Posttraumatic Stress Disorder Among Military Returnees From Afghanistan and Iraq

National Center for PTSD, VA Medical Center, 215 North Main St., White River Junction, VT 05009, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 05/2006; 163(4):586-93. DOI: 10.1176/appi.ajp.163.4.586
Source: PubMed


Mr. K, a 38-year-old National Guard sol- dier, was assessed in an outpatient psy- chiatric clinic several months after he re- turned home from a 12-month deployment to the Sunni Triangle in Iraq, where he had his first exposure to com- bat in his 10 years of National Guard duty. Before deployment, he worked suc- cessfully as an automobile salesman, was a happily married father with children ages 10 and 12 years, and was socially outgoing with a large circle of friends and active in civic and church activities. While in Iraq, he had extensive combat exposure. His platoon was heavily shelled and was ambushed on many occasions, often resulting in death or injury to his buddies. He was a passenger on patrols and convoys in which roadside bombs destroyed vehicles and wounded or killed people with whom he had become close. He was aware that he had killed a number of enemy combatants, and he feared that he may also have been re- sponsible for the deaths of civilian by- standers. He blamed himself for being unable to prevent the death of his best friend, who was shot by a sniper. When asked about the worst moment during his deployment, he readily stated that it occurred when he was unable to inter- cede, but only to watch helplessly, while a small group of Iraqi women and chil- dren were killed in the crossfire during a particularly bloody assault.

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    • "Keywords: prazosin, sleep disturbance, nightmares, PTSD, meta-­‐ analysis 1 I N T R O D U C T I O N Estimates of the lifetime prevalence of Post-­‐Traumatic Stress Disorder (PTSD) vary substantially depending on the population studied (military, police, general adult population, etc.), but most population lifetime estimates are reported to be at around 10% (7.8% in the USA, 9.2% in Canada and 12.2% in Australia) [1-­‐ 3]. PTSD can affect both the mental and physical functioning of individuals and is associated with the presence of comorbid psychiatric conditions and physical illnesses [4]. Despite significant advances in the treatment of PTSD, only 30-­‐50% of patients reach complete remission [5]. "
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    ABSTRACT: Objective Post Traumatic Stress Disorder (PTSD) is a disorder with significant sleep morbidity and limited treatment options. Prazosin may constitute a novel management approach, and has been tested recently in a number of trials. We conducted a meta-analysis to examine the effectiveness of prazosin for nightmares and other sleep disturbances in adults with PTSD. Method A systematic review of databases for randomized, double-blind, placebo-controlled trials of adults diagnosed with PTSD and reporting sleep disturbances that were treated with prazosin was conducted in January 2015. No limitations were placed on language or year of publication. Results Six randomized controlled trials of prazosin for sleep disturbances in patients with PTSD were included (sample n= 240). We found that prazosin was statistically significantly more effective than placebo in improving sleep quality g =0.987, 95% CI (0.324-1.651), reducing overall PTSD symptoms, g =0.699, 95% CI (0.139-1.260), and sleep disturbances in particular g =0.799, 95% CI (0.391-1.234). Conclusions Prazosin showed medium-to-large and statistically significant effects on PTSD symptoms in general and sleep disturbances in particular. While promising, results should be interpreted with caution given the limited total number of participants and the limitations induced by the majority of participants being male and non-civilian.
    General Hospital Psychiatry 10/2015; DOI:10.1016/j.genhosppsych.2015.10.007 · 2.61 Impact Factor
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    • "Schut, De Graaff, & Verweij, 2014). Most studies address emotions in relation to stress or symptoms of posttraumatic stress disorder (PTSD) and are mainly of a more clinical nature (e.g., Engelhard, Olatunji, & de Jong, 2001; Friedman, 2006; Litz et al., 1997; Rademaker, Vermetten, & Kleber, 2009; cf. De Graaff et al., 2014). "
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    ABSTRACT: This study explores the association between different types of morally challenging interactions during military deployment and response strategies (e.g., moral justification), as well as the mediating role of moral emotions. Interviews with Dutch servicemen who participated in military operations (e.g., in Afghanistan, Angola; N = 45) were content coded. We found a relationship between local-cultural and team-related interactions and moral justification; these effects were mediated by other-condemning emotions. Similarly, other-condemning emotions mediated the relationship between local-cultural interactions and relativism. This study points at the importance of other-condemning emotions in shaping military reactions to frequently occurring morally challenging interactions. During a patrol mission in Afghanistan, where I was one of the drivers, we escaped from a suicide attack. A man had blown himself up in a marketplace close by. We are still not sure what his target might have been. Except for him, nobody had died in the incident.. .. Since we were this close to the site, we were commanded to collect body parts and remains of the bomb. After identification, the
    Ethics & Behavior 01/2015; DOI:10.1080/10508422.2014.975815 · 0.78 Impact Factor
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    • "PTSD treatment guidelines support exposure therapy as a first line intervention (e.g., Friedman, 2006; IOM, 2007; VA/DoD Clinical Practice Guideline, 2010). Prolonged Exposure (PE) therapy , the most utilized exposure treatment program for PTSD, has consistently demonstrated efficacy in reducing the symptoms of PTSD and related psychopathology, such as depression, anger, and guilt for both veterans and non-veterans (Cahill, Rauch, Hembree, & Foa, 2003; Foa et al., 1999, 2005; Paunovic & Ost, 2001; Rauch et al., 2009; Resick, Nishith, Weaver, Astin, & Feuer, 2002; Rothbaum, Astin, & Marsteller, 2005; Schnurr et al., 2007; Tuerk et al., 2011). "
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    ABSTRACT: Previous research has consistently demonstrated that Prolonged Exposure (PE) therapy is an effective treatment for posttraumatic stress disorder (PTSD). Traditionally, PE has been studied and delivered on an individual basis. However, the growing number of Veterans in need of PTSD treatment has led to increased interest in group therapies as an efficient way to provide access to care. The current study examined a group and individual hybrid treatment that was developed based on PE principles. Treatment was 12 weeks in length and consisted of 12 one-hour group sessions focused on in vivo exposures, and an average of approximately five-hour long individual imaginal exposure sessions. Data for this study were derived from 67 veterans who participated in 12 cohorts of the Group PE. Significant reductions in PTSD and depression symptoms were found in both completers and intent-to-treat sample analyses. The clinical implications of these findings are discussed. Published by Elsevier Ltd.
    Journal of Anxiety Disorders 12/2014; 30C:23-27. DOI:10.1016/j.janxdis.2014.12.008 · 2.96 Impact Factor
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