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The Voice of Nursing Education

Post-Traumatic Stress Disorder

Dolan, S., Martindale, S., Robinson, J., Kimbrel, N. A., Meyer, E. C., Kruse, M. I., . . . Gulliver, S. B. (2012). Neuropsychological sequelae of PTSD and TBI following war deployment among OEF/OIF veterans. Neuropsychology Review, 22(1), 21-34. doi:10.1007/s11065-012-9190-5
This article synthesizes neuropsychological and neuroanatomical imaging studies that focus on post-traumatic stress disorder and mild traumatic brain injury (mTBI), noting that both diagnoses are highly prevalent among veterans of the conflicts in Iraq and Afghanistan. The article identifies gaps in the literature and future research directions.

Erbes, C. R., Meis, L. A., Polusny, M. A., Compton, J. S., & Wadsworth, S. M. (2012). An examination of PTSD symptoms and relationship functioning in U.S. soldiers of the Iraq war over time. Journal of Traumatic Stress, 25(2), 187-190. doi:10.1002/jts.21689
This research examines associations between overall post-traumatic stress disorder, symptom clusters of PTSD (re-experiencing, avoidance, dysphoria, and arousal), and relationship adjustment cross-sectionally and longitudinally in a sample of US National Guard soldiers from the Iraq war and their intimate partners.

Gerlock, A. A., Grimesey, J. L., Pisciotta, A. K., & Harel, O. (2011). Documentation of screening for perpetration of intimate partner violence in male veterans with PTSD. American Journal of Nursing, 111(11), 26-32; quiz 33-24. doi:10.1097/01.NAJ.0000407296.10524.d7
This study sought to investigate the relationship between PTSD and relationship conflict and intimate partner violence (IPV) among male veterans. The authors also examined what steps were taken to screen for IPV perpetration in this population. Results in this sample revealed that less than a quarter of male veterans with PTSD had a documented screening. Recommendations include a call for health care providers to be more aware of opportunities for screening for IPV in this population.

Goodson, J., Helstrom, A., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Powers, M. B. (2011). Treatment of posttraumatic stress disorder in U.S. combat veterans: A meta-analytic review. Psychological Reports, 109(2), 573-599.
The authors conducted a literature review and analysis of research that PTSD and a variety of psychotherapeutic treatments and responses associated with these interventions. Veterans who participated in exposure-based interventions showed the highest within-group effect size. Results of this meta-analysis were positive for treatment seekers for combat-related PTSD in VA settings.

Hassija, C. M., Jakupcak, M., Maguen, S., & Shipherd, J. C. (2012). The influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans. Journal of Traumatic Stress, 25(2), 216-219. doi:0.1002/jts.21686
The study evaluated the impact of combat and interpersonal trauma exposure in a sample of US women veterans from Gulf War I and the Iraq and Afghanistan wars on three postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Findings highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Recommendations to aid in mental health treatment planning include incorporating combat exposure into routine screening procedures for Gulf, Iraq, and Afghanistan wars' women veterans.

Hayes, J., Wakefield, B., Andresen, E. M., Scherrer, J., Traylor, L., Wiegmann, P., . . . DeSouza, C. (2010). Identification of domains and measures for assessment battery to examine well-being of spouses of OIF/OEF veterans with PTSD. Journal of Rehabilitation Research and Development, 47(9), 825-840.
Soldiers returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) have been identified as at risk for PTSD; family members play an important role in the physical and mental recovery process. The objective of this study was to identify appropriate assessment measures for examining the well-being of spouses assisting with veterans' recovery and to identify opportunities for supporting veterans' spouses. Future research is needed to elucidate and refine the special needs and issues surrounding PTSD in current and future OIF/OEF veterans and their families.

McNally, R. J. (2012). Are we winning the war against posttraumatic stress disorder? Science, 336(6083), 872-874. doi:10.1126/science.1222069
This article discusses Battlemind, an innovative resilience training program that the US Army has developed as a postdeployment early intervention strategy aimed at reducing the risk for post-traumatic stress disorder.

Nayback, A. M. (2009). PTSD in the combat veteran: Using Roy's Adaptation Model to examine the combat veteran as a human adaptive system. Issues in Mental Health Nursing, 30(5), 304-310. doi:10.1080/01612840902754404
The authors discuss how Roy's Adaptation Model can be an effective framework for nurses to understand the phenomenon of post-traumatic stress disorder in the combat veteran population. The paper highlights current research conducted on PTSD across other disciplines within the context of Roy's model to reveal the idea of the combat veteran as a human adaptive system and to identify gaps for future nursing research.

Nazarian, D., Kimerling, R., & Frayne, S. M. (2012). Posttraumatic stress disorder, substance use disorders, and medical comorbidity among returning U.S. veterans. Journal of Traumatic Stress, 25(2), 220-225. doi:10.1002/jts.21690
This research study examined the independent and interactive effects of PTSD and substance use disorders (SUD) on medical comorbidity among US veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Overall, findings suggest that PTSD had a stronger association with medical comorbidity (in total and across various medical condition categories) than SUD among female and male OEF/OIF veterans.

Ray, S. L., & Vanstone, M. (2009). The impact of PTSD on veterans' family relationships: An interpretative phenomenological inquiry. International Journal of Nursing Studies, 46(6), 838-847. doi:10.1016/j.ijnurstu.2009.01.002
This article examines the impact of PTSD on veterans' family relationships and the impact of these relationships on healing from trauma utilizing an interpretative phenomenological approach. Two major themes emerged on the impact of PTSD on veterans' family relationships: emotional numbing and anger negatively impacts familial relationships; and emotional withdrawal from family support creates a struggle with healing from trauma. The authors concluded that the impact of PTSD on veterans' family relationships, in particular the symptoms of emotional numbing and anger, should be closely followed and recommended that treatment for PTSD include support of the family and interpersonal skills training for military personnel suffering from trauma.

Romanoff, M. R. (2006). Assessing military veterans for posttraumatic stress disorder: A guide for primary care clinicians. Journal of the American Academy of Nurse Practitioners, 18(9), 409-413. doi:10.1111/j.1745-7599.2006.00147.x
The purpose of this study was to educate primary care providers on the physical effects of PTSD, explain why military veterans are at great risk, and describe how to identify PTSD in primary care clients. In a literature review, authors concluded that PTSD is prevalent in the military community because of the frequency and type of trauma seen in the combat zone and that primary care clinicians, including those outside the military health system, are essential in identifying trauma histories and directing clients to appropriate care.

Strom, T. Q., Leskela, J., James, L. M., Thuras, P. D., Voller, E., Weigel, R., . . . Holz, K. B. (2012). An exploratory examination of risk-taking behavior and PTSD symptom severity in a veteran sample. Millitary Medicine, 177(4), 390-396.
The authors of this study conducted an exploratory examination of the relationship between self-reported symptoms of PTSD and an expanded definition of risk-taking behaviors in a sample of veterans at a large midwestern Veterans Affairs Medical Center. In this study, post-traumatic stress disorder symptoms were found to be associated with elevated rates of substance use, thrill seeking, aggression, risky sexual practices, and firearm possession. Results indicated that suicidal ideation and aggressive driving behavior were among the most frequently reported symptoms.

Sutherland, R. J., Mott, J. M., Lanier, S. H., Williams, W., Ready, D. J., & Teng, E. J. (2012). A pilot study of a 12-week model of group-based exposure therapy for veterans with PTSD. Journal of Traumatic Stress, 25(2), 150-156. doi:10.1002/jts.21679
This study assessed the feasibility and acceptability of a group-based exposure therapy (GBET), an intensive group treatment that targets symptoms through repeated imaginable and in vivo exposure, and to examine its effectiveness in reducing veterans' PTSD symptoms. Findings indicate that the abbreviated 12-week GBET protocol is a potentially effective treatment for PTSD.

Whyte, A. (2010). The trauma of war. Nursing Standard, 25(13), 20-21.
Ex-service personnel who develop post-traumatic stress disorder are to be offered better access to care. But there are doubts about how adequate services will be.