• December 27, 2014

Study examines treatment for PTSD

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Posted: Sunday, November 10, 2013 4:30 am

BELTON — The numbers are staggering. Among the nearly 2.5 million U.S. military personnel who deployed in support of operations in Iraq and Afghanistan, 14 percent show symptoms of post-traumatic stress disorder, according to figures from Veterans Affairs.

As many as 25 percent of returning veterans report some type of psychological problem, such as depression, anxiety, substance abuse or problems sleeping. About 350,000 military personnel are at significant risk for chronic PTSD.

In August, the Defense Department and the VA invested $45 million to study the effectiveness of different types of PTSD treatment.

The funds were used to help create the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience, or STRONG STAR, which is a joint effort between the University of Texas Health Science Center at San Antonio and the VA’s National Center for PTSD in Boston.

Katherine Dondanville, an assistant professor of psychiatry in the school of medicine at the University of Texas Health Science Center at San Antonio, is STRONG STAR’s chief of psychology at the organization’s Fort Hood research site.

Dondanville said the research currently being done looks at the effectiveness of using prolonged exposure and cognitive process therapy on active-duty personnel.

“A lot of the existing research on PTSD has looked at it in the civilian population,” Dondanville said. “It’s looked into PTSD after events like car crashes or sexual trauma but no one has looked at the effects of combat PTSD, which is different because it’s repeated.”

Intensifying treatment

One of the major things being examined at Fort Hood is the effectiveness of intensifying the type of treatment being offered while compressing the schedule of the treatment sessions, Dondanville said.

“Typical prolonged exposure treatment is one to two times a week over five to 10 weeks,” Dondanville said.

“We’re looking to see if it’s as effective if it’s delivered every day for two weeks.”

If a two-week treatment cycle can alleviate symptoms, it would “reduce the impact on the mission,” Dondanville said.

One of the things that Dondanville and the rest of the research team are working against is the perception that PTSD is a permanent illness.

“There’s this idea that PTSD can’t be cured,” Dondanville said. “We have a lot of evidence in the civilian population that shows that 80 percent of people with PTSD can be symptom free within five years.”

She also said that new research shows that PTSD patients who go through prolonged exposure or cognitive processing therapy have a significantly reduced chance of developing PTSD again.

The reduction in relapse rates is because former PTSD patients now have the coping mechanisms to apply to future traumatic events, Dondanville said.

Emerging field

Stacey Young-McCaughan, a professor of psychiatry in the school of medicine at the University of Texas Health Science Center at San Antonio, is the director of research for STRONG STAR and, like many researchers, is trying to find the answer to why some people develop PTSD and others don’t.

“It’s an emerging field, there’s genetics, childhood trauma, environmental factors,” Young-McCaughan said. “It’s what we’re trying to figure out. Why 85 percent of people can go through a traumatic event and be fine.”

Linda Malsbary, a clinical social worker and therapist in Temple who works with PTSD patients, said she sees many people, civilians and military, who have prior traumatic events.

“Being exposed to a traumatic event in childhood can exacerbate a traumatic event in adulthood,” Malsbary said.

The original traumatic event, such as physical abuse or witnessing domestic violence, creates a negative belief that can resurface with later traumatic events, such as a car wreck or an IED explosion, Malsbary said.

In her work treating military and civilians, Malsbary uses techniques that help her patients process the traumatic events in a safe space, which often allow them to almost relive the events.

“I’ll have soldiers that will feel the heat of an IED blast or smell the smoke,” Malsbary said. “Some report feeling the same pain from when they were injured.”

Increase effectiveness

Dondanville’s research, as well as research done with civilians, has shown that getting to people with PTSD greatly increases the effectiveness of the treatment.

“It’s easier to help people before they start developing habits,” Dondanville said. “If they’ve spent 10, 20 or 30 years pushing people away and barricading themselves in their homes, it’s hard to break those habits.”

Part of the beginning process of treating PTSD is talking to other people about it, Malsbary said.

Many Iraq and Afghanistan veterans aren’t getting involved in organizations such as the VFW or the American Legion, places where they are likely to find sympathetic ears. Part of their reluctance could be because of the age-range of most recent veterans.

“Almost every organization has at least one or two Iraq or Afghanistan vets,” said Rocky Hernandez, veteran service officer for VFW Post 9191 in Killeen.

“But a lot of them are trying to establish themselves in the civilian world.”

Jim Endicott, Bell County’s veteran services liaison, echoed Hernandez’s words.

“The old traditional veterans post, with the bar and the bingo, is old-timers,” Endicott said. “Young veterans are interested in raising families.”

Endicott said one thing attracting younger veterans to organizations is some posts are embracing motorcycle culture.

“Younger veterans are more into motorcycles,” Endicott said. “My American Legion post wouldn’t be open today if it wasn’t for the riders.”

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