Entries in PTSD (31)


How Should Doctors Treat Childhood Trauma?

Jupiterimages/Thinkstock(NEW YORK) -- After tragic events involving children, including the Sandy Hook Elementary School shooting in Connecticut and the kidnapping of 5-year-old Ethan by Jimmy Lee Dykes’ in Alabama, researchers are focusing more attention on how to treat children who’ve experienced trauma to avoid post traumatic stress disorder and other psychological repercussions.  But they have few answers on what course of treatment is best.

Researchers Valerie Forman-Hoffman, Dr. Adam Zolotor and the rest of their team set out in 2010 to pull together data from hundreds of studies to determine which medicines and behavioral therapy produced the best results in traumatized children and adolescents. But they were surprised to find that only 25 studies fit the criteria of being large, randomized and controlled.

“We’re seeing more and more of these [traumas] every day, but we don’t have good evidence for how to make decisions for these kids,” said Forman-Hoffman, a psychiatric epidemiologist at RTI International, a research institute in North Carolina. "This topic is so hard to study when you consider the kids involved and what they’re exposed to. The last thing we want to do when kids are involved in a terrible tragedy and traumatic event is come in with clipboards.”

The review, which was published Monday in the journal of the American Academy of Pediatrics, says in its background that two thirds of children experience a traumatic event before they’re 16 years old.  (This comes from a 2007 study that followed 1,420 children for up to seven years.)  A traumatic event could include seeing or being the victim of domestic abuse, experiencing a natural disaster or witnessing a violent act involving strangers.

Although the Pediatrics review revealed that children taking medications for their trauma didn’t experience fewer signs of trauma than those who didn’t, and that children undergoing cognitive behavioral therapy showed some benefit, it’s hard to determine how heavily to weigh the findings, Forman-Hoffman said. There were also no studies that examined treatment-outcome differences between genders, ages or types of trauma.

“It was very, very surprising to me,” she said. “This is a really important topic.  Nobody seems to be talking about how to get these children who are witnesses to these things treatment.”

Forman-Hoffman and Zolotor only examined studies about non-relational trauma, meaning the person (or thing) afflicting the trauma was not a friend or family member of the child. For instance, a non-relational trauma would be a shooting by a stranger or a national disaster, but not a domestic abuse situation.

Zolotor, a family physician and professor at the University of North Carolina School of Medicine, said he embarked on the study because he often treats patients -- children and adults -- who experienced trauma during their childhood.  He’s not sure of the best early treatment, and added that many children don’t fit neatly into the post traumatic stress disorder diagnosis as adults do.  Sometimes, they experience other symptoms of mental illness.

He, too, expected more studies and studies of better quality during the Pediatrics review. He said he hopes his findings prompt more studies to determine how to treat these children in the future.

“The science is quite immature,” he said. “With the recent experience in Newtown, I think we see this over and over again. ...School of public health officials and practices feel the need to do something, and we don’t have a lot of good guidance on what’s the best thing to do.”

Copyright 2013 ABC News Radio


Former Navy SEAL Chris Kyle's Killing Puts Spotlight on PTSD

iStockphoto/Thinkstock(NEW YORK) -- The shooting death of former Navy SEAL Chris Kyle, an advocate for veterans' mental health, has pushed the problem of post-traumatic stress disorder among American troops to the fore.

Kyle, who was known as America's deadliest sniper, was killed Saturday at a gun range in Erath County, Texas.  The suspect, identified by police as 25-year-old Eddie Ray Routh, is a veteran who served in Iraq and Haiti and who police say may have been suffering from some type of mental illness from being in the military.

A second man, identified by police as 35-year-old Chad Littlefield, was also shot at point-blank range and killed.  Kyle and Littlefield had taken Routh to the shooting range to aid his recovery, police said.

"My heart is breaking," Travis Cox, director of FITCO Cares, the non-profit foundation Kyle co-founded to help ease veterans back into civilian life, said in a statement.  "Chris died doing what he filled his heart with passion -- serving soldiers struggling with the fight to overcome PTSD.  His service, life and premature death will never be in vain."

Routh will be charged with two counts of capital murder, police said on Sunday.

While the details of Routh's mental health are unclear, up to 20 percent of soldiers returning from Iraq and Afghanistan suffer from PTSD, according to a 2008 RAND study.

"The symptoms can range from mildly disturbing to wholly incapacitating," said Dr. Jeffrey Lieberman, chair of psychiatry at Columbia University Medical Center in New York City and president elect of the American Psychiatric Association, describing the nightmares and flashbacks that can haunt soldiers long after their return to civilian life.  "And we're still limited in our understanding of why it occurs, what it consists of and the best approaches to treatment."

One treatment approach involves the slow, steady, re-exposure of patients to their PTSD triggers, according to George Everly, associate professor of psychiatry at Johns Hopkins Bloomberg School of Public Health in Baltimore.

"It makes sense, in a way, re-exposing people to the thing they fear of in small doses, almost like an inoculation so the body says, 'this is uncomfortable, but I can handle it,'" Everly said.  "Under proper, controlled conditions, re-exposure therapy is certainly one of the most popular treatments for PTSD when done by a professional."

Although Kyle was known to take veterans battling PTSD to the shooting range, it's unclear whether Routh suffered from the disorder and whether the activity was intended to expose him to any PSTD triggers, such as gunfire.

"Kind of have an idea that maybe that's why they were at the range, for some type of therapy that Mr. Kyle assists people with," Erath County Sheriff Tommy Bryant told reporters on Sunday.  "I don't know if it's called shooting therapy, I don't have any idea but that's what little bit of information that we can gather so far."

The shooting is the latest in a string of tragedies stirring debates around gun control and mental health.  But Lieberman said the mentally ill "do not contribute substantially to the overall rates of gun violence in this country."

"People with mental illness tend to be overrepresented in these sorts of tragedies largely because their symptoms have gone untreated -- they lack access to care or they lack insight to the fact they need care," he said.

Copyright 2013 ABC News Radio


Denver Woman Sentenced for Faking PTSD to Dodge Jury Duty

Hemera/Thinkstock(DENVER) -- A Denver woman has pleaded guilty to second-degree perjury and attempting to influence a public servant for faking post-traumatic stress disorder to dodge jury duty, according to a statement from the Denver District Attorney.

Susan Cole arrived for jury selection in June 2011 looking purposefully disheveled, wearing curlers in her hair and mismatched shoes, according to an affidavit obtained by the Denver Post.

Cole reportedly told Denver District Court Judge Anne Mansfield she “broke out of domestic violence in the military” and had “a lot of repercussions,” including PTSD.

“Her makeup looked like something you would wear during a theater performance,” court reporter Kelli Wessels told investigators at the time, according to the Denver Post.  “When the judge asked the entire panel if anyone had a mental illness, [Cole] stated she had difficulties getting ready in the morning, which was apparent to me by the way she was dressed.”

Cole was excused from her civic duties.  But her plot was foiled four months later when Judge Mansfield heard a woman bragging about how she faked mental illness to evade jury duty on a local radio show.

The woman, who called herself “Char from Denver,” was Cole, an author who uses “Char” as a pen name, the Denver Post reported.

Cole pleaded guilty Tuesday and was given a two-year deferred judgment for the felony count of attempting to influence a public servant -- a felony -- and two years of probation for the misdemeanor count of second degree perjury, according to the Denver District Attorney.  She is also required to perform 40 hours of community service.

“As a mental health professional, I find this disturbing and upsetting,” Dr. Joseph Calabrese, a psychiatrist at University Hospitals Case Medical Center in Cleveland, told ABC News at the time.  “PTSD is a very serious, life threatening illness.  And things like this tend to trivialize it.”

PTSD is an anxiety disorder brought on by a traumatic event, such as domestic abuse.  The debilitating symptoms -- which include emotional numbing, anger and terrifying flashbacks -- increase the risk of suicide.

“I find these sorts of things distracting and inappropriate,” Calabrese said of Cole’s “manipulative” behavior.  “That sort of criminal behavior has nothing to do with mental illness.”

Copyright 2012 ABC News Radio


Military Wives Stripping Down to Battle PTSD

Ashley Wise(NEW YORK) -- Military wives across the country are stripping down for their soldier husbands to draw attention to what they see as the rampant problem of post traumatic stress disorder.  They say they want to create awareness of the anxiety syndrome and help soldiers and families get support.

Ashley Wise of Fort Campbell, Ky., launched Battling Bare this April to provide a network of support for the soldiers struggling with PTSD after military service.  The project provides an environment for spouses, children and families to share stories and raise awareness of post traumatic battle stress.

"Nobody had an outlet to communicate," said Wise in an interview with ABC News.  "Many, many women are very good at putting on this image of perfection when it was a war zone inside their homes.  We need to make sure they're getting the help that they need."

Wise, 29, said that her husband, Robert Earl Wise, an E-6 Staff Sergeant who did three tours in Iraq, suffered a traumatic brain injury in an IED explosion in Iraq in 2004.  Though he received a purple heart, she says that he never received a brain scan.

Prior to his service in Iraq, Staff Sgt. Wise, 38, had completed eight years with the Marines.  While deployed to Somalia, he had been stabbed in the spine.  Later, while stationed overseas on his second tour, he also saw six people die, and was eventually placed on death notification detail.  His wife says that after years of combat duty, he began to withdraw.

"He has never gotten rid of the Marine Corps hard-a** mentality.  His solution was to drink Crown Royal whisky and pass out," she said.

Last October, as he and Ashley were beset with financial problems and a promotion that hadn't materialized, Robert decided to take all four of his guns and two cases of beer and check into a hotel room.  Thinking quickly, Ashley tracked him down through online transaction records when he didn't show up for a meal, and soon spoke with her despondent husband in the hotel room.

"He said, 'Life is really hard right now.'  He'd never said anything like that," she said.

Ashley decided that she needed to get him the help that he needed, and called his chain of command and got him to sober up.  Soon, he was on the road to recovery.  But in March he took a turn for the worse when Robert Bales, who was in the same company and with whom he did multiple missions during his first tour, allegedly murdered 16 Afghan civilians.  Ashley recalls her husband having an immediate reaction as the news of Bales' alleged rampage ran on TV.

"He quickly logged onto Facebook, and Bobby's page was down," she said.  "By the time I walked into the office he was white, in shock -- 'It's Bobby.  He's a good dad.  How could this have happened?'"

A few weeks later, when another friend ended his life, Staff Sgt. Wise took another sharp turn for the worse.

"He would sit up in the bedroom and stare at the wall.  He was edgy.  I found little bottles of coke, filled with whiskey in random places," Ashley said.

In April, she and her husband went to Military & Family Life Consultants, and the Army Substance Abuse Program, but the couple felt that they were not addressing the source of the problem -- the post traumatic stress that was causing her husband's withdrawal and drinking.

At one point Staff Sgt. Wise's condition became so bad that while having a flashback he broke Ashley's nose.  She said he tells her that he can still smell the body odor of someone he thought was an Iraqi soldier, but turned out to be his wife.

Ashley's frustration with how the Army dealt with PTSD peaked when he was charged with assault after she went to the Army's Family Advocacy Program for help.

"I was very p***ed off, so I started sharing with other wives," she said.  "'This is ridiculous,' I'd say.  April was the height of suicides at Fort Campbell.  I felt like streaking the general's lawn, or the 101st Airborne Command building, but that would end my butt in jail."

She says she was talking to a fellow military wife on her porch when the idea suddenly hit her.  She went into the garage, grabbed her husband's M4, and quickly wrote up her pledge to support her husband.  She then gave her friend a diagram of how to write it up on her back.  

After snapping a photo, she immediately uploaded it to Facebook.  Within hours she was contacted by Military Minds, which helps soldiers suffering from PTSD, who suggested she increase her social media efforts and offered to promote her efforts.  A week after Battling Bare became public, its Facebook page had 1,000 fans.  Now, the page has over 35,000.

Today, Wise says that over 600 women have sent photos to Battling Bare.  It is even getting submissions from kids writing about their fathers on their arms.  The organization's website also provides a forum for military families to share their personal stories and find support.

Copyright 2012 ABC News Radio


Painful Memories May Be Erasable, Study Suggests

Jupiterimages/Thinkstock(NEW YORK) -- Bad memories are hard to shake. But a new study suggests some details can be intentionally forgotten, raising hope for people with depression and post-traumatic stress disorder.

Scottish researchers used words like "barbecue" to cue memories in 30 young men and women, and then tested their ability to forget.

"For the cue word 'barbecue,' they might think of a birthday party," said study author Saima Noreen, a neuroscientist at the University of St. Andrews in Scotland.  "Some of the memories were just embarrassing, like a school friend saying something unpleasant.  Others were more painful, like an inappropriate touch from a family friend."

For each of the 24 cue words, the study subjects were asked to recall a memory in as much detail as possible, explaining its cause, consequence and personal meaning.  A week later, they were shown the same cue words in green or red.

"For the green words, we asked them to describe the memory in detail like before.  But for the red words, we asked them to avoid thinking of the event," said Noreen.

That avoidance appeared to wipe out parts of the memory, as study subjects later asked to recall events linked to red-colored cue words omitted painful details.

"We found people were actually recalling significantly less about the memories they'd been told to suppress," said Noreen.  "Most of the time they recalled the event's cause, but the consequence and personal meaning were more susceptible to being forgotten."

The small study, published in the Journal of Experimental Psychology: Learning, Memory and Cognition, could have big implications for people plagued by painful memories.

"People with conditions like PTSD and depression have intrusive, uncontrollable negative thoughts that make them unable to move on with their lives," said Noreen, who became interested in intentional forgetting while studying depression.  "Our research suggests we can actually reduce or change the accessibility of certain details."

Previous studies have hinted at the ability to deliberately forget, but this is the first to find that painful details may be particularly susceptible to the process, according to Noreen.

Copyright 2012 ABC News Radio


Study Shows Veterans May Be at Risk for Aging at Accelerated Rate

iStockphoto/Thinkstock(NEW YORK) -- Men and women who serve their country come home every day only to suffer from mild traumatic brain injury and post-traumatic stress disorder.  And now there is increasing evidence that there are even more negative consequences to their time in the military: early signs of conditions that are typically seen in older people.

Preliminary research on veterans and active-duty members of the military shows that symptoms like hypertension, elevated cholesterol and glucose levels, and obesity, which are typically seen in older Americans, are plaguing members of the military at a much earlier age, according to Regina McGlinchey, co-director of the Transitional Research Center for TBI and Stress Disorders (TRACTS).

“Other work prior to this has shown a link between PTSD and risk for metabolic syndrome,” said Dr. Ann Rasmusson, a research affiliate with the National Center for PTSD and TRACTS.  "We think that there may be common underlying risk factors for both, plus the trauma and stress they are exposed to may also have influence on cardiovascular risk.”

The center, which began testing veterans who suffer from brain injuries and PTSD in 2010, has seen more than 270 veterans and active-duty members. The center sees veterans of all ages, but the focus has been on those in their 20s and early 30s.

“People are coming in and have one or more of those risk factors, even in very young soldiers,” Rasmusson said. “It’s usually the kind of thing that happens when you’re 45 or 50 and you get a wake-up call. That doesn’t usually happen to people in their 20s.”

“What we are finding is alarming,” McGlinchey said. “We weren’t prepared for the numbers we’ve seen.”

While these findings are only preliminary, both researchers emphasized the importance of treatment.

“This is the earliest this has ever been looked at,” Rasmusson said. “We urge people to come in sooner rather than later for treatment of PTSD and any associated medical problems.”

Copyright 2012 ABC News Radio


Couples Therapy Cuts PTSD Symptoms, Improves Relationships

iStockphoto/Thinkstock(TORONTO) -- According to statistics, veterans with post-traumatic stress disorder, or PTSD, are twice as likely to separate from a spouse or divorce.  But a new study suggests couples therapy can cut PTSD symptoms and keep families together.

"The best way to think of it is as a PTSD treatment that happens to be delivered to couples," said study author Candice Monson, professor of psychology at Ryerson University in Toronto.  "We tried to take what we know about trauma recovery -- that social support and interpersonal relationships are some of the most important factors for overcoming traumatic events -- and incorporate that into PTSD treatment."

The study of 40 couples plagued by PTSD found that those who participated in 15 therapy sessions reported relief from PTSD symptoms and improvements in relationship satisfaction -- even three months after the sessions stopped.  The findings, published Tuesday in the Journal of the American Medical Association, suggest spousal support can boost the response to PTSD treatment.

"We would never say to a cancer patient, 'You're going through this treatment alone,'" said Monson, describing the double standard for psychological illness.  "We would encourage loved ones to be there for the treatment, and understand its course and how they can help."

Dr. Carol Bernstein, associate professor of psychiatry at NYU Langone Medical Center in New York and past president of the American Psychiatric Association, called couples therapy for PTSD "a superb idea."

"The symptoms of psychiatric illness have a tremendous impact on those who love the person suffering.  And to the extent that partners can be engaged in the treatment and educated about the condition and how they can help, the better the outcome for everyone," she said.

Copyright 2012 ABC News Radio


Shooting Witnesses: Shock Value Could Add to PTSD Vulnerability

Medioimages/Photodisc(NEW YORK) -- A shooting erupted at the midnight premiere showing of Dark Knight Rises in an Aurora, Colo., theater complex filled with young adults, teenagers and young children with their families, some dressed in playful Batman-genre costumes.

Everyone expected a night of fun; not a massacre. Smoke bombs went off. A gunman stalked victims in the aisles, killing at least 12 people. Witnesses said blood was everywhere.

The surprise, as well as the magnitude of the mass shooting, was enough to trigger post-traumatic stress symptoms in those who were vulnerable, said Dr. Jeffrey A. Lieberman, psychiatrist in chief at New York Presbyterian Hospital-Columbia University Medical Center and director of the New York State Psychiatric Institute.

"On the emotional Richter scale it was very high," he said. "You go to a movie like Batman because it's fun-loving entertainment, and you are seeing kids in costumes and the last thought you are thinking about is some type of seriously dangerous, potentially life-threatening situation. The contrast adds to the potential for emotional trauma."

One witness told ABC News, "You just smelled smoke and you just kept hearing it. You just heard bam bam bam, nonstop. "The gunman never had to reload. Shots just kept going, kept going, kept going."

Psychiatric experts said it was hard to know who would experience serious after-effects of the attack. Only about 7 to 8 percent of all individuals will go on to develop post-traumatic stress disorder, or PTSD, after such an event, according to the Dart Center for Journalism and Trauma.

Most people, if they are not exposed to repeated trauma like war, are resilient and have extraordinary coping skills. But those who are vulnerable can have lifelong effects, said experts.

"We all have our breaking points," said Lieberman. "Everyone, given sufficient stress, like prisoners of war, have different levels of endurance. But events have a residual effect."

Nine miles away in 1999, among those who witnessed the slaughter of 19 students and teachers at Columbine High School in Littleton, Colo., a handful went on to experience repeated nightmares, flashbacks and anxiety-related disorders.

"Even for those people who were not affected, these are peripheral events for people who live in the town and in the state, and they can have an identification from the geography and connection to this," said Lieberman.

About 10 percent of women develop PTSD sometime in their lives compared with 5 percent of men -- about 5.2 million adults in a given year, according to the Department of Veterans Affairs.

Children, it seems, are more resilient than adults.

"It has an impact on them," said Lieberman. "But they have in place readily defined support systems in family and school social structures."

Those who are most prone to PTSD were directly exposed to a traumatic event -- they were either victims or witnesses, or were seriously injured. But one study after the 9/11 attacks found rippling effects on witnesses.

At one school two blocks from the World Trade Center, about 27 percent of staff members who saw a plane fly into one of the towers lost time from work because of physical symptoms, according to a Centers for Disease Control and Prevention study. About one-third reported symptoms consistent with depression.

The degree to which people are affected is determined by their proximity and how sustained or horrific their exposure; their own psychological make-up and the help they receive after the event.

"Your individual vulnerability and resilience is determined by your genetic make-up, and also in part by the psychological features you have developed over the course of your lifetime -- were you confident and successful and could you overcome experiences, or were you cautious and fearful?" said Lieberman.

The best approach for immediate support is a technique called psychological first aid, according to Robin Kerner, director of quality initiative and outcomes at St. Luke's-Roosevelt Hospital Center in New York City.

Rather than asking people to retell their traumatic stories, responders tend to the victims' immediate needs, reassure and comfort them and "perhaps, most importantly, connect them with their social supports.

"Research has shown that the retelling of the traumatic story in the immediate aftermath can lead to retraumatization and does not provide comfort to victims," said Kerner.

The probability of developing PTSD is increased if the victims had direct exposure or were seriously hurt or believed they or their families were in danger. Reactions such as crying, shaking, vomiting, feeling apart from their surroundings or helpless to get out, can be signals, Kerner said.

An earlier life-threatening event, a history of child abuse or mental problems raises the vulnerability level.

Those exposed to the movie theater shooting through images and reports on Twitter may see these posts and feel anxious or worried.

Viewing such events can be "disturbing if not dangerous" for young children, said Dr. Eugene Beresin, director of training in child and adolescent psychiatry at Massachusetts General Hospital in Boston.

"This has largely been seen and studied in a number of situations, such as the Oklahoma City Bombing, the Challenger disaster and the 9/11 attack," he said. "There is considerable evidence that PTSD in kids may develop by watching such events in the media."

Parents can help their children by encouraging them to express their thoughts about the event, and reassure them they are safe. Stick to usual routines, and seek help if the child has distressing dreams of the event or relives the trauma through repetitive play.

Experts recommend that parents limit their children's viewing of television news coverage of the Aurora shooting. Pediatric research shows it can be associated with more long-term distress.

No one is exempt from that emotional distress, say experts.

"One reason is that events such as this are a threat to our assumptive world," said Dr. David J. Schonfeld, director of the National Center for School Crisis and Bereavement at Cincinnati Children's Hospital Medical Center.

"Every day, we make assumptions about our safety and those we care about. Otherwise, we may become overwhelmed by the harsh reality that, at any point, tragedy can happen to those we love," he said. "When something like this event occurs, it forces us to acknowledge that these are assumptions and therefore may not be true. It leaves us feeling vulnerable and unsettled."

Copyright 2012 ABC News Radio


Soldiers and Veterans Should Have Annual PTSD Screenings, Report Says

iStockphoto/Thinkstock(WASHINGTON) -- Servicemen and women returning from the war zones get screened for post-traumatic stress disorder, but a new report says too little happens after that.

An Institute of Medicine study says that of those who show symptoms, just 40 percent get referred for more treatment. The report also recommends that all service members and veterans should be screened at least once each year.
The review, mandated by Congress and funded by the Pentagon and the Veterans Administration, says many soldiers don't get PTSD treatment, worried it could jeopardize their careers.

"[There is] a certain amount of fearfulness around having psychological diagnosis, that it may affect a soldier's potential for promotion and a certain worry around the acceptability of the diagnosis," said report committee chair Dr. Sandro Galea at Columbia University.

The report also notes that there's no real systematic tracking of soldiers to pinpoint the most effective treatments. Galea says there's work to be done but he's optimistic.

"It will need a concerted system-wide effort on behalf of DOD [Department of Defense] and VA to raise awareness among all its ranks of the importance of PTSD, of the potential benefit of treatment and to implement specific programs," he says.

Copyright 2012 ABC News Radio


Post Traumatic Stress Disorder Soldiers and Vets Should Receive Purple Heart

Jupiterimages/Comstock(NEW YORK) -- The National Alliance on Mental Illness (NAMI) stated that Soldiers and veterans suffering from Post Traumatic Stress Disorder (PTSD) should be considered to receive the Purple Heart Medal, as reported in the Medical News Today.

Veterans often have a difficult time obtaining access to the Veterans Medical System, and most veterans under the age of 35 do not have health insurance. Furthermore,  most veterans have a problem receiving free care when mental conditions take a longer time to be develop.

According to NAMI Executive Director Michael J. Fitzpatrick, "NAMI is drawing a line in the sand with the Department of Defense. Troops with invisible wounds are heroes. It's time to honor them. It will also strike a tremendous blow against the stigma that often discourages individuals from seeking help when they need it."

The Purple Heart is now the oldest medal given to US Servicemen.

Copyright 2012 ABC News Radio

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