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combat trial trauma

James Snyder, Abigail Gewirtz, Lynn Schrepferman, Suzanne R Gird, Jamie Quattlebaum, Michael R Pauldine, Katie Elish, Osnat Zamir, Charles Hayes
Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms...
November 2016: Development and Psychopathology
Todd M Bishop, Peter C Britton, Kerry L Knox, Wilfred R Pigeon
Disrupted sleep is common among combat veterans and can negatively impact response to mental health treatments. A trial of cognitive behavioral therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for nightmares was conducted with 14 combat veterans diagnosed with insomnia, and who were experiencing posttraumatic stress and/or depression. In the case-series that follows veterans experienced clinically significant changes in sleep, and statistically significant reductions in insomnia, nightmare, depression and posttraumatic stress severity following treatment...
2016: Military Behavioral Health
Raymond Devlin, Laura Bonanno, Jennifer Badeaux
BACKGROUND: Rapid replacement of blood loss is critical in patients suffering from traumatic hemorrhage. When the availability of blood products is limited, certain interventions have shown promise in conserving blood supplies. Recombinant factor (rF) VIIa has been administered, as an off-label use, to assist in controlling hemorrhage in trauma patients. Although rFVIIa has a tendency to remain localized to areas of vascular insult, there may be an increase in thromboembolism formation when patients suffer multiple sites of injury as seen in blunt force trauma...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
Frederic J Sautter, Shirley M Glynn, Julia J Becker-Cretu, Damla Senturk, Aaron P Armelie, Dustin B Wielt
To address the impact of combat-related posttraumatic stress disorder (PTSD) on U.S. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans, the investigators developed a 12-session manualized PTSD treatment for couples called structured approach therapy (SAT). A randomized controlled trial had shown that 29 OEF/OIF veterans with combat-related PTSD who had participated in SAT showed significantly greater reductions in PTSD compared to 28 veterans receiving a 12-session PTSD family education intervention (Sautter, Glynn, Cretu, Senturk, & Vaught, 2015)...
August 2016: Journal of Traumatic Stress
Rachel L Choron, Joshua P Hazelton, Krystal Hunter, Lisa Capano-Wehrle, John Gaughan, John Chovanes, Mark J Seamon
BACKGROUND: Intra-abdominal packing with laparotomy pads (LP) is a common and rapid method for hemorrhage control in critically injured patients. Combat Gauze™ and Trauma Pads™ ([QC] Z-Medica QuikClot(®)) are kaolin impregnated hemostatic agents, that in addition to LP, may improve hemorrhage control. While QC packing has been effective in a swine liver injury model, QC remains unstudied for human intra-abdominal use. We hypothesized QC packing during damage control laparotomy (DCL) better controls hemorrhage than standard packing and is safe for intracorporeal use...
July 21, 2016: Injury
Cindy A McGeary, Donald D McGeary, Jose Moreno, Robert J Gatchel
Chronic musculoskeletal pain, such as low back pain, often appears in the presence of psychiatric comorbidities (e.g., depression, posttraumatic stress disorder (PTSD)), especially among U.S. military service members serving in the post-9/11 combat era. Although there has been much speculation about how to best address pain/trauma psychiatric symptom comorbidities, there are little available data to guide practice. The present study sought to examine how pre-treatment depression and PTSD influence outcomes in a functional restoration pain management program using secondary analysis of data from the Department of Defense-funded Functional and Orthopedic Rehabilitation Treatment (FORT) trial...
2016: Healthcare (Basel, Switzerland)
I Wald, E Fruchter, K Ginat, E Stolin, D Dagan, P D Bliese, P J Quartana, M L Sipos, D S Pine, Y Bar-Haim
BACKGROUND: Efficacy of pre-trauma prevention for post-traumatic stress disorder (PTSD) has not yet been established in a randomized controlled trial. Attention bias modification training (ABMT), a computerized intervention, is thought to mitigate stress-related symptoms by targeting disruptions in threat monitoring. We examined the efficacy of ABMT delivered before combat in mitigating risk for PTSD following combat. METHOD: We conducted a double-blind, four-arm randomized controlled trial of 719 infantry soldiers to compare the efficacy of eight sessions of ABMT (n = 179), four sessions of ABMT (n = 184), four sessions of attention control training (ACT; n = 180), or no-training control (n = 176)...
September 2016: Psychological Medicine
J Cobb Scott, Steven Paul Woods, Kristen M Wrocklage, Brian C Schweinsburg, Steven M Southwick, John H Krystal
OBJECTIVES: Neuropsychological studies of posttraumatic stress disorder (PTSD) have revealed deficits in attention/working memory, processing speed, executive functioning, and retrospective memory. However, little is known about prospective memory (PM) in PTSD, a clinically relevant aspect of episodic memory that supports the encoding and retrieval of intentions for future actions. METHODS: Here we examined PM performance in 40 veterans with PTSD compared to 38 trauma comparison (TC) veterans who were exposed to combat but did not develop PTSD...
August 2016: Journal of the International Neuropsychological Society: JINS
Tara L Sacco, Brenton LaRiccia
Trauma patients experience pain and agitation during their hospitalization. Many complications have been noted both in the absence of symptom management and the in presence of oversedation/narcotization. To combat noted untoward effects of pain and sedation management, an interprofessional team convened to develop a pain and sedation guideline for use in a trauma intensive care unit. Guideline development began with a comprehensive review of the literature. With the input of unit stakeholders, a nurse-driven analgosedation guideline was implemented for a 6-month trial...
May 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Ruifeng Cui, Moira Haller, Jessica R Skidmore, Kelly Goldsteinholm, Sonya Norman, Susan R Tate
OBJECTIVE: Low attendance in psychotherapy, particularly among individuals with comorbid disorders, is a pervasive challenge. The present study examined predictors of treatment attendance in a sample of veterans with depression, substance use disorder, and trauma. METHODS: This is an analysis of data collected as part of a larger clinical trial involving outpatients at a Veterans Administration dual diagnosis clinic. Individuals were excluded if they had significant memory deficits, schizophrenia, bipolar disorder, or substantial travel constraints...
2016: Journal of Dual Diagnosis
Ismene L Petrakis, Nitigna Desai, Ralitza Gueorguieva, Albert Arias, Erin O'Brien, J Serrita Jane, Kevin Sevarino, Steven Southwick, Elizabeth Ralevski
BACKGROUND: Posttraumatic stress disorder (PTSD) is an important and timely clinical issue particularly for combat veterans. Few pharmacologic options are available to treat PTSD, particularly among military personnel, and they are not based on rational neurobiology. The evidence for noradrenergic dysregulation in PTSD is strong, and the alpha-adrenergic agonist prazosin is one of the most promising medications to treat sleep disturbances associated with PTSD as well as PTSD symptoms among both veterans and civilians...
January 2016: Alcoholism, Clinical and Experimental Research
Bethany C Wangelin, Peter W Tuerk
BACKGROUND: Physiological reactivity to trauma-related cues is a primary symptom of PTSD and can be assessed objectively using script-driven imagery paradigms. However, subjective self-reported symptom measures are the most common outcome indices utilized in PTSD treatment trials and clinic settings. We examined physiological reactivity during a short trauma imagery task as an objective index of response to PTSD treatment, optimized for use in routine clinical care settings. METHODS: Participants were 35 male combat veterans receiving prolonged exposure (PE) therapy in a Veterans Affairs outpatient clinic...
December 2015: Depression and Anxiety
Rachel Kornhaber, Rick Wiechula, Loyola McLean
BACKGROUND: Trauma is the most frequent cause of significant functional impairment that leads to the deterioration in health and often delayed functional and psychosocial recovery. Fundamentally, rehabilitation of those with traumatic injuries surpasses the acute management extending into the reintegration of patients to home life and the wider community. Consequently, rehabilitation from a traumatic injury is a multidisciplinary process that incorporates the continuum of care across different settings and organizations...
2015: JBI Database of Systematic Reviews and Implementation Reports
Shibani Pati, Marcello Pilia, Juanita M Grimsley, Alexia T Karanikas, Blessing Oyeniyi, John B Holcomb, Andrew P Cap, Todd E Rasmussen
Trauma is a leading cause of death in both military and civilian populations worldwide. Although medical advances have improved the overall morbidity and mortality often associated with trauma, additional research and innovative advancements in therapeutic interventions are needed to optimize patient outcomes. Cell-based therapies present a novel opportunity to improve trauma and critical care at both the acute and chronic phases that often follow injury. Although this field is still in its infancy, animal and human studies suggest that stem cells may hold great promise for the treatment of brain and spinal cord injuries, organ injuries, and extremity injuries such as those caused by orthopedic trauma, burns, and critical limb ischemia...
December 2015: Shock
Stevan E Hobfoll, Rebecca K Blais, Natalie R Stevens, Lisa Walt, Richard Gengler
OBJECTIVE: Despite heightened rates of depression and posttraumatic stress disorder (PTSD) among in Iraq/Afghanistan veterans, the majority of distressed veterans will not receive mental health care. Overcoming barriers to mental health services requires innovative approaches to broaden the reach of evidence-based treatment. The current study examined the efficacy and acceptability of an innovative and dynamic online cognitive-behavioral therapy intervention for PTSD and depression called Vets Prevail...
January 2016: Journal of Consulting and Clinical Psychology
Ofir Levi, Yair Bar-Haim, Yitshak Kreiss, Eyal Fruchter
UNLABELLED: This study compared the effectiveness of two psychotherapy approaches for treating combat veterans with chronic post-traumatic stress disorder (PTSD): cognitive-behavioural therapy (CBT) and psychodynamic psychotherapy (PDT). These treatments are routinely used by the Unit for Treatment of Combat-Related PTSD of the Israel Defense Forces (IDF). IDF veterans with chronic PTSD were assigned to either CBT (n = 148) or PDT (n = 95) based on the nature of their complaint and symptoms...
July 2016: Clinical Psychology & Psychotherapy
Richard J McNally, Richard A Bryant, Anke Ehlers
In the wake of the terrorist attacks at the World Trade Center, more than 9,000 counselors went to New York City to offer aid to rescue workers, families, and direct victims of the violence of September 11, 2001. These mental health professionals assumed that many New Yorkers were at high risk for developing posttraumatic stress disorder (PTSD), and they hoped that their interventions would mitigate psychological distress and prevent the emergence of this syndrome. Typically developing in response to horrific, life-threatening events, such as combat, rape, and earthquakes, PTSD is characterized by reexperiencing symptoms (e...
November 2003: Psychological Science in the Public Interest: a Journal of the American Psychological Society
Michael P Chapman, Ernest E Moore, Theresa L Chin, Arsen Ghasabyan, James Chandler, John Stringham, Eduardo Gonzalez, Hunter B Moore, Anirban Banerjee, Christopher C Silliman, Angela Sauaia
The existing evidence shows great promise for plasma as the first resuscitation fluid in both civilian and military trauma. We embarked on the Control of Major Bleeding After Trauma (COMBAT) trial with the support of the Department of Defense to determine if plasma-first resuscitation yields hemostatic and survival benefits. The methodology of the COMBAT study represents not only 3 years of development work but also the integration of nearly two decades of technical experience with the design and implementation of other clinical trials and studies...
August 2015: Shock
Thomas E Grissom, Raymond Fang
PURPOSE OF REVIEW: Death from exsanguinating hemorrhage remains a priority in the management of combat casualties and civilian trauma patients with truncal and junctional injuries. Appropriate use of hemostatic agents and dressings in the prehospital setting may allow for earlier control and an improved survival rate. RECENT FINDINGS: Third-generation chitosan-based hemostatic agents and dressings appear to be equally efficacious to the dressing currently deployed by the US military forces in the management of hemorrhage not amenable to tourniquet placement...
April 2015: Current Opinion in Anaesthesiology
Stuart F White, Michelle E Costanzo, James R Blair, Michael J Roy
BACKGROUND: Recent neuroimaging work suggests that increased amygdala responses to emotional stimuli and dysfunction within regions mediating top down attentional control (dorsomedial frontal, lateral frontal and parietal cortices) may be associated with the emergence of anxiety disorders, including posttraumatic stress disorder (PTSD). This report examines amygdala responsiveness to emotional stimuli and the recruitment of top down attention systems as a function of task demands in a population of U...
2015: NeuroImage: Clinical
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