Operator syndrome: Nursing care and considerations for military Special Operators.

Operator syndrome is a common and predictable constellation of interrelated medical and psychiatric conditions and social and functional impairments experienced by special operations forces. Nurses in all settings should be aware of this emerging trend among veterans they encounter in practice so they may identify and intervene using evidence-based approaches and effect a positive outcome.

Efficacy of combined subanesthetic ketamine infusion and cervical sympathetic blockade as a symptomatic treatment of PTSD/TBI in a special forces patient with a 1-year follow-up: A case report.

Co-occurrence of posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) symptoms are particularly prevalent in the special operations forces' community, along with other related conditions (e.g., endocrine dysregulation, sleep disorders, chronic pain).

History of childhood physical abuse is associated with gut microbiota diversity among adult psychiatric inpatients.

Background: Traumatic life events are associated with the development of psychiatric and chronic medical illnesses. This exploratory study examined the relationship between traumatic life events and the gut microbiota among adult psychiatric inpatients.

Methods: 105 adult psychiatric inpatients provided clinical data and a single fecal sample shortly after admission.

Differential co-expression networks of the gut microbiota are associated with depression and anxiety treatment resistance among psychiatric inpatients.

Background: Comorbid anxiety and depression are common and are associated with greater disease burden than either alone. Our recent efforts have identified an association between gut microbiota dysfunction and severity of anxiety and depression. In this follow-up, we applied Differential Co-Expression Analysis (DiffCoEx) to identify potential gut microbiota biomarker(s) candidates of treatment resistance among psychiatric inpatients.

Transition from Military Service: Mental Health and Well-being Among Service Members and Veterans with Service-connected Disabilities.

Transitioning from military service is stressful for veterans with service-connected disabilities seeking civilian employment. This descriptive study examined self-assessed mental health, well-being, and substance use of men and women shortly before or after transition from US military service, compared to norms from community and military samples. As part of a prospective study evaluating an innovative employment program, researchers interviewed 229 current and former service members with service-connected disabilities transitioning from U.

Personality trait domains predict psychiatric symptom and functional outcomes.

A review of high intensity, high dose mentalization-based inpatient psychiatric treatment indicated large effect-size reductions in symptoms of depression, anxiety, somatization, and improving emotion-regulation functioning (Allen et al., 2017). This study examined the impact of pathological personality traits has on baseline symptoms and functioning, as well as their impact on the longitudinal course in a large cohort of adult inpatient psychiatric sample ( = 804).

Evaluation of an Employment Intervention for Veterans Transitioning From the Military: A Randomized Controlled Trial.

Military personnel face numerous challenges transitioning from military jobs to meaningful civilian employment. The Independence Project compared an innovative employment program (National Career Coach Program) with standard employment services (Local Community Resources) in a randomized controlled trial. Study participants were transitioning veterans with self-reported service-connected disabilities seeking permanent employment.

Attachment Style Mediates the Relationship between Trauma and Somatic Distress among Individuals with Serious Mental Illness.

: Individuals with mental illnesses severe enough to require psychiatric hospitalization often have significant trauma histories, have developed maladaptive attachment styles, and experience comorbid somatic distress. Gaining an understanding about the interaction of such factors may lead to prioritizing interventions that target factors that mediate the relationship between trauma and adverse somatic distress. Prior research has examined various mediation models, but results have been mixed and conducted only on outpatient samples.

Naturalistic Study of Posttraumatic Stress Disorder Among Israeli Civilians Exposed to Wartime Attacks.

Objective: Civilians who survive wartime attacks commonly experience substantial psychological distress, including acute stress reactions (ASRs) and posttraumatic stress disorder (PTSD). The authors sought to determine the level of Israeli civilian exposure to wartime attacks, prevalence of posttraumatic stress disorder (PTSD) and physical injuries, and associated medical costs over a 7-year period.

Methods: Data from the National Insurance Institute of Israel on civilian survivors of wartime attacks in the 2009-2015 period were retrospectively examined.

Improving Psychiatric Care Through Integrated Digital Technologies.

This manuscript provides an overview of our efforts to implement an integrated electronic monitoring and feedback platform to increase patient engagement, improve care delivery and outcome of treatment, and alert care teams to deterioration in functioning. Patients First utilizes CareSense, a digital care navigation and data collection system, to integrate traditional patient-reported outcomes monitoring with novel biological monitoring between visits to provide patients and caregivers with real-time feedback on changes in symptoms such as stress, anxiety, and depression. The next stage of project development incorporates digital therapeutics (computerized therapeutic interventions) for patients, and video resources for primary care physicians and nurse practitioners who serve as the de facto front line for psychiatric care.

Diagnostic accuracy of DSM-5 borderline personality disorder criteria: Toward an optimized criteria set.

Objective: The polythetic system used by the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) for diagnosing borderline personality disorders (BPD) is far from optimal; however, accumulated research and clinical data are strong enough to warrant ongoing utilization. This study examined diagnostic efficiency of the nine DSM-IV BPD criteria, then explored the feasibility of an optimized criteria set in classifying BPD.

Methods: Adults (N=1,623) completed the Structured Clinical Interviews for DSM-IV Axis II Disorders resulting in a BPD group (n=352) and an inpatient psychiatric control group (PC) with no personality disorders (n=1,271).

Predicting depression outcomes throughout inpatient treatment using the general and specific personality disorder factors.

Background: Clinical intuition suggests that personality disorders hinder the treatment of depression, but research findings are mixed. One reason for this might be the way in which current assessment measures conflate general aspects of personality disorders, such as overall severity, with specific aspects, such as stylistic tendencies. The goal of this study was to clarify the unique contributions of the general and specific aspects of personality disorders to depression outcomes.

"Operator syndrome": A unique constellation of medical and behavioral health-care needs of military special operation forces.

Objective: U.S. military special operation forces represent the most elite units of the U.

Opponent Effects of Hyperarousal and Re-experiencing on Affective Habituation in Posttraumatic Stress Disorder.

Background: Aberrant emotion processing is a hallmark of posttraumatic stress disorder (PTSD), with neurobiological models suggesting both heightened neural reactivity and diminished habituation to aversive stimuli. However, empirical work suggests that these response patterns may be specific to subsets of those with PTSD. This study investigates the unique contributions of PTSD symptom clusters (re-experiencing, avoidance and numbing, and hyperarousal) to neural reactivity and habituation to negative stimuli in combat-exposed veterans.

National Study of Childhood Traumatic Events and Adolescent and Adult Criminal Justice Involvement Risk: Evaluating the Protective Role of Social Support From Mentors During Adolescence.

Objective: With nearly 11 million people in the United States arrested in 2015, the need to identify antecedent risk factors driving criminal justice involvement (CJI) and possible mitigating factors is crucial. This study examines the relation between childhood trauma and CJI in adolescence and adulthood and assesses how this relation is moderated by mentoring during young adulthood.

Methods: The analysis included 3 waves of data-adolescents, young adults, and adults-collected from 1995 to 2008 from 12,288 adolescents who participated in the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of adolescents in grades 7 to 12.

Assessment of the revised Difficulties in Emotion Regulation Scales among adolescents and adults with severe mental illness.

The Difficulties in Emotion Regulation Scale (DERS) comprising 36 items has been widely used across age, gender, psychopathology, language, and culture. Recently several alternative abridged forms have been introduced, namely, the DERS-16 (Bjureberg et al. 2016), the DERS-SF (Kaufman et al.

Differentiating bipolar disorder from borderline personality disorder: Diagnostic accuracy of the difficulty in emotion regulation scale and personality inventory for DSM-5.

Background: Confusion abounds when differentiating the diagnoses of bipolar disorder (BD) from borderline personality disorder (BPD). This study explored the relative clinical utility of affective instability and self-report personality trait measures for accurate identification of BD and BPD.

Methods: Receiver operator characteristics and diagnostic efficiency statistics were calculated to ascertain the relative diagnostic efficiency of self-report measures.

Associations of Adolescent Exposure to Severe Violence with Substance Use From Adolescence into Adulthood: Direct Versus Indirect Exposures.

Background: While previous research has documented the impact of violence on substance use, none has looked longitudinally across the lifespan to measure independent effects of direct and indirect violence exposure.

Objective: To examine independent associations between adolescent experiences of violence and subsequent substance use in adolescence and adulthood in the United States.

Method: Using the National Longitudinal Study of Adolescent to Adult Health (N = 12,288), we examined being shot or stabbed ("experienced"), being threatened with a knife or gun ("threatened"), and seeing someone either shot or stabbed ("witnessed") during adolescence (Wave I) as correlates of substance use in adolescence and adulthood (Wave IV) via logistic regression.

Lessons learned while integrating patient-reported outcomes in a psychiatric hospital.

In today's world of smart-device monitoring systems, clinicians may be lulled into the assumption that we can download software to monitor our patients' psychological and behavioral functioning with little or no effort or follow-up. This belief is as erroneous as it is tempting; in fact, implementing effective and efficient systems for utilizing patient-reported outcomes (PROs) in daily practice and research takes a virtual village of stakeholders, clinicians, developers, analysts, and clinical researchers. Here, we describe the iterative processes required for designing, implementing, and updating a large-scale inpatient psychiatric quality improvement/research platform that provides real-time feedback to clinicians and patients.