: pilot evaluation of a new intervention to reduce internalized stigma among people with mental illnesses.
Lucksted A, Drapalski A, Calmes C, Forbes C, Deforge B, & Boyd J.
Psychiatr Rehabil J. 2011 Summer;35(1):51-4. PMID:21768078[PubMed - in process]

Abstract: Objective: This study evaluated "Ending Self-Stigma" (ESS), a structured 9-session group intervention to help people with serious mental illnesses reduce internalized stigma. Methods: Participants from two Veterans Administration mental health sites were assessed before and after the intervention regarding their levels of internalized stigma, empowerment, recovery orientation, perceived social support, and beliefs about societal stigma. Results: Internalized stigma significantly decreased, and perceived social support and recovery orientation significantly increased. Conclusions and Implications for Practice: "Ending Self-Stigma" is the first of its kind and may be a valuable intervention for reducing internalized stigma among people with serious mental illnesses, suitable for both professionally-delivered psychiatric rehabilitation programs and consumer-led programs and services.
22/07/2011
Predictors of posttraumatic stress disorder, depression, and suicidal ideation among Canadian Forces personnel in a National Canadian Military Health Survey.
Nelson C, Cyr KS, Corbett B, Hurley E, Gifford S, Elhai JD, & Donald Richardson J.
J Psychiatr Res. 2011 Jul 11. [Epub ahead of print] [PMID:21752395[PubMed - as supplied by publisher]

Abstract: Despite efforts to elucidate the relationship between traumatic event exposure and adverse mental health outcomes, our ability to understand why only some trauma-exposed individuals become emotionally affected remains challenged. The aim of the current study is to determine the relations between social support, religiosity, and number of lifetime traumatic events experienced on past-12 month posttraumatic stress disorder (PTSD), depression, and suicidal ideation (SI) in a nationally representative sample of Canadian Forces personnel. The current study used data from the Canadian Community Health Survey Cycle 1.2 - Canadian Forces Supplement. The impact of a number of predictive and mediating factors was assessed using structural equation modeling. Social support and number of lifetime traumatic events experienced were significant predictors of past-year PTSD, depression, and SI; however PTSD did not mediate the relationship between number of traumatic events and SI nor between social support and SI. Conversely, depression mediated the relationship between number of traumatic events and SI. Possible mechanisms for these findings and their implications are discussed.
15/07/2011
Coming home: Social functioning and the mental health of UK Reservists on return from deployment to Iraq or Afghanistan.
Harvey SB, Hatch SL, Jones M, Hull L, Jones N, Greenberg N, Dandeker C, Fear NT, & Wessely S.
Ann Epidemiol. 2011 Jul 5. [Epub ahead of print] PMID:21737306[PubMed - as supplied by publisher]

Abstract: PURPOSE: There is speculation that high rates of mental illness among Reservists returning from deployment to Iraq and Afghanistan may be due to the challenge of reintegrating into civilian life. We aimed to examine the postdeployment social functioning of Reservists and to explore the relationship between adverse postdeployment experiences and subsequent mental ill health. Read more . . .
15/07/2011
The comparative effectiveness of cognitive processing therapy for male veterans treated in a VHA posttraumatic stress disorder residential rehabilitation program.
Alvarez J, McLean C, Harris AH, Rosen CS, Ruzek JI, & Kimerling R.
J Consult Clin Psychol. 2011 Jul 11. [Epub ahead of print] PMID:21744946[PubMed - as supplied by publisher]

Abstract: Objective: To examine the effectiveness of group cognitive processing therapy (CPT) relative to trauma-focused group treatment as usual (TAU) in the context of a Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) residential rehabilitation program. Read more . . .
15/07/2011
The impact of Purple Heart commendation and PTSD on mortality rates in older veterans.
Kimbrell T, Pyne JM, Kunik ME, Magruder KM, Petersen NJ, Yu HJ, Hudson TJ, Schulz PE, & Qureshi SU.
Depress Anxiety. 2011 Jul 12. doi: 10.1002/da.20850. [Epub ahead of print] PMID:21751302[PubMed - as supplied by publisher]

Abstract: Background: To determine whether having received a Purple Heart (PH) or having been diagnosed with posttraumatic stress disorder (PTSD) affected mortality in older veterans. Read more . . .
08/07/2011
Associations among experiential avoidance, couple adjustment, and interpersonal aggression in returning Iraqi war veterans and their partners.
Reddy MK, Meis LA, Erbes CR, Polusny MA, & Compton JS.
J Consult Clin Psychol. 2011 Jul 4; [epub ahead of print] PMID: 21728401 [PubMed - as supplied by publisher]

Objective: The purpose of the present study was to examine the role of experiential avoidance (EA) in relationship adjustment, psychological aggression, and physical aggression among military couples. Read more . . .
08/07/2011
Psychiatric diagnoses and neurobehavioral symptom severity among OEF/OIF VA patients with deployment-related traumatic brain injury: A gender comparison.
Iverson KM, Hendricks AM, Kimerling R, Krengel M, Meterko M, Stolzmann KL, Baker E, Pogoda TK, Vasterling JJ, & Lew HL.
Womens Health Issues. 2011 Jul-Aug;21(4 Suppl):S210-7. PMID:21724143[PubMed - in process]

Abstract: BACKGROUND: Traumatic brain injury (TBI) has substantial negative implications for the post-deployment adjustment of veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF); however, most research on veterans has focused on males. This study investigated gender differences in psychiatric diagnoses and neurobehavioral symptom severity among OEF/OIF veterans with deployment-related TBI. Read more . . .
08/07/2011
Work-related quality of life and posttraumatic stress disorder symptoms among female veterans.
Schnurr PP, & Lunney CA.
Womens Health Issues. 2011 Jul-Aug;21(4 Suppl):S169-75. PMID:21724137[PubMed - in process]

Abstract: BACKGROUND: Posttraumatic stress disorder (PTSD) can have pervasive, negative effects on multiple aspects of quality of life. We investigated the relationship between PTSD symptom clusters and work-related quality of life among female veterans. Although prior studies have shown that PTSD symptom clusters are differentially related to work-related quality of life, no study has assessed these relationships in women specifically. Read more . . .
08/07/2011
Coping strategies and beliefs about pain in veterans with comorbid chronic pain and significant levels of posttraumatic stress disorder symptoms.
Alschuler KN, & Otis JD.
Eur J Pain. 2011 Jun 29. [Epub ahead of print] PMID:21723169[PubMed - as supplied by publisher]

Abstract: OBJECTIVES: The purpose of this study was to assess differences in beliefs about pain and coping strategies employed in veterans with comorbid chronic pain and posttraumatic stress disorder (PTSD), compared to veterans with chronic pain alone. It was hypothesized that veterans with comorbid chronic pain and significant levels of PTSD symptomatology would report higher levels of maladaptive coping strategies and beliefs about pain when compared to veterans with pain alone. Read more . . .
08/07/2011
Systematic review of women veterans' health: update on successes and gaps.
Bean-Mayberry B, Yano EM, Washington DL, Goldzweig C, Batuman F, Huang C, Miake-Lye I, & Shekelle PG.
Womens Health Issues. 2011 Jul-Aug;21(4 Suppl):S84-97 PMID: 21724149 [PubMed - in process]

Abstract: OBJECTIVE: We assessed the state of women veterans' health research by conducting a systematic review of scientific literature published from 2004 to 2008, updating a prior review spanning the history of this literature to 2004. METHODS: We identified articles by searching scientific databases and contacting experts. Relevant articles were independently evaluated by two physician reviewers. We categorized 195 articles by study design, funding source, period of military service, research topic, and health condition. Read more . . .
June
24/06/2011
"Warriors": Impact of a Powerful Television Drama on the Psychological Health of U.K. Bosnia Peacekeepers.
Fernando A, Hull L, Greenberg N, Fear NT, Hotopf M, & Wessely S.
Ann Epidemiol. 2011 Jun 16; [epub ahead of print] PMID: 21684177 [PubMed - as supplied by publisher]

Abstract: PURPOSE: The impact of secondary trauma, such as watching powerful images on television, on the etiology of posttraumatic stress disorder in adults remains controversial. We explored the impact of a powerful TV drama ("Warriors") on the psychological health of U.K. peacekeeping troops compared with other military personnel who also saw the program but did not deploy on the same mission. Read more . . .
24/06/2011
Changes in brain anatomy during the course of posttraumatic stress disorder.
Cardenas VA, Samuelson K, Lenoci M, Studholme C, Neylan TC, Marmar CR, Schuff N, & Weiner MW.
Psychiatry Res. 2011 Jun 15; [epub ahead of print] PMID: 21683556 [PubMed - as supplied by publisher]

Abstract: The goal of this study was to determine whether posttraumatic stress disorder (PTSD) was associated with an increase in time-related decline in macrostructural brain volume and whether these changes were associated with accelerated cognitive decline. To quantify brain structure, three-dimensional T1-weighted MRI scans were performed at baseline and again after a minimum of 24months in 25 patients with PTSD (PTSD+) and 22 controls (PTSD-). Longitudinal changes in brain volume were measured using deformation morphometry. For the group as a whole, PTSD+ patients did not show significant ongoing brain atrophy compared to PTSD-. PTSD+ patients were then subgrouped into those with decreasing or increasing symptoms. We found little evidence for brain markers of accelerated atrophy in PTSD+ veterans whose symptoms improved over time, with only a small left parietal region showing greater ongoing tissue loss than PTSD-. PTSD patients whose symptoms increased over time showed accelerated atrophy throughout the brain, particularly brainstem and frontal and temporal lobes. Lastly, for the sample as a whole, greater rates of brain atrophy were associated with greater rates of decline in verbal memory and delayed facial recognition.
24/06/2011
Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions.
Wilkins KC, Lang AJ, & Norman SB.
Depress Anxiety. 2011 Jun 16. [Epub ahead of print] PMID:21681864[PubMed - as supplied by publisher]

Abstract: The posttraumatic stress disorder checklist is a commonly used measure, with military (PCL-M), civilian (PCL-C), and specific trauma (PCL-S) versions. This synthesis of the psychometric properties of all three versions found the PCL to be a well-validated measure. The PCL shows good temporal stability, internal consistency, test-retest reliability, and convergent validity. The majority of structural validity studies support four factor models. Little is available on discriminant validity and sensitivity to change. Strengths, limitations, and future research directions are discussed. Understanding the PCL's psychometric properties, strengths (e.g., items map on to DSM-IV diagnostic criteria), and limitations (e.g., may overestimate PTSD prevalence) will help clinicians and researchers make educated decisions regarding the appropriate use of this measure in their particular setting. Depression and Anxiety 0:1-11, 2011. © 2011 Wiley-Liss, Inc.
17/06/2011
Preliminary analysis of posttraumatic stress disorder screening within specialty clinic setting for OIF/OEF veterans seeking care for neck or back pain.
Dunn AS, Julian T, Formolo LR, Green BN, & Chicoine DR.
J Rehabil Res Dev. 2011;48(5):493-502 PMID: 21674400 [PubMed - in process]
http://www.rehab.research.va.gov/jour/11/485/pdf/dunn485.pdf

Abstract: Escalating prevalence estimates of posttraumatic stress disorder (PTSD) among recently returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans highlight the need for early detection and management for reducing chronic mental illness and disability. Because PTSD and chronic pain are common comorbid conditions among veterans, PTSD screening within specialty clinic settings addressing musculoskeletal pain may be of value. This retrospective study evaluated measures of diagnostic value for the PTSD Checklist (PCL) for a sample (n = 79) of OIF/OEF veterans seeking care for neck or back pain within a Department of Veterans Affairs specialty clinic. Because published accounts of optimal PCL cutoff scores vary considerably, we used receiver operating characteristic curves to identify whether the optimal PCL cutoff score for the sample differed from a conventional cutoff score of 50. A clinical psychologist experienced in diagnosing and managing PTSD confirmed the diagnosis of PTSD for 37 veterans through a review of clinical records. The prevalence of diagnosed PTSD was 46.8%, with an optimal PCL cutoff score of 44. These findings may guide future research and influence clinical practice regarding PTSD screening for recently returning veterans with chronic pain.
17/06/2011
The structure of PTSD among two cohorts of returning soldiers: Before, during, and following deployment to Iraq.
Meis LA, Erbes CR, Kaler ME, Arbisi PA, & Polusny MA.
J Abnorm Psychol. 2011 Jun 13. [Epub ahead of print] PMID:21668079[PubMed - as supplied by publisher]

Abstract: Evidence suggests either a four-factor emotional numbing or dysphoria model likely reflects the underlying structure of posttraumatic stress disorder (PTSD). Questions remain as to which of these structures best represents PTSD, how the structure changes with time, the applicability of models to returning veterans, and the validity of the symptom clusters. The present study addresses these questions among two longitudinal samples of National Guard soldiers assessed prior to, during, and following a combat deployment to Iraq. Findings support a four-factor intercorrelated dysphoria model of PTSD that remains stable across samples and time points. Differential associations were observed among PTSD symptom clusters over time and between symptom clusters and both depression and combat exposure, supporting important distinctions between symptom clusters.
10/06/2011
A brief self-guided telehealth intervention for post-traumatic stress disorder in combat veterans: a pilot study.
Possemato K, Ouimette P, & Knowlton P.
J Telemed Telecare. 2011 Jun 2; [epub ahead of print] PMID: 21636687 [PubMed - as supplied by publisher]

Abstract: To engage more US combat veterans in PTSD treatment, we offered a psychological intervention that could be initiated in primary care and completed using the Internet. Participants (n = 31) were randomized to complete either Written Emotional Disclosure (WED) or time management narratives on a secure Internet website. In the WED group, participants wrote about their thoughts and emotions regarding one traumatic combat experience in three 20-min sessions. Writing instructions encouraged exposure to traumatic memories and cognitive processing of trauma. The intervention was found to be feasible and safe to implement. Although follow-up assessments did not reveal significant group differences in PTSD symptoms, half of the WED participants reported symptom reductions. Content analyses revealed that participants who expressed more emotion and cognitions were significantly more likely to experience decreased PTSD symptoms. WED may have promise as a brief intervention for veterans with PTSD.
10/06/2011
Couple adjustment and posttraumatic stress disorder symptoms in National Guard veterans of the Iraq war.
Erbes CR, Meis LA, Polusny MA, & Compton JS.
J Fam Psychol. 2011 May 30; [epub ahead of print] PMID: 21639633 [PubMed - as supplied by publisher]

Abstract: Relationship adjustment and posttraumatic stress disorder (PTSD) symptoms were assessed across two time points in a sample of 313 married or partnered National Guard soldiers recently returned from combat duty in Iraq. Structural equation modeling using a four-factor model for PTSD found the latent variable dysphoria (reflecting generalized distress including aspects of emotional numbing and arousal) had the strongest independent contribution to predicting relationship adjustment at Time 1 and indirectly predicted poorer relationship adjustment at Time 2. Exploratory analysis of gender differences (n = 33 women; n = 280 men) suggested a different pattern of relations between PTSD factors and relationship adjustment among female soldiers at Time 1, with a trend toward trauma specific avoidance being more highly related to relationship adjustment. Clinical and research implications are discussed.
10/06/2011
Distress in spouses of service members with symptoms of combat-related PTSD: Secondary traumatic stress or general psychological distress?
Renshaw KD, Allen ES, Rhoades GK, Blais RK, Markman HJ, & Stanley SM.
J Fam Psychol. 2011 May 30; [epub ahead of print] PMID: 21639635 [PubMed - as supplied by publisher]

Abstract: Combat-related posttraumatic stress disorder (PTSD) is linked with elevated psychological distress in service members'/veterans' spouses. Researchers use a variety of terms to describe this distress, and recently, secondary traumatic stress and secondary traumatic stress disorder (STS/STSD) have become increasingly commonly used. Although STS/STSD connotes a specific set of symptoms that are linked to service members'/veterans' symptoms, researchers often use general measures of distress or generically worded measures of PTSD symptoms to assess STS/STSD. To determine how often scores on such measures appear to be an accurate reflection of STS/STSD, we examined responses to a measure of PTSD symptoms in 190 wives of male service members with elevated levels of PTSD symptoms. Read more . . .
10/06/2011
The implication of combat-induced stress reaction, PTSD, and attachment in parenting among war veterans.
Cohen E, Zerach G, & Solomon Z.
J Fam Psychol. 2011 May 30; [epub ahead of print] PMID: 21639634 [PubMed - as supplied by publisher]

Abstract: This study examined parental functioning, parental satisfaction, and concern for offspring during their child's military service, among war veterans, some of whom suffered from acute combat-induced stress reaction (CSR) and posttraumatic stress disorder (PTSD). In addition, we examined the additive and interactive contributions of CSR, PTSD and attachment dimensions to parenting measures. Read more . . .
03/06/2011
Assessment and treatment of combat-related PTSD in returning war veterans.
Peterson AL, Luethcke CA, Borah EV, Borah AM, & Young-McCaughan S.
J Clin Psychol Med Settings. 2011 May 28; [epub ahead of print] PMID: 21626355 [PubMed - as supplied by publisher]

Abstract: Over the past 9 years approximately 2 million U.S. military personnel have deployed in support of Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in and around Afghanistan. It has been estimated that 5-17% of service members returning from these deployments are at significant risk for combat-related posttraumatic stress disorder (PTSD). Many of these returning war veterans will seek medical and mental health care in academic health centers. This paper reviews the unique stressors that are related to the development of combat-related PTSD. It also reviews evidence-based approaches to the assessment and treatment of PTSD, research needed to evaluate treatments for combat-related PTSD, and opportunities and challenges for clinical psychologists working in academic health centers.
03/06/2011
Complicating Factors Associated with Mild Traumatic Brain Injury: Impact on Pain and Posttraumatic Stress Disorder Treatment.
Otis JD, McGlinchey R, Vasterling JJ, & Kerns RD.
J Clin Psychol Med Settings. 2011 May 28. [Epub ahead of print] PMID:21626354[PubMed - as supplied by publisher]

Abstract: The nature of combat in Iraq and Afghanistan has resulted in high rates of comorbidity among chronic pain, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Although separate evidence-based psychological treatments have been developed for chronic pain and PTSD, far less is known about how to approach treatment when these conditions co-occur, and especially when they co-occur with mTBI. To provide the best care possible for OEF/OIF Veterans, clinicians need to have a clearer understanding of how to identify these conditions, ways in which these conditions may interact with one another, and ways in which existing evidence-based treatments can be modified to meet the needs of individuals with mTBI. The purpose of the present paper is to review the comorbidity of pain, PTSD, and mTBI in OEF/OIF Veterans, and provide recommendations to clinicians who provide care to Veterans with these conditions. First, we will begin with an overview of the presentation, symptomatology, and treatment of chronic pain and PTSD. The challenges associated with mTBI in OEF/OIF Veterans will be reported and data will be presented on the comorbidity among all three of these conditions in OEF/OIF Veterans. Second, we will present recommendations for providing psychological treatment for chronic pain and PTSD when comorbid with mTBI. Finally, the paper concludes with a discussion of the need for a multidisciplinary treatment approach, as well as a call for continued research to further refine existing treatments for these conditions.
03/06/2011
Effects of transcendental meditation in veterans of Operation Enduring Freedom and Operation Iraqi Freedom with posttraumatic stress disorder: A pilot study.
Rosenthal JZ, Grosswald S, Ross R, & Rosenthal N.
Military Medicine June 2011;176(6): 626-630.

Abstract: We conducted an uncontrolled pilot study to determine whether transcendental meditation (TM) might be helpful in treating veterans from Operation Enduring Freedom or Operation Iraqi Freedom with combat-related posttraumatic stress disorder (PTSD). Five veterans were trained in the technique and followed for 12 weeks. All subjects improved on the primary outcome measure, the Clinician Administered PTSD Scale (mean change score, 31.4; p = 0.02; df = 4). Significant improvements were also observed for 3 secondary outcome measures: Clinician's Global Inventory-Severity (mean change score, 1.60; p < 0.04; df = 4), Quality of Life Enjoyment and Satisfaction Questionnaire (mean change score, ?13.00; p < 0.01; df = 4), and the PTSD Checklist-Military Version (mean change score, 24.00; p < 0.02; df = 4). TM may have helped to alleviate symptoms of PTSD and improve quality of life in this small group of veterans. Larger, placebo-controlled studies should be undertaken to further determine the efficacy of TM in this population.
03/06/2011
Exploring the efficacy of a residential treatment program incorporating cognitive processing therapy-cognitive for veterans with PTSD and traumatic brain injury.
Chard KM, Schumm JA, McIlvain SM, Bailey GW, & Parkinson RB.
J Trauma Stress. 2011 May 27; PMID: 21626573 [PubMed - as supplied by publisher]

Abstract: As the numbers of military personnel participating in the wars in Afghanistan and Iraq continue to grow, the percentage of individuals who return with both a traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) also increases. Although there appears to be significant overlap in the symptoms resulting from PTSD and TBI, the best course of treatment remains an area of controversy. The authors present initial findings from a Veterans Administration residential program for comorbid PTSD and TBI. Forty-two participants completed a program comprising psychoeducational groups and cognitive skill building that was augmented with a modification of standard cognitive processing therapy. The results suggest that residential programs that incorporate this form of cognitive therapy can anticipate meaningful participation from patients, and that it may be an effective approach to treat PTSD in individuals with a history of TBI.
03/06/2011
Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder.
Macdonald A, Monson CM, Doron-Lamarca S, Resick PA, & Palfai TP.
J Trauma Stress. 2011 May 27. doi: 10.1002/jts.20642. [Epub ahead of print] PMID:21626572[PubMed - as supplied by publisher]

Abstract: Cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) has been shown to reduce symptoms of PTSD in a veteran population. This study explored patterns of self-reported symptom change during CPT. Veterans (N = 60) with PTSD were randomized to receive CPT immediately or after 10 weeks. We hypothesized that those treated immediately would evidence initial symptom stability followed by decline compared with those who waited, whose PTSD symptoms would remain stable. The best model fit based on deviance statistics and Bayesian information criteria comparisons was one in which participants treated immediately showed more rapid initial decline followed by a slower rate of PTSD symptom improvement relative to those who waited, who showed a stable level of symptomatology. Findings suggest that CPT produces quick and maintained improvements in veterans. The effect sizes for change between those who received CPT immediately and those who waited were approximately medium sized. Implications of findings are discussed.
03/06/2011
Posttraumatic growth in combat veterans.
Tedeschi RG.
J Clin Psychol Med Settings. 2011 May 28. [Epub ahead of print] PMID:21626349[PubMed - as supplied by publisher]

Abstract: Combat veterans and their families face significant challenges not only to their abilities to cope, but often to their fundamental belief systems. Traumatic events represent assaults on core beliefs, yet at times, produce cognitive processing that can ultimately result in personal transformations called posttraumatic growth (PTG). Clinicians can utilize a systematic therapeutic approach to facilitate PTG as they carry out a relationship of expert companionship. PTG in service members is described in this article, as well as the approach to facilitation of PTG.
03/06/2011
Relationships between soldiers' PTSD symptoms and spousal communication during deployment.
Carter S, Loew B, Allen E, Stanley S, Rhoades G, & Markman H.
J Trauma Stress. 2011 May 25. doi: 10.1002/jts.20649. [Epub ahead of print] PMID:21618290[PubMed - as supplied by publisher]

Abstract: Social support, including support from spouses, may buffer against posttraumatic stress disorder (PTSD) symptoms. The current study assessed whether the frequency of spousal communication during a recent deployment, a potentially important source of support for soldiers, was related to postdeployment PTSD symptoms. Data came from 193 married male Army soldiers who returned from military deployment within the past year. For communication modalities conceptualized as delayed (i.e., letters, care packages, and e-mails), greater spousal communication frequency during deployment was associated with lower postdeployment PTSD symptom scores, but only at higher levels of marital satisfaction (p = .009). At lower marital satisfaction, more delayed spousal communication during deployment was associated with more PTSD symptoms (p = .042). For communication modalities conceptualized as interactive (i.e., phone calls, instant messaging, instant messaging with video), the same general direction of effects was seen, but the interaction between communication frequency and marital satisfaction predicting PTSD symptoms did not reach significance.
03/06/2011
The evaluation and treatment of comorbid pain and PTSD in a military setting: An overview.
McGeary D, Moore M, Vriend CA, Peterson AL, & Gatchel RJ.
J Clin Psychol Med Settings. 2011 May 28. [Epub ahead of print] PMID:21626356[PubMed - as supplied by publisher]

Abstract: The present article reviews the growing prevalence of comorbid pain and post-traumatic stress disorder (PTSD) in the military. This has been caused by the ongoing military conflicts in Iraq and Afghanistan, where new combat conditions/strategies are causing these comorbid conditions. Fortunately, comprehensive interdisciplinary treatment programs, originally developed for a civilian population and in academic settings, are being successfully "translated" or utilized in the military environment. Recent data demonstrating this translational clinical intervention are presented. Finally, challenges encountered when translating these interventions in a military environment are also discussed.
May
27/05/2011
A review of atypical antipsychotic medications for posttraumatic stress disorder.
Ahearn EP, Juergens T, Cordes T, Becker T, & Krahn D.
Int Clin Psychopharmacol. 2011 May 18. [Epub ahead of print] PMID:21597381 [PubMed - as supplied by publisher]

Abstract: Posttraumatic stress disorder (PTSD) can be a chronic and disabling illness with a limited response to antidepressant treatment, particularly in the case of combat-inducedPTSD. The purpose of this study is to review randomized controlled and open-label trials of atypical antipsychotics for the treatment of PTSD. We conducted PUBMED and PILOTS database searches for clinical trials of atypical antipsychotic medications for PTSD in May 2010. Eighteen clinical trials (10 double-blind placebo-controlled, eight open-label) of atypical antipsychotics for PTSD were found and reviewed. Effect sizes of double-blind placebo-controlled trials were small, but were positive for risperidone and quetiapine. Intrusive and hypervigilance symptom subscales showed the most improvement. We concluded that atypical antipsychotic medications have a modest benefit for the treatment of PTSD. Larger randomized controlled trials are needed to clarify the potential utility of these medications in the treatment of PTSD and more rigorous examination of metabolic side effects is warranted.
27/05/2011
Exploring the relationship between underlying dimensions of posttraumatic stress disorder and depression in a national, trauma-exposed military sample.
Elhai JD, Contractor AA, Palmieri PA, Forbes D, & Richardson JD.
J Affect Disord. 2011 May 18. [Epub ahead of print] PMID:21600663 [PubMed - as supplied by publisher]

Abstract: BACKGROUND: Posttraumatic stress disorder (PTSD) and depression are highly comorbid and intercorrelated. Yet little research has examined the underlying processes explaining their interrelationship. Read more . . .
27/05/2011
Posttraumatic stress disorder, traumatic brain injury, and suicide attempt history among veterans receiving mental health services.
Brenner LA, Betthauser LM, Homaifar BY, Villarreal E, Harwood JE, Staves PJ, & Huggins JA.
Suicide Life Threat Behav. 2011 May 20. doi: 10.1111/j.1943-278X.2011.00041.x. [Epub ahead of print] PMID:21599727 [PubMed - as supplied by publisher]

Abstract: History of posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI) has been found to increase risk of suicidal behavior. The association between suicide attempt history among veterans with PTSD and/or TBI was explored. Cases (N = 81) and 2:1 matched controls (N = 160) were randomly selected from a Veterans Affairs Medical Center clinical database. PTSD history was associated with an increased risk for a suicide attempt (OR = 2.8; 95% CI: 1.5, 5.1). This increased risk was present for those with and without a history of TBI. Results support incorporating PTSD history when assessing suicide risk among veterans with and without TBI.
20/05/2011
Aripiprazole augmentation in the treatment of military-related PTSD with major depression: a retrospective chart review.
Richardson JD, Fikretoglu D, Liu A, & McIntosh D.
BMC Psychiatry. 2011 May 17;11(1):86. [Epub ahead of print] PMID:21586149 [PubMed - as supplied by publisher] http://www.biomedcentral.com/content/pdf/1471-244x-11-86.pdf

Abstract: BACKGROUND: In this chart review, we attempted to evaluate the benefits of adding aripiprazole in veterans with military-related PTSD and comorbid depression, who had been minimally or partially responsive to their existing medications. Read more . . .
20/05/2011
Dispositional optimism buffers combat veterans from the negative effects of warzone stress on mental health symptoms and work impairment.
Thomas JL, Britt TW, Odle-Dusseau H, & Bliese PD.
J Clin Psychol. 2011 May 16. doi: 10.1002/jclp.20809. [Epub ahead of print] PMID:21590690 [PubMed - as supplied by publisher]

Abstract: The study examined dispositional optimism s role in buffering the effect of warzone stress on mental health symptoms and mental health symptoms on work impairment. A total of 2,439 soldiers from an active-duty brigade combat team were surveyed following a 12-month deployment to Iraq. Posttraumatic stress disorder (PTSD) symptoms, depression symptoms, combat exposure, deployment demands, and work impairment were measured. Soldiers higher in dispositional optimism showed weaker relationships between combat exposure and PTSD symptoms, and between deployment demands and PTSD and depression symptoms. Dispositional optimism also buffered mental health symptom effects on work impairment. Dispositional optimism may protect soldiers from warzone stress and mental health symptoms. Potential mechanisms explaining how dispositional optimism may serve as a protective factor are discussed.
20/05/2011
Pain and post traumatic stress disorder - Review of clinical and experimental evidence.
Moeller-Bertram T, Keltner J, & Strigo IA.
Neuropharmacology. 2011 May 10. [Epub ahead of print] PMID:21586297 [PubMed - as supplied by publisher]

Abstract: Pain and Post Traumatic Stress Disorder (PTSD) are highly comorbid conditions. Patients with chronic pain have higher rates of PTSD. Likewise, patients with PTSD are often diagnosed with numerous chronic pain conditions. Despite the high pain-PTSD comorbidity, the neurobehavioral mechanisms underlying this phenomenon are incompletely understood and only recently researchers have started investigating it using experimental models. In this article, we systematically review the substantial clinical evidence on the co-occurrence of pain and PTSD, and the limited experimental evidence of pain processing in this disorder. We provide a detailed overview of the psychophysical and brain imaging experiments that compared somatosensory and pain processing in PTSD and non-PTSD populations. Based on the presented evidence, an extensive body of literature substantiates the clinical coexistence of pain and PTSD in patients but the limited experimental data show inconsistent results highlighting the need for well-controlled future studies.
20/05/2011
Personality-based latent classes of posttraumatic psychopathology: Personality disorders and the Internalizing/Externalizing model.
Wolf EJ, Miller MW, Harrington KM, & Reardon A.
J Abnorm Psychol. 2011 May 16. [Epub ahead of print] PMID:21574669 [PubMed - as supplied by publisher]

Abstract: Prior research using the Brief Form of the Multidimensional Personality Questionnaire (MPQ-BF; Patrick, Curtin, & Tellegen, 2002) has shown evidence of 3 temperament-based 6 subtypes-termed internalizing, externalizing, and simple PTSD-among individuals with symptoms of posttraumatic stress disorder (PTSD; Miller, Greif, & Smith, 2003). This study sought to replicate and extend research in this area by conducting a latent profile analysis of higher order temperament scales from the MPQ-BF using a new sample of 208 veterans with symptoms of PTSD. Read more . . .
13/05/2011
Prospectively assessed posttraumatic stress disorder and associated physical activity.
LeardMann CA, Kelton ML, Smith B, Littman AJ, Boyko EJ, Wells TS, & Smith TC; Millennium Cohort Study Team. Collaborators (20) Creaven G, Davies J, Farnell L, Granado N, Gumbs G, Jacobson I, Leleu T, McGrew J, Snell K, Speigel S, Sausedo K, White M, Whitmer J, Wong C, Amoroso P, Gackstetter G, Gray G, Hooper T, Riddle J, Ryan M.
Public Health Rep. 2011 May-Jun;126(3):371-83. PMID:21553666 [PubMed - in process]

Abstract:
OBJECTIVES: We examined the association of physical activity with prospectively assessed posttraumatic stress disorder (PTSD) symptoms in a military cohort.
13/05/2011
The role of intimate relationships, appraisals of military service, and gender on the development of posttraumatic stress symptoms following Iraq deployment.
Skopp NA, Reger MA, Reger GM, Mishkind MC, Raskind M, & Gahm GA.
J Trauma Stress. 2011 May 5. doi: 10.1002/jts.20632. [Epub ahead of print] PMID:21547955 [PubMed - as supplied by publisher]

Abstract:
A retrospective cohort study was conducted to examine risk and protective factors for combat-related posttraumatic stress disorder (PTSD) symptoms reported by soldiers (n = 2,583) at postdeployment. Positive appraisals of military service related negatively, OR = 0.86, 95% CI [0.83, 0.89], to screening positive for presumed PTSD at postdeployment. Decreases in perceived intimate relationship strength from predeployment to postdeployment were positively associated with presumed PTSD at higher, but not lower, levels of combat exposure; this effect, OR = 1.91, 95% CI [1.08, 3.39], was found only for female soldiers. Overall risk for postdeployment presumed PTSD was found to be nearly 2.5 times greater for women, as compared to men. In addition, positive screening rates of anxiety, depression, hazardous alcohol use, and PTSD increased from predeployment to postdeployment, with the most prominent increase found for PTSD.
13/05/2011
Trajectories of stress reactions and somatization symptoms among war veterans: a 20-year longitudinal study.
Ginzburg K. & Solomon Z.
Psychol Med. 2011 Feb;41(2):353-62. Epub 2010 Apr 21. PMID:20406521 [PubMed - indexed for MEDLINE]

Abstract:
BACKGROUND: There is considerable evidence that immediate and long-term stress reactions are associated with increased somatic symptomatology. However, because of the scarcity of long-term longitudinal studies, the trend of mutual change of these factors has not been assessed. This study examined the chronological inter-relationships between post-traumatic stress reactions and somatization symptoms among combatants over a 20-year period. Read more . . .
13/05/2011
Virtual Reality goes to war: A brief review of the future of military behavioral healthcare.
Rizzo A, Parsons TD, Lange B, Kenny P, Buckwalter JG, Rothbaum B, Difede J, Frazier J, Newman B, Williams J, & Reger G.
J Clin Psychol Med Settings. 2011 May 7. [Epub ahead of print] PMID:21553133 [PubMed - as supplied by publisher]

Abstract:
Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in returning OEF/OIF military personnel is creating a significant healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. Virtual Reality delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. This article details how virtual reality applications are being designed and implemented across various points in the military deployment cycle to prevent, identify and treat combat-related PTSD in OIF/OEF Service Members and Veterans. The summarized projects in these areas have been developed at the University of Southern California Institute for Creative Technologies, a U.S. Army University Affiliated Research Center, and this paper will detail efforts to use virtual reality to deliver exposure therapy, assess PTSD and cognitive function and provide stress resilience training prior to deployment.
06/05/2011
Post-traumatic stress disorder, coronary atherosclerosis, and mortality.
Ahmadi N, Hajsadeghi F, Mirshkarlo HB, Budoff M, Yehuda R, & Ebrahimi R.
Am J Cardiol. 2011 Apr 29. [Epub ahead of print] PMID:21530936 [PubMed - as supplied by publisher]

Abstract:
Post-traumatic stress disorder (PTSD) is associated with increased risk of multiple medical problems including myocardial infarction. However, a direct link between PTSD and atherosclerotic coronary artery disease (CAD) has not been made. Coronary artery calcium (CAC) score is an excellent method to detect atherosclerosis. This study investigated the association of PTSD to atherosclerotic CAD and mortality. Read more . . .
06/05/2011
Posttraumatic sequelae associated with military sexual trauma in female veterans enrolled in VA outpatient mental health clinics.
Luterek JA, Bittinger JN, & Simpson TL.
J Trauma Dissociation. 2011 May;12(3):261-74. PMID:21534095 [PubMed - in process]

Abstract:
The purpose of this study was to explore the relationship between military sexual assault (MSA) and posttraumatic stress disorder (PTSD) and other symptoms associated with trauma, referred to as disorders of extreme stress not otherwise specified (DESNOS) or complex PTSD within a Veterans Affairs (VA) Medical Center outpatient mental health treatment-seeking sample. The present results focus on female Veterans only because of the low rates of endorsement of MSA among male Veterans resulting in a sample too small to use in analyses. Compared with those who did not endorse MSA, those who did reported greater frequency of other potentially traumatic events; PTSD symptoms; and symptoms characteristic of DESNOS, such as difficulties with interpersonal relationships, emotion regulation, dissociation, somatization, and self-perception. When childhood and other adulthood interpersonal trauma were both taken into account, MSA continued to contribute unique variance in predicting PTSD and DESNOS symptoms. VA patients reporting MSA may represent notably heterogeneous groups that include more complex posttraumatic reactions. Treatment interventions focused on complex PTSD may be warranted for a subset of female veterans who endorse MSA.
06/05/2011
Posttraumatic stress symptomatology as a mediator of the association between military sexual trauma and post-deployment physical health in women.
Smith BN, Shipherd JC, Schuster JL, Vogt DS, King LA, & King DW.
J Trauma Dissociation. 2011 May;12(3):275-89. PMID:21534096 [PubMed - in process]

Abstract:
This study examined posttraumatic stress symptomatology (PSS) as a mediator of the association between military sexual trauma and post-deployment physical health. Relationships were examined in a sample of 83 female veterans of the first Gulf War (1990-1991) approximately 10 years post-deployment. Participants reported on the frequency of sexual harassment and sexual assault experienced during deployment. Physical health was measured using participants' self-reports of pre-deployment and post-deployment symptoms within 7 body systems. Sexual harassment exposure was not found to be associated with PSS-mediated associations with physical health symptoms. However, sexual assault during deployment was found to be associated with PSS and 4 of the 7 health symptom clusters assessed: gastrointestinal, genitourinary, musculoskeletal, and neurological symptoms. Furthermore, PSS was found to be a significant mediator of the sexual assault-physical health relationship in each of these domains, with the indirect path accounting for 74% to 100% of the relationship. The findings from the current study indicate that sexual assault has detrimental associations with physical health and that PSS plays a primary role in that relationship.
06/05/2011
Preinjury psychiatric status, injury severity, and postdeployment posttraumatic stress disorder.
Sandweiss DA, Slymen DJ, Leardmann CA, Smith B, White MR, Boyko EJ, Hooper TI, Gackstetter GD, Amoroso PJ, & Smith TC: for the Millennium Cohort Study Team.
Arch Gen Psychiatry. 2011 May;68(5):496-504. PMID:21536979 [PubMed - as supplied by publisher]

Abstract:
CONTEXT: Physical injury has been associated with the development of posttraumatic stress disorder (PTSD). Previous studies have retrospectively examined the relationship of preinjury psychiatric status and postinjury PTSD with conflicting results, but no prospective studies regarding this subject have been conducted, to our knowledge. Read more . . .
06/05/2011
Psychosocial screening in children with wartime-deployed parents.
Aranda MC, Middleton LS, Flake E, & Davis BE.
Mil Med. 2011 Apr;176(4):402-7. PMID:21539162 [PubMed - in process]

Abstract:
Children of U.S. military families are exposed to unique challenges and stressors directly related to their parents' wartime deployments, potentially placing them at higher risk for psychosocial disruption. The objective of this study was to investigate the effects of parental wartime military deployment on psychosocial symptoms as measured by parent and youth self-report on the Pediatric Symptom Checklist. During annual physicals at a large military pediatric clinic, parents (216) and youth (198) were surveyed about emotional and behavioral difficulties and the current status of parental deployment. Parents reported more child psychosocial symptoms, and youth self reported more psychosocial symptoms if there was a currently deployed parent. Youth self-reports may be another way to identify psychosocial symptoms in at-risk military youth. These findings accentuate the importance of training providers who care for military youth to recognize and respond to their unique needs during parental deployment.
April
29/04/2011
Mental health impact of the Iraq and Afghanistan conflicts: A review of US research, service provision, and programmatic responses.
Wells TS, Miller SC, Adler AB, Engel CC, Smith TC, & Fairbank JA.
Int Rev Psychiatry. 2011 Apr;23(2):144-52. PMID:21521083 [PubMed - in process]

Abstract:
Although documentation that war inflicts psychological casualties dates back to the American Civil War and earlier, most research began after the Vietnam conflict, when studies focused on post-traumatic stress disorder (PTSD). With ongoing conflicts in Iraq and Afghanistan, there has been significant research to illuminate the epidemiology of war-related psychological casualties. Significant findings include an appreciation for the role combat plays in the development of mental disorders, including PTSD and traumatic brain injury (TBI). Recent research has endeavoured to understand and improve psychological resilience to temper potentially adverse mental health effects of military service in the theatre of combat operations. Over 2 million US service members have now deployed and returned over 3 million times to the Iraq and Afghanistan conflicts. Mental health providers in the Departments of Defense and Veterans Affairs healthcare systems have consequently observed steep increases in mental health service use among these personnel. The Departments have responded aggressively to bolster staffing levels, increase capacity, improve available services, and anticipate future needs. Scientists and clinicians continue efforts to understand the determinants, prevention, recognition, and treatment of combat-related mental disorders.
29/04/2011
Post-traumatic stress disorder, depression, and health-related quality of life in OEF OIF veterans.
Pittman JO, Goldsmith AA, Lemmer JA, Kilmer MT, & Baker DG.
Qual Life Res. 2011 Apr 23. [Epub ahead of print] PMID:21516356 [PubMed - as supplied by publisher]

Abstract:
PURPOSE: Comorbid post-traumatic stress disorder (PTSD) and depression are often associated with negative physical and mental health outcomes in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) combat veterans. The current study examines the individual contributions of these two disorders on health-related quality of life (HRQoL) in an OEF/OIF cohort. The study hypothesizes that PTSD and depression will each significantly predict lower physical and mental HRQoL even when controlling for overlapping symptoms: anhedonia, concentration, and insomnia. Read more . . .
29/04/2011
Posttraumatic stress in U.S. marines: The role of unit cohesion and combat exposure.
Armistead-Jehle P, Johnston S, Wade N, & Ecklund C.
Journal of Counseling & Development. 2011 Winter; 89(1):81-88. [not in PubMed] http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=3&hid=112&sid=9614f073-84f6-401d-bd89-3bc71bb33147%40sessionmgr114

Abstract:
Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure predicted PTS, depression, and anger. Furthermore, results indicated that unit cohesion may be an important buffer, possibly limiting the development of PTS and depression following combat exposure.
29/04/2011
PTSD among military personnel.
Creamer M, Wade D, Fletcher S, & Forbes D.
Int Rev Psychiatry. 2011 Apr;23(2):160-5. PMID:21521085 [PubMed - in process]

Abstract:
Although symptoms characteristic of post-traumatic stress disorder (PTSD) have been noted in military personnel for many centuries, it was not until 1980 that the disorder was formally recognized and became the focus of legitimate study. This paper reviews our current state of knowledge regarding the prevalence and course of this complex condition in past and present members of the defence forces. Although rates vary across conflicts and countries, there is no doubt that PTSD affects substantial numbers of personnel and results in considerable impairment in functioning and quality of life. The paper goes on to discuss recent attempts to build resilience and to promote adjustment following deployment, noting that there is little evidence at this stage upon which to draw firm conclusions. Finally, effective treatment for PTSD is reviewed, with particular reference to the challenges posed by this population in a treatment setting.
29/04/2011
The current state of intervention research for posttraumatic stress disorder within the primary care setting.
Possemato K.
Abstract:
Posttraumatic Stress Disorder (PTSD) is common among primary care patients and is associated with significant functional impairment, physical health concerns, and mental health comorbidities. Significant barriers to receiving adequate treatment often exist for primary care patients with PTSD. Mental health professionals operating as part of the primary care team have the potential to provide effective brief intervention services. While good PTSD screening and assessment measures are available for the primary care setting, there are currently no empirically supported primary care-based brief interventions for PTSD. This article reviews early research on the development and testing of primary care-based PTSD treatments and also reviews other brief PTSD interventions (i.e., telehealth and early intervention) that could be adapted to the primary care setting. Cognitive and behavioral therapies currently have the strongest evidence base for establishing an empirically supported brief intervention for PTSD in primary care. Recommendations are made for future research and clinical practice.
29/04/2011
The impact of the conflicts of Iraq and Afghanistan: A UK perspective.
Sundin J, Forbes H, Fear NT, Dandeker C, & Wessely S.
Int Rev Psychiatry. 2011 Apr;23(2):153-9. PMID:21521084 [PubMed - in process]

Abstract:
Concerns about the mental health of military personnel deployed to Iraq and Afghanistan has led to a new generation of research. This review is an examination of the UK literature on the mental health consequences of deployment of armed forces personnel to Iraq and Afghanistan. As yet, deployment to Iraq or Afghanistan has not been associated with a general increase in mental health problems for the UK Armed Forces. However, research has highlighted certain problems that continue to need to be addressed. Whilst, the rate of post-traumatic stress disorder (PTSD) is low in the UK Armed Forces (1.6-6%), deployment to Iraq or Afghanistan is associated with an increased risk of PTSD for reserve personnel. In contrast to PTSD, the rate of alcohol misuse is high in the UK Armed Forces (between 16-20%), and has been associated with deployment to Iraq or Afghanistan for regular personnel. As the UK military engagement in Afghanistan continues and more personnel are deployed, the demand for help from military health services, the NHS and the service charities will increase.
29/04/2011
The relationship between posttraumatic stress disorder and smoking outcome expectancies among U.S. military veterans who served since September 11, 2001.
Calhoun PS, Levin HF, Dedert EA, & Johnson Y.
The VA Mid-Atlantic Mental Illness Research, Education, Clinical Center Registry Workgroup, Beckham JC. J Trauma Stress. 2011 Apr 26. doi: 10.1002/jts.20634. [Epub ahead of print] PMID:21523829 [PubMed - as supplied by publisher]

Abstract:
Posttraumatic stress disorder (PTSD) is associated with increased rates of smoking although little is known regarding the mechanisms underlying this relationship. The current study examined expectations about smoking outcomes among smokers with and without PTSD. The sample included 96 veterans (mean age of 34 years) and included 17% women and 50% racial minorities. Smoking expectancies were measured with the Smoking Consequences Questionnaire-Adult (Copeland, Brandon, & Quinn, 1995). Read more . . .
29/04/2011
The role of genes in defining a molecular biology of PTSD.
Yehuda R, Koenen KC, Galea S, & Flory JD.
Dis Markers. 2011 Jan;30(2-3):67-76. PMID:21508511 [PubMed - in process]

Abstract:
Because environmental exposure to trauma is the sine qua non for the development of Post Traumatic Stress Disorder (PTSD), the recent focus on genetic studies has been noteworthy. The main catalyst for such studies is the observation from epidemiological studies that not all trauma survivors develop this disorder. Furthermore, neuroendocrine findings suggest pre-existing hormonal alterations that confer risk for PTSD. This paper presents the rationale for examining genetic factors in PTSD and trauma exposure, but suggests that studies of genotype may only present a limited picture of the molecular biology of this disorder. We describe the type of information that can be obtained from candidate gene and genomic studies that incorporate environmental factors in the design (i.e., gene - environment interaction and gene-environment correlation studies) and studies that capitalize on the idea that environment modifies gene expression, via epigenetic or other molecular mechanisms. The examination of epigenetic mechanisms in tandem with gene expression will help refine models that explain how PTSD risk, pathophysiology, and recovery is mediated by the environment. Since inherited genetic variation may also influence the extent of epigenetic or gene expression changes resulting from the environment, such studies should optimally be followed up by studies of genotype.
22/04/2011
Exposure therapy for PTSD delivered to veterans via Telehealth: Predictors of treatment completion and outcome and comparison to treatment delivered in person.
Gros DF, Yoder M, Tuerk PW, Lozano BE, Acierno R.
Behav Ther. 2011 Jun;42(2):276-83. Epub 2011 Jan 27. PMID:21496512. [PubMed - in process]

Abstract:
Recent research has focused on the effectiveness of evidence-based psychotherapy delivered via telehealth services. Unfortunately to date, the majority of studies employ very small samples and limited predictor and moderator variables. To address these concerns and further replicate and extend the literature on telehealth, the present study investigated the effectiveness of 12-session exposure therapy delivered either via telehealth (n=62) or in person (n=27) in veterans with posttraumatic stress disorder (PTSD). Findings demonstrated that although older veterans and Vietnam veterans were more likely to complete the telehealth treatment, telehealth findings were not influenced by patient age, sex, race, combat theater, or disability status. Exposure therapy delivered via telehealth was effective in reducing the symptoms of PTSD, anxiety, depression, stress, and general impairment with large effect sizes. Interestingly, exposure therapy via telehealth was less effective than exposure therapy delivered in person; however, lack of random assignment to condition limits conclusions of differential effectiveness. Overall, these findings support the utility of telehealth services to provide effective, evidence-based psychotherapies.
22/04/2011
Mindfulness in the treatment of posttraumatic stress disorder among military veterans.
Vujanovic AA, Niles B, Pietrefesa A, Schmertz SK., Potter CM.
Prof Psychol Res Pr. 2011 Feb 1;42(1):24-31. (PsycINFO Database Record)

Abstract:
How might a practice that has its roots in contemplative traditions, seeking heightened awareness through meditation, apply to trauma-related mental health struggles among military veterans? In recent years, clinicians and researchers have observed the increasing presence of mindfulness in Western mental health treatment programs. Mindfulness is about bringing an attitude of curiosity and compassion to present experience. This review addresses the above question in a detailed manner with an emphasis on the treatment of military veterans suffering from posttraumatic stress disorder (PTSD) and related psychopathology. In addition, the integration of mindfulness with current empirically supported treatments for PTSD is discussed with specific attention to directions for future research in this area.
22/04/2011
Significant other enhanced cognitive-behavioral therapy for PTSD and alcohol misuse in OEF/OIF veterans.
McDevitt-Murphy ME.
Prof Psychol Res Pr. 2011 Feb 1;42(1):40-46. (PsycINFO Database Record)

Abstract:
This manuscript describes early work to develop a cognitive-behavioral therapy protocol for returning OEF/OIF veterans with co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD). Based on the unique characteristics of this population, and on the literature supporting cognitive behavioral coping skills and significant other involvement for both PTSD and for AUD, the new therapy involves both of those components. The paper includes brief descriptions of two patients who were successfully treated with this approach. Although preliminary, these case studies suggest that cognitive-behavioral therapy enhanced by significant other involvement may be a promising approach for OEF/OIF veterans with PTSD-AUD.
22/04/2011
The development of a couple-based treatment for PTSD in returning veterans.
Sautter FJ, Armelie AP, Glynn SM, Wielt DB.
Prof Psychol Res Pr. 2011 Feb 1;42(1):63-69. (PsycINFO Database Record)

Abstract:
Military personnel deployed in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high levels of emotional distress and posttraumatic stress disorder (PTSD), and these deployment-related problems may be expected to have a devastating impact on their relationships. It is urgent that researchers develop couple-based treatments to reduce PTSD in OEF/OIF veterans and to reduce PTSD-related relationship problems. This article describes the development of a novel couple-based treatment for PTSD, called Structured Approach Therapy (SAT), that uses empathic communication training and stress inoculation procedures to help couples improve their ability to cope with trauma-related anxiety and a multicomponent emotion activation program to help couples reduce emotional numbing. The theoretical basis of the SAT Treatment Model is described, and the various treatment components are presented. The authors recommend that couple-based interventions be used to provide OEF/OIF veterans and their partners with empathic communication skills to discuss their thoughts and feelings about deployment and with dyadic coping skills to confront trauma-related aversive emotions and emotional numbing and return intimacy to their lives.
22/04/2011
Treatment of war trauma in veterans: pharmacotherapy and self-help proposal.
Marvasti JA.
Conn Med. 2011 Mar;75(3):133-41. PMID:21500703. [PubMed - in process]

Abstract:
Over 1.9 million U.S. veterans have been deployed to the Middle East since 2001. Statistics show that when they return, a significant number of them will develop psychiatric/psychosomatic disorders. Many of these returning veterans will be seen in primary-care offices or at hospitals. It is important for physicians to be familiar with combat trauma, post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and acute stress disorder (ASD). Best standard of care, pharmacological treatment of war trauma and its comorbidities-depression, suicide, aggression, addiction and other disorders are reviewed. As part of the treatment protocol, the author has also designed a 12-Step Self-Help Proposal for combat veterans with PTSD, inspired by addiction and AA self-help programs. It is an experimental design which has helped many patients but needs further research to confirm the benefit. To the best of my knowledge this is the first time that a 12-step program has been developed for war trauma soldiers.
08/04/2011
A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans.
Romesser J, Shen S, Reblin M, Kircher J, Allen S, Roberts T, Marchand WR.
Mil Med. 2011 Mar;176(3):246-52. PMID: 21456348 [PubMed - in process]

Abstract:
The aim of this study was to assess whether a diagnosis of concussion given at a Veterans Healthcare Administration secondary traumatic brain injury assessment impacted either posttraumatic stress disorder (PTSD) symptomatology or other variables at the time veterans sought treatment for PTSD. This retrospective study compared 61 male veterans with a history of military-related concussion and military-related PTSD to 83 male veterans with military-related PTSD but without a diagnosis of military-related concussion. There were no significant between-group differences in PTSD symptomatology. However, the cohort with a history of military concussion endorsed decreased ability to cope with PTSD symptoms, increased problems with physical health, and more pain complaints. If replicated, these results may guide the design of more effective interventions for veterans who receive diagnoses of PTSD and concussion.
08/04/2011
Association of predeployment gaze bias for emotion stimuli with later symptoms of PTSD and depression in soldiers deployed in Iraq.
Beevers CG, Lee HJ, Wells TT, Ellis AJ, Telch MJ.
Am J Psychiatry. 2011 Mar 31. [Epub ahead of print] PMID: 21454916 [PubMed - as supplied by publisher] http://ajp.psychiatryonline.org/cgi/reprint/appi.ajp.2011.10091309v1

Abstract:
Objective: Biased processing of emotion stimuli is thought to confer vulnerability to psychopathology, but few longitudinal studies of this link have been conducted. The authors examined the relationship between predeployment gaze bias for emotion stimuli and later symptoms of posttraumatic stress disorder (PTSD) and depression in soldiers deployed to Iraq. Read more . . .
08/04/2011
Citalopram-induced hallucinations and delusions in a young adult.
Capaldi VF 2nd, Carr RB.
Gen Hosp Psychiatry. 2010 Nov-Dec;32(6):648.e1-3. Epub 2010 Sep 15. PMID: 21112465 [PubMed - indexed for MEDLINE]

Abstract:
OBJECTIVE: To report on a case of citalopram-induced hallucinations and delusions. METHOD: The authors present the case of a patient who developed psychotic symptoms including hallucinations and delusions shortly after starting the SSRI citalopram for posttraumatic stress disorder and associated depression. Read more . . .
01/04/2011
Hopelessness and suicidal ideation in iraq and afghanistan war veterans reporting subthreshold and threshold posttraumatic stress disorder.
Jakupcak M, Hoerster KD, Varra A, Vannoy S, Felker B, Hunt S. J
Nerv Ment Dis. 2011 Apr;199(4):272-5. PMID: 21451353 [PubMed - in process]

Abstract:
We examined hopelessness and suicidal ideation in association with subthreshold and threshold posttraumatic stress disorder (PTSD) in a sample of Iraq and Afghanistan War Veterans (U.S., N = 275) assessed within a specialty VA postdeployment health clinic. Veterans completed paper-and-pencil questionnaires at intake. The military version of the PTSD Checklist was used to determine PTSD levels (No PTSD; subthreshold PTSD; PTSD), and endorsement of hopelessness or suicidal ideation were used as markers of elevated suicide risk. Veterans were also asked if they received mental health treatment in the prior 6 months. Veterans reporting subthreshold PTSD were 3 times more likely to endorse these markers of elevated suicide risk relative to the Veterans without PTSD. We found no significant differences in likelihood of endorsing hopelessness or suicidal ideation comparing subthreshold and threshold PTSD groups, although the subthreshold PTSD group was less likely to report prior mental health treatment. Clinicians should be attentive to suicide risk in returned Veterans reporting both subthreshold and threshold PTSD.
01/04/2011
Twin studies of posttraumatic stress disorder: differentiating vulnerability factors from sequelae.
Kremen WS, Koenen KC, Afari N, Lyons MJ.
Neuropharmacology. 2011 Mar 25. [Epub ahead of print] PMID: 21443892 [PubMed - as supplied by publisher]

Abstract:
Posttraumatic stress disorder (PTSD) is defined by one's response to an environmental event. However, genetic factors are important in determining people's response to that event, and even their likelihood of being exposed to particular traumatic events in the first place. Classical twin designs can decompose genetic and environmental sources of variance. Such studies are reviewed extensively elsewhere, and we cover them only briefly in this review. Instead, we focus primarily on the identical co-twin control design. This design makes it possible to resolve the "chicken-egg" dilemma inherent in standard case-control designs, namely, distinguishing risk from sequelae. Read more . . .
March
25/03/2011
Military sexual trauma among U.S. Female veterans.
Williams I & Bernstein K. Arch Psychiatr Nurs. 2011 Apr;25(2):138-47. Epub 2010 Sep 1. PMID: 21421165 [PubMed - in process]

Sexual abuse among female veterans reportedly occurs in significant numbers in the U.S. military and has been recognized to cause posttraumatic stress disorder (PTSD). PTSD, which stems from sexual abuse, has been called military sexual trauma (MST), which has only recently been recognized by the Department of Defense. Consequently, there has been scant research on the prevalence, impact, and treatment of MST. This article explores the phenomenon of sexual aggression against female veterans in the U.S. military, risk factors for MST, PTSD as a result of MST, a conceptual framework for treating PTSD stress, and treatment strategies for PTSD.
25/03/2011
Two sessions of sleep-focused mind-body bridging improve self-reported symptoms of sleep and PTSD in veterans: A pilot randomized controlled trial.
Nakamura Y, Lipschitz DL, Landward R, Kuhn R & West G. J Psychosom Res. 2011 Apr;70(4):335-45. Epub 2010 Dec 16. PMID: 21414453 [PubMed - in process]

OBJECTIVE: Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind-body interventions may be beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind-body intervention, mind-body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans. Read more...
25/03/2011
Gender differences in depression and PTSD symptoms following combat exposure.
Luxton DD, Skopp NA & Maguen S. Depress Anxiety. 2010 Nov;27(11):1027-33. doi: 10.1002/da.20730 Epub 2010 Aug 18. PMID: 20721909 [PubMed - indexed for MEDLINE]

BACKGROUND: This research examined gender as a moderator of the association between combat exposure (CE) and depression as well as CE and PTSD symptoms among a nonclinical sample of Soldiers following deployment in support of operations in Afghanistan and Iraq. Read more...
25/03/2011
Factor structure and concurrent validity of the Posttraumatic Growth Inventory-Short Form among veterans from the Iraq war.
Kaler ME, Erbes CR, Tedeschi RG, Arbisi PA & Polusny MA.
J Trauma Stress. 2011 Mar 18. doi: 10.1002/jts.20623. [Epub ahead of print] PMID: 21425192 [PubMed - as supplied by publisher]

The Posttraumatic Growth Inventory is a frequently used self-report measure of posttraumatic growth. It was adapted recently to a short form with preliminary evidence in support of its psychometric properties. The current survey study replicates evidence for the short form's factor structure, internal consistency reliability, and concurrent validity among a sample of 327 National Guard soldiers deployed in support of military operations in Iraq, a population distinct from the original scale-development sample of undergraduates. Findings provide evidence for satisfactory reliability, replicable factor structure (i.e., the same 5-factor structure as the original measure), and support for concurrent validity (i.e., relations with theoretically related constructs). Further research should address validity of the scale among more ethnically and racially heterogeneous samples.
18/03/2011
The impact of endorsing Spitzer's proposed criteria for PTSD in the forthcoming DSM-V on male and female Veterans
Miller LN, Chard KM, Schumm JA, & O'Brien C.
J Anxiety Disord. 2011 Feb 18. [Epub ahead of print] PMID: 21411274 [PubMed - as supplied by publisher]

Abstract:
This study explored differences between Spitzer's proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer's proposed criteria. Veterans who met both DSM-IV and Spitzer's proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed criteria. These findings have important implications regarding proposed changes to the diagnostic classification criteria for PTSD in the forthcoming DSM-V.
18/03/2011
Treating nightmares and insomnia in posttraumatic stress disorder: A review of current evidence
Nappi CM, Drummond SP & Hall JM.
Neuropharmacology. 2011 Mar 9. [Epub ahead of print] PMID: 21396945 [PubMed - as supplied by publisher]

Abstract:
Emerging evidence supports the notion of disrupted sleep as a core component of Posttraumatic Stress Disorder (PTSD). Effective treatments for nighttime PTSD symptoms are critical because sleep disruption may be mechanistically linked to development and maintenance of PTSD and is associated with significant distress, functional impairment, and poor health. This review aimed to describe the state of science with respect to the impact of the latest behavioral and pharmacological interventions on posttraumatic nightmares and insomnia. Published studies that examined evidence for therapeutic effects upon sleep were included. Some behavioral and pharmacological interventions show promise, especially for nightmares, but there is a need for controlled trials that include valid sleep measures and are designed to identify treatment mechanisms. Our ability to treat PTSD-related sleep disturbances may be improved by moving away from considering sleep symptoms in isolation and instead conducting integrative studies that examine sequential or combined behavioral and/or pharmacological treatments targeting both the daytime and nighttime aspects of PTSD.
11/03/2011
Consistency of retrospective reports of peritraumatic responses and their relation to PTSD diagnostic status
David AC, Akerib V, Gaston L, & Brunet A.
J Trauma Stress. 2010 Oct;23(5):599-605. PMID: 20839309 [PubMed - indexed for MEDLINE]

Abstract:
Few studies have examined whether trauma-exposed individuals are consistent in their retrospective reports of how they reacted at the time of trauma exposure, and whether this phenomenon has any implications at the diagnostic level. In a series of three longitudinal studies (N = 113) with different timeframes, the authors prospectively investigated the consistency of peritraumatic response scores as a function of posttraumatic stress disorder (PTSD) diagnostic status. Across the three studies, consistency of scores was better among individuals who either did not develop PTSD or who remitted from it than among those whose PTSD did not remit. These results are consistent with the literature suggesting that compromised memory processes are related to sustained PTSD.
04/03/2011
A randomized, double-blind, placebo-controlled trial on the efficacy and tolerability of sertraline in Iranian veterans with post-traumatic stress disorder
Panahi Y, Moghaddam BR, Sahebkar A, Nazari MA, Beiraghdar F, Karami G, & Saadat AR.
Psychol Med. 2011 Feb 24:1-8. [Epub ahead of print] PMID: 21349225 [PubMed - as supplied by publisher]

Abstract:
BACKGROUND: Unlike civilian post-traumatic stress disorder (PTSD), the efficacy of sertraline for the treatment of combat-related PTSD has not yet been proven. The present study aimed to evaluate the clinical efficacy of sertraline against combat-related PTSD in a randomized, double-blind, placebo-controlled trial. Read more . . .
04/03/2011
Imagery rescripting and exposure group treatment of posttraumatic nightmares in Veterans with PTSD
Long ME, Hammons ME, Davis JL, Frueh BC, Khan MM, Elhai JD, & Teng EJ.
J Anxiety Disord. 2011 Jan 13. [Epub ahead of print] PMID: 21354767 [PubMed - as supplied by publisher]

Abstract:
This study details results of an open trial of a group psychological treatment for Veterans with posttraumatic stress disorder (PTSD) and chronic posttraumatic nightmares called "Imagery Rescripting and Exposure Therapy" (IRET). IRET is a variant of a successful imagery rescripting treatment for civilian trauma-related nightmares that was modified to address the needs of the Veteran population. Thirty-seven male U.S. Veterans with PTSD and nightmares attended 6 multicomponent group sessions. Findings indicated that the intervention significantly reduced frequency of nightmares and PTSD severity, as well as increased hours of sleep. Unlike the few open trials examining treatment of nightmares in Veterans, effect sizes in this study were similar to those that have been found in the civilian randomized controlled trial. These preliminary findings suggest that a nightmares treatment can be adapted to successfully reduce distress associated with combat Veterans' chronic nightmares. Clinical and research implications are discussed.
04/03/2011
Posttraumatic stress, family adjustment, and treatment preferences among National Guard soldiers deployed to OEF OIF
Khaylis A, Polusny MA, Erbes CR, Gewirtz A, & Rath M.
Mil Med. 2011 Feb;176(2):126-31. PMID: 21366071 [PubMed - in process]

Abstract:
We used an anonymous self-reported questionnaire to assess posttraumatic stress disorder symptoms, relationship concerns, and treatment preferences including interest in family-focused interventions among 100 National Guard Soldiers who were recently redeployed from Iraq or Afghanistan. We found that the majority of married or partnered soldiers were concerned about getting along with their partners, while the majority of parents were concerned about their child-rearing practices. Posttraumatic stress disorder symptoms were significantly associated with the degree of relationship concerns. Soldiers showed a striking preference for family-based interventions over individual treatment, highlighting the importance of developing family-based interventions tailored to address post-deployment mental health and co-occurring family problems.
04/03/2011
Sensitivity of the SF-36 to PTSD symptom change in veterans
Shiner B, Watts BV, Pomerantz A, Young-Xu Y, & Schnurr PP.
J Trauma Stress. 2011 Feb;24(1):111-5. doi: 10.1002/jts.20613. PMID: 21351169 [PubMed - in process] http://onlinelibrary.wiley.com/doi/10.1002/jts.20613/pdf

Abstract:
The authors examined the relationship between changes in symptoms of posttraumatic stress disorder (PTSD) and functioning as measured by the Medical Outcomes Study Short Form-36 (SF-36) among 167 veterans in a primary care clinic. Those who reported at least moderate baseline symptoms were categorized as better, unchanged, or worse at reassessment. The SF-36 was used to examine concordance between change in functioning and symptoms. Veterans with reliable changes in symptoms of PTSD showed corresponding statistically significant changes in functioning across health domains. Moreover, these changes in functioning were clinically significant on several SF-36 subscales and on one summary scale.
04/03/2011
Therapist adherence to manualized cognitive-behavioral therapy for anger management delivered to veterans with PTSD via videoconferencing
Morland LA, Greene CJ, Grubbs K, Kloezeman K, Mackintosh MA, Rosen C, & Frueh BC.
J Clin Psychol. 2011 Feb 25. doi: 10.1002/jclp.20779. [Epub ahead of print] PMID: 21360528 [PubMed - as supplied by publisher]

Abstract:
Therapist adherence to a manualized cognitive-behavioral anger management group treatment (AMT) was compared between therapy delivered via videoconference (VC) and the traditional in-person modality, using data from a large, randomized controlled trial comparing the effectiveness of AMT for veterans with combat-related posttraumatic stress disorder. Therapist adherence was rated for the presence or absence of process and content treatment elements. Secondary analyses were conducted using a repeated measures ANOVA. Overall adherence to the protocol was excellent (M = 96%, SD = 1%). Findings indicate that therapist adherence to AMT is similar across delivery modalities and VC is a viable service delivery strategy that does not compromise a therapist's ability to effectively structure sessions and manage patient care.
04/03/2011
Assessment of rates of overweight and obesity and symptoms of posttraumatic stress disorder and depression in a sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans
Barber J, Bayer L, Pietrzak RH, & Sanders KA.
Mil Med. 2011 Feb;176(2):151-5. PMID: 21366076 [PubMed - in process]

Abstract:
OBJECTIVE: We examined rates of overweight and obesity in a sample of Operation Enduring Freedom/Operation Iraqi Freedom Veterans setting up routine care within 1 Veterans Affairs medical center and examined associations between weight and measures of symptoms of posttraumatic stress disorder (PTSD) and depression. Read more . . .
04/03/2011
Enhancing self-report assessment of PTSD: Development of an item bank
Del Vecchio N, Elwy AR, Smith E, Bottonari KA, & Eisen SV.
J Trauma Stress. 2011 Feb 23. doi: 10.1002/jts.20611. [Epub ahead of print] PMID: 21351175 [PubMed - as supplied by publisher]

Abstract:
The authors report results of work to enhance self-report posttraumatic stress disorder (PTSD) assessment by developing an item bank for use in a computer-adapted test. Computer-adapted tests have great potential to decrease the burden of PTSD assessment and outcomes monitoring. The authors conducted a systematic literature review of PTSD instruments, created a database of items, performed qualitative review and readability analysis, and conducted cognitive interviews with veterans diagnosed with PTSD. The systematic review yielded 480 studies in which 41 PTSD instruments comprising 993 items met inclusion criteria. The final PTSD item bank includes 104 items representing each of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association [APA], 1994), PTSD symptom clusters (reexperiencing, avoidance, and hyperarousal), and 3 additional sub-domains (depersonalization, guilt, and sexual problems) that expanded the assessment item pool.
04/03/2011
Executive function and PTSD: Disengaging from trauma
Aupperle RL, Melrose AJ, Stein MB, & Paulus MP.
Neuropharmacology. 2011 Feb 21. [Epub ahead of print] PMID: 21349277 [PubMed - as supplied by publisher]

Abstract:
Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD.
04/03/2011
No effect of PTSD and other psychiatric disorders on cognitive functioning in veterans with mild TBI
Gordon SN, Fitzpatrick PJ, & Hilsabeck RC.
Clin Neuropsychol. 2011 Feb 22:1-11. [Epub ahead of print] PMID: 21360415 [PubMed - as supplied by publisher]

Abstract:
There has been speculation that post-traumatic stress disorder (PTSD) superimposed on mild traumatic brain injury (mTBI) may have synergistic, negative effects on cognitive functioning. The purpose of this study was to investigate differences in processing speed, executive functioning, and memory of 82 veterans with mTBI and PTSD, mTBI, and another psychiatric condition, or mTBI alone. It was hypothesized that there would be no group differences in cognitive performances. Participants completed the Trail Making Test, Stroop, Rey Complex Figure, and California Verbal Learning Test-2. There were no significant group differences on any cognitive measure. Findings suggest that PTSD and other psychiatric disorders do not necessarily have a negative exacerbating effect on processing speed, executive functioning, or memory in veterans with mTBI.
February
25/02/2011
A multi-component cognitive-behavioral intervention for sleep disturbance in veterans with PTSD: A pilot study.
Ulmer CS, Edinger JD, & Calhoun PS.
J Clin Sleep Med. 2011 Feb 15;7(1):57-68. PMID: 21344046 [PubMed - in process]

Abstract:
STUDY OBJECTIVES: A significant portion of US military personnel are returning from deployment with trauma-related sleep disturbance, and disrupted sleep has been proposed as a mechanism for the development of medical conditions in those with posttraumatic stress disorder (PTSD). Although individuals with PTSD may realize improved sleep with either PTSD treatment or CBT for insomnia, many continue to experience residual sleep difficulties. Read more...
25/02/2011
Reality graded exposure therapy with physiological monitoring for the treatment of combat related post traumatic stress disorder: a pilot study.
Wood DP, Webb-Murphy J, McLay RN, Wiederhold BK, Spira JL, Johnston S, Koffman RL, Wiederhold MD, & Pyne J.
Stud Health Technol Inform. 2011;163:696-702. PMID: 21335883 [PubMed - in process]

Abstract:
A high percentage of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) combat veterans have been diagnosed with Posttraumatic Stress Disorder (PTSD) during and following their respective combat tours. Virtual Reality (VR) treatment has been documented as an exceptional treatment for anxiety disorders and specifically for PTSD. An Office of Naval Research (ONR) funded pilot study, completed by the Virtual Reality Medical Center and Naval Medical Center San Diego (NMCSD), investigated the use of Virtual Reality Graded Exposure Therapy (VR-GET) study with participants who had been diagnosed with PTSD following their combat deployments. A significant reduction in PTSD symptoms severity was noted. Implications for treatment with VR-GET and future research areas of investigation, including the use of VR-GET with smart phones and the internet, are suggested.
25/02/2011
A randomized, controlled trial of virtual reality-graded exposure therapy for post-traumatic stress disorder in active duty service members with combat-related post-traumatic stress disorder.
McLay RN, Wood DP, Webb-Murphy JA, Spira JL, Wiederhold MD, Pyne JM, & Wiederhold BK.
Cyberpsychol Behav Soc Netw. 2011 Feb 20. [Epub ahead of print] PMID: 21332375 [PubMed - as supplied by publisher]

Abstract:
Virtual reality (VR)-based therapy has emerged as a potentially useful means to treat post-traumatic stress disorder (PTSD), but randomized studies have been lacking for Service Members from Iraq or Afghanistan. This study documents a small, randomized, controlled trial of VR-graded exposure therapy (VR-GET) versus treatment as usual (TAU) for PTSD in Active Duty military personnel with combat-related PTSD. Success was gauged according to whether treatment resulted in a 30 percent or greater improvement in the PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS) after 10 weeks of treatment. Seven of 10 participants improved by 30 percent or greater while in VR-GET, whereas only 1 of the 9 returning participants in TAU showed similar improvement. This is a clinically and statistically significant result (?(2)?=?6.74, p<0.01, relative risk 3.2). Participants in VR-GET improved an average of 35 points on the CAPS, whereas those in TAU averaged a 9-point improvement (p<0.05). The results are limited by small size, lack of blinding, a single therapist, and comparison to a relatively uncontrolled usual care condition, but did show VR-GET to be a safe and effective treatment for combat-related PTSD.
25/02/2011
Gender differences on documented trauma histories: inpatients admitted to a military psychiatric unit for suicide-related thoughts or behaviors.
Cox DW, Ghahramanlou-Holloway M, Szeto EH, Greene FN, Engel C, Wynn GH, Bradley J, & Grammer G.
J Nerv Ment Dis. 2011 Mar;199(3):183-90. PMID: 21346489 [PubMed - in process]

Abstract:
Suicide is a leading cause of death among men and women in the United States Military. Using a retrospective chart review design, the current study investigated gender differences on documented traumas for people admitted to a military inpatient psychiatric unit for suicide-related thoughts or behaviors (N = 656). Men more often had no documented lifetime traumas and women more often had 2 or more trauma types. Women had significantly more documented incidences of childhood sexual abuse, adulthood sexual assault, adulthood physical assault, and pregnancy loss. The gender gap in documented trauma types for childhood and adulthood traumas persisted even after adjusting for demographic variables, psychiatric diagnoses, and comorbid trauma types (i.e., trauma types other than the one being used as the dependent variable). Given the observed gender differences in documented traumas, professionals working with military women admitted for suicide-related thoughts or behaviors need to consider trauma in the context of treatment.
25/02/2011
Posttraumatic stress, difficulties in emotion regulation, and coping-oriented marijuana use.
Bonn-Miller MO, Vujanovic AA, Boden MT, & Gross JJ.
Cogn Behav Ther. 2011 Mar;40(1):34-44. PMID: 21337213 [PubMed - in process]

Abstract:
In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M(age) = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.
18/02/2011
Review of Veterans Health Administration telemedicine interventions.
Hill RD, Luptak MK, Rupper RW, Bair B, Peterson C, Dailey N, & Hicken BL.
Am J Manag Care. 2010 Dec;16(12 Suppl HIT):e302-10. PMID: 21322300 [PubMed - in process]

Abstract:
The Veterans Health Administration (VHA) is a leader in developing and implementing innovative healthcare technology. We review 19 exemplary peer-reviewed articles published between 2000 and 2009 of controlled, VHA-supported telemedicine intervention trials that focused on health outcomes. These trials underscore the role of telemedicine in large managed healthcare organizations in support of (1) chronic disease management, (2) mental health service delivery through in-home monitoring and treatment, and (3) interdisciplinary team functioning through electronic medical record information interchange. Telemedicine is advantageous when ongoing monitoring of patient symptoms is needed, as in chronic disease care (eg, for diabetes) or mental health treatment. Telemedicine appears to enhance patient access to healthcare professionals and provides quick access to patient medical information. The sustainability of telemedicine interventions for the broad spectrum of veteran patient issues and the ongoing technology training of patients and providers are challenges to telemedicine-delivered care.
18/02/2011
Characteristics of stress-induced mental disorders in combatants who have committed criminal actions.
Fastovtsov GA.
Neurosci Behav Physiol. 2011 Feb 12. [Epub ahead of print] PMID: 21318546 [PubMed - as supplied by publisher]

Abstract:
The aim of the present work was to identify the symptoms of post-traumatic stress disorder (PTSD) affecting the manifestation of aggressive behavior in combatants and to develop approaches to the prophylaxis of this behavior. A total of 174 veterans taking part in combat actions (aged 22-43 years) who had committed illegal acts were studied. Aggressive illegal behavior was most commonly seen in veterans with prolonged experience of participating in combat operations, especially after exposure to particularly severe (extremely severe) combat stress and who had had difficulty returning to peaceful life because of PTSD and characteristic personality changes. The results showed that all illegal acts were committed on the background of acute stress reactions of different degrees of severity, associated with interpersonal conflict (occurring suddenly or building up slowly). In these conditions, some PTSD symptoms in combatants masked the real circumstances of the psychologically traumatizing conflict situation, creating the impression of irreconcilable confrontation.
18/02/2011
Treatment of civilian and combat-related posttraumatic stress disorder with topiramate.
Andrus MR & Gilbert E.
Ann Pharmacother. 2010 Nov;44(11):1810-6. Epub 2010 Oct 5. PMID: 20923947 [PubMed - indexed for MEDLINE]

Abstract:
OBJECTIVE: To evaluate the use of topiramate for the treatment of posttraumatic stress disorder (PTSD). DATA SOURCES: Ovid MEDLINE (1950 to June week 4, 2010), International Pharmaceutical Abstracts (1970 to May 2010), ISI Web of Science (1945 to July 3, 2010), and Iowa Drug Information Service (searched July 6, 2010) were searched using the terms posttraumatic stress disorder and topiramate. Guidelines and other sources were identified from bibliography searches. Read more . . .
18/02/2011
The stigma of mental health problems and other barriers to care in the UK Armed Forces.
Iversen AC, van Staden L, Hacker Hughes J, Greenberg N, Hotopf M, Rona RJ, Thornicroft G, Wessely S, & Fear NT.
BMC Health Serv Res. 2011 Feb 10;11(1):31. [Epub ahead of print] PMID: 21310027 [PubMed - as supplied by publisher]

Abstract:
BACKGROUND: As with the general population, a proportion of military personnel with mental health problems do not seek help. As the military is a profession at high risk of occupational psychiatric injury, understanding barriers to help seeking is a priority. The stigma of mental health problems and other barriers to care in the UK Armed Forces. Read more ...
11/02/2011
Does PTSD Impair Cognition Beyond the Effect of Trauma?
Qureshi SU, Long ME, Bradshaw MR, Pyne JM, Magruder KM, Kimbrell T, Hudson TJ, Jawaid A, Schulz PE, & Kunik ME.
J Neuropsychiatry Clin Neurosci. 2011 Fall;23(1):16-28. PMID: 21304135 [PubMed - as supplied by publisher] http://neuro.psychiatryonline.org/cgi/reprint/23/1/16

Abstract:
This systematic review analyzed data from studies examining memory and cognitive function in subjects with posttraumatic stress disorder (PTSD), compared with subjects exposed to trauma (but without PTSD). Based on analysis of 21 articles published in English from 1968 to 2009, the conclusion is that individuals with PTSD, particularly veterans, show signs of cognitive impairment when tested with neuropsychological instruments, more so than individuals exposed to trauma who do not have PTSD.
11/02/2011
Novel combination strategy to optimize treatment for PTSD.
Shad MU, Suris AM & North CS.
Hum Psychopharmacol. 2011 Feb 9. doi: 10.1002/hup.1171. [Epub ahead of print] PMID: 21308782 [PubMed - as supplied by publisher]

Abstract:
Post-traumatic stress disorder (PTSD) is increasingly recognized as a serious and potentially debilitating condition in combat veterans returning from Iraq and Afghanistan. Exposure to a potentially life-threatening event such as military combat may be followed by PTSD. Despite recent advances in pharmacotherapy for PTSD, monotherapy with the currently available medications is only partially effective, as demonstrated in large clinical trials of combat veterans with PTSD. This underscores the need to investigate novel combination strategies to enhance treatment response in PTSD. Read more ...
11/02/2011
Effectiveness of virtual reality exposure therapy for active duty soldiers in a military mental health clinic.
Reger GM, Holloway KM, Candy C, Rothbaum BO, Difede J, Rizzo AA, & Gahm GA.
J Trauma Stress. 2011 Feb 3:1-4. doi: 10.1002/jts.20574. [Epub ahead of print] PMID: 21294166 [PubMed - as supplied by publisher]

Abstract:
Exposure therapy is an evidence-based treatment for posttraumatic stress disorder (PTSD), but research evaluating its effectiveness with active duty service members is limited. This report examines the effectiveness of virtual reality exposure therapy (VRE) for active duty soldiers (N = 24) seeking treatment following a deployment to Iraq or Afghanistan. Relative to their pretreatment self-reported symptoms on the PTSD Checklist, Military Version (M = 60.92; SD = 11.03), patients reported a significant reduction at posttreatment (M = 47.08; SD = 12.70; p < .001). Sixty-two percent of patients (n = 15) reported a reliable change of 11 points or more. This study supports the effectiveness of exposure therapy for active duty soldiers and extends previous research on VRE to this population.
11/02/2011
The effectiveness of a trauma focused spiritually integrated intervention for veterans exposed to trauma.
Harris JI, Erbes CR, Engdahl BE, Thuras P, Murray-Swank N, Grace D, Ogden H, Olson RH, Winskowski AM, Bacon R, Malec C, Campion K, & Le T.
J Clin Psychol. 2011 Feb 3. doi: 10.1002/jclp.20777. [Epub ahead of print] PMID: 21294116 [PubMed - as supplied by publisher]

Abstract:
Building Spiritual Strength (BSS) is an 8-session, spiritually integrated group intervention designed to address religious strain and enhance religious meaning making for military trauma survivors. It is based upon empirical research on the relationship between spirituality and adjustment to trauma. To assess the intervention's effectiveness, veterans with histories of trauma who volunteered for the study were randomly assigned to a BSS group (n = 26) or a wait-list control group (n = 28). BSS participants showed statistically significant reductions in PTSD symptoms based on self-report measures as compared with those in a wait-list control condition. Further research on spiritually integrated interventions for trauma survivors is warranted.
04/02/2011
Mental health-related beliefs as a barrier to service use for military personnel and veterans: a review.
Vogt D.
Psychiatr Serv. 2011 Feb;62(2):135-42. http://ps.psychiatryonline.org/cgi/content/full/62/2/135

Abstract:
Objective: Although military personnel are at high risk of mental health problems, research findings indicate that many military personnel and veterans do not seek needed mental health care. Thus it is critical to identify factors that interfere with the use of mental health services for this population, and where possible, intervene to reduce barriers to care. The overarching goal of this review was to examine what is known with regard to concerns about public stigma and personal beliefs about mental illness and mental health treatment as potential barriers to service use in military and veteran populations and to provide recommendations for future research on this topic. Read more ...
04/02/2011
Effects of war exposure on air force personnel's mental health, job burnout and other organizational related outcomes.
Vinokur AD, Pierce PF, Lewandowski-Romps L, Hobfoll SE, & Galea S.
J Occup Health Psychol. 2011 Jan;16(1):3-17.

Abstract:
Longitudinal data from a stratified representative sample of U.S. Air Force personnel (N = 1009) deployed to the wars in Iraq, Afghanistan, and other locations were analyzed in this study. Using structural equation models, we examined the effects of war exposure on traumatic experiences, Post Traumatic Stress (PTS) symptoms, resource loss, and on subsequent functioning, perceived health, and on job and organizationally relevant outcomes. Read more ...
04/02/2011
Combat exposure, posttraumatic stress symptoms and risk-taking behavior in veterans of the second Lebanon war.
Svetlicky V, Solomon Z, Benbenishty R, Levi O, & Lubin G.
Isr J Psychiatry Relat Sci. 2010;47(4):276-83.

Abstract:
Prior research has revealed heightened risk-taking behavior among veterans with posttraumatic stress disorder (PTSD). This study examined whether the risktaking behavior is a direct outcome of the traumatic exposure or whether this relationship is mediated by posttraumatic stress symptoms. The sample was comprised of 180 traumatized Israeli reserve soldiers, who sought treatment in the wake of the Second Lebanon War. Combat exposure was indirectly associated with risk-taking behavior primarily through its relationship with posttraumatic stress symptoms. Results of the multivariate analyses depict the implication of posttraumatic stress symptoms in risk taking behavior, and the role of self-medication and of aggression in traumatized veterans. PMID: 21270500 [PubMed - in process]
04/02/2011
Substance use disorders in Iraq and Afghanistan veterans in VA healthcare, 2001-2010: Implications for screening, diagnosis and treatment.
Seal KH, Cohen G, Waldrop A, Cohen BE, Maguen S, & Ren L.
Drug Alcohol Depend. 2011 Jan 28. [Epub ahead of print]

Abstract:
BACKGROUND: The prevalence and correlates of alcohol use disorder (AUD) and drug use disorder (DUD) diagnoses in Iraq and Afghanistan veterans who are new users of Department of Veterans Affairs (VA) healthcare nationwide has not been evaluated. Read more ...
04/02/2011
Prevalance and determinants of antidepressant use among canadian forces members experiencing major depressive episodes.
Sanyal C, Asbridge M, Kisely S, Sketris I, & Andreaou P.
J Popul Ther Clin Pharmacol. 2011;18(1):e54-64. Epub 2011 Jan 28.

Abstract:
Background: Major depression affects a significant proportion of individuals including those serving in the military; but, there is less information on the pharmacological treatment they receive. Objectives: We assessed the prevalence and determinants of past year antidepressant use among regular and reservist members of the Canadian Forces who have experienced major depressive episodes in the past 12 months. Read more ...
04/02/2011
Relationship adjustment, PTSD symptoms, and treatment utilization among coupled National Guard soldiers deployed to Iraq.
Meis LA, Barry RA, Kehle SM, Erbes CR, & Polusny MA.
J Fam Psychol. 2010 Oct;24(5):560-7.

Abstract:
Although combat-related posttraumatic stress disorder (PTSD) is associated with considerable impairment in relationship adjustment, research has yet to investigate how PTSD symptoms and relationship distress uniquely and jointly predict utilization of a range of mental health services. Read more ...
04/02/2011
Panic attacks and panic disorder in a population-based sample of active Canadian military personnel.
Kinley DJ, Walker JR, Mackenzie CS, & Sareen J.
J Clin Psychiatry. 2011 Jan;72(1):66-74.

Abstract:
BACKGROUND: The factors contributing to psychiatric problems among military personnel, particularly for panic, are unclear. The objective of this study was to examine the prevalence and correlates of panic disorder and panic attacks in the Canadian military. Read more ...
January
28/01/2011
Posttraumatic stress disorder and intimate relationship problems: A meta-analysis.
Taft CT, Watkins LE, Stafford J, Street AE, & Monson CM.
J Consult Clin Psychol. 2011 Feb;79(1):22-33.

Abstract:
Objective: The authors conducted a meta-analysis of empirical studies investigating associations between indices of posttraumatic stress disorder (PTSD) and intimate relationship problems to empirically synthesize this literature. Read more ...
28/01/2011
Cannabis use among military veterans after residential treatment for posttraumatic stress disorder.
Bonn-Miller MO, Vujanovic AA, & Drescher KD.
Psychol Addict Behav. 2011 Jan 24. [Epub ahead of print]

Abstract:
The present investigation prospectively evaluated whether treatment changes in PTSD symptom severity, among military Veterans in residential PTSD treatment, were related to cannabis use 4 months after discharge from residential rehabilitation. Read more ...
21/01/2011
Practical considerations for addressing substance use disorders in veterans and service members.
Skidmore WC & Roy M.
Soc Work Health Care. 2011 Jan;50(1):85-107.

Abstract:
Support and treatment for military veterans and active duty service members is a national priority. Furthermore, there is increased need for professionals with experience and interest in working with these brave individuals. Read more . . .
21/01/2011
Considerations for the effects of military deployment on children and families.
Lincoln AJ & Sweeten K.
Soc Work Health Care. 2011 Jan;50(1):73-84.

Abstract:
Children of deployed military personnel represent a unique subculture in the United States. While many children exhibit high levels of resiliency, others will struggle with the impact of a parent who has gone to war. This article looks at some of the stressors of deployment as experienced by children and offers three case examples as well as clinical considerations for those who work with the children and families of the deployed. PMID: 21240772 [PubMed - in process]
21/01/2011
The battle within: understanding the physiology of war-zone stress exposure.
Bruner VE & Woll P.
Soc Work Health Care. 2011 Jan;50(1):19-33.

Abstract:
Faced with pervasive loss, life threat, and moral conflict in the field of battle, the human body and brain adapt to extraordinary circumstances in extraordinary ways. These adaptations come at a high price, and many men and women returning from Iraq and Afghanistan are paying that price every day. For the clinician who seeks to help, an understanding of the physiology of war-zone stress and resilience is an essential foundation, both for recovery from post-traumatic stress disorder and other conditions, and for addressing the stigma and shame that keep many service members and veterans from seeking and accepting the help and support they need. This article explores ways in which the body and brain adapt to war-zone stress, resulting challenges, and implications for clinical services and ongoing recovery. PMID: 21240769 [PubMed - in process]
21/01/2011
Women at war: implications for mental health.
Dutra L, Grubbs K, Greene C, Trego LL, McCartin TL, Kloezeman K, & Morland L.
J Trauma Dissociation. 2011 Jan;12(1):25-37.

Abstract:
Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment posttraumatic stress disorder (PTSD) symptoms and depressive symptoms. Read more ...
21/01/2011
A civilian social worker's guide to the treatment of war-induced PTSD.
Yarvis JS.
Soc Work Health Care. 2011 Jan;50(1):51-72.

Abstract:
Post-traumatic stress disorder has been designated as one of the signature wounds of the Iraq/Afghanistan war. Approximately 15% of returning service members have been diagnosed with PTSD and the numbers increase daily. As such, civilian social workers and other mental health professionals need to understand the diagnosis and how best to help those struggling with the disorder. This article will explore the etiology and treatment approaches used in management for those with PTSD. PMID: 21240771 [PubMed - in process]
14/01/2011
Relationship between anger, alcoholism and symptoms of posttraumatic stress disorders in war veterans.
Sakusic A, Avdibegovic E, Zoricic Z, Pavlovic S, Gaspar V, & Delic A.
Med Arh. 2010;64(6):354-8.

Abstract:
PURPOSE: Studies among veterans indicate that veterans with posttraumatic stress disorder (PTSD) express anger, hostility and aggression as well as alcohol and substance abuse more then veterans without PTSD. The aim of this study was to analyze the relationship between anger, use of alcohol and symptoms of PTSD in war veterans in Bosnia and Herzegovina (B&H). Read more ...
14/01/2011
The clinical picture of post-traumatic stress disorder and its treatment in different types of traumatic exposures.
Rumyantseva GM & Stepanov AL.
Neurosci Behav Physiol. 2011 Jan 12. [Epub ahead of print]

Abstract:
The effects of different extreme events were studied in relation to two types of stress - combat (military) stress and stress imposed by the Chernobyl nuclear power station accident. Totals of 30 combatants and 33 clean-up workers were investigated and treated. The characteristics of the initial stage of stress reactions and post-traumatic stress disorder (PTSD) were assessed in terms of the major diagnostic criteria in each group. Read more ...
07/01/2011
Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in national guard soldiers deployed to Iraq.
Polusny MA, Kehle SM, Nelson NW, Erbes CR, Arbisi PA, & Thuras P.
Arch Gen Psychiatry. 2011 Jan;68(1):79-89.

Abstract:
CONTEXT: Troops deployed to Iraq and Afghanistan are at high risk for exposure to combat events resulting in mild traumatic brain injury (MTBI) or concussion and posttraumatic stress disorder (PTSD). The longer-term impact of combat-related concussion/MTBI and comorbid PTSD on troops' health and well-being is unknown.
OBJECTIVE: To assess longitudinal associations between concussion/MTBI and PTSD symptoms reported in theater and longer-term psychosocial outcomes in combat-deployed National Guard soldiers. Read more ...
07/01/2011
Predeployment and in-theater diagnoses of american military personnel serving in Iraq.
Larson GE, Hammer PS, Conway TL, Schmied EA, Galarneau MR, Konoske P, Webb-Murphy JA, Schmitz KJ, Edwards N, & Johnson DC.
Psychiatr Serv. 2011 Jan;62(1):15-21.

Abstract:
Objective: This purpose of this study was to determine the incidence and types of preexisting mental disorders among military personnel who received mental health services in an Iraqi war zone.
07/01/2011
Serving those who served: retention of newly returning veterans from iraq and afghanistan in mental health treatment.
Harpaz-Rotem I & Rosenheck RA.
Psychiatr Serv. 2011 Jan;62(1):22-7.

Abstract:
Objective: There are growing concerns about the mental health status of returning veterans from the recent conflicts in Iraq (Operation Iraq Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) and about retention in mental health treatment of veterans with posttraumatic stress disorder (PTSD). This study obtained data from veterans who had a new diagnosis of PTSD from fiscal year (FY) 2004 to FY 2007 and determined whether retention in PTSD treatment and the number of mental health visits were comparable among OIF-OEF veterans and veterans from other service eras. Read more...
01/01/2011
Effects of exogenous glucocorticoid on combat-related PTSD symptoms.
SurÌs A, North C, Adinoff B, Powell CM, & Greene R.
Ann Clin Psychiatry. 2010 Nov;22(4):274-9.

Abstract:
BACKGROUND: Very few systematic human studies focus on changing the underlying traumatic memory after posttraumatic stress disorder (PTSD) has been established. Evidence from animal and human studies indicates that cortisol can be used to address traumatic memories. This translational pilot study is based on our previous rodent research in which extinction of fear memories was enhanced by glucocorticoids. The current study aims to assess the effectiveness of glucocorticoids in augmenting memory extinction and reducing clinical symptoms in veterans with combat-related PTSD. Read more . . .
01/01/2011
A prospective study on personality and the cortisol awakening response to predict posttraumatic stress symptoms in response to military deployment.
van Zuiden M, Kavelaars A, Rademaker AR, Vermetten E, Heijnen CJ, & Geuze E.
J Psychiatr Res. 2010 Dec 23. [Epub ahead of print]

Abstract:
Few prospective studies on pre-trauma predictors for subsequent development of posttraumatic stress disorder (PTSD) have been conducted. In this study we prospectively investigated whether pre-deployment personality and the cortisol awakening response (CAR) predicted development of PTSD symptoms in response to military deployment. Furthermore, we hypothesized that potential effects of age, childhood trauma and previous deployment on development of PTSD symptoms were mediated via pre-deployment personality, CAR and PTSD symptoms. Read more ...
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