The impact of war on the individual is profound.

War is “bad for your brain”.

No one returns from deployment the same.

The “consequences of war” are exacerbated as deployments increase.

Prevalence of TBI & PTSD in OIF/OEF Soldiers

Estimates vary and sampling problems have been identified:

TBI: 19.5% of soldiers translating to 320,000 probable TBI cases (95% CI of 16.4% - 22.7%).

PTSD: 13.8% of soldiers translating to

226,000 probable PTSD cases (95% CI of 11.1% - 16.5%).

mTBI/PTSD SX OverlapmTBI/PTSD SX OverlapM. STEIN M. STEIN ET AL., AM J PSYCHIATRYET AL., AM J PSYCHIATRY 166, 7 (JULY 2009) 166, 7 (JULY 2009)

The consequences of war and post-deployment adjustment issues can lead to chronic conditions that impairs the entire person – body, mind & spirit.

The “Typical” TBI Clinic PtThe “Typical” TBI Clinic PtThe majority of SMs who present to the TBI Clinic suffer The majority of SMs who present to the TBI Clinic suffer

from complex biopsychosocial disease including:from complex biopsychosocial disease including:

A)A) Chronic PainChronic Pain

B)B) Chronic InsomniaChronic Insomnia

C)C) Cognitive WeaknessesCognitive Weaknesses

D)D) Other Physical Symptoms &/or Medical ConditionsOther Physical Symptoms &/or Medical Conditions

E)E) DepressionDepression

F)F) Anxiety Anxiety

G)G) Some degree of PTSDSome degree of PTSD

H)H) Probable Alteration of Self Concept & Self-EsteemProbable Alteration of Self Concept & Self-Esteem

These variables interact & can yield globalThese variables interact & can yield global

impairment. impairment.

TREATMENT

* This complex clinical sequelae demands

aggressive, integrated interdisciplinary

intervention.

* Each area of difficulty must be addressed.

* Because SXs interact, improvement in

one area can have carry-over effects.

Fort Hood TBI ClinicNumerous Services are AvailablePrimary Care Medical Management

Acupuncture Biofeedback Chiropractic Clinical Pharmacy Education Psychotherapy Massage Therapy NCM Occupational Therapy Physiatry Physical Therapy Speech Therapy

Fort Hood TBI ClinicIntensive Outpatient

ProgramThe SM’s Command signs-off on participation.

Duty station for 6-weeks.

0800 – 1600 5 days per-week.

Each cohort includes 6 SMs.

Group & Individual Sessions.

Longitudinal Mutivariate Research Design.

Intrepid Spirit/Intrepid Spirit/NICoE