Summarizes key findings and recommendations from Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery (Tanielian and Jaycox [Eds.], MG-720-CCF, 2008), a comprehensive study of the post-deployment health-related needs associated with post-traumatic stress disorder, major depression, and traumatic brain injury among veterans of Operations Enduring Freedom/Iraqi Freedom.
Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme
Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.
A complete guide to an innovative, research-based brief treatment specifically developed for service members and veterans, this book combines clinical wisdom and in-depth knowledge of military culture. Adaptive disclosure is designed to help those struggling in the aftermath of traumatic war-zone experiences, including life threat, traumatic loss, and moral injury, the violation of closely held beliefs or codes. Detailed guidelines are provided for assessing clients and delivering individualized interventions that integrate emotion-focused experiential strategies with elements of cognitive-behavioral therapy (CBT). Reproducible handouts can be downloaded and printed in a convenient 8 1/2" x 11" size.
With the contribution from more than one hundred CNS neurotrauma experts, this book provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma including biomarker studies, experimental models, diagnostic methods, and neurotherapeutic intervention strategies in brain injury research. It discusses neurotrauma mechanisms, biomarker discovery, and neurocognitive and neurobehavioral deficits. Also included are medical interventions and recent neurotherapeutics used in the area of brain injury that have been translated to the area of rehabilitation research. In addition, a section is devoted to models of milder CNS injury, including sports injuries.
Includes a foreword by Major General David A. Rubenstein. From the editor: "71F, or "71 Foxtrot," is the AOC (area of concentration) code assigned by the U.S. Army to the specialty of Research Psychology. Qualifying as an Army research psychologist requires, first of all, a Ph.D. from a research (not clinical) intensive graduate psychology program. Due to their advanced education, research psychologists receive a direct commission as Army officers in the Medical Service Corps at the rank of captain. In terms of numbers, the 71F AOC is a small one, with only 25 to 30 officers serving in any given year. However, the 71F impact is much bigger than this small cadre suggests. Army research psychologists apply their extensive training and expertise in the science of psychology and social behavior toward understanding, preserving, and enhancing the health, well being, morale, and performance of Soldiers and military families. As is clear throughout the pages of this book, they do this in many ways and in many areas, but always with a scientific approach. This is the 71F advantage: applying the science of psychology to understand the human dimension, and developing programs, policies, and products to benefit the person in military operations. This book grew out of the April 2008 biennial conference of U.S. Army Research Psychologists, held in Bethesda, Maryland. This meeting was to be my last as Consultant to the Surgeon General for Research Psychology, and I thought it would be a good idea to publish proceedings, which had not been done before. As Consultant, I'd often wished for such a document to help explain to people what it is that Army Research Psychologists "do for a living." In addition to our core group of 71Fs, at the Bethesda 2008 meeting we had several brand-new members, and a number of distinguished retirees, the "grey-beards" of the 71F clan. Together with longtime 71F colleagues Ross Pastel and Mark Vaitkus, I also saw an unusual opportunity to capture some of the history of the Army Research Psychology specialty while providing a representative sample of current 71F research and activities. It seemed to us especially important to do this at a time when the operational demands on the Army and the total force were reaching unprecedented levels, with no sign of easing, and with the Army in turn relying more heavily on research psychology to inform its programs for protecting the health, well being, and performance of Soldiers and their families."
As U.S. service members deploy for extended periods on a repeated basis, their ability to cope with the stress of deployment may be challenged. Many programs are available to encourage and support psychological resilience among service members and families. However, little is known about these programs' effectiveness. This report reviews resilience literature and programs to identify evidence-informed factors for promoting resilience.
Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the psychological toll of these deployments -- many involving prolonged exposure to combat-related stress over multiple rotations -- may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a Presidential Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise. The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it. RAND conducted a comprehensive study of the post-deployment health-related needs associated with these three conditions among OEF/OIF veterans, the health care system in place to meet those needs, gaps in the care system, and the costs associated with these conditions and with providing quality health care to all those in need. This monograph presents the results of our study, which should be of interest to mental health treatment providers; health policymakers, particularly those charged with caring for our nation's veterans; and U.S. service men and women, their families, and the concerned public. All the research products from this study are available at http://veterans.rand.org. Data collection for this study began in April 2007and concluded in January 2008. Specific activities included a critical reviewof the extant literature on the prevalence of post-traumatic stress disorder, major depression, and traumatic brain injury and their short- and long-term consequences; a population-based survey of service members and veterans who served in Afghanistan or Iraq to assess health status and symptoms, as well asutilization of and barriers to care; a review of existing programs to treat service members and veterans with the three conditions; focus groups withmilitary service members and their spouses; and the development of a microsimulation model to forecast the economic costs of these conditions overtime. Among our recommendations is that effective treatments documented in the scientific literature -- evidence-based care -- are available for PTSD and major depression. Delivery of such care to all veterans with PTSD or majordepression would pay for itself within two years, or even save money, by improving productivity and reducing medical and mortality costs. Such care may also be a cost-effective way to retain a ready and healthy military force for the future. However, to ensure that this care is delivered requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the U.S. health care system.
Traumatic brain injury (TBI) may affect 10 million people worldwide. It is considered the "signature wound" of the conflicts in Iraq and Afghanistan. These injuries result from a bump or blow to the head, or from external forces that cause the brain to move within the head, such as whiplash or exposure to blasts. TBI can cause an array of physical and mental health concerns and is a growing problem, particularly among soldiers and veterans because of repeated exposure to violent environments. One form of treatment for TBI is cognitive rehabilitation therapy (CRT), a patient-specific, goal-oriented approach to help patients increase their ability to process and interpret information. The Department of Defense asked the IOM to conduct a study to determine the effectiveness of CRT for treatment of TBI.
