Post Traumatic Stress Disorder among Veterans

Miles, S. R., Harik, J. M., Hundt, N. E., Mignogna, J., Pastorek, N. J., Thompson, K. E., Freshour, J. S., … McDonald, S. (2017). Delivery of mental health treatment to combat veterans with psychiatric diagnoses and TBI histories. Plos One, 12(9), 1-14.

Combat veterans coming back from Iraq or Afghanistan have been found to have traumatic brain injury and mental health disorders. In fact, as from 2001, more than 2.6 million veterans have left duty and found eligible for health care. Among the many conditions, a majority of these people have been receiving care for the posttraumatic disorder, anxiety, and depressive disorders. In the case of TBI’s, Miles, Harik, Hundt (2017) note that, mild and severe cases of the condition are more common and characterized by a short-term change in mental status. This is then followed by a cognitive such as fatigue, headaches, irritability, anxiety, and depression among others. Along with that, Miles et al. insist that, although moderate or severe traumatic brain injury is less common, they can also end up limiting the individual and restricting their participation in various activities. In light of this, this study examined data from Veterans Health Association database of returning veterans who had been diagnosed with PTSD, anxiety, and depression disorder. The purpose was to unveil the relationship between TBI history and MH service utilization. From the number of participants examined, it was evident that TBI history was associated with increased MH usage service. The results were consistent with a previous study of veterans who had undergone screening for TBI history and MH service use. Similarly, it was also evident that veterans with psychiatric diagnoses and TBI history attend more psychotherapy and medical management as compared to those without traumatic brain injury history. The limitation of the study was in the fact that use of national databases did not provide an independent verification of diagnostic validity. Similarly, although veterans are required by mandate to be screened for TBI, about 8 percent of veterans do not have documented TBI screen. The study recommends future studies to focus on examining if the increase in the use of services by veterans with TBI history has any significance in reducing MH symptoms and recovery of former combatants.

Fullwood, D. (2015). Understanding and managing the health needs of veterans. Nursing Standard, 30(10), 37-43.

As part of their work, military veterans are typically posted in high-risk areas, where they sometimes survive in merely nothing, with high levels of noise, extreme temperatures, and low hygiene level among other health hazardous. It is therefore not surprising that individuals serving in military service are usually at a higher risk of several possible health consequences. Such problems include abuse of alcohol, display of aggressive behavior, anxiety, and depressive disorders as well as post-traumatic stress disorder among others. Female veterans are also likely to display complex issues such as sexual trauma. Unfortunately, even with this known fact, health care professionals do not understand the health needs of veterans fully. In response to demand, the Armed Forces Covenant agreed with the forces and the government to set up healthcare provisions directed at serving the military. As part of the initiative to improve the health care services for veteran military individuals, the author suggests that the medical personnel should have a clear understanding of the needs of veterans to enable them to deliver sensitive and appropriate care.  Healthcare professionals are also advised to always start the patient health assessment with enquiring whether the patient has served in the military. Nonetheless, this knowledge would be futile if the care personnel are not aware of the right way to take care of the individual. The best way to approach this issue is by including learning of veterans’ vulnerability in the curriculum of healthcare professionals to enhance their knowledge of the health risks of the individuals. The study acknowledges that managing the healthcare needs of veterans is hard, due to the nature of their work and risk exposure. Psychological and psychosocial issues are always likely to overlap with mental and physical conditions, but having the knowledge and skills to support them is essential for the healthcare professionals.

Müller, M., Vandeleur, C., Rodgers, S., Rössler, W., Castelao, E., Preisig, M., & Ajdacic-Gross, V. (2014). Factors associated with comorbidity patterns in full and partial PTSD: Findings from the PsyCoLaus study. Comprehensive Psychiatry, 55, 4, 837-848.

Among patients exposed to traumatic stress, there is a high probability of increased risk for various psychiatric disorders, with the most common being post-traumatic stress disorder. Anxiety, mood, and substance-based disorders are also part of frequently recurring conditions. In this context, the study sought to explore existing literature to understand the patterns of DSM-IV Axis-I disorders and antisocial personality comorbid and their relationship to post-traumatic stress disorders. The logistic regressions revealed that high comorbidity with substance-related disorders was highly prevalent in males. Severe and high anxiety and depression disorders were highly widespread in females. Exposure to sexual abuse was also strongly linked to substance-dependent class, where PTSD was likely to follow. However, the study failed to confirm whether predominant males who abused drugs and were exposed to increased risk of interpersonal violence were at a high risk of disorder onsets. Overall, the study broadly contributed to the existing literature on comorbidity of PTSD. The recommendations suggest that screening, prevention, and intervention programs should be put in place and not only target individuals with full PTSD but also those with less severe cases.

Wolf, E. J., & Schnurr, P. P. (2016). Posttraumatic Stress Disorder-Related Cardiovascular Disease and Accelerated Cellular Aging. Psychiatric Annals, 46(9), 527-532.

According to Wolf & Shnurr (2016), posttraumatic stress disorder and cardio-metabolic health conditions are highly related, including stroke and coronary artery disease among others. Consequently, PTSD has been associated with high risks of cardio-metabolic problems, with previous studies providing evidence of behavioral and biological mediators of this relationship. The authors reviewed past studies from 2010 to 2016 to establish the contribution of the behavioral and physiological mechanisms to accelerated cellular aging, which is a risk factor for cardio-metabolic health decrease. After an extensive study, it was revealed that Post Traumatic Stress Disorder highly contributes to cardio-metabolic conditions and its associates such as stroke, pulmonary embolism, MI, angina, and coronary bypass surgery among others. It is also important to understand that the study failed to consider the probability of reversing accelerated PTSD-related cellular aging and if halting has any significance to the reduction of cardiovascular risk and mortality rates. This warrants future studies to unveil the best interventions to early and late stages of PTSD accelerated aging.

Vujanovic, A. A., Niles, B., Pietrefesa, A., Schmertz, S. K., & Potter, C. M. (January 01, 2013). Mindfulness in the treatment of posttraumatic stress disorder among military veterans. Spirituality in Clinical Practice, 1(s), 15-25.

In recent times, there has been a high number of returning veterans with trauma exposure and posttraumatic stress disorder. In line with this, there has been increased mindfulness among mental health treatment programs. Mindfulness in this case focuses on bringing compassion to present experience and various ways in which this move can be helpful to veterans with PTSD. The authors found that increase of utilization of mindfulness in mental health clinics and VHA warrants for more research to establish ways in which mindfulness is likely to reduce psychological problems. We cannot also ignore the fact that the study failed to consider the way mindfulness is described and the components that should be emphasized. Consequently, the study recommended the need to evaluate further the applicability of mindfulness interventions to patients with PTSD.

References

Fullwood, D. (2015). Understanding and managing the health needs of veterans. Nursing Standard, 30(10), 37-43.

Miles, S. R., Harik, J. M., Hundt, N. E., Mignogna, J., Pastorek, N. J., Thompson, K. E., Freshour, J. S., … McDonald, S. (2017). Delivery of mental health treatment to combat veterans with psychiatric diagnoses and TBI histories. Plos One, 12(9), 1-14.

Müller, M., Vandeleur, C., Rodgers, S., Rössler, W., Castelao, E., Preisig, M., & Ajdacic-Gross, V. (2014). Factors associated with comorbidity patterns in full and partial PTSD: Findings from the PsyCoLaus study. Comprehensive Psychiatry, 55, 4, 837-848.

Vujanovic, A. A., Niles, B., Pietrefesa, A., Schmertz, S. K., & Potter, C. M. (January 01, 2013). Mindfulness in the treatment of posttraumatic stress disorder among military veterans. Spirituality in Clinical Practice, 1, 15-25.

Wolf, E. J., & Schnurr, P. P. (2016). Posttraumatic Stress Disorder-Related Cardiovascular Disease and Accelerated Cellular Aging. Psychiatric Annals, 46(9), 527-532.

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