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Combat Veterans (combat + veteran)
Kinds of Combat Veterans Selected AbstractsReview of assessment and treatment of PTSD among elderly American armed forces veteransINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2005Gina P. Owens Abstract Background The number of elderly combat veterans is steadily increasing in the US and estimates project that a notable percentage of these veterans experience symptoms of posttraumatic stress disorder (PTSD). Limited data exist specifically related to prevalence, assessment, and treatment of PTSD among the elderly veteran population. Objective This review summarizes the available research related to difficulties in assessment with the elderly American Armed Forces veteran population. In addition, both psychotherapeutic and pharmacological treatment interventions for PTSD are discussed. Methods A literature search was conducted using PsycINFO, Medline, and the National Center for PTSD's PILOTS database. Results Evidence suggests that elderly veterans generally present more somatic symptoms of PTSD. Medical and psychological comorbodities, such as depression, substance abuse, or cognitive deficits can further complicate the assessment process. Cut-scores for existing instruments need to be further established with elderly veterans. Use of exposure therapies with the elderly has not been adequately researched and mixed results have been obtained for supportive therapy for treatment of PTSD. Controlled research investigating pharmacological interventions for PTSD with the elderly is also limited. Conclusion Evidence suggests that some psychotherapeutic and pharmacological interventions already utilized with younger individuals may be useful with the elderly veteran population. However, research indicates that modifications may be required for working with the elderly population and further research in the areas of assessment and treatment are necessary. Copyright © 2005 John Wiley & Sons, Ltd. [source] Eye movement desensitization and reprocessing (EMDR) in the treatment of war veteransJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2008Steven M. Silver Abstract Recent practice guidelines and meta-analyses have designated eye movement desensitization and reprocessing (EMDR) as a first-line treatment for trauma. Eye movement desensitization and reprocessing is an eight-phase therapeutic approach guided by an information-processing model that addresses the combat veteran's critical incidents, current triggers, and behaviors likely to prove useful in his or her future. Two case examples of combat veterans illustrate the ability of EMDR to achieve symptom reduction in a variety of clinical domains (e.g., anxiety, depression, anger, physical pain) simultaneously without requiring the patient to carry out homework assignments or discuss the details of the event. The treatment of phantom limb pain and other somatic presentations is also reviewed. The ability of EMDR to achieve positive effects without homework indicates that it can be effectively employed on consecutive days, making it especially useful during combat situations. © 2008 Wiley Periodicals, Inc. J Clin Psychol: In Session 64:1,11, 2008. [source] MMPI-2 profiles of Gulf and Vietnam combat veterans with chronic posttraumatic stress disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2002D. Michael Glenn The current study examined service era differences in a sample of 172 Gulf and Vietnam outpatient veterans with combat-related posttraumatic stress disorder (PTSD). Participants completed the MMPI-2 and several additional self-report measures of symptom severity (PTSD, depression, anxiety, hostility, and health complaints). Results indicated that MMPI-2 profiles differed significantly according to service era with Vietnam veterans scoring higher on scales 2, 8, and 0 and lower on scale 9 than did Gulf veterans. Examination of group means derived from parametric analysis of MMPI-2 data suggested a mean two-point code type of 2,8/8,2 for Vietnam veterans and 1,8/8,1 for Gulf veterans. In contrast, when the data were examined using descriptive techniques based on frequency counts of individual MMPI-2 profiles, the most frequently occurring two-point codetype was 7,8/8,7 for Vietnam veterans, and 6,8/8,6 for Gulf veterans. In addition, Gulf veterans reported a greater number of total health complaints than Vietnam veterans, whereas Vietnam veterans reported a greater number of physician-diagnosed physical conditions. Potential advantages of incorporating descriptive approaches versus parametric methods when examining profile data are also presented. © 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 371,381, 2002. [source] Factors associated with antisocial behavior in combat veterans,AGGRESSIVE BEHAVIOR, Issue 5 2010Stephanie Booth-Kewley Abstract The objective of this study was to identify factors associated with antisocial behavior in 1,543 Marines who deployed to combat zones in support of conflicts in Iraq and Afghanistan during 2002,2007. Five factors were associated with antisocial behavior in multivariate analyses: post-traumatic stress disorder (PTSD) symptoms, deployment-related stressors, combat exposure, younger age, and being divorced. PTSD symptoms had a stronger association with antisocial behavior than any other variable. A unique and important finding of this study was the association between deployment-related stressors and a higher incidence of antisocial behavior. Because deployment-related stressors are potentially modifiable, the military may be able to address them in concrete ways such as by shortening deployments and improving communication with home. Aggr. Behav. 36:330,337, 2010. Published 2010 by Wiley-Liss, Inc. [source] Locus of control and psychopathology in relation to levels of trauma and loss: Self-reports of Peloponnesian wildfire survivorsJOURNAL OF TRAUMATIC STRESS, Issue 3 2009Robert C. Mellon This study investigated whether relations between beliefs about the personal controllability of reinforcing events and levels of psychopathology were differentiated with respect to levels of trauma and loss experienced in a series of devastating wildfires. In contrast with studies of combat veterans and professional firefighters, in wildfire survivors external locus of control beliefs and psychopathology were correlated only in respondents who experienced higher levels of trauma and loss; specifically, for residents of designated disaster areas (N = 409), but not for a demographically matched sample of residents of adjacent, non-fire-damaged areas (N = 391). The conflicting findings across studies are interpreted with respect to probable differences in contingencies of reinforcement for causal attributions in professionals and in novices in disaster management. [source] Mechanisms of anger and treatment outcome in combat veterans with posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 2 2008David Forbes Research has identified anger as prominent in, and an influence on, treatment outcome for military veterans with posttraumatic stress disorder (PTSD). This study examined factors influencing the relationship between anger and outcome to improve treatment effectiveness. Participants comprised 103 veterans attending PTSD treatment. Measures of PTSD and comorbidity were obtained at intake and 9-month follow-up. Measures also included potential mediators of therapeutic alliance, social support, problematic/undermining relationships and fear of emotion. Path analyses supported anger as a predictor of treatment outcome, with only fear of anger and alcohol comorbidity accounting for the variance between anger and outcome. To improve treatment effectiveness, clinicians need to assess veterans' anger, aggression, and alcohol use, as well as their current fear of anger and elucidate the relationship between these factors. [source] Aggression among combat veterans: Relationships with combat exposure and symptoms of posttraumatic stress disorder, dysphoria, and anxietyJOURNAL OF TRAUMATIC STRESS, Issue 2 2007Casey T. Taft Prior research has revealed heightened aggressive behavior among veterans with PTSD. This study tested a model examining the interrelationships among combat exposure, posttraumatic stress disorder (PTSD) symptoms, dysphoric symptoms, and anxiety symptoms in predicting aggressive behavior in a sample of 265 male combat veterans seeking diagnostic assessment of PTSD. Combat exposure was indirectly associated with aggression primarily through its relationship with PTSD symptoms. Symptoms of PTSD were directly related to aggression, and indirectly related to aggression through dysphoric symptoms. Results highlight the role of PTSD symptoms and dysphoric symptoms with respect to aggressive behavior among this population, and suggest the relevance of aggression theory to the study of combat veterans. [source] Quality of parental relationships among persons with a lifetime history of posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 2 2007Dean Lauterbach Several studies of combat veterans have examined the relationship between parental satisfaction and PTSD symptoms. These studies found that numbing is associated with substantial decrements in parent,child relationship quality. The current study extends previous work by assessing the effect of PTSD on parent,child relationships in a nationally representative sample of civilian men and women with PTSD resulting from a broad range of trauma. It was hypothesized that PTSD avoidance/numbing symptoms would be predictive of parent,child relationship quality and parent,child conflict. Moreover, these relationships are predicted to hold after controlling for a broad range of support-related variables and work/finance related variables. As hypothesized, after controlling for number of children and respondent-initiated domestic violence, numbing was predictive of increased parent,child aggression. [source] Ambulatory monitoring and physical health report in Vietnam veterans with and without chronic posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 4 2003Jean C. Beckham Abstract This study investigated the associations among PTSD, ambulatory cardiovascular monitoring, and physical health self-reports in 117 male Vietnam combat veterans (61 with PTSD and 56 without PTSD). PTSD was associated with health symptoms and number of current health conditions beyond the influence of several covariates. PTSD was associated with greater systolic blood pressure variability, and an elevated percentage of heart rate and systolic blood pressure readings above baseline. Higher mean heart rate and an elevated percentage of heart rate above baseline were associated with physical health symptoms. None of the ambulatory monitoring variables mediated the association between PTSD and physical health outcomes. Findings suggest that the interrelationships among ambulatory autonomic responses, PTSD, and physical health deserve more research attention. [source] Hazardous alcohol use and treatment outcome in male combat veterans with posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 1 2003Stanley R. Steindl Abstract The relationship between alcohol problems and posttraumatic stress disorder (PTSD) remains unclear. Six hundred and eight combat veterans diagnosed with PTSD were assessed for PTSD symptoms and alcohol problems prior to group cognitive,behavioral treatment. They were reassessed 3 and 9 months after treatment. Participants were classified into low-risk and hazardous drinkers at each time point. Drinking status at intake did not predict PTSD symptoms at intake or follow-up. However, drinking status was associated with PTSD symptoms when both were assessed at follow-up. PTSD arousal symptoms were the only symptom cluster to differentiate drinking groups. [source] Anger and combat-related posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 2 2002Raymond W. Novaco Abstract We examined whether combat-related PTSD was differentially associated with particular dimensions of anger on two multi-index, psychometric instruments and whether the proportion of variation in PTSD scores explained by anger was significantly greater than that by demographic and exposure variables. We also examined the reliability and validity of a subset of Mississippi Scale items as an anger measure. Participants were 143 Vietnam combat veterans. Anger accounted for over 40% of the variance in Mississippi PTSD scores (minus the anger items) above that associated with age, education, and combat exposure. Veterans with structured-interview,diagnosed PTSD were significantly differentiated from those without PTSD on all anger indices. The results point to anger treatment as a high priority for combat-related PTSD. [source] Fluvoxamine and sleep disturbances in posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 3 2001Thomas C. Neylan Abstract This study assesses the efficacy of fluvoxamine treatment on different domains of subjective sleep quality in Vietnam combat veterans with chronic posttraumatic stress disorder (PTSD). Medically healthy male Vietnam theater combat veterans (N = 21) completed a 10-week open label trial. Fluvoxamine treatment led to improvements in PTSD symptoms and all domains of subjective sleep quality. The largest effect was for dreams linked to the traumatic experience in combat. In contrast, generic unpleasant dreams showed only a modest response to treatment. Sleep maintenance insomnia and the item "troubled sleep" showed a large treatment response, whereas sleep onset insomnia improved less substantially. These therapeutic benefits contrast with published reports that have found activating effects of Selective Serotonin Reuptake Inhibitors on the sleep electroencephalogram. [source] Predictors of emotional numbing, revisited: A replication and extensionJOURNAL OF TRAUMATIC STRESS, Issue 4 2000William F. Flack Jr. Abstract Litz et al. (1997), theorizing that emotional numbing (EN) is the result of emotional depletion caused by chronic hyperarousal, demonstrated that a cluster of hyperarousal symptoms was a robust predictor of EN symptoms. In the present study, these findings were replicated and extended in two multiple regression analyses of data from a large, multisite investigation (T. M. Keane et al., 1998) of psychophysiological responding by male combat veterans. The arousal (D) cluster of symptoms was again the most robust predictor of EN symptoms, whereas physiological indices of arousal and reactivity accounted for negligible amounts of variance in both regression equations. These findings underscore the possible link between disturbances related to arousal and the capacity of traumatized individuals to express and experience pleasant feelings. [source] Intimate Partner and General Aggression Perpetration Among Combat Veterans Presenting to a Posttraumatic Stress Disorder ClinicAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2009Casey T. Taft PhD This study examined rates and correlates of intimate partner and general aggression perpetration among 236 male combat veterans seeking services in a Veteran's Affairs posttraumatic stress disorder (PTSD) clinic. Approximately 33% of those in an intimate relationship reported perpetrating partner physical aggression in the previous year, and 91% reported partner psychological aggression. Comparable rates were found for general aggression perpetration among partnered and nonpartnered veterans. PTSD symptoms as well as symptoms of depression were associated with aggression across subgroups and forms of aggression, and PTSD symptoms reflecting arousal and lack of control were generally the strongest predictor of aggression. Findings indicate a need for additional aggression screening and intervention development for this population, and highlight the targeting of heightened arousal and lack of behavioral control in aggression interventions. [source] Safety and efficacy of sildenafil citrate in treating erectile dysfunction in patients with combat-related post-traumatic stress disorder: a double-blind, randomized and placebo-controlled studyBJU INTERNATIONAL, Issue 3 2009Mohammad Reza Safarinejad OBJECTIVE To evaluate the safety and efficacy of sildenafil citrate for treating erectile dysfunction (ED) in patients with combat-related post-traumatic stress disorder (PTSD). PATIENTS AND METHODS In all, 266 combat-exposed war veterans with ED (aged 37,59 years) were recruited. They met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for PTSD according to the Structured Clinical Interview for Patients, Investigator Version. The patients were also evaluated with the Clinician-Administered PTSD Scale, both to establish the diagnosis of PTSD and to measure symptom severity. Only patients with psychogenic ED were included in the study. Patients with comorbid conditions (diabetes mellitus, hypercholesterolaemia, hypertension, Peyronie's disease) and smokers of more than five cigarettes daily were excluded. The patients were randomly divided into a group of 133 who received 100 mg of on-demand sildenafil 0.75,2 h before sexual stimulation, and 133 who received placebo. Patients were asked to use ,16 doses or attempts at home. The efficacy of the treatments was assessed every four attempts during treatment, and at the end of the study, using responses to the 15-question International Index of Erectile Function (IIEF), Sexual Encounter Profile diary questions 2 and 3, Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire, patients' event logs of sexual activity, and a Global Assessment Question about erections. RESULTS Sildenafil did not produce significantly and substantially greater improvement than placebo in each of the primary and secondary outcome measures (P = 0.08). A normal EF domain score (,26) at endpoint was reported by 13 (9.8%), and 11 (8.3%) of patients on the sildenafil and placebo regimens, respectively (P = 0.09). Patients treated with sildenafil had no statistically significantly greater improvement in the five sexual function domains of the IIEF questionnaire than those treated with placebo (P = 0.08). The incidences of treatment-emergent adverse events were significantly greater in the sildenafil arm than in the placebo group (P = 0.01). CONCLUSIONS Sildenafil is no better than placebo in treating PTSD-emergent ED. Further randomized clinical trials are warranted in combat veterans and other populations with PTSD to better elucidate the role of phosphodiesterase type 5 inhibitors in treating PTSD-emergent ED. [source] | |||||||||||||