Integration of Arts and Health Sciences in Developing an Opera on Veteran Resilience and Recovery

2021 ◽  
pp. 152483992110654
Author(s):  
Kenneth B. Wells ◽  
Kia Skrine Jeffers ◽  
Joseph Mango
Keyword(s):  
Health Science ◽  
Mixed Data ◽  
Post Traumatic Stress ◽  
Arts And Health ◽  
History Of ◽  
Research Interviews ◽  
Post Traumatic ◽  
Data Informed

There is an emerging literature on research interviews to inform arts projects, but little on opera. This case study illustrates how research data informed an opera on Veteran recovery. Deidentified interviews were selected from 280 adults with a history of depression at 10-year follow-up to a randomized trial. Interviews were used to inform characters, storyline, and libretto. Ethical strategies included: changing details and merging stories and characters to create two Veterans and one spouse as leads, a storyline, and choral passages, with a focus on recovery from post-traumatic stress and homelessness. To engage a broad audience and address stigma, accessible composition techniques (melody, harmony) were used. We found that qualitative/mixed data can inform libretto and composition for an opera on Veteran recovery, through integrating art and health science.

White water kayaking, positive affect, and perceived self-awareness: A case study of a veteran of the Vietnam era

2017 ◽  
Vol 13 (4) ◽  
pp. 41
Author(s):  
Kristen Hartman, MS, CTRS ◽  
Heather Porter, PhD, CTRS
Keyword(s):  
Positive Affect ◽  
Outdoor Recreation ◽  
Therapeutic Modality ◽  
Self Awareness ◽  
Post Traumatic Stress ◽  
Vietnam Era ◽  
History Of ◽  
Post Traumatic ◽  
White Water

Veterans from Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and the Vietnam era have sustained multiple injuries and disabilities as a result of their service, including Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD), and depression. The use of outdoor recreation as a therapeutic modality for civilians with TBI has been found to correlate with greater self-awareness and positive affect, however, scarce literature exists regarding its use and outcomes for veterans. To explore this, a veteran from the Vietnam era reporting a history of depression who is involved with a white water kayaking group completed a series of surveys designed to measure its effect on perceived self-awareness and positive affect. The case study reported that involvement with the white water kayaking group improved his perceived self-awareness. The case study also reported the highest positive affect and lowest negative affect immediately after traveling down the river during a white water kayaking river trip. More research in this area is needed.

Case formulation using pattern-based formulation (PBF) methodology: clinical case 4

2018 ◽  
Vol 26 (6) ◽  
pp. 662-666
Author(s):  
Irosh Fernando ◽  
Lisa Lampe
Keyword(s):  
Traumatic Stress ◽  
Late Onset ◽  
Past History ◽  
Building Blocks ◽  
Case Formulation ◽  
Post Traumatic Stress ◽  
History Of ◽  
Post Traumatic ◽  
Considerable Complexity

Objectives: To provide a further example of the utility of the pattern-based model in formulation, and to introduce some further patterns. Methods: A case study was carried out using the Pattern-based Formulation (PBF). Results: Based on the case of a patient with a past history of trauma who developed late onset somatic symptoms, post-traumatic stress disorder and major depression, the PBF approach enabled development of a comprehensive formulation to explain the patient’s current presentation. Four patterns were utilised. Conclusions: The PBF method of using patterns as building blocks enables development of a psychobiological formulation that can accommodate considerable complexity. PBF represents a broadly applicable method that may assist psychiatry trainees and others to develop good quality formulations.

scholarly journals Comparison of Accelerated Resolution Therapy (ART) for Post-Traumatic Stress Disorder (PTSD) Between Veterans With and Without Prior PTSD Treatment

2021 ◽  
Author(s):  
Tiantian Pang ◽  
Lindsay Murn ◽  
Dana Williams ◽  
Maayan Lawental ◽  
Anya Abhayakumar ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Prior History ◽  
Post Traumatic Stress ◽  
First Line ◽  
Ptsd Treatment ◽  
Treatment Naïve ◽  
History Of ◽  
Post Traumatic

Background: Post-traumatic stress disorder (PTSD) is a psychiatric disorder commonly caused by a traumatic event(s) and prevalent among service members and veterans. Accelerated Resolution Therapy (ART) is an emerging "mind-body" psychotherapy for PTSD that is generally briefer and less expensive than current first-line treatments, such as cognitive processing therapy (CPT) and prolonged exposure (PE) therapy. Objective: This study aimed to examine the results of ART for treatment of military-related PTSD, with stratification by prior history of PTSD treatment, including refractory PTSD following receipt of guideline-driven first-line psychotherapy. Methods: The study compares the PTSD treatment results of ART between (military service members and/or) veterans with a prior history of PTSD treatment (medication only, n=40; first-line psychotherapy, n=33; other psychotherapy, n=42) and a treatment-naive group (n=33). Participants were assessed at baseline, post-treatment, and 3- or 6-month follow-up using PCL-M scores (PTSD checklist). Results: Mean age was 43.8 years, 95% male, 84% white race. The treatment completion rate was 72% with a mean of 3.5 treatment sessions. Within-group standardized effect sizes for pre-to-post changes in PTSD scores (PCL-M) were large at 1.11, 1.88, 1.03, and 1.48 for the medication only, first-line psychotherapy, other psychotherapy, and treatment-naive groups, respectively (p=0.02 for between-group comparison). Similar results were observed for measures of depression and anxiety, and baseline to follow-up results was generally similar. Conclusions: In a brief treatment period, ART appears to result in substantial reductions in symptoms of PTSD among veterans, including those previously treated (unsuccessfully) with first-line psychotherapies endorsed by the U.S. Department of Defense (DoD) and Veterans Affairs (VA). These results suggest that ART be considered as a treatment modality for veterans with refractory PTSD.

scholarly journals An Emulation of Randomized Trials of Administrating Benzodiazepines in PTSD Patients for Outcomes of Suicide-Related Events

2020 ◽  
Vol 9 (11) ◽  
pp. 3492
Author(s):  
Michael Gilbert ◽  
Andrew Dinh La ◽  
Noah Romulo Delapaz ◽  
William Kenneth Hor ◽  
Peihao Fan ◽  
...  
Keyword(s):  
Previous History ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Regression Methods ◽  
Increased Risk ◽  
History Of ◽  
Post Traumatic ◽  
Or History

Benzodiazepines is a class of medications frequently prescribed to patients with post-traumatic stress disorder. Patients with PTSD have a notable increased risk of suicide compared to the general population. These medications have been theorized to increase suicidality and pose a risk when used in this patient population. Previous research has found little utility of using benzodiazepines in the PTSD population. However, benzodiazepines are still commonly prescribed by some clinicians for their symptomatic benefit. This study aims to identify the comparative efficacy of commonly prescribed benzodiazepines including midazolam, lorazepam, alprazolam, clonazepam, diazepam and temazepam in relation to suicide-related behaviors (SRBs). A total of 38,807 patients who had an ICD9 or ICD10 diagnosis of PTSD from January 2004 to October 2019 were identified through an electronic medical record database. Inclusion criteria include patients that initiated one of the above benzodiazepines after PTSD diagnosis. Exclusion criteria include previous history of benzodiazepine usage or history of SRBs within the last year prior to enrollment. For patients enrolled in this study, other concomitant drugs were not limited. The primary outcome was onset of SRBs with each respective benzodiazepine. SRBs were identified as ideation, attempt, or death from suicide. We emulated clinical trials of head-to-head comparison between two drugs by pooled logistic regression methods with the Firth option adjusting for baseline characteristics and post-baseline confounders. A total of 5753 patients were eligible for this study, with an average follow up of 5.82 months. The overall incidence for SRB was 1.51% (87/5753). Head-to-head comparisons identified that patients who received alprazolam had fewer SRBs compared to clonazepam (p = 0.0351) and lorazepam (p = 0.0373), and patients taking midazolam experienced fewer relative incidences of SRBs when compared to lorazepam (p = 0.0021) and clonazepam (p = 0.0297). After adjusting for the false discovery rate (FDR), midazolam still had fewer SRBs compared to lorazepam (FDR-adjusted p value = 0.0315). Certain benzodiazepines may provide a reduced risk of development of SRBs, suggesting careful consideration when prescribing benzodiazepines to the PTSD population.

scholarly journals Suicide among Scottish military veterans: follow-up and trends

2021 ◽  
pp. oemed-2021-107713
Author(s):  
Beverly P Bergman ◽  
Daniel F Mackay ◽  
Jill P Pell
Keyword(s):  
Older Women ◽  
Military Veterans ◽  
Female Veterans ◽  
Veterans Health ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Post Traumatic

ObjectivesThe risk of suicide among UK military veterans remains unclear. Few recent studies have been undertaken, and most studies found no clear evidence of increased risk. We used data from the Trends in Scottish Veterans Health cohort to investigate suicides up to 2017 in order to examine whether there have been any changes in the long-term pattern of veteran suicides since our earlier study to 2012, and to compare trends in the risk of suicide among veterans with matched non-veterans.MethodRetrospective cohort study of 78 000 veterans and 253 000 non-veterans born between 1945 and 1995, matched for age, sex and area of residence, using survival analysis to examine the risk of suicide in veterans in comparison with non-veterans overall and by subgroup, and to investigate associations with specific mental health conditions.ResultsUp to 37 years of follow-up, 388 (0.5%) veterans and 1531 (0.6%) non-veterans died from suicide. The risk of suicide among veterans did not differ from non-veterans overall. Increased risk among early service leavers was explained by differences in deprivation, and the previously reported increased risk in female veterans is now confined to older women. Suicide was most common in the fifth decade of life, and around 20 years postservice. A history of mood disorder or post-traumatic stress disorder was non-significantly more common in veterans.ConclusionsVeterans are not at increased risk of suicide overall. The highest risk for both men and women is in middle age, many years after leaving service.

scholarly journals Moral Resistance in Treatment of Post-Traumatic Stress Disorder

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Mahmud Said
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Rational Emotive Behavior Therapy ◽  
Post Traumatic Stress ◽  
Symptom Scale ◽  
Post Traumatic ◽  
Traumatic Incident

This case study illustrates with a detailed report the treatment of a person with post-traumatic stress disorder (PTSD). The therapist noted that the patient did not improve despite all the necessary psychological interventions taken, the patient’s request for treatment, and his commitment to the treatment. Enquiry revealed that the patient unconsciously preferred to continue suffering and feeling guilty towards his deceased so. The patient was suffering in order to preserve his loyalty to his deceased son, a phenomenon which we name moral resistance. PTSD Symptom Scale Interview (PSSI) was applied pre and post treatment and in follow-up. The Traumatic Incident Reduction (TIR) was the main therapeutic strategy, as well as Rational Emotive Behavior Therapy (REBT). The study found significant effectiveness of TIR and REBT in treatment of moral resistance according to the PSSI scale. The total score decreased from 43, which indicated a very severe level of the disorder, to 10 a week after commencement of the treatment, and to 7 after a month. Scores of 4 was kept constant in 3- and 6- months follow-up.

Life Perspective and Social Health in Acid Burn Victims (Preprint)

2018 ◽  
Author(s):  
Unsa Athar ◽  
Saad-Ur Rahman ◽  
Hafeez Ur Rehman ◽  
Waqar Ahmed ◽  
Shaarif Kaleem
Keyword(s):  
Traumatic Stress ◽  
Social Health ◽  
Post Traumatic Stress ◽  
Young Sister ◽  
Burn Victims ◽  
Negative Change ◽  
Depth Interview ◽  
Post Traumatic ◽  
Socially Isolated

UNSTRUCTURED ABSTRACT: Life perspective, behavior, feelings and social health changes in a victim of acid burn attack. Objective: To determine the changes and life perspective and social health in acid burn victims. Study Design: Case report study Study Duration and Place: The study was conducted in 6-month duration in the department of Plastic Surgery, Mayo Hospital, Lahore. Methodology: This is a case study of unmarried woman and her young sister, who suffered acid burn violence. Two sessions were held. First was to develop the rapport while the second was an in depth interview. Data were collected using a question guide, and was analyzed using Grounded theory. Results: The patient suffered from structural and functional loss after the incident and also suffered from post-traumatic stress disorder. She feels socially stigmatized and isolated. Her life perspective has changed. She received informal social support but required formal social rehabilitation. Lack of legislation has made her feel hopeless because she has not received justice. Conclusion: Our patient is a 20 years old woman, who suffered from an acid throwing attack from a neighbor. Her young sister who was sleeping beside suffered too. The incident has led to a negative change in her behavior, feelings, and life perspective. She is socially isolated. She has had informal support but she needs better formal support. The need of the hour is improvement of public sector rehabilitation for acid burn victims and proper legislation. Keywords: Acid burn victims. Life perspective, social health

scholarly journals An Emulation of Randomized Trials of Administrating Antipsychotics in PTSD Patients for Outcomes of Suicide-Related Events

2021 ◽  
Vol 11 (3) ◽  
pp. 178
Author(s):  
Noah R. Delapaz ◽  
William K. Hor ◽  
Michael Gilbert ◽  
Andrew D. La ◽  
Feiran Liang ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Previous History ◽  
Current Treatment ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Almost All

Post-traumatic stress disorder (PTSD) is a prevalent mental disorder marked by psychological and behavioral changes. Currently, there is no consensus of preferred antipsychotics to be used for the treatment of PTSD. We aim to discover whether certain antipsychotics have decreased suicide risk in the PTSD population, as these patients may be at higher risk. A total of 38,807 patients were identified with a diagnosis of PTSD through the ICD9 or ICD10 codes from January 2004 to October 2019. An emulation of randomized clinical trials was conducted to compare the outcomes of suicide-related events (SREs) among PTSD patients who ever used one of eight individual antipsychotics after the diagnosis of PTSD. Exclusion criteria included patients with a history of SREs and a previous history of antipsychotic use within one year before enrollment. Eligible individuals were assigned to a treatment group according to the antipsychotic initiated and followed until stopping current treatment, switching to another same class of drugs, death, or loss to follow up. The primary outcome was to identify the frequency of SREs associated with each antipsychotic. SREs were defined as ideation, attempts, and death by suicide. Pooled logistic regression methods with the Firth option were conducted to compare two drugs for their outcomes using SAS version 9.4 (SAS Institute, Cary, NC, USA). The results were adjusted for baseline characteristics and post-baseline, time-varying confounders. A total of 5294 patients were eligible for enrollment with an average follow up of 7.86 months. A total of 157 SREs were recorded throughout this study. Lurasidone showed a statistically significant decrease in SREs when compared head to head to almost all the other antipsychotics: aripiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (p < 0.0001 and false discovery rate-adjusted p value < 0.0004). In addition, olanzapine was associated with higher SREs than quetiapine and risperidone, and ziprasidone was associated with higher SREs than risperidone. The results of this study suggest that certain antipsychotics may put individuals within the PTSD population at an increased risk of SREs, and that careful consideration may need to be taken when prescribed.

scholarly journals The association between body mass index and recovery from post-traumatic stress disorder after the nuclear accident in Fukushima

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masato Nagai ◽  
Tetsuya Ohira ◽  
Masaharu Maeda ◽  
Seiji Yasumura ◽  
Itaru Miura ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Error Variance ◽  
Normal Weight ◽  
Post Traumatic Stress ◽  
Post Traumatic

AbstractPost-traumatic stress disorder (PTSD) and obesity share common risk factors; however, the effect of obesity on recovery from PTSD has not been assessed. We examined the association between body mass index (BMI) and recovery from PTSD after the Great East Japan Earthquake. We analyzed 4356 men and women with probable PTSD aged ≥ 16 years who were living in evacuation zones owing to the radiation accident in Fukushima, Japan. Recovery from probable PTSD was defined as Post-traumatic Stress Disorder Checklist-specific scores < 44. Using Poisson regression with robust error variance adjusted for confounders, we compared the prevalence ratios (PRs) and 95% confidence intervals (CIs) for this outcome in 2013 and 2014. Compared with point estimates for normal weight (BMI: 18.5–24.9 kg/m2), especially in 2013, those for underweight (BMI: < 18.5 kg/m2) and obesity (BMI: ≥ 30.0 kg/m2) tended to slightly increase and decrease, respectively, for recovery from probable PTSD. The multivariate-adjusted PRs (95% CIs) for underweight and obesity were 1.08 (0.88–1.33) and 0.85 (0.68–1.06), respectively, in 2013 and 1.02 (0.82–1.26) and 0.87 (0.69–1.09), respectively, in 2014. The results of the present study showed that obesity may be a useful predictor for probable PTSD recovery. Obese victims with PTSD would require more intensive support and careful follow-up for recovery.

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