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Combat Veteran

Jenny A Bannister, Frederick G Lopez, Deleene S Menefee, Peter J Norton, Jill Wanner
Samples in prior studies examining attachment theory in the military have been predominantly composed of male combat veterans. Given the rates of sexual trauma among female veterans and differences in the association between attachment and posttraumatic stress disorder (PTSD) severity for sexual trauma survivors, it was necessary to consider the attachment characteristics of veterans within a mixed-sex sample. Participants were a mixed-sex veteran sample seeking inpatient trauma-related treatment (N = 469)...
August 9, 2018: Journal of Traumatic Stress
Raj C Singaraju, Janet N Myers, Jill T Owczarzak, Andrea C Gielen
Introduction: More than half a century after the first Surgeon General's Report on Smoking and Tobacco Use, tobacco use remains the leading cause of preventable disease for the U.S. military. Military tobacco use impairs troop readiness, decreases productivity, reduces servicemember physical performance, and leads to chronic illness in veterans. The Department of Defense (DoD) spends considerable effort to maintain a combat ready force, and tobacco use is contradictory to these efforts...
July 31, 2018: Military Medicine
Alan L Peterson, Edna B Foa, Tabatha H Blount, Carmen P McLean, Dhiya V Shah, Stacey Young-McCaughan, Brett T Litz, Richard P Schobitz, Diane T Castillo, Timothy O Rentz, Jeffrey S Yarvis, Katherine A Dondanville, Brooke A Fina, Brittany N Hall-Clark, Lily A Brown, Bryann R DeBeer, Vanessa M Jacoby, Allison K Hancock, Douglas E Williamson, Wyatt R Evans, Samantha Synett, Casey Straud, Hunter R Hansen, Eric C Meyer, Martin A Javors, Allah-Fard M Sharrieff, Jose Lara-Ruiz, Lauren M Koch, John D Roache, Jim Mintz, Terence M Keane
Combat-related posttraumatic stress disorder (PTSD) is the most common psychological health condition in military service members and veterans who have deployed to the combat theater since September 11, 2001. One of the highest research priorities for the Department of Defense and the Department of Veterans Affairs is to develop and evaluate the most efficient and efficacious treatments possible for combat-related PTSD. However, the treatment of combat-related PTSD in military service members and veterans has been significantly more challenging than the treatment of PTSD in civilians...
July 25, 2018: Contemporary Clinical Trials
Alyson K Zalta, Philip Held, Dale L Smith, Brian J Klassen, Ashton M Lofgreen, Patricia S Normand, Michael B Brennan, Thad S Rydberg, Randy A Boley, Mark H Pollack, Niranjan S Karnik
BACKGROUND: Intensive delivery of evidence-based treatment for posttraumatic stress disorder (PTSD) is becoming increasingly popular for overcoming barriers to treatment for veterans. Understanding how and for whom these intensive treatments work is critical for optimizing their dissemination. The goals of the current study were to evaluate patterns of PTSD and depression symptom change over the course of a 3-week cohort-based intensive outpatient program (IOP) for veterans with PTSD, examine changes in posttraumatic cognitions as a predictor of treatment response, and determine whether patterns of treatment outcome or predictors of treatment outcome differed by sex and cohort type (combat versus military sexual trauma [MST])...
July 27, 2018: BMC Psychiatry
Ursula S Myers, Moira Haller, Abigail C Angkaw, Juliette M Harik, Sonya B Norman
OBJECTIVE: Despite the availability of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) in the Veterans Health Administration, treatment completion rates are low and not all veterans benefit from these treatments. Understanding factors associated with PTSD EBP completion and symptom improvement is critical to improving completion rates and effectiveness. METHOD: This chart review study used the Andersen Behavioral Model to examine whether predisposing characteristics (nonmodifiable characteristics such as demographics), enabling factors (modifiable logistic variables that can facilitate or impede treatment use), and need factors (clinical characteristics such as symptom severity or comorbidities) predicted treatment completion or symptom improvement following PTSD EBP treatment among 82 Iraq and Afghanistan combat veterans...
July 23, 2018: Psychological Trauma: Theory, Research, Practice and Policy
Han Yuan, Raquel Phillips, Chung Ki Wong, Vadim Zotev, Masaya Misaki, Brent Wurfel, Frank Krueger, Matthew Feldner, Jerzy Bodurka
Posttraumatic stress disorder (PTSD) is a trauma- and stressor-related disorder that may emerge following a traumatic event. Neuroimaging studies have shown evidence of functional abnormality in many brain regions and systems affected by PTSD. Exaggerated threat detection associated with abnormalities in the salience network, as well as abnormalities in executive functions involved in emotions regulations, self-referencing and context evaluation processing are broadly reported in PTSD. Here we aimed to investigate the behavior and dynamic properties of fMRI resting state networks in combat-related PTSD, using a novel, multimodal imaging approach...
2018: NeuroImage: Clinical
Vadim Zotev, Raquel Phillips, Masaya Misaki, Chung Ki Wong, Brent E Wurfel, Frank Krueger, Matthew Feldner, Jerzy Bodurka
Posttraumatic stress disorder (PTSD) is a chronic and disabling neuropsychiatric disorder characterized by insufficient top-down modulation of the amygdala activity by the prefrontal cortex. Real-time fMRI neurofeedback (rtfMRI-nf) is an emerging method with potential for modifying the amygdala-prefrontal interactions. We report the first controlled emotion self-regulation study in veterans with combat-related PTSD utilizing rtfMRI-nf of the amygdala activity. PTSD patients in the experimental group (EG, n  = 20) learned to upregulate blood‑oxygenation-level-dependent (BOLD) activity of the left amygdala (LA) using the rtfMRI-nf during a happy emotion induction task...
2018: NeuroImage: Clinical
Martha L Lincoln, Roland S Moore, Genevieve M Ames
Sleep deprivation and sleep disturbance are pervasive among military personnel during and after combat deployment. However, occupational and other constraints often influence military workers to decline behavioral health services and prescription pharmaceutical sleep aids. This article, drawing on ethnographic interviews with National Guard veterans of combat deployment, demonstrates that soldiers with sleep disturbance frequently manage symptoms without medical supervision and by using ad hoc methods including alcohol use...
August 2018: Sleep Health
Noelle B Smith, Lauren M Sippel, Candice Presseau, David Rozek, Natalie Mota, Charles Gordon, Mark Horvath, Ilan Harpaz-Rotem
Given elevated rates of posttraumatic stress disorder (PTSD) among US military veterans, identifying correlates of PTSD and specific PTSD symptom clusters that best represent PTSD in veterans (i.e., the five-factor Dysphoric Arousal model) is critical to prevention and intervention efforts. One potential correlate is locus of control (i.e., the extent to which individuals believe they have control over events in their lives). The aim of this study was to examine the relations between locus of control and five-factor model PTSD symptom clusters (i...
July 11, 2018: Psychiatry Research
Jeffrey M Pyne, Joseph I Constans, John T Nanney, Mark D Wiederhold, Douglas P Gibson, Timothy Kimbrell, Teresa L Kramer, Jeffery A Pitcock, Xiaotong Han, D Keith Williams, Don Chartrand, Richard N Gevirtz, James Spira, Brenda K Wiederhold, Rollin McCraty, Thomas R McCune
Introduction: There is a long history of pre-deployment PTSD prevention efforts in the military and effective pre-deployment strategies to prevent post-deployment PTSD are still needed. Materials and Methods: This randomized controlled trial included three arms: heart rate variability biofeedback (HRVB), cognitive bias modification for interpretation (CBM-I), and control. The hypothesis was that pre-deployment resilience training would result in lower post-deployment PTSD symptoms compared with control...
July 18, 2018: Military Medicine
Jennifer DiMauro, Keith D Renshaw
OBJECTIVE: Intimate relationships are critical to posttrauma functioning and recovery. The vast majority of research focusing on PTSD and relationship functioning has focused exclusively on male combat veterans, from whom female sexual assault survivors may differ in critical ways. This study investigates the strength of the association between PTSD symptoms and relationship satisfaction, as well as the role of three interpersonal processes (sexuality, communication, and hostility) in female sexual assault survivors...
July 16, 2018: Psychological Trauma: Theory, Research, Practice and Policy
Christian L Williams, Howard Berenbaum
OBJECTIVE: The present study explored acts of omission (i.e., inactions) among military service members. We also investigated whether the meanings and interpretations that service members assign to their actions and inactions, particularly alterations to their conceptualization of themselves, others, and the world (i.e., altered worldviews) would be associated with psychological problems (specifically, depression, suicidality, posttraumatic stress disorder [PTSD], and alcohol use). METHOD: A sample of 50 Iraq/Afghanistan military veterans (8% female) completed questionnaires measuring their (in)actions and the meanings and interpretations attached to those (in)actions...
July 16, 2018: Psychological Trauma: Theory, Research, Practice and Policy
Christina M Sheerin, Kelcey J Stratton, Ananda B Amstadter, The Va Mid-Atlantic Mental Illness Research Education Clinical Center Mirecc Workgroup, Scott D McDonald
Background : The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma. Objective : illustrate the impact of various definitions on our understanding and prevalence of resilience, we compared various resilience definitions (absence of PTSD, absence of current mental health diagnosis, absence of generalized psychological distress, and an alternative trauma load-resilience discrepancy model of the difference between actual and predicted distress given lifetime trauma exposure) within a combat-exposed military personnel and veteran sample...
2018: European Journal of Psychotraumatology
Shawn Hirsch, Heather G Belanger, Harvey Levin, Barry S Eggleston, Elisabeth A Wilde, Scott D McDonald, Timothy W Brearly, David F Tate
OBJECTIVE: The goal of the Chronic Effects of Neurotrauma Consortium (CENC) study is to explore the effects of concussions among Service Members and Veterans. A factor model was fit to selected neuropsychological measures to identify potentially useful relationships between assessments collected on CENC-enrolled participants. METHOD: 492 post-9/11 participants with combat exposure were enrolled across four VA study sites. Participants completed assessments including concussion history, neurocognitive functioning, and self-report questionnaires...
July 9, 2018: Brain Injury: [BI]
Sarah L Martindale, Jared A Rowland, Robert D Shura, Katherine H Taber
PRIMARY OBJECTIVE: The purpose of this study was to evaluate preliminary data on longitudinal changes in psychiatric, neurobehavioural, and neuroimaging findings in Iraq and Afghanistan combat veterans following blast exposure. RESEARCH DESIGN: Longitudinal observational analysis. METHODS AND PROCEDURES: Participants were invited to participate in two research projects approximately 7 years apart. For each project, veterans completed the Structured Clinical Interview for DSM-IV Disorders and/or the Clinician-Administered PTSD Scale, Neurobehavioral Symptom Inventory, and magnetic resonance imaging (MRI)...
July 9, 2018: Brain Injury: [BI]
Nicholas D Davenport, James T Gullickson, Scott F Grey, Shawn Hirsch, Scott R Sponheim
PRIMARY OBJECTIVE: To investigate differences in longitudinal trajectories of ventricle-brain ratio (VBR), a general measure of brain atrophy, between Veterans with and without history of mild traumatic brain injury (mTBI). RESEARCH DESIGN: Structural magnetic resonance imaging (MRI) was used to calculate VBR in 70 Veterans with a history of mTBI and 34 Veterans without such history at two time points approximately 3 and 8 years after a combat deployment. MAIN OUTCOMES AND RESULTS: Both groups demonstrated a quadratic relationship between VBR and age that is consistent with normal developmental trajectories...
July 9, 2018: Brain Injury: [BI]
Daniel Bertenthal, Kristine Yaffe, Deborah E Barnes, Amy L Byers, Carolyn J Gibson, Karen H Seal
OBJECTIVES: Opioid therapy is contraindicated in patients with traumatic brain injury (TBI) with neuropsychological impairment, yet guidelines do not consistently predict practice. We evaluated independent risk for initiation of opioid therapy among combat veterans with chronic pain diagnoses and persistent postconcussive symptoms. METHODS: We assembled a retrospective cohort of 53 124 Iraq and Afghanistan veterans in Veterans Affairs (VA) healthcare between October 2007 and March 2015 who received chronic pain diagnoses, completed a Comprehensive TBI Evaluation (CTBIE) and had not received opioid therapy in the prior year...
July 9, 2018: Brain Injury: [BI]
Yonit Schorr, Nathan R Stein, Shira Maguen, J Ben Barnes, Jeane Bosch, Brett T Litz
OBJECTIVE: Service members deployed to war are at risk for moral injury, but the potential sources of moral injury are poorly understood. The aim of this qualitative study was to explore the types of events that veterans perceive as morally injurious and to use those events to develop a categorization scheme for combat-related morally injurious events. METHOD: Six focus groups with US war veterans were conducted. RESULTS: Analysis based on Grounded Theory yielded two categories (and eight subcategories) of events that putatively cause moral injury...
July 9, 2018: Journal of Clinical Psychology
Roseann F Titcombe-Parekh, Jingyun Chen, Nadia Rahman, Nicole Kouri, Meng Qian, Meng Li, Richard A Bryant, Charles R Marmar, Adam D Brown
Cognitive models suggest that posttraumtic stress disorder (PTSD) is maintained, in part, as a result of an individual's maladaptive beliefs about one's ability to cope with current and future stress. These models are consistent with considerable findings showing a link between low levels of self-efficacy and PTSD. A growing body of work has demonstrated that perceptions of self-efficacy can be enhanced experimentally in healthy subjects and participants with PTSD, and increasing levels of self-efficacy improves performance on cognitive, affective, and problem-solving tasks...
June 9, 2018: Journal of Psychiatric Research
Tine Molendijk
The last decade has witnessed fast-growing scholarly interest in the concept of moral injury, which addresses the link between the ethics of military intervention and deployment-related suffering. However, current research on moral injury, predominantly psychological in nature, tends to approach the phenomenon as an internally contained disorder. Consequently, it medicalizes moral injury and de-contextualizes it from the people who send soldiers to conflict zones and 'welcome' them back. This article addresses the ways in which the experience of moral injury is embedded in and shaped by public debates on military intervention, drawing on relevant literature from the fields of psychology, philosophy, and social sciences, and on in-depth qualitative interviews collected in 2016 and 2017 with 80 Dutch veterans...
August 2018: Social Science & Medicine
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