Trauma Blog

A new perspective on the brain basis of PTSD in Veterans involves alterations in both fear and anxiety networks
Date posted: 09/1/2023
Topic: Military and Combat
PTSD is a common and disabling disorder that impacts many Veterans. This blog discusses our  new study examining how Veterans with PTSD respond to threat in fear and anxiety brain networks. The study findings extend the current understanding of the brain basis of PTSD to include both fear and anxiety networks and highlight new treatment targets. 

Predicting long-term outcomes of Iraq War deployment
Date posted: 09/9/2023
Topic: Military and Combat
In a large cohort of US Army personnel and veterans that were assessed before and after deployment to the Iraq War and at a long-term follow-up assessment, we examined predictors of individual PTSD symptom courses.  Results suggested that in addition to unmodifiable risk factors (e.g., stress exposure), there are potentially modifiable factors (e.g., social support and visual memory processes) that may be a target for preventive efforts. 

Military matters: Emerging hormone-based pharmacological treatments for comorbid PTSD and alcohol use in ‎veterans: An update on science ‎
StressPoints
Date posted: 06/28/2023
Topic: Military and Combat

Posttraumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD) commonly co-occur among ‎veterans.^1,2 PTSD is related to increased alcohol use^3,4 and hazardous alcohol use increases following combat ‎exposure.^5,6 This reciprocal relationship contributes to heightened impairment and lower treatment success.^3,7-9 ‎Individuals with comorbid PTSD/AUD enroll in treatment at higher rates;^3,9 however, they experience poor ‎treatment outcomes. There are no current pharmacological interventions to target comorbid PTSD/AUD.¹⁰ ‎Thus, novel pharmacological treatments are urgently needed to improve treatment outcomes. ‎

What is the psychological impact of suicide exposure among active duty service members?
Date posted: 04/3/2023
Topic: Military and Combat
Millions of people have lost someone in their lives to suicide. Research has shown the profound impact of being exposed to suicide among civilians and veterans, but less information is available about the psychological impact of exposure among active duty service members.  This blog discusses the work done by a team from San Diego State University to investigate the psychological health correlates of suicide exposure among a large clinical sample of active duty service members.

Military Matters: Veteran Psychotherapy and the Use of Military Metaphor
Date posted: 03/30/2023
Topic: Military and Combat
The use of military metaphor in the health sciences has been a topic of recurrent interest and debate for several decades. In that time, writers have decried how “wars” against such scourges as cancer, drugs, and, more recently the COVID-19 pandemic, can shape conceptualizations of these maladies and their treatments in unproductive ways (see, for example, Hauser & Schwarz, 2020; Nie et al., 2016; for an earlier and seminal statement of this position, see Sontag, 1978). Fuks (2010) cautions against this militarized language, in which providers wage war against disease, concerned not only that the disease might supplant the patient as the focus of attention but also that providers themselves might be adversely affected: “it is not simply for patients that medicine must create new metaphors. 
 

Military Matters: Not All Traumas are Created Equal: Phenotypic Heterogeneity of PTSD Symptoms in Relation to Index Traumas in U.S. Military Veterans
StressPoints
Date posted: 12/15/2022
Topic: Military and Combat
Posttraumatic stress disorder (PTSD) is prevalent in military veterans and is associated with reduced mental and physical health functioning as well as overall quality of life (e.g., Hoge, Auchterlonie, & Milliken, 2006; Hoge et al., 2007; Pietrzak et al., 2013). According to the Fifth Edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5, American Psychiatric Association, 2013), PTSD consists of 20 different symptoms. However, not all symptoms are required for a diagnosis of PTSD, and PTSD symptom profiles can vary considerably. Indeed, one study found that there are over 600,000 symptom combinations that could yield a DSM-5 diagnosis of PTSD (Galatzer-Levy & Bryant, 2013). Given such heterogeneity, increased attention has been given to the nature and severity of trauma exposures, as well as the role of index traumas in shaping the phenotypic expression of PTSD symptoms. 

Gender Differences in PTSD and Relationship Functioning
Date posted: 10/7/2022
Topic: Military and Combat
Many clinicians are aware of the painful impact of posttraumatic stress disorder (PTSD) on individuals' lives, including disrupting sleep, interfering with work and hobbies, and damaging self-worth. A growing body of research shows that PTSD is also harmful for some of the most important relationships in people's lives, including relationships with family and intimate partners. This tends to be especially true for military veterans. 

Military Matters: Childhood Trauma Among Veterans: Impact and Implications‎
Date posted: 09/29/2022
Topic: Military and Combat
During my psychology internship training last year at a U.S. hospital within the Department of Veterans Affairs (VA), I co-facilitated an ongoing sexual trauma psychotherapy group for female veterans. Before joining this group, I assumed that it would focus on the veterans’ experiences of military sexual trauma (MST). However, I came to learn that group sessions frequently focused on experiences of childhood abuse. Unfortunately, these veterans were far from alone in their experiences. Childhood trauma is a highly prevalent, yet often under-discussed, issue among veterans. Estimates of the prevalence of childhood trauma among veterans range from 26-85% (Katon et al., 2015). In a large, nationally representative sample of U.S. veterans, one in five had experienced childhood physical or sexual abuse (Nichter et al., 2020). Among female veterans, one review found that 27-49% reported childhood sexual abuse and 35% reported childhood physical abuse (Zinzow et al., 2007). It is important to assess for childhood trauma among veterans, given its high prevalence and the many detrimental ways in which such experiences may influence health and coping.
 

Trauma profiles relate to differential alcohol use risk in military populations and intimate partner violence may be particularly important
Date posted: 09/19/2022
Topic: Military and Combat
It is important to consider a broader range of potentially traumatic exposures among military populations, to address cumulative risk. Our research suggests that non-combat traumatic exposures are common among reserve soldiers, and relate to differential risk for alcohol use, indicating a need for more comprehensive screening and connections to care. 

Do Gender Differences in Prescribing among Veterans with PTSD still Exist?
Date posted: 08/26/2022
Topic: Military and Combat
Women veterans with posttraumatic stress disorder (PTSD) have historically received more psychiatric medications relative to males. Even with increased rates of PTSD and greater numbers of comorbidities, these differences do not account for the gender differences observed in prescribing.