discussion title: PTSD in the news: October
From Home Fires in the NYTimes:
October 11, 2009, 8:35 pm
Living the Dream
By Michael Jernigan
Greetings again from the Sunshine State.
As I mentioned in my first post I would like to bring some awareness to an issue facing many of us returning war veterans. Post Traumatic Stress Disorder (P.T.S.D.) is a monster that war veterans have been facing since the beginning of armed conflict. In a nutshell, it is the stress brought on by a traumatic event. I understand that it is more complicated than that but I would like to keep it as simple as possible for our purposes here.
I am living with P.T.S.D., and I am thriving in some respects and having problems in others. In this and future posts I plan to use myself and my experiences as examples.
Post-traumatic stress can manifest itself in many different ways. It is usually brought on by a trigger mechanism, or what some might call a catalyst. It can be something very minor that can be easily controlled or it can be so large that it has life altering circumstances.
So what do I mean when I say I am both thriving and having problems at the same time? Well, I can tell you that in school I am thriving. I have been back for a couple of years now and continue to pull a 3-plus grade point average every semester. It is in other parts of my life that I am struggling.
My relationship with my wife has been strained because of the way I react to certain things; my relationship with my stepson has suffered as well. I have quick reactions full of emotion that are not checked before they come out. In many cases they are very aggressive and quite counterproductive. I am impatient in numerous situations and become frustrated easily. To top it all off I often have to overcome bouts of anxiety, especially when I am outside my house. I do well in social situations but I find them physically taxing. I have been receiving help with all of these problems and I am improving at a good rate. My wife and I have worked hard to help me overcome a lot of these symptoms.
One of the most common problems facing our war veterans when we return home is drug and alcohol abuse. We turn to these to escape from emotions. I drank heavily when I returned home. I would drink to the point that I would pass out at night. I would do this because I could not sleep. I could not sleep because there were a healthy wave of emotions that I refused to face. What made sleep hard was the P.T.S.D. in conjunction with a traumatic brain injury. When I would finally sleep I had to deal with some strange and horrific dreams.
Continue to read here as the author describes how he learned to interpret his dreams in a positive way.
re: PTSD in the news: Octobermessage #: 4084.2 in response to 4084.1
From Haaretz.com:
http://www.haaretz.com/hasen/spages/1119806.html
Israeli study: Trauma of rape harsher than shell shock
By Dan Even, Haaretz Correspondent
The first Israeli study to examine which types of trauma produce the most severe post-traumatic stress has found that rape victims' symptoms are far more severe than those experienced by victims of other types of trauma, such as traffic accidents, shell shock, serious illness or the death of a close friend or relative.
The study, conducted by Dr. Avigail Moor and Dr. Moshe Farchi of the social work program at Tel Hai Academic College, is based on questionnaires filled out by 341 adults who have experienced post-traumatic stress.
The questionnaire, originally developed by an American researcher, covers topics such as anxiety, uncontrollable memories of the traumatic incident, flashbacks, nightmares and feelings of guilt, powerlessness, despair and depression. A score of 15 or above (on a scale of zero to 51) indicates clinical post-traumatic stress disorder.
The researchers found that 25.6 of rape victims had scores in the top third of the post-traumatic stress scale (34-51 points), compared to only 11.4 percent of other trauma victims. The average score for rape victims was 22 points, compared to 17.5 for shell-shocked soldiers, 12.7 for people involved in traffic accidents and 12.6 for those with a serious illness.
Studies in the United States and Europe have similarly found that rape victims suffer more severe post-traumatic stress than other types of trauma victims.
"The purpose of the study is not to conduct a 'competition' among the severity of different traumas, but to open the public's eyes to the great severity of the emotional response to rape and to raise this issue to a higher position on the public's order of priorities," Moor said.
One major reason why rape victims experience more severe post-traumatic stress is that they experience much higher levels of guilt, the study found. Fully 46.2 percent of rape victims blamed themselves, as expressed in statements such as "I acted stupidly," compared to only 20.4 percent of other trauma victims.
Moor said the guilty feelings are exacerbated by the fact that when it comes to rape, society often blames the victim as well.
Another factor that makes rape a more severe form of trauma, Moor said, is that rape is a deliberate attack on the victim personally. That is not true for other trauma victims, even shell-shocked soldiers:, who are not targeted as an individual.
"It's important that those who treat [the victims] do not approach all trauma patients as an indistinguishable mass," Moor said. "They must look at the factors that distinguish different types of traumas."
re: PTSD in the news: Octobermessage #: 4084.3 in response to 4084.1
From abcnews.com:
http://abcnews.go.com/Health/wireStory?id=8783059
Attitude May Affect Long-Term Recovery From Whiplash
October 8, 2009
NEW YORK (Reuters Health) - For people who suffer whiplash in a car accident, feelings of being wronged may raise their risk of lingering post-traumatic stress, a new study suggests.
The study, which followed 112 patients in rehab for whiplash injuries, found that 45 percent had symptoms of post-traumatic stress disorder (PTSD) when they started treatment. And those with a greater sense of "perceived injustice" about their situation were more likely than others to still have PTSD symptoms at the end of their rehab program.
In fact, the study found, feelings of injustice -- in particular, feeling like the victim of someone else's negligence -- were the only strong predictor of whether PTSD symptoms persisted.
Patients with more-severe pain and disability were at relatively greater risk of developing PTSD symptoms in the first place. But those physical symptoms were not related to the risk of lingering post-traumatic stress.
The researchers, led by Dr. Michael J. L. Sullivan of McGill University in Montreal, Canada, report their findings in the latest issue of the journal Pain.
They say their results raise the possibility that treating patients' pain early on might prevent serious PTSD symptoms in the first place -- and that addressing people's sense of injustice may help keep any symptoms from becoming chronic.
Other studies, the team notes, have pointed to the importance of psychological factors in recovery from whiplash -- an injury to the neck's soft tissue, including muscles, ligaments and discs, which typically occurs during a car accident that sends the head and neck suddenly forward and back.
One recent study found that whiplash patients who were more optimistic about their recovery were less likely than their pessimistic counterparts to have disabilities six months later -- even when the severity of the injury was taken into account.
These latest findings suggest that attitude may also affect the odds of lingering PTSD, an anxiety disorder marked by symptoms such as nightmares or flashbacks of the traumatic event.
It is not clear how common PTSD is after whiplash injuries, but some studies suggest that up to 30 percent of patients have PTSD symptoms one month after their accident.
The higher rate seen in this study (45 percent) may owe to the fact that the patients had all been referred to a recovery program because they were still off of work eight weeks after their accidents, according to Sullivan's team. Other research suggests that 60 percent to 70 percent of whiplash sufferers return to work within two months.
The researchers also stress that their findings point only to an association between perceived injustice and persistent PTSD; they do not prove that the former causes the latter.
re: PTSD in the news: Octobermessage #: 4084.4 in response to 4084.1
Katie Drummond on True/Slant:
http://trueslant.com/katiedrummond/2009/10/07/vision21-ptsd-traumatic-disorder/
Tweeting traumatic stress: An online initiative for PTSD
It’s impossible to know how many troops coming back from Iraq and Afghanistan are suffering from PTSD, but estimates suggest that the rates are unprecedented. The number of PTSD diagnoses have “risen steadily” in the past few years, according to Veterans Affairs, and one team of researchers is warning that 35 percent of returning troops will be afflicted. But less than a quarter of vets seek help, meaning that too few are being diagnosed – let alone treated.
The Pentagon is heeding warnings about the crisis, by hiring more mental health staff and funding more suicide-prevention programs. They’ve even launched a $50-million-dollar research project to determine the underlying causes of veteran suicide, which reached an all-time high this summer. And, as I reported for Danger Room in August, they’re also trying to prevent PTSD before it starts, using pharmaceutical intervention to short-circuit stress reactions.
But pill-popping prevention is a ways off. For now, there’s another initiative harnessing 21st century tech to bolster soldier wellness. The program is Vision 21, and its founders are using online social networking to help vets reintegrate into day-to-day life. Ali Reza Manouchehri , the CEO of MetroStar Systems, who launched the program, tells me that Vision 21 is for the Gen-Y Warrior. “We’re living in a new era, where people, especially those between 18-24, are connected like they never used to be,” he says. “Why not reach out to them using Twitter, using YouTube, using the web?”
MetroStar, a company that specializes in government software innovation, came up with the idea of an online PTSD project nearly two years ago, at the urging of Col. Randall Falk, a National Guard medical director who organized a meeting-of-the-minds around social networking in the military. A group of experts, from Israeli defense staffers to cognitive scientists, batted around ideas on how the Internet could help stress mitigation, both overseas and back home.
From there, MetroStar got a grant from the Kansas National Guard, and started working on an Internet hub for troops, commanders and military families. Members can log in, then search using a drill-down engine that zeroes in on others in similar circumstances. Ross Beurmann, now home after serving in Iraq, says he found other vets who were parents reintegrating into family life. “I’m a father of two, so I wanted to get advice from other people in my position,” he says. “And I’m not a religious person, so maybe hearing someone who coped with scripture wouldn’t help me.”
The segmented search allows for quick, on-target, human connections, and personal advice based on individual circumstances. Delineations include spirituality, age and family, and commanders can also search for tips on helping their troops manage war-time distress. The program also incorporates Facebook groups, Twitter updates, video journals and interactive games. And Vision 21 will be accessible on mobile phones and handsets in addition to computers, so that troops overseas are more likely to have access.
Right now, the Vision 21 website is still a pilot project. But MetroStar has big plans for the near future: they’ve been sub-contracted by Lockheed Martin to develop a publicly-accessible search engine on the stress reduction, veteran reintegration and PTSD treatment programs and research going on around the world.
But for Beurmann, the biggest benefit to Vision 21 isn’t the advice or the networking. It’s the potential to minimize PTSD stigma. “Trust me, you can lose your job if they find out you’re dealing with post-traumatic stress. Troops are scared to admit it,” he says. “The anonymous element of these interactive tools is huge, because more people might start reaching out for help.”
re: PTSD in the news: Octobermessage #: 4084.5 in response to 4084.1
From Dartmouth.com:
http://thedartmouth.com/2009/10/08/news/dms/
DMS researchers study PTSD, substance abuse
By Christina Wray
Published on Thursday, October 8, 2009
The Cutting Edge
----------
Patients suffering from both substance abuse and post traumatic stress disorder are most successfully treated when the two conditions are addressed simultaneously, according to a study by Dartmouth Medical School faculty members published in the October issue of the journal Addictive Behaviors.
Study participants received cognitive behavioral therapy, a psychiatric treatment that changes thought patterns established as a result of the trauma, according to DMS researcher and project coordinator Stephanie Acquilano.
The study examined the effectiveness of a specific form of cognitive behavioral therapy in treating substance addiction and PTSD simultaneously. PTSD is traditionally not addressed until up to a year after addiction treatment, according to the study’s principal investigator, DMS professor Mark McGovern.
“I’ve treated many patients with substance use disorders, and I noticed in my clinical work that many patients had experiences of trauma in their background,” McGovern said in an interview with The Dartmouth. “With [trauma experience], their chances of getting better from substance abuse were particularly complicated.”
Many people who suffer from PTSD initially turn to substances to avoid their symptoms, McGovern said. When substance abusers attempt to quit, their trauma symptoms “come back with a vengeance,” he said.
“Because of the way addiction and PTSD interact with each other, people who have both are less likely to recover from either one,” Acquilano said.
Many textbooks advise against treating PTSD at the same time as substance abuse to avoid drawing the patient’s attention to the negative emotions resulting from the trauma, McGovern said, adding that recurring trauma symptoms often lead patients to discontinue treatment for substance abuse.
McGovern said, however, that “the best approach is an integrated approach dealing with both at the same time.”
Between 25 percent and 42 percent of substance abusers also suffer from PTSD, Acquilano said. In some cases, the trauma resulted from the substance use itself.
Only 27 percent of patients suffered from PTSD immediately following the cognitive behavior therapy treatment, the researchers found. At the three month follow-up, only 20 percent of the patients still reported symptoms of PTSD. The number of patients suffering from substance abuse also decreased, Acquilano said, although the study did not specify by how much.
Patients continued to improve after the three month follow-up because they had learned a set of skills through the cognitive behavior therapy, including relaxation techniques, to help them cope with their disorders, Acquilano said. Patients were also taught about PTSD symptoms, she said.
Since research has already shown cognitive behavior therapy to be an effective treatment for PTSD, the study results were not surprising, DMS professor Janine Scheiner, who was not an author on the study, said in an interview with The Dartmouth.
Scheiner compared the findings of the study to previous findings about the treatment of co-occurring substance addiction and bipolar disorder.
“We used to say that you can’t tell if there’s a mood disorder unless the patient had been off substances for six to 12 months,” Scheiner said. “Once they realized that they had to manage the mood instability, the substance abuse treatment was much more effective.”
McGovern plans to expand on the cognitive behavior therapy study by focusing his efforts on a larger group of patients who suffer from both PTSD and substance abuse, Acquilano said.
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