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Combat Veteran

Noelle B Smith, Lauren M Sippel, David C Rozek, Rani A Hoff, Ilan Harpaz-Rotem
Background: Successful psychotherapy for posttraumatic stress disorder (PTSD) necessitates initial and sustained engagement. However, treatment dropout is common, with rates of 50-70% depending on the setting, type of treatment and how dropout is calculated. Dropout from residential treatment is less understood and could be impacted by participation of more symptomatic patient populations and reduced day-to-day barriers to engagement. Gaining insight into predictors of treatment dropout is critical given that individuals with greater symptoms are the most in need of successful treatments but also at higher risk of unsuccessful psychotherapy episodes...
2019: Frontiers in Psychology
Julia Diehle, Victoria Williamson, Neil Greenberg
BACKGROUND: Reservists often have different experiences to regular military personnel which may impact their mental health. AIMS: To investigate the incidence of mental health problems in both active and veteran reservists and determine how this compares to regular service personnel and ex-regular veterans. METHOD: Five studies which included reservist and/or veteran participants, a validated assessment of mental health problems, and provided primary data were included in the synthesis...
March 12, 2019: Journal of Mental Health
Shannon R Forkus, Juliana G Breines, Nicole H Weiss
INTRODUCTION: Military veterans are at heightened risk for developing mental and behavioral health problems. Morally injurious combat experiences have recently gained empirical and clinical attention following the increased rates of mental and behavioral health problems observed in this population. OBJECTIVE: Extending extant research, the current investigation assessed the relationship between morally injurious experiences and mental and behavioral health outcomes...
March 11, 2019: Psychological Trauma: Theory, Research, Practice and Policy
Leslie A Morland, Stephanie Y Wells, Lisa H Glassman, Kathleen M Grubbs, Margaret-Anne Mackintosh, Shahrokh Golshan, Min Ji Sohn, Steven R Thorp, Ulysses C Savage, Ronald E Acierno
INTRODUCTION: Home-based delivery of psychotherapy may offer a viable alternative to traditional office-based treatment for post-traumatic stress disorder (PTSD) by overcoming several barriers to care. Little is known about patient perceptions of home-based mental health treatment modalities. This study assessed veterans' preferences for treatment delivery modalities and how demographic variables and trauma type impact these preferences. MATERIALS AND METHODS: Veterans with PTSD (N = 180) participating in a randomized clinical trial completed a clinician-administered PTSD assessment and were asked to identify their modality preference for receiving prolonged exposure: home-based telehealth (HBT), office-based telehealth (OBT), or in-home-in-person (IHIP)...
March 6, 2019: Military Medicine
Jay Salpekar
Psychiatric Comorbidity and Traumatic Brain Injury Attribution in Patients With Psychogenic Nonepileptic or Epileptic Seizures: A Multicenter Study of US Veterans Salinsky M, Rutecki P, Parko K, Goy E, Storzbach D, O'Neil M, Binder L, Joos S. Epilepsia. 2018. Epub ahead of print. Objective: To determine the frequency and severity of psychiatric disorders and attribution of seizures to traumatic brain injury (TBI) in veterans with verified psychogenic nonepileptic seizures (PNES) versus epileptic seizures (ES)...
January 2019: Epilepsy Currents
Vinnu Bhardwaj, Abigail C Angkaw, Massimo Franceschetti, Ramesh Rao, Dewleen G Baker
Hostility, anger, and aggression are conceptually related but unique constructs found to occur more often among veterans with posttraumatic stress disorder (PTSD) than among civilians or veterans without PTSD. However, the pathways between PTSD, depression, hostility, anger, and aggression have not been comprehensively characterized. Therefore, drawing on a sample of returning Operation Enduring Freedom/Operation Iraqi Freedom combat veterans ( N = 175; 95% male; mean age 30 years), this study sought to examine the direct and indirect relationships among PTSD, depression, hostility, anger, and four types of aggression: verbal, and physical toward self, others, and objects...
March 5, 2019: Aggressive Behavior
Bryan J Stevens, Grant A Justin, Donovan S Reed, Alexandria F Jaksha, Brett W Davies, Sherri L DeMartelaere, Denise S Ryan, Eric D Weichel, Marcus H Colyer
PURPOSE: To describe the demographics and clinical outcomes of patients who underwent posttraumatic enucleation or evisceration during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) from 2001 to 2011. METHODS: The Walter Reed Ocular Trauma Database is a retrospective case series of US Servicemembers and Department of Defense civilians who had combat ocular injuries in OIF and OEF. Data regarding posttraumatic enucleations and eviscerations performed during OIF and OEF were extracted...
February 21, 2019: Journal of Craniofacial Surgery
Hyunyup Lee, Carolyn M Aldwin, Soyoung Choun, Avron Spiro
Cross-sectional studies have shown contradictory results concerning the impact of combat exposure on mental health in later life. We examined whether combat exposure influences trajectories of mental health symptoms in older male veterans using longitudinal data collected from 1985 to 1991 in the Veterans Affairs Normative Aging Study ( N = 1,105, age range = 40-86 years in 1985). Noncombat veterans showed little systematic change in depressive and anxiety symptoms with age, whereas combat veterans showed U-shaped nonlinear changes, with higher levels in midlife decreasing until the mid-60s and then increasing again in the 70s and 80s...
February 28, 2019: Psychology and Aging
Diana C Bennett, Edward J Thomas, Katherine E Porter, Rachel B Broman, Sheila A M Rauch, Minden B Sexton
Despite the high rates of military sexual trauma (MST) experienced by service members and veterans, little is known about how contextual features of the MST event or concurrent histories of other interpersonal traumas are associated with diverse clinical presentations. This study examined contextual factors of MST events (number of perpetrators, location of MST, relationship to perpetrator, location of MST) and dual history of interpersonal traumas (including sexual abuse or assault throughout the lifespan, repeated MST, and intimate partner violence) in relation to total symptoms and symptom clusters of Posttraumatic Stress Disorder (PTSD)...
February 1, 2019: Violence and Victims
Daniel W Grupe, Ted Imhoff-Smith, Joseph Wielgosz, Jack B Nitschke, Richard J Davidson
Previous studies have identified reduced heart rate variability (HRV) in post-traumatic stress disorder (PTSD), which may temporally precede the onset of the disorder. A separate line of functional neuroimaging research in PTSD has consistently demonstrated hypoactivation of the ventromedial prefrontal cortex (vmPFC), a key aspect of a descending neuromodulatory system that exerts inhibitory control over heart rate. No research to date, however, has simultaneously investigated whether altered vmPFC activation is associated with reduced HRV and elevated PTSD symptoms in the same individuals...
February 22, 2019: Psychophysiology
Royce E Clifford, Dewleen Baker, Victoria B Risbrough, Mingxiong Huang, Kate A Yurgil
INTRODUCTION: Mild TBI (TBI) is associated with up to a 75.7% incidence of tinnitus, and 33.0% of tinnitus patients at the US Veterans Administration carry a diagnosis of post-traumatic stress syndrome (PTSD). Yet factors contributing to new onset or exacerbation of tinnitus remain unclear. MATERIALS AND METHODS: Here we measure intermittent and constant tinnitus at two time points to ascertain whether pre-existing or co-occurring traumatic brain injury (TBI), hearing loss, or post-traumatic stress disorder (PTSD) predicts new onset, lack of recovery and/or worsening of tinnitus in 2,600 United States Marines who were assessed before and after a combat deployment...
February 22, 2019: Military Medicine
Shira Maguen, Yongmei Li, Erin Madden, Karen H Seal, Thomas C Neylan, Olga V Patterson, Scott L DuVall, Callan Lujan, Brian Shiner
Little is known about predictors of initiation and completion of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD), with most data coming from small cohort studies and post-hoc analyses of clinical trials. We examined patient and treatment factors associated with initiation and completion of EBP for PTSD in a large longitudinal cohort. We conducted a national, retrospective cohort study of all Iraq and Afghanistan War veterans who had a post-deployment PTSD diagnosis from 10/01-9/15 at a Veterans Health Administration facility and had at least one coded post-deployment psychotherapy visit...
February 11, 2019: Psychiatry Research
Erica L Epstein, Sarah L Martindale, Va Mid-Atlantic Mirecc Workgroup, Holly M Miskey
Around half of Iraq and Afghanistan war veterans with traumatic brain injury (TBI) have co-occurring posttraumatic stress disorder (PTSD). Research on the differences between male and female veterans with co-occurring PTSD/TBI is sparse. This study evaluated behavioral health differences between sexes with these conditions. Veterans (N = 1577) completed a structured psychiatric interview, TBI interview, and self-report interviews assessing sleep quality, alcohol use, substance use, pain, depression symptoms, PTSD symptoms, and combat exposure...
January 31, 2019: Psychiatry Research
A J Khan, Y Li, J V Dinh, R Donalson, C L Hebenstreit, S Maguen
Suicide rates amongst women veterans are significantly higher than rates for their civilian counterparts. However, risk factors for suicide among women veterans remain unclear. The current study examined the impact of exposure to a number of military stressors (e.g., perceived life threat, killing in combat, military sexual trauma) on suicidal ideation (SI) in women veterans. A total of 403 women veterans responded to mailed self-report surveys, 383 (ages 24-70 years) returned fully completed surveys and were included in analyses, and 16% of those included endorsed current SI...
February 11, 2019: Psychiatry Research
Krishnan Radhakrishnan, Mihaela Aslan, Kelly M Harrington, Robert H Pietrzak, Grant Huang, Sumitra Muralidhar, Kelly Cho, Rachel Quaden, David Gagnon, Saiju Pyarajan, Ning Sun, Hongyu Zhao, Michael Gaziano, John Concato, Murray B Stein, Joel Gelernter
OBJECTIVES: Heritability in the risk for developing posttraumatic stress disorder (PTSD) has been established, but most genome-wide association studies (GWASs) of PTSD involve relatively small sample sizes and limited identification of associated genetic loci. This report describes the methodology of a Veterans Affairs (VA) Cooperative Studies Program GWAS of PTSD among combat-exposed U.S. veterans. METHODS: Probable cases (with PTSD) and probable controls (without PTSD) were identified from among veterans enrolled in the VA Million Veteran Program (MVP) with an algorithm developed using questionnaire responses and electronic health record information...
February 14, 2019: International Journal of Methods in Psychiatric Research
Jeffrey S Simons, Raluca M Simons, Kyle J Walters, Jessica A Keith, Carol O'Brien, Kate Andal, Scott F Stoltenberg
OBJECTIVE: To estimate a network model of risk and resilience factors of suicidal ideation among veterans. METHODS: Two network models of suicidal ideation among OIF/OEF/OND veterans (N = 276) incorporated key disorders, traumatic stress, and resilience constructs to contextualize suicidal ideation. RESULTS: Childhood trauma was positively connected with suicidal ideation and harassment and inversely connected with social support and distress tolerance...
February 8, 2019: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
Gadi Zerach, Yossi Levi-Belz
Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as significant stressful combat events that may lead to mental health problems, including self-injurious thoughts and behavior (SITB). However, few studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SITB. In the current study, we aimed to examine the association between PMIEs and SITB among combat veterans and explore the moderating roles of intolerance of uncertainty (IU) in this association...
February 5, 2019: Journal of Traumatic Stress
Lauren E Salminen, Rajendra A Morey, Brandalyn C Riedel, Neda Jahanshad, Emily L Dennis, Paul M Thompson
BACKGROUND AND PURPOSE: Posttraumatic stress disorder (PTSD) is a heterogeneous condition associated with a range of brain imaging abnormalities. Early life stress (ELS) contributes to this heterogeneity, but we do not know how a history of ELS influences traditionally defined brain signatures of PTSD. Here, we used a novel machine learning method - evolving partitions to improve classification (EPIC) - to identify shared and unique structural neuroimaging markers of ELS and PTSD in 97 combat-exposed military veterans...
February 3, 2019: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Victoria Williamson, Neil Greenberg, Dominic Murphy
Background : Moral injury has been found to adversely affect US veteran mental health, and the mental health difficulties resulting from moral injury can be particularly challenging to treat. Yet little is known about the impact of moral injury on the well-being of UK armed forces (AF) veterans and how moral injury is currently addressed in treatment. Objective : The aim of this study was to examine UK AF veterans' experiences of moral injury, and the perceptions and challenges faced by clinicians in treating moral injury-related mental health difficulties...
2019: European Journal of Psychotraumatology
Sasja Dorresteijn, Thomas Edward Gladwin, Iris Eekhout, Eric Vermetten, Elbert Geuze
Background : Childhood trauma and combat-related trauma are both associated with decreased psychosocial functioning. Coping strategies play an important role in the adjustment to traumatic events. Objective : The present study examined childhood trauma and the mediating role of coping strategies in adult psychological symptoms in a non-clinical military population after deployment to Afghanistan. Additionally, the moderating role of coping strategies in vulnerability to combat events was explored. Method : Participants ( N = 932) were drawn from a prospective study assessing psychological complaints (SCL-90), early trauma (ETISR-SF), combat-related events and coping strategies (Brief COPE)...
2019: European Journal of Psychotraumatology
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