scholarly journals Resilience in the aftermath of war trauma: a critical review and commentary

2014 ◽  
Vol 4 (5) ◽  
pp. 20140008 ◽  
Author(s):  
Brett T. Litz
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
War Trauma ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Traumatic Life Events ◽  
Military Trauma ◽  
The Face ◽  
Post Traumatic

The resilience construct has received a great deal of attention as a result of the long wars in Iraq and Afghanistan. The discourse about resilience, especially the promise of promoting it and mitigating risk for serious post-traumatic negative outcomes among service members and veterans, is hopeful and encouraging. Remarkably, most service members exposed to horrific war trauma are not incapacitated by the experience. Yet, resilience is elusive and fleeting for many veterans of war. In this paper, I address some of the complexities about resilience in the context of exposure to war stressors and I offer some assumptions and heuristics that stem from my involvement in the dialogue about resilience and from experiences helping prevent post-traumatic stress disorder among active-duty service members with military trauma. My goal is to use my observations and applied experiences as an instructive context to raise critical questions for the field about resilience in the face of traumatic life-events.

scholarly journals Post-mTBI Pain Interference in a U.S. Military Population: A Chronic Effects of Neurotrauma Consortium Study

2020 ◽  
Author(s):  
Bilal R Khokhar ◽  
Megan A Lindberg ◽  
William C Walker
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Pain Interference ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Chronic Effects ◽  
Post Traumatic

ABSTRACT Introduction Chronic pain is a significant problem for service members and veterans with mild traumatic brain injury (mTBI). While the root cause of pain is not clearly understood, comorbidities may contribute to how their pain disrupts their functional status, a construct termed “pain interference.” The purpose of this study is to examine the associations between mTBI, other comorbidities, and pain interference. Materials and Methods The sample comprised participants with mTBI(s) from The Chronic Effects of Neurotrauma Consortium multicenter observational study. Potential concussive events were identified using a modified Ohio State University traumatic brain injury (TBI) Identification interview and then further with a structured interview. Pain interference was measured with the TBI quality-of-life pain interference score, which was categorized into insignificant, moderate, and high pain interference. Comorbidities of interest included anxiety, depression, post-traumatic stress disorder, insomnia, and arthritis. Multivariable relationships were analyzed using logistic regression. Results The analysis sample included 346 participants with mTBI(s). In adjusted analysis, those with high pain interference were more likely to have history of ≥ 3 TBIs (odds ratio (OR) 3.1, 95% confidence interval [CI] 1.4, 6.9) and to have clinical levels of post-traumatic stress disorder (OR 5.4, 95% CI 1.9, 15.7), depression (OR 2.5, 95% CI, 1.0, 6.1), anxiety (OR 4.9, 95% CI, 2.0, 11.7), and sleep disturbances (OR 6.1, 95% CI 2.0, 19.0) versus those with insignificant pain interference. Conclusion These results identify clinical features of veterans and service members with mTBI(s) who are at highest risk for pain-related disability. These findings also demonstrate the need to consider mental health and sleep problems in their pain evaluation and treatment approach.

Post-traumatic stress disorder symptom severity in service members returning from Iraq and Afghanistan with different types of injuries

CNS Spectrums ◽  
2012 ◽  
Vol 17 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Robert N. McLay ◽  
Jennifer Webb-Murphy ◽  
Paul Hammer ◽  
Stacy Volkert ◽  
Warren Klam
Keyword(s):  
World War I ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Medical Center ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Severity Scores ◽  
Post Traumatic

IntroductionRisk for post-traumatic stress disorder (PTSD) varies in part due to the nature of the traumatic event involved. Both injury and return from combat pose high risk of PTSD symptoms. How different injuries may predispose towards PTSD is less well understood.MethodsA retrospective record review was conducted from 1402 service members who had returned to Naval Medical Center San Diego from Iraq or Afghanistan and who had completed the PTSD Checklist as part of their post-deployment screening. Rates of PTSD were examined in relation to mechanism of injury.ResultsOf those without injury, 8% met Diagnostic and Statistical Manual criteria for PTSD. Thirteen percent of those with a penetrating injury, 29% with blunt trauma, and 33% with combination injuries met criteria for PTSD. PTSD severity scores varied significantly according to type of injury.DiscussionThe World War I concept of “shell shock” implied that blast-related injuries were more likely to result in psychological symptoms than were other injuries. These data may support that idea. Circumstance of injury, population differences, and reporting bias could also have influenced the results.ConclusionThese results suggest that service members with blunt or combination injuries merit particular attention when screening for PTSD.

Post-traumatic stress disorder and depression

1997 ◽  
Vol 170 (5) ◽  
pp. 479-482 ◽  
Author(s):  
Avi Bleich ◽  
Meni Koslowsky ◽  
Aliza Dolev ◽  
Bernard Lerer
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Affective Disorders ◽  
Stress Disorder ◽  
Psychiatric Morbidity ◽  
War Trauma ◽  
Drug Misuse ◽  
Special Focus ◽  
Post Traumatic Stress ◽  
Post Traumatic

BackgroundWe examined psychiatric morbidity following war-related psychic trauma, with a special focus on the depressive comorbidity of post-traumatic stress disorder (PTSD).MethodSubjects consisted of 60 Israeli veterans who sought psychiatric treatment 4–6 years after having been exposed to war trauma. PTSD and psychiatric comorbidity were diagnosed using the Structured Interview for PTSD and the Schedule for Affective Disorders and Schizophrenia.ResultsBoth lifetime (100%) and current (87%) PTSD were the most prevalent disorders. Comorbidity was extensive, with major depressive disorder (MDD) most prevalent (95% lifetime, 50% current), followed by anxiety disorders, minor affective disorders, and alcoholism or drug misuse.ConclusionsWithin post-traumatic psychiatric morbidity of combat origin, PTSD and MDD are the most prevalent disorders. In addition it appears that PTSD, although related to post-traumatic MDD beyond a mere sharing of common symptoms, is of the same time differentiated from it as an independent diagnostic category.

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