Preliminary data suggest rates of male military sexual trauma may be higher than previously reported.

Stigma associated with disclosing military sexual trauma (MST) makes estimating an accurate base rate difficult. Anonymous assessment may help alleviate stigma. Although anonymous research has found higher rates of male MST, no study has evaluated whether providing anonymity sufficiently mitigates the impact of stigma on accurate reporting.

How do deployed health care providers experience moral injury?

Combat deployments put health care providers in ethically compromising and morally challenging situations. A sample of recently deployed nurses and physicians provided narratives that were analyzed to better appreciate individual perceptions of moral dilemmas that arise in combat. Specific questions to be answered by this inquiry are: 1) How do combat deployed nurses and physicians make sense of morally injurious traumatic exposures? and 2) What are the possible psychosocial consequences of these and other deployment stressors? This narrative inquiry involves analysis of ten deployed military nurses' and physicians' aversive or traumatic experiences.

Improving base rate estimation of alcohol misuse in the military: a preliminary report.

Objective: Stigma associated with behavioral health problems in the military pose challenges to accurate base rate estimations. Recent work has highlighted the importance of anonymous assessment methods, yet no study to date has assessed the ability of anonymous self-report measures to mitigate the impact of stigma on honest reporting. This study used the unmatched count technique (UCT), a form of randomized response techniques, to gain information about the accuracy of base rate estimates of alcohol misuse derived via anonymous assessment of Operation Enduring Freedom/Operation Iraqi Freedom active duty service members.

The Saratoga WarHorse project: a case study of the treatment of psychological distress in a veteran of Operation Iraqi Freedom.

Objective: We theorized that ability to direct and control a horse will lead to a sense of empowerment, facilitate a relationship between horse and veteran, lead to a decrease in anxiety, and improve physical and social functioning.

Methods: This case study utilizes the Connection methodology: nonverbal language of the horse in a predictable, sequential, and repeatable method. Psychological testing occurred immediately pre- and post-Connection with follow-up occurring at 2, 4, 6, and 12 wks post-Connection.

Combat health care providers and resiliency: adaptive coping mechanisms during and after deployment.

The purpose of this investigation was to understand the varied health care provider responses to traumas by identifying perceptions of control and self-efficacy, appraisal styles, and postevent coping strategies in active duty military nurses and physicians deployed to combat/terrorist regions. Twenty purposively sampled military health care providers completed a descriptive questionnaire, the Posttraumatic Stress Disorder Checklist, the General Self-Efficacy Scale, and a recorded semistructured interview that was later transcribed and content analyzed. Cognitive-behavioral determinants of healthy response to trauma were used to frame this descriptive interpretive study and to assist with developing a model for healthy adaptation in trauma-exposed health care providers.

Posttraumatic stress disorder and use of psychiatric and alcohol related services: the effect of the 2004-2005 Florida hurricane seasons on veterans.

The purpose of this study was to document preliminary findings of the association between posttraumatic stress disorder (PTSD), mental health service use, and alcohol related health visits among veterans following 2004-2005 Florida hurricane seasons. A retrospective review of the Veterans Health Administration Medical SAS Outpatient Dataset was conducted to identify veterans residing in Florida during the 2004-2005 hurricane seasons with a history of PTSD and/or PTSD and a substance use disorder. It was found that veterans with PTSD residing in counties affected by hurricanes demonstrated an immediate 28 % increase in use of mental health services following hurricane landfall versus veterans residing in non-hurricane affected counties (+28.

The role of military chaplains in mental health care of the deployed service member.

This research utilized a cross-sectional design secondarily analyzing data from active duty military health care personnel who anonymously completed the "2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel." Sample for this analysis of Operation Iraqi Freedom/Operation Enduring Freedom deployed mental health seeking service members was N = 447. Religiosity/spirituality and psychological distress experienced by active duty military personnel who sought help from military mental health providers (MH), military chaplains (CHC) or both (CHC & MH) were explored and compared.

Family stress and posttraumatic stress: the impact of military operations on military health care providers.

This study uses data from the 2005 Department of Defense Survey of Health-Related Behaviors Among Military Personnel to examine relationships between family stress and posttraumatic stress symptoms across 4 subgroups of Operation Iraqi Freedom-deployed (i.e., war in Iraq) or Operation Enduring Freedom-deployed (i.

Stress, coping, and mental health-seeking behaviors: gender differences in OEF/OIF health care providers.

Health care providers (HCPs) are often placed in positions of heightened stress when serving in military operations. As military HCPs have a large number of female providers, there is a concern that gender may influence both risk and resiliency within the health care provider subgroup. The purpose of this secondary analysis of the 2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel (data collected April through August 2005) is to describe stress, coping, and health-seeking behaviors of Operation Enduring Freedom and Operation Iraqi Freedom deployed military health care providers and the role gender may have for both health care officers and specialists.

Gender differences in response to deployment among military healthcare providers in Afghanistan and Iraq.

Background: Despite their growing numbers in the United States military, little has been published on healthcare providers (HCP) or female service members from conflicts in Afghanistan and Iraq. The purpose of this secondary analysis of data from the 2005 Department of Defense (DoD) Survey of Health Related Behaviors Among Active Duty Military Personnel was to determine gender differences in reaction to the impact of operational stress in deployed military healthcare providers.

Methods: The unweighted study sample selected for this data analysis included results from female and male active duty military personnel over the age of 18 years (n=16,146) deployed at least once to Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) within the past 3 years (n=1,425), for a final sample consisting of either officer (healthcare officer) or enlisted (healthcare specialist) personnel (n=455) (weighted n=23,440).

The psychological impact of deployment on OEF/OIF healthcare providers.

The psychological impact of military experience on healthcare providers has received little attention to date. The 2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Personnel was used as a secondary data source, and deployed healthcare officers and healthcare specialists were identified and compared to deployed non-healthcare officers and enlisted personnel: 6,116 respondents were surveyed. Findings revealed clinically significant psychological distress among deployed military healthcare provider respondents including posttraumatic stress symptoms, depression, anxiety, and adverse psychosocial impact, more prominent in the deployed healthcare specialist group.

Combat stressors and post-traumatic stress in deployed military healthcare professionals: an integrative review.

Background:   While there has been a growing body of literature on the impact of combat stressors and post-traumatic stress on military service members involved in current conflicts, there has been little available information that directly examines the impact of these on healthcare providers.

Aims: Aims for this integrative review included: (1) identifying exposures, experiences and other factors influencing stress responses in military healthcare providers previously engaged in a war effort and (2) describing the incidence of post-traumatic stress and related mental health problems in this population.

Review Methods: Using Cooper's integrative review method, relevant documents were collected and analysed using content categories and a coding scheme to assist with identifying and recording data for units of analysis.

Factors contributing to anxious driving behavior: the role of stress history and accident severity.

Although fear and travel avoidance among anxious drivers are well documented, relatively little is known about the behavior of anxious individuals who continue to drive. Previous research has identified three broad domains of anxious driving behavior: exaggerated safety/caution behaviors, anxiety-based performance deficits, and hostile/aggressive driving behaviors. In an effort to explicate factors associated with the development of anxious driving behavior, associations with objective accident severity, accident-related distress, and life stress history were explored among individuals reporting accident involvement (N=317).

Emergencies, disasters, and catastrophic events: the role of rehabilitation nurses in preparedness, response, and recovery.

Rehabilitation nurses play an integral role in helping patients and communities plan for, respond to, and recover from disasters. This article provides an overview of various types of disasters, the terminology used by planners and responders, and the structure that governs the delivery of services, resources, and patient care. Information about specialized training in disaster response and volunteer opportunities through national and state humanitarian relief programs are provided.

Women with PTSD have lower basal salivary cortisol levels later in the day than do men with PTSD: a preliminary study.

Unlabelled: Acute stress responses of women are typically more reactive than that of men. Women, compared to men, may be more vulnerable to posttraumatic stress disorder (PTSD). Whether there are differences between women and men with PTSD in levels of the stress hormone, cortisol, was investigated in a pilot study.

Heart rate of motor vehicle accident survivors in the emergency department, peritraumatic psychological reactions, ASD, and PTSD severity: a 6-month prospective study.

This small-scale study investigates the relationships between the heart rate of motor vehicle accident survivors presenting in the emergency department (ED) and acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) symptom severity. It also examines the relationships between the survivor's heart rate in the ED and peritraumatic dissociation and peritraumatic distress reported 2 weeks posttrauma. Fifty motor vehicle accident (MVA) survivors were assessed 2 weeks, 1 (N = 42), 3 (N = 37), and 6 months (N = 37) post-MVA.

Psychophysiological assessment of youthful motor vehicle accident survivors.

Twenty-one children and adolescents (age range 8-17, mean 12.7 years) who had been in motor vehicle accidents (MVAs), and 14 non-MVA controls matched for age and gender, underwent a psychophysiological assessment in which heart rate, systolic and diastolic blood pressure, and skin conductance were measured during baseline and two stressor phases: mental arithmetic and listening to and imagining a MVA like their own. The eight youth who currently met criteria for PTSD or sub-syndromal PTSD significantly reported more subjective distress to the MVA audiotape than the 13 MVA non-PTSD youth or the 14 non-MVA controls.

One- and two-year prospective follow-up of cognitive behavior therapy or supportive psychotherapy.

We followed up over 90% of 57 motor vehicle accident survivors, who completed a controlled comparison of cognitive behavioral therapy (CBT) to supportive psychotherapy (SUPPORT). One-year results showed a continued significant advantage on categorical diagnosis (PTSD or not) and structured interview measures (CAPS) for CBT over SUPPORT. Other measures generally showed the same results.

Physiological responsiveness of motor vehicle accident survivors with chronic posttraumatic stress disorder.

This study sought to replicate past research that has shown differences in physiological responsiveness among survivors of motor vehicle accidents (MVAs) with posttraumatic stress disorder (PTSD) and those survivors who do not develop this disorder. Such physiological differences have been found specifically with heart rate (HR) reactivity. This study also attempts to account for differences among those survivors with PTSD who do respond physiologically in laboratory situations and those who do not show a physiological response when presented with audiotaped descriptions of their accidents.

Two studies of psychiatric morbidity among motor vehicle accident survivors 1 year after the crash.

We assessed the psychiatric co-morbidity associated with chronic posttraumatic stress disorder (PTSD) (1-2 years) secondary to personal injury motor vehicle accidents (MVAs) in two studies. In Study 1, we compared the results of SCID assessments for 75 treatment-seeking MVA survivors (51 with PTSD and 24 with symptoms but no PTSD). In Study 2, we compared similar results among 132 MVA survivors who had been followed prospectively for 12+ months after their accidents (19 with PTSD, 32 who had PTSD but who had remitted, and 81 who never met criteria for PTSD).

Effect of psychological treatment on cognitive bias in motor vehicle accident-related Posttraumatic Stress Disorder.

The modified or "emotional" Stroop paradigm has been frequently employed in previous evaluations of information processing models of Posttraumatic Stress Disorder (PTSD) and other anxiety disorders. These studies have frequently documented an attentional bias to trauma-specific threatening stimuli in PTSD patients. However, the response of the Stroop color-naming interference effect to psychological treatment has yet to be tested in a trauma population.

Studies of the vicarious traumatization of college students by the September 11th attacks: effects of proximity, exposure and connectedness.

From mid-October 2001 through the end of November 2001, we collected fairly large sets of questionnaires from undergraduates at three public universities (Albany, NY, n = 507, Augusta, GA, n = 336, Fargo, ND, n = 526 ) to assess rate of acute stress disorder (ASD) and level of ASD symptoms following the September 11th attacks, rate of current posttraumatic stress disorder (PTSD) and level of PTSD symptoms, and current level of depressive symptoms resulting from the September 11th attacks. We also gathered information on exposure to media coverage of the attacks, connectedness to the World Trade Center (WTC) and personnel there, and degree of engagement in reparative acts such as giving blood, attending vigils. We found higher levels of ASD, ASD symptoms, PTSD and PTSD symptoms as a function of geographical proximity to New York City (and within the Albany site, proximity of students' homes) and gender.

Of "crashes" and "accidents," a comment on Stewart and Lord.

A. E. Stewart and J.

Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors.

To examine criterion F variables of PTSD, the psychosocial functioning of two samples of motor vehicle accident (MVA) survivors was investigated. Within each sample, comparisons between MVA survivors with and without PTSD were conducted on four psychosocial functioning indices at three time points. In addition, the relationships between specific PTSD symptom clusters and psychosocial functioning indices were examined.

Posttraumatic headache: biopsychosocial comparisons with multiple control groups.

Objective: This study examined somatic, psychological, and cognitive functioning of subjects with posttraumatic headache in comparison with multiple control groups.

Background: Posttraumatic headache is not as widely studied as other forms of headache (eg, tension-type, migraine). Previous research has suggested poor psychological functioning in patients with posttraumatic headache in comparison with other groups of patients with pain; however, this group has yet to be compared with a group of persons who have experienced trauma but are headache-free.