Importance of anonymity to encourage honest reporting in mental health screening after combat deployment.

Context: US soldiers are required to undergo screening for depression, posttraumatic stress disorder (PTSD), and other mental health problems on return from service in Iraq or Afghanistan as part of routine postdeployment health assessments.

Objective: To assess the influence of the anonymity of screening processes on willingness of soldiers to report mental health problems after combat deployment.

Design: Anonymous and nonanonymous surveys.

Effectiveness of battlefield-ethics training during combat deployment: a programme assessment.

Background: Breakdowns in the ethical conduct of soldiers towards non-combatants on the battlefield are of grave concern in war. Evidence-based training approaches to prevent unethical conduct are scarce. We assessed the effectiveness of battlefield-ethics training and factors associated with unethical battlefield conduct.

Acute stress disorder, depression, and tobacco use in disaster workers following 9/11.

Early posttraumatic psychiatric disorders have not been well studied in disaster workers. This study examined the rates of probable acute stress disorder (ASD), probable depression, increased tobacco use, and their associated risk factors in 9/11 World Trade Center disaster workers. Surveys were obtained from 90 disaster workers (e.

Ethical considerations in military psychiatry.

Military psychiatrists are faced with multiple, difficult questions that shape the context for ethical patient care. These questions are difficult to answer and future efforts, including policy and evidence-based treatment practices, should aim at reducing the ambiguity faced by military psychiatrists. New research should focus on issues as diverse as optimal approaches to informed consent, evidence-derived approaches to protecting confidentiality, outcomes of care for individuals in widely varying military roles, and medication use in the field.

Military family physician attitudes toward treating obesity.

Objective: The goal was to examine current knowledge, attitudes, and treatment practices of family practitioners regarding obesity.

Methods: A cross-sectional, anonymous, self-report survey of active members of the Uniformed Services Chapter of the American Academy of Family Physicians was performed. Measures included demographic information, attitudes toward obese patients, knowledge of associated health risks, and treatment recommendations, rated on a 5-point Likert scale.

Soldier attitudes toward mental health screening and seeking care upon return from combat.

Objective: This study examined soldier attitudes about postdeployment mental health screening, treatment, barriers to care, strategies for overcoming barriers, and settings, personnel and timing for conducting postdeployment mental health screening.

Methods: Deploying soldiers participated in a voluntary anonymous survey.

Results: Of 3,294 soldiers, 2,678 (81.

Models of PTSD and traumatic stress: the importance of research "from bedside to bench to bedside".

The epidemiology and psychology of PTSD noted above is not often considered in neurobiological models of PTSD. Neurobiological models tend to focus on symptoms. This is an important perspective but it does not capture the brains total response to traumatic events.

Postdeployment Health Reassessment: a sustainable method for brigade combat teams.

Objective: The Postdeployment Health Reassessment (PDHRA) was mandated in 2006 and the 3rd Infantry Division was the first unit to perform a large-scale implementation. This article outlines a reproducible model for conducting PDHRA using only existing resources.

Methods: The PDHRA (DD 2900) screening and referral processes are reviewed and data on positive screens are reported.

The evolving role of the division psychiatrist.

With the recent restructuring of Army infantry divisions in the new brigade combat team model, division psychiatrists are facing new and unique demands. This article outlines the varying perspectives of the position and the duties and responsibilities of a division psychiatrist. It provides guidance on how to negotiate the myriad of challenges unique to the position.

Division mental health in the new brigade combat team structure: part II. Redeployment and postdeployment.

Objective: Recent Army transformation has led to significant changes in roles and demands for division mental health staff members. This article focuses on redeployment and postdeployment.

Methods: The postdeployment health assessment behavioral health screening and referral process and redeployment plan are reviewed, and data on postdeployment rates of negative events are reported.

Division mental health in the new brigade combat team structure: part I. Predeployment and deployment.

Objective: Recent Army transformation has led to significant changes in roles and demands for division mental health (DMH) staff members. This article focuses on predeployment and deployment.

Methods: Surveillance of Combat and Operational Stress Reactions data, review of DMH implementation plans, and observations by staff members, providers, and soldiers were reviewed.

Depression in entry-level military personnel.

Objective: The goal was to determine the prevalence of, and risk factors for, depression in an entry-level U.S. Army population.

Post-traumatic stress disorder and depression in health care providers returning from deployment to Iraq and Afghanistan.

Objective: This study examines risk factors for post-traumatic stress disorder (PTSD), depression, and mental health care use among health care workers deployed to combat settings.

Methods: Anonymous surveys were administered to previously deployed workers at a military hospital. PTSD and depression were assessed by using the PTSD Checklist and the Patient Health Questionnaire depression scale, respectively.

Disordered eating in entry-level military personnel.

Objective: The goal was to determine the prevalence of and risk factors for disordered eating in an entry-level U.S. Army population.

Posttraumatic stress disorder and depression in battle-injured soldiers.

Objective: This study examined rates, predictors, and course of probable posttraumatic stress disorder (PTSD) and depression among seriously injured soldiers during and following hospitalization.

Method: The patients were 613 U.S.

Follow-up of Pentagon employees two years after the terrorist attack of September 11, 2001.

Objective: This study examined probable posttraumatic stress disorder (PTSD) and probable depression, degree of psychological distress, and rates of mental health treatment in a sample of Pentagon staff two years after the terrorist attack of September 11, 2001.

Methods: Anonymous surveys were administered to staff at one Pentagon work center. Respondents were asked about exposure to the attack; injuries; exposure to dead bodies or families of the deceased; psychological distress; and use of mental health services.

Psychiatric symptoms and cognitive appraisal following the near sinking of a research submarine.

Objective: This study assessed the stress reactions of a submarine crew forced to abandon their vessel in high seas after flooding and fire damaged their ship.

Methods: The remaining crew members (n = 22) were surveyed 7 months after the incident regarding exposures, initial emotional responses, peritraumatic dissociation, subsequent life events, current safety appraisal, and current symptoms of posttraumatic stress disorder (PTSD) and depression.

Results: At 7 months, 9.

Characteristics of repeat users of an inpatient psychiatry service at a large military tertiary care hospital.

Objective: The purpose of this study was to identify clinical and demographic variables that correlated with readmission to a large tertiary care military psychiatric inpatient service located in the Washington, DC area.

Methods: Data from 983 consecutive inpatient admissions (comprised of 814 individual patients) over a 13-month period (July 1999-July 2000) were abstracted from medical records for retrospective analysis. Repeat users were defined as those individuals receiving two or more inpatient admissions to Walter Reed Army Medical Center during the study period.

Posttraumatic stress disorder, depression, and perceived safety 13 months after September 11.

This study assessed relationships between exposure to the September 11, 2001, terrorist attack, current posttraumatic stress disorder (PTSD), current major depression, and current safety perceptions in a sample of 212 Pentagon staff members 13 months after the attack. Forty-eight respondents (23 percent) had possible PTSD; eight (4 percent) had probable major depression. Respondents who were directly exposed to the attack were more likely to have PTSD and major depression and were less likely to have a perception of safety at work and in usual activities and travel only.

Acute stress disorder, alcohol use, and perception of safety among hospital staff after the sniper attacks.

Objective: This study examined emotional and behavioral effects on hospital staff after a series of sniper shootings in the Washington, D.C., area.

Posttraumatic stress disorder, alcohol use, and perceived safety after the terrorist attack on the pentagon.

Objective: The authors examined posttraumatic stress disorder (PTSD), alcohol use, and perceptions of safety in a sample of survivors of the September 11, 2001, terrorist attack on the Pentagon.

Methods: Analyses were conducted to examine the effect of past traumatic experience, trauma exposure, initial emotional response, and peritraumatic dissociation on probable PTSD, substance use, and perceived safety among 77 survivors seven months after the attack.

Results: Eleven respondents (14 percent) had PTSD.