Serving Veterans of OEF/OIF APA Education Leadership ... · TOGETHER WE REACH Together We Reach...
Transcript of Serving Veterans of OEF/OIF APA Education Leadership ... · TOGETHER WE REACH Together We Reach...
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TOGETHER WE REACH
Together We Reach
Serving Veterans of OEF/OIF APA Education Leadership Conference 2010
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TOGETHER WE REACH
Together We Reach
OverviewOverview•Since 9‐11‐2001 almost 2 million U.S.
military have deployed in support of:
–Operation Iraqi Freedom (OIF)
–Operation Enduring Freedom (OEF)
• 4000+ killed
• 30,000+ combat wounded Iraq Coalition Causality Count, 2009
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TOGETHER WE REACH
Together We Reach
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TOGETHER WE REACH
Together We Reach
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Why are Soldiers Vulnerable?• Repeated deployments, combat exposure
– PTSD, depression, anxiety, substance abuse• Increased high risk behaviors (e.g. substance abuse,
criminal activity)– Access to methods
• Issue of acquired capability– Habituation to risk and violence– Commander hesitation to respond
• Impact of warrior identity– Beliefs about mental illness
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TOGETHER WE REACH
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Signature Injuries of OIF/OEFSignature Injuries of OIF/OEF
•PTSD (Posttraumatic Stress Disorder)
•TBI (Traumatic Brain Injury)
•Amputations
•Burns
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TOGETHER WE REACH
Together We Reach
Rate of PTSD is Influencedby the Type of Trauma
Kessler (1995)
010
203040
5060
Disaster Accident Assault Molestation Combat* Rape
Perc
ent (
%)
Trauma PTSD
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TOGETHER WE REACH
Together We Reach
Trauma Trauma Exposure in Exposure in OIF/OEFOIF/OEF
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Weaponry Cause of DeathWeaponry Cause of Death (1 Oct 01 through 14 Sep 06)(1 Oct 01 through 14 Sep 06)
0
200
400
600
800
1000
1200
Explosive Device
Gunshot
Mortar/Rocket
Bomb
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Lethality of Combat InjuriesLethality of Combat Injuries ((GawandeGawande, 2004), 2004)
05
1015202530354045
Revolutionary War
Civil War
WW
I
WW
II
Korea
Vietnam
Persian Gulf War
OIF/OEF
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TOGETHER WE REACH
Together We Reach
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TOGETHER WE REACH
Together We Reach
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TOGETHER WE REACH
Together We Reach
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TOGETHER WE REACH
Together We Reach
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TOGETHER WE REACH
Together We Reach
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TOGETHER WE REACH
Together We Reach
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TOGETHER WE REACH
Together We Reach
PTSD & TBI Risk in OIF/OEF Veterans
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RAND Report (2008)RAND Report (2008)
• 20% of returning OIF/OEF veterans have symptoms of PTSD or depression
–About 300,000 in total–Estimated societal
costs first 2 years after deployment: $4‐6.2
Billion
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Time Course of Posttraumatic ReactionsTrauma
11 monthmonth
33 monthsmonths
66 monthsmonths
2020 yearsyears
4040 yearsyears
Acute stress disorderAcute stress disorder
Acute PTSDAcute PTSD
Chronic PTSDChronic PTSD
DelayedDelayed--onset PTSDonset PTSD
Acute stress reactionAcute stress reaction
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Together We ReachResearch Gap Analysis
•Previous clinical trials have targeted:–PTSD in civilian populations–PTSD in discharged Vietnam
veterans
•No clinical trial has ever been published to evaluate treatment of
combat‐related PTSD in active‐duty military personnel
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Together We Reachfor PTSD–Prolonged Exposure (PE)
• Edna Foa, PhD• Involves repeated exposure to
–memories of the trauma–trauma-related situations
–Cognitive Processing Therapy (CPT)• Patricia Resick, PhD• Involves exposure to trauma through
–Writing and reading accounts of the trauma–Challenge and modify maladaptive thoughts and beliefs related to
trauma
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Lessons from the Vietnam War
• 500,000 Vietnam vets have chronic PTSD
• Rates not decreasing; may be increasing
• Annual cost for disability payments $4.3B
–20.5% of all VA compensation payments
• Medical discharge of 1 active duty member for PTSD costs an estimated
$250,000 in
medical disability alone
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TOGETHER WE REACH
Together We Reach