Journal articles: 'Delayed ptsd in combat veterans'

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Moldofsky, Harvey, Lorne Rothman, Robert Kleinman, Shawn G. Rhind, and J. Donald Richardson. "Disturbed EEG sleep, paranoid cognition and somatic symptoms identify veterans with post-traumatic stress disorder." BJPsych Open 2, no. 6 (November 2016): 359–65. http://dx.doi.org/10.1192/bjpo.bp.116.003483.

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BackgroundChronic post-traumatic stress disorder (PTSD) behavioural symptoms and medically unexplainable somatic symptoms are reported to occur following the stressful experience of military combatants in war zones.AimsTo determine the contribution of disordered EEG sleep physiology in those military combatants who have unexplainable physical symptoms and PTSD behavioural difficulties following war-zone exposure.MethodThis case-controlled study compared 59 veterans with chronic sleep disturbance with 39 veterans with DSM-IV and clinician-administered PTSD Scale diagnosed PTSD who were unresponsive to pharmacological and psychological treatments. All had standardised EEG polysomnography, computerised sleep EEG cyclical alternating pattern (CAP) as a measure of sleep stability, self-ratings of combat exposure, paranoid cognition and hostility subscales of Symptom Checklist-90, Beck Depression Inventory and the Wahler Physical Symptom Inventory. Statistical group comparisons employed linear models, logistic regression and chi-square automatic interaction detection (CHAID)-like decision trees.ResultsVeterans with PTSD were more likely than those without PTSD to show disturbances in non-rapid eye movement (REM) and REM sleep including delayed sleep onset, less efficient EEG sleep, less stage 4 (deep) non-REM sleep, reduced REM and delayed onset to REM. There were no group differences in the prevalence of obstructive sleep apnoeas/hypopnoeas and periodic leg movements, but sleep-disturbed, non-PTSD military had more EEG CAP sleep instability. Rank order determinants for the diagnosis of PTSD comprise paranoid thinking, onset to REM sleep, combat history and somatic symptoms. Decision-tree analysis showed that a specific military event (combat), delayed onset to REM sleep, paranoid thinking and medically unexplainable somatic pain and fatigue characterise chronic PTSD. More PTSD veterans reported domestic and social misbehaviour.ConclusionsMilitary combat, disturbed REM/non-REM EEG sleep, paranoid ideation and medically unexplained chronic musculoskeletal pain and fatigue are key factors in determining PTSD disability following war-zone exposure.

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SAMUELSON, KRISTIN W., THOMAS C. NEYLAN, MARYANNE LENOCI, THOMAS J. METZLER, VALERIE CARDENAS, MICHAEL W. WEINER, and CHARLES R. MARMAR. "Longitudinal effects of PTSD on memory functioning." Journal of the International Neuropsychological Society 15, no. 6 (November 2009): 853–61. http://dx.doi.org/10.1017/s1355617709990282.

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AbstractNumerous studies have demonstrated explicit and working memory deficits related to posttraumatic stress disorder (PTSD), but few have addressed longitudinal changes in memory functioning. There is some evidence to suggest an interactive effect of PTSD and aging on verbal memory decline in Holocaust survivors (Yehuda et al., 2006). However, the longitudinal trajectory of neuropsychological functioning has not been investigated in Vietnam veterans, a younger but substantial population of aging trauma survivors. We administered tests of visual and verbal memory, and working memory to derive different dependent measures in veterans between the ages of 41 and 63, the majority of whom served in the Vietnam War. Twenty-five veterans with PTSD and 22 veterans without PTSD were assessed over two time points (mean age at follow-up = 54.0; mean inter-test interval = 34 months). The PTSD+ group, consisting of veterans with chronic, primarily combat-related PTSD, did not show a significant change in PTSD symptoms over time. Compared to veterans without PTSD, veterans with PTSD showed a greater decline in delayed facial recognition only, and this decline was extremely subtle. (JINS, 2009, 15, 853–861.)

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Burdett, Howard, Neil Greenberg, Nicola T. Fear, and Norman Jones. "The mental health of military veterans in the UK." International Psychiatry 11, no. 4 (November 2014): 88–89. http://dx.doi.org/10.1192/s1749367600004665.

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Risk factors for poor mental health among UK veterans include demonstrating symptoms while in service, being unmarried, holding lower rank, experiencing childhood adversity and having a combat role; however, deploy ment to a combat zone does not appear to be associated with mental health outcomes. While presentation of late-onset, post-service difficulties may explain some of the difference between veterans and those in service, delayed-onset post-traumatic stress disorder (PTSD) appears to be partly explained by prior subthreshold PTSD, as well as other mental health difficulties. In the longer term, veterans do not appear to suffer worse mental health than equivalent civilians. This overall lack of difference, despite increased mental health difficulties in those who have recently left, suggests that veterans are not at risk of worse mental health and/or that poor mental health is a cause, rather than a consequence, of leaving service.

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Ramaswamy, S., A. Hickert, K. Miller, V. Kolli, D. Driscoll, and Y. KC. "ID: 42: FACTORS ASSOCIATED WITH TREATMENT SEEKING IN VETERANS WITH LATE-ONSET PTSD." Journal of Investigative Medicine 64, no. 4 (March 22, 2016): 946.1–946. http://dx.doi.org/10.1136/jim-2016-000120.68.

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Background and SignificancePost-traumatic stress disorder (PTSD) is a chronic anxiety disorder with a lifetime prevalence of 6.8% in the general population and up to 30% among Vietnam War veterans. While presentation of PTSD is typically acute, delayed onset of PTSD (i.e., 6 months post trauma) is considered to be relatively rare. There is anecdotal evidence supporting reactivation of trauma memories and symptoms of PTSD among aging veterans who previously had no symptoms or treatment for PTSD. Clinically this type of presentation appears to be different from those presenting with symptoms earlier in life. It is unclear what might precipitate or reactivate these symptoms many years following trauma exposure. The Veterans Health Administration has a growing population of aging veterans exposed to combat during their military service. Current treatment guidelines provide limited guidance towards the management of late-onset PTSD. The prevalence of PTSD among OEF/OIF veterans is very high and as this cohort ages, we need to be better equipped to manage clinical changes seen across the lifespan. Understanding the clinical phenomenology, risk factors and potential biomarkers of this condition could pave the way for better screening methods and treatment interventions for clinicians.ObjectiveTo identify the characteristics and risk factors among late-life post-traumatic stress disorder (PTSD) treatment seekers.MethodsThe study is a retrospective chart review of patients diagnosed with PTSD after the age of 55 and a comparison group of veterans diagnosed with PTSD prior to the age of 55 in the VA Nebraska–Western Iowa Health Care System.ResultsPrimary variables for analysis included demographic factors, military history, age at treatment seeking, PTSD Checklist (PCL) scores, PTSD treatment, recent stressors/reasons for seeking treatment (e.g., recent life changes, another trauma or reminder), and comorbid medical conditions.ConclusionsA number of explanations have been proposed for the development of late-onset PTSD, including chronic inflammation and cumulative stress. We are conducting a separate study to determine whether plasma concentration of the inflammatory marker C-reactive protein (CRP) might help in predicting late-onset PTSD. Further studies are needed to evaluate the contributions of other factors (e.g., physical or cognitive decline, sleep disturbances, other traumas) to late-onset PTSD.

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Frueh, B. Christopher, Jon D. Elhai, Anouk L. Grubaugh, Jeannine Monnier, Todd B. Kashdan, Julie A. Sauvageot, Mark B. Hamner, B. G. Burkett, and George W. Arana. "Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder." British Journal of Psychiatry 186, no. 6 (June 2005): 467–72. http://dx.doi.org/10.1192/bjp.186.6.467.

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BackgroundThere are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers.AimsTo verify combat exposure history for a relevant sample through objective historical data.MethodArchival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic. Cross-sectional clinical assessment and 12-month service use data were also examined.ResultsAlthough 93% had documentation of Vietnam war-zone service, only 41% of the total sample had objective evidence of combat exposure documented in their military record. There was virtually no difference between the Vietnam ‘combat’ and ‘no combat’ groups on relevant clinical variables.ConclusionsA significant number of treatment-seeking Veterans Affairs patients may misrepresent their combat involvement in Vietnam. There are implications for the integrity of the PTSD database and the Veterans Affairs healthcare system.

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Salisbury, Aaron Gray, and Eileen J. Burker. "Assessment, Treatment, and Vocational Implications of Combat Related PTSD in Veterans." Journal of Applied Rehabilitation Counseling 42, no. 2 (June 1, 2011): 42–49. http://dx.doi.org/10.1891/0047-2220.42.2.42.

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Post Traumatic Stress Disorder (PTSD) is a potentially disabling condition among combat veterans. Often misunderstood, misdiagnosed, stigmatized, and improperly treated, veterans do not know where to seek appropriate services. The prevalence of combat related PTSD is reviewed. The symptoms of PTSD are described, common assessment measures are presented, treatment modalities are discussed, and vocational implications are described. Suggestions are made for rehabilitation counselors to be able to work within multidisciplinary teams to treat veterans with PTSD and to better accommodate veterans' readjustment to noncombatant life.

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Hyer, Lee, Stephanie Boyd, Ellen Stanger, Harry Davis, and Paul Walters. "Validation of the MCMI-III PTSD Scale among Combat Veterans." Psychological Reports 80, no. 3 (June 1997): 720–22. http://dx.doi.org/10.2466/pr0.1997.80.3.720.

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The new MCMI-III Posttraumatic Stress Disorder (PTSD) scale was validated on 104 combat veterans who were divided into two groups, PTSD Treatment Group and Non-PTSD Treatment Group. PTSD status was carefully determined by clinical interview and therapists' reports. The Combat Exposure Scale, the Mississippi Scale for Combat-related PTSD, and the Impact of Events Scale were also given. Analysis showed that the MCMI-III PTSD scale had a low internal consistency, but that it significantly differentiated the two groups and significantly correlated to those on other PTSD self-report scales. This scale appeared to be influenced by an acquiescent response style. Further validation studies are needed.

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Spiric, Z., R. Samardzic, M. Preradovic, and N. Bjelica. "Coping Styles of Combat Veterans with PTSD." European Psychiatry 12, S2 (1997): 198s. http://dx.doi.org/10.1016/s0924-9338(97)80601-3.

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Samardzic, R., Z. Spiric, M. Preradovic, T. Zujovic, and B. Kuljic. "Symptomatology profile of combat veterans with PTSD." European Psychiatry 13, S4 (1998): 280s. http://dx.doi.org/10.1016/s0924-9338(99)80533-1.

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Taft, Casey T., Lynda A. King, Daniel W. King, Gregory A. Leskin, and David S. Riggs. "Partners' ratings of combat veterans' PTSD symptomatology." Journal of Traumatic Stress 12, no. 2 (April 1999): 327–34. http://dx.doi.org/10.1023/a:1024780610575.

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Pivar, Ilona L., and Nigel P. Field. "Unresolved grief in combat veterans with PTSD." Journal of Anxiety Disorders 18, no. 6 (January 2004): 745–55. http://dx.doi.org/10.1016/j.janxdis.2003.09.005.

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Hyer, Lee, and Stephanie Boyd. "Personality Scales as Predictors of Older Combat Veterans with Posttraumatic Stress Disorder." Psychological Reports 79, no. 3 (December 1996): 1040–42. http://dx.doi.org/10.2466/pr0.1996.79.3.1040.

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The sparse literature on Posttraumatic Stress Disorder among older combat veterans has not explored individual personality styles. 120 older combat veterans who were treatment-seeking in medical and psychiatric outpatient clinics, were assessed whether two personality styles (identified in other research as potentially reflective of PTSD) added to the problems of PTSD beyond the information associated with the stressors of combat and aging. Analyses indicated that the personality style, Sensitivity, was significantly related to PTSD beyond these other factors.

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Khanna, M. M., A. S. Badura-Brack, T. J. McDermott, C. M. Embury, A. I. Wiesman, A. Shepherd, T. J. Ryan, E. Heinrichs-Graham, and T. W. Wilson. "Veterans with post-traumatic stress disorder exhibit altered emotional processing and attentional control during an emotional Stroop task." Psychological Medicine 47, no. 11 (May 8, 2017): 2017–27. http://dx.doi.org/10.1017/s0033291717000460.

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BackgroundPost-traumatic stress disorder (PTSD) is often associated with attention allocation and emotional regulation difficulties, but the brain dynamics underlying these deficits are unknown. The emotional Stroop task (EST) is an ideal means to monitor these difficulties, because participants are asked to attend to non-emotional aspects of the stimuli. In this study, we used magnetoencephalography (MEG) and the EST to monitor attention allocation and emotional regulation during the processing of emotionally charged stimuli in combat veterans with and without PTSD.MethodA total of 31 veterans with PTSD and 20 without PTSD performed the EST during MEG. Three categories of stimuli were used, including combat-related, generally threatening and neutral words. MEG data were imaged in the time-frequency domain and the network dynamics were probed for differences in processing threatening and non-threatening words.ResultsBehaviorally, veterans with PTSD were significantly slower in responding to combat-related relative to neutral and generally threatening words. Veterans without PTSD exhibited no significant differences in responding to the three different word types. Neurophysiologically, we found a significant three-way interaction between group, word type and time period across multiple brain regions. Follow-up testing indicated stronger theta-frequency (4–8 Hz) responses in the right ventral prefrontal (0.4–0.8 s) and superior temporal cortices (0.6–0.8 s) of veterans without PTSD compared with those with PTSD during the processing of combat-related words.ConclusionsOur data indicated that veterans with PTSD exhibited deficits in attention allocation and emotional regulation when processing trauma cues, while those without PTSD were able to regulate emotion by directing attention away from threat.

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Golier, Julia A., Kimberly Caramanica, Rebecca DeMaria, and Rachel Yehuda. "A Pilot Study of Mifepristone in Combat-Related PTSD." Depression Research and Treatment 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/393251.

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Background. We obtained pilot data to examine the clinical and neuroendocrine effects of short-term mifepristone treatment in male veterans with PTSD.Methods. Eight male veterans with military-related PTSD completed a randomized, double-blind trial of one week of treatment with mifepristone (600 mg/day) or placebo. The primary clinical outcome measures were improvement in PTSD symptoms and dichotomously defined clinical responder status as measured by the CAPS at one-month follow-up. Additional outcome measures included self-reported measures of PTSD symptom severity, CAPS-2 symptom subscale scores, and morning plasma cortisol and ACTH levels.Results. Mifepristone was associated with significant improvements in total CAPS-2 score. At one-month follow-up, all four veterans in the mifepristone group and one of four veterans in the placebo group achieved clinical response; three of four veterans in the mifepristone group and one of four veterans in the mifepristone group remitted. Mifepristone treatment was associated with acute increases in cortisol and ACTH levels and decreases in cytosolic glucocorticoid receptor number in lymphocytes.Conclusions. Further controlled trials of the effects of mifepristone and their durability are indicated in PTSD. If effective, a short-term pharmacological treatment in PTSD could have myriad uses.

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Lynne Beal, A. "Post-Traumatic Stress Disorder in Prisoners of War and Combat Veterans of the Dieppe Raid: A 50-Year Follow-Up." Canadian Journal of Psychiatry 40, no. 4 (May 1995): 177–84. http://dx.doi.org/10.1177/070674379504000404.

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Objective This paper presents the first 50-year study of the differential effects of incarceration and combat on the development and persistence of post-traumatic stress disorder (PTSD) in Canadian veterans and prisoners of war (POWs) from the Dieppe Raid. Method A large sample of Dieppe. POWs and nonPOWs completed a questionnaire diagnosing PTSD and other psychological and health problems of the veterans in 1946 and in 1992. Results The POWs showed a higher incidence of PTSD and other psychological symptoms than veterans with the same combat exposure. The POWs' experiences of malnutrition, maltreatment and torture, and mental suffering showed strong links to PTSD. Conclusions For many veterans, PTSD has lasted 50 years. Failure to be eligible for psychological disability pensions demonstrates that PTSD and other psychological disorders in these veterans have been greatly unrecognized by the Canadian Department of Veteran's Affairs.

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O'toole, Brian I., Richard P. Marshall, Ralph J. Schureck, and Matthew Dobson. "Risk Factors for Posttraumatic Stress Disorder in Australian Vietnam Veterans." Australian & New Zealand Journal of Psychiatry 32, no. 1 (February 1998): 21–31. http://dx.doi.org/10.3109/00048679809062702.

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Objective: The aims of this paper are to determine the risk factors for combat-related posttraumatic stress disorder (PTSD) and to examine the relative contribution of pre-military factors, pre-trauma psychiatric diagnoses, military factors such as combat posting, and combat and casualty stress exposure. Method: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Multivariate logistic regression was used to examine the relative contribution of factors derived from interview and from military records in four categories: pre-enlistment circumstances including home life, education, major life stress; pre-Vietnam psychiatric diagnoses; military experiences before and during Vietnam; and combat and stress experiences. Results: Of the 128 data items examined, significant associations were found for 39, in addition to combat stress. Pre-enlistment items accounted for about 3% of the deviance towards PTSD diagnosis, pre-enlistment psychiatric diagnosis about 13%, military variables about 7% and combat stress about 18%; all factors together accounted for 42%. Conclusions: The results confirm that pre-military and military variables make only a small but significant contribution to PTSD either alone or after controlling for combat stress; that psychiatric diagnoses of depression, dysthymia and agoraphobia make strong contributions to PTSD; but that combat stress makes the largest contribution even after controlling for the effects of other variables. Psychiatric diagnoses and combat stress appear to be independent in their effects on PTSD.

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Becirovic, E., R. Softic, M. Mirkovic Hajdukov, and A. Becirovic. "Childhood Physical Punishment as Risk Factor for Combat-Related PTSD." European Psychiatry 33, S1 (March 2016): S511—S512. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1889.

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IntroductionRisk and protective factors for PTSD can be grouped into pretraumatic, peritraumatic, and posttraumatic. Reported childhood abuse has predictive risk effects for PTSD than most other pretraumatic risk factors.ObjectiveTo examine childhood physical abuse history in war veterans.AimsTo determine whether childhood physical abuse is risk factor for PTSD in war veterans.MethodsCross-sectional study of 205 war veterans tested by Harvard Trauma Questionnaire and sociobiographic Questionnaire (with data of childhood physical punishment).ResultsA significant difference in reported childhood physical punishment between war veterans with and without PTSD was found. Veterans with PTSD were identified as recipients of childhood physical punishment.ConclusionsChildhood physical punishment has positive correlation with development of PTSD in war veterans.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Kurth, Maria, Soyoung Choun, Dylan Lee, David Rothwell, and Carolyn aldwin. "PTSD SYMPTOMS AMONG VIETNAM, PERSIAN GULF, AND OEF/OIF/OND VETERANS: A RURAL/URBAN COMPARISON." Innovation in Aging 3, Supplement_1 (November 2019): S388—S389. http://dx.doi.org/10.1093/geroni/igz038.1427.

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Abstract There are mixed results in studies examining rural/urban differences in PTSD symptoms among veterans; however, many of these studies failed to consider possible confounds with geographic location. This study examined rural/urban differences in PTSD symptoms by combat exposure, war cohort, and gender. The VALOR (Veterans Aging: Longitudinal studies in Oregon) pilot study sampled Vietnam, Persian Gulf, and OEF/OIF/OND war cohorts using an online survey. The sample (N=237, Mage=57.84, SD=12.68) was mainly male (65%), White (85%), and urban (75.95%); most reported combat exposure (71%). Participants completed measures of PTSD, combat exposure, and demographics. Results indicate no effect of cohort or rural/urban status on PTSD symptoms. There was a significant effect of combat exposure, F(1,224)=4.58, p=.03, and gender, F(1,224)=4.13, p =.04, with males reporting higher levels of PTSD symptoms and combat exposure. Contrary to our expectations, there were no effects of cohort or geographic location on PTSD symptoms.

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O'toole, Brian I., Richard P. Marshall, Ralph J. Schureck, and Matthew Dobson. "Posttraumatic Stress Disorder and Comorbidity in Australian Vietnam Veterans: Risk Factors, Chronicity and Combat." Australian & New Zealand Journal of Psychiatry 32, no. 1 (February 1998): 32–42. http://dx.doi.org/10.3109/00048679809062703.

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Objective: The objective of this study was to examine the relationship between combat-related posttraumatic stress disorder (PTSD) and comorbid DSM-III-R psychiatric diagnoses to determine commonalities in risk factors, relative onsets and the role of combat exposure. Method: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Interviews and searches of military records yielded risk factors for PTSD, which were examined for association with each psychiatric diagnosis. Relative onsets of PTSD and each Diagnostic Interview Schedule diagnosis were compared. Comorbidity odds ratios were adjusted for combat exposure effects using logistic regression, and the relation between each diagnosis and combat was assessed after controlling for PTSD. Results: Commonality of risk factor profile was evident for several diagnoses, and for many their onset preceded PTSD onset. Combat was independently related to only a few diagnoses after controlling for PTSD, and PTSD remained strongly associated with several conditions after controlling for combat exposure. Conclusions: The analysis suggests that the disorders that may constitute risk factors or vulnerabilities for PTSD comprise depression and dysthymia, antisocial personality disorder, agoraphobia and simple phobia, while those that may be consequent on PTSD are panic and generalised anxiety disorder, drug use disorders and somatoform pain disorder. Alcohol and drug use disorders and social phobia may have a mixed aetiology, while obsessive-compulsive disorder may be serendip-itously related to PTSD through an association with risk of combat. Gambling disorder is unrelated.

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Kurth, Maria, Carolyn Aldwin, and Richard Settersten. "PTSD Symptoms Among Vietnam, Persian Gulf, and Post-9/11 Combat Veterans: Findings From VALOR." Innovation in Aging 4, Supplement_1 (December 1, 2020): 636–37. http://dx.doi.org/10.1093/geroni/igaa057.2181.

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Abstract Much is known about the mental health of combat Vietnam Veterans, but less is known about Persian Gulf and post-9/11 veterans and how they compare to those from earlier eras. Using data from an online survey of Oregon veterans, we examine how PTSD symptoms differ by combat exposure across these three cohorts. The sample (N=167, Mage=57.86, SD=12.09), was largely composed of White (88%), male (69%) Veterans. Most served in the Persian Gulf (41%), followed by Vietnam (36%) and post-9/11 (23%) eras. ANCOVAs showed significant cohort differences in PTSD, after controlling for severity of combat exposure and demographics (age, gender, education, income) (F(2, 157) = 4.24, p < .05). Post-9/11 veterans had significantly lower PTSD symptom severity than Vietnam-era veterans but were comparable to Persian Gulf. There were no cohort differences for noncombat veterans. Future research should investigate why Vietnam veterans continue to have worse mental health than younger veteran cohorts. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.

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Attias, Joseph, Avi Bleich, and Shlomo Gilat. "Classification of Veterans with Post-Traumatic Stress Disorder Using Visual Brain Evoked P3s to Traumatic Stimuli." British Journal of Psychiatry 168, no. 1 (January 1996): 110–15. http://dx.doi.org/10.1192/bjp.168.1.110.

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BackgroundPost-traumatic stress disorder (PTSD) typically involves a re-experiencing of traumatic events. In a previous P3 study it was found that PTSD patients react both selectively and involuntarily to combat-related pictures, exhibiting augmented P3 event-related potentials and thus providing a brain activity measure. The clinical application of these findings in differentiating PTSD patients from controls was tested.MethodTwenty Israeli combat veterans suffering from PTSD and 20 age-matched veterans without PTSD were evaluated. P3 potentials were recorded at Pz and Cz in response to visual motor-task target stimuli (pictures of domestic animals), non-target probe stimuli (combat-related pictures), and non-target irrelevant stimuli (pictures of furnishings and flowers).ResultsUsing the Fisher Linear Discrimination Method the P3 measures correctly classified 90% of the PTSD patients and 85% of the controls.ConclusionsVisual P3s recorded in response to combat-related pictorial stimuli may introduce an efficient tool for studying higher brain activity in PTSD, complementing other behavioural and psychophysiological measurements.

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Hennessy, Brian, and Tian P. S. Oei. "The Relationship between Severity of Combat Exposure and Army Status on Post-traumatic Stress Disorder among Australian Vietnam War Veterans." Behaviour Change 8, no. 3 (September 1991): 136–44. http://dx.doi.org/10.1017/s0813483900006720.

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This study investigated the relationship between the level of combat exposure and army status (regular army soldiers vs national servicemen) and the subsequent development of combat-related post-traumatic stress disorder (PTSD). Sixty-four Australian infantrymen who were exposed to combat stress in Vietnam were used in this study. They were divided into four groups based on combat exposure and status as a regular or conscripted soldier. Subjects were assessed 23 years after their tour of duty in Vietnam for PTSD and psychiatric symptomatology using a PTSD inventory based on DSM-III-R criteria, the Self-report Checklist 90 (SCL-90), the Beck Depression Inventory (BDI), the Impact of Events Scale (IES), the Mississippi Scale for Combat-related PTSD (Mississippi Scale), the State and Trait Anxiety Inventory (STAI), and a demographic questionnaire. Results showed that 29.85% of the veterans have a positive diagnosis of PTSD according to self-report of symptoms based on the DSM-III-R criteria, while 54.89% of the remaining veterans suffer major symptoms of this disorder. MANOVA results show that neither the level of combat exposure nor the army status of the veterans had any significant effect on their psychiatric symptomatology as measured by the SCL-90, the BDI, the IES, and the STAI.

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Redwood, Stephen, and Fiona Alpass. "Posttraumatic Stress Disorder, Combat and the Vietnam Veteran." Australian Journal of Rehabilitation Counselling 11, no. 1 (January 2005): 44–67. http://dx.doi.org/10.1017/s1323892200000181.

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The impact of stress on both the psychological and physical wellbeing of the individual has been a primary topic in the psychological literature over the past decade. Alongside the weight of research on the effects of life stressors, the study of traumatic stress and its physical and psychological sequelae has overwhelmingly captivated researchers across the full range of the social science disciplines. Recent events have focused attention on the plight of combat veterans once again. The current review was undertaken in order to provide an overview of the recent extensive research activity on PTSD in war and combat veterans and focuses predominantly on veterans from the Vietnam War. Epidemiological data is presented on the prevalence of traumatic stress and the incidence of PTSD. Evidence for the high rates of co-morbidity between PTSD and other major clinical disorders is reviewed and the contribution of a number of peri-traumatic variables, pre-trauma and post-trauma factors to the development of PTSD is assessed. A review of the cognitive theories of PTSD suggests a number of common elements and theoretical similarities.

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Renaud, Edwin F. "The attachment characteristics of combat veterans with PTSD." Traumatology 14, no. 3 (2008): 1–12. http://dx.doi.org/10.1177/1534765608319085.

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Uglesic, B., D. Lasic, D. Degmecic, V. Visic, and P. Filaković. "P-1118 - Psychopharmacotherapy of PTSD in combat veterans." European Psychiatry 27 (January 2012): 1. http://dx.doi.org/10.1016/s0924-9338(12)75285-9.

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Woodward, Steven H., Danny G. Kaloupek, Chris C. Streeter, Matthew O. Kimble, Allan L. Reiss, Stephan Eliez, Lawrence L. Wald, et al. "Hippocampal Volume, PTSD, and Alcoholism in Combat Veterans." American Journal of Psychiatry 163, no. 4 (April 2006): 674–81. http://dx.doi.org/10.1176/ajp.2006.163.4.674.

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Levin, Aaron. "Combat Veterans With PTSD Benefit From Online CBT." Psychiatric News 42, no. 22 (November 16, 2007): 19. http://dx.doi.org/10.1176/pn.42.22.0019.

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Wilcox, Sherrie. "Social relationships and PTSD symptomatology in combat veterans." Psychological Trauma: Theory, Research, Practice, and Policy 2, no. 3 (September 2010): 175–82. http://dx.doi.org/10.1037/a0019062.

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Hyer, Lee, Carol Walker, Greg Swanson, Shelby Sperr, Edwin Sperr, and John Blount. "Validation of PTSD measures for older combat veterans." Journal of Clinical Psychology 48, no. 5 (September 1992): 579–88. http://dx.doi.org/10.1002/1097-4679(199209)48:5<579::aid-jclp2270480502>3.0.co;2-j.

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Dodson, Darrel W., Pedro Lucero, and Michael Morris. "Sleep-Disordered Breathing in Combat Veterans With PTSD." Chest 138, no. 4 (October 2010): 616A. http://dx.doi.org/10.1378/chest.10924.

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Forbes, David, Virginia Lewis, Ruth Parslow, Graeme Hawthorne, and Mark Creamer. "Naturalistic Comparison of Models of Programmatic Interventions for Combat-Related Post-Traumatic Stress Disorder." Australian & New Zealand Journal of Psychiatry 42, no. 12 (January 1, 2008): 1051–59. http://dx.doi.org/10.1080/00048670802512024.

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Objectives: Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans’ psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment. Method: Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type. Results: Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes. Conclusion: Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments.

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Kintzle, Sara, Nicholas Barr, Gisele Corletto, and Carl Castro. "PTSD in U.S. Veterans: The Role of Social Connectedness, Combat Experience and Discharge." Healthcare 6, no. 3 (August 22, 2018): 102. http://dx.doi.org/10.3390/healthcare6030102.

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Service members who transition out of the military often face substantial challenges during their transition to civilian life. Leaving military service requires establishing a new community as well as sense of connectedness to that community. Little is known about how social connectedness may be related to other prominent transition outcomes, particularly symptoms of posttraumatic stress disorder (PTSD). The purpose of this study was to explore the role of social connectedness in the development of PTSD, as well as its relationship to the known risk factors of combat exposure and discharge status. Data used were drawn from a needs assessment survey of 722 veterans. A path model was specified to test direct and indirect effects of combat experiences, non-honorable discharge status, and social connectedness on PTSD symptoms. Results demonstrated positive direct effects for combat experiences and non-honorable discharge status on PTSD symptoms while social connectedness demonstrated a negative direct effect. Both combat experiences and non-honorable discharge status demonstrated negative direct effects on social connectedness and indirect on PTSD through the social connectedness pathway. Study findings indicate social connectedness may be an important factor related to PTSD in veterans as well as an intervention point for mitigating risk related to combat exposure and discharge status.

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Koso, Maida, and Stefan Hansen. "Executive function and memory in posttraumatic stress disorder: a study of Bosnian war veterans." European Psychiatry 21, no. 3 (April 2006): 167–73. http://dx.doi.org/10.1016/j.eurpsy.2005.06.004.

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AbstractThe present study assessed neuropsychological functions related to attention, executive function and everyday memory in a group of men with a diagnosis of combat-related posttraumatic stress disorder (PTSD). Twenty Bosnian male combat veterans with a diagnosis of PTSD were tested using the Sustained Attention to Response Task, the Hayling Sentence Completion Test, the Trail Making Test, Rivermead Behavioral Memory Test and Wechsler Adult Intelligence Scale (verbal scales). Their performance was compared with age- and IQ-matched male war veterans with no PTSD. The study disclosed pervasive cognitive impairments with large effect sizes pertaining to attention, working memory, executive function, and memory. The effects did not appear to be attributable to alcohol abuse, loss of consciousness, or educational level. We speculate that, in the present group of combat veterans, PTSD was associated with dysfunction of a higher-level attentional resource which in turn affected the activity in other systems concerned with memory and thought.

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Adams, Zachary, Thomas Adams, Kirstin Stauffacher, Howard Mandel, and Zhewu Wang. "The Effects of Inattentiveness and Hyperactivity on Posttraumatic Stress Symptoms: Does a Diagnosis of Posttraumatic Stress Disorder Matter?" Journal of Attention Disorders 24, no. 9 (April 16, 2015): 1246–54. http://dx.doi.org/10.1177/1087054715580846.

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Objective: To address the nature of associations between ADHD symptoms and posttraumatic stress disorder (PTSD) psychopathology in adult military veterans. Method: Ninety-five combat veterans, with PTSD ( n = 63) and without PTSD ( n = 32), were recruited for this study. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS) and ADHD was assessed with Connors’ Adult ADHD Rating Scale−Self-Report: Short Version (CAARS-S:S). Results: PTSD participants endorsed greater hyperactivity or restlessness, inattention or memory problems, and impulsivity or emotional lability scores than participants without PTSD. Among PTSD participants, inattention or memory problems and impulsivity or emotional lability were significant predictors of total PTSD symptoms, but only inattention or memory problems significantly predicted PTSD symptoms when other ADHD symptom clusters were considered simultaneously. Conclusion: Our data suggest that inattention may serve as a risk factor for posttraumatic stress symptoms following combat exposure.

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Bajaj, Jasmohan S., Masoumeh Sikaroodi, Andrew Fagan, Douglas Heuman, HoChong Gilles, Edith A. Gavis, Michael Fuchs, et al. "Posttraumatic stress disorder is associated with altered gut microbiota that modulates cognitive performance in veterans with cirrhosis." American Journal of Physiology-Gastrointestinal and Liver Physiology 317, no. 5 (November 1, 2019): G661—G669. http://dx.doi.org/10.1152/ajpgi.00194.2019.

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Posttraumatic stress disorder (PTSD) is associated with cirrhosis in veterans, and therapeutic results are suboptimal. An altered gut-liver-brain axis exists in cirrhosis due to hepatic encephalopathy (HE), but the added impact of PTSD is unclear. The aim of this study was to define linkages between gut microbiota and cognition in cirrhosis with/without PTSD. Cirrhotic veterans (with/without prior HE) underwent cognitive testing [PHES, inhibitory control test (ICT), and block design test (BDT)], serum lipopolysaccharide-binding protein (LBP) and stool collection for 16S rRNA microbiota composition, and predicted function analysis (PiCRUST). PTSD was diagnosed using DSM-V criteria. Correlation networks between microbiota and cognition were created. Patients with/without PTSD and with/without HE were compared. Ninety-three combat-exposed male veterans [ (58 yr, MELD 11, 34% HE, 31% combat-PTSD (42 no-HE/PTSD, 19 PTSD-only, 22 HE-only, 10 PTSD+HE)] were included. PTSD patients had similar demographics, alcohol history, MELD, but worse ICT/BDT, and higher antidepressant use and LBP levels. Microbial diversity was lower in PTSD (2.1 ± 0.5 vs. 2.5 ± 0.5, P = 0.03) but unaffected by alcohol/antidepressant use. PTSD ( P = 0.02) and MELD ( P < 0.001) predicted diversity on regression. PTSD patients showed higher pathobionts ( Enterococcus and Escherichia/Shigella) and lower autochthonous genera belonging to Lachnospiraceaeae and Ruminococcaceae regardless of HE. Enterococcus was correlated with poor cognition, while the opposite was true for autochthonous taxa regardless of PTSD/HE. Escherichia/Shigella was only linked with poor cognition in PTSD patients. Gut-brain axis-associated microbiota functionality was altered in PTSD. In male cirrhotic veterans, combat-related PTSD is associated with cognitive impairment, lower microbial diversity, higher pathobionts, and lower autochthonous taxa composition and altered gut-brain axis functionality compared with non-PTSD combat-exposed patients. Cognition was differentially linked to gut microbiota, which could represent a new therapeutic target. NEW & NOTEWORTHY Posttraumatic stress disorder (PTSD) in veterans with cirrhosis was associated with poor cognitive performance. This was associated with lower gut microbial diversity in PTSD with higher pathobionts belonging to Enterococcus and Escherichia/Shigella and lower beneficial taxa belonging to Lachnospiraceaeae and Ruminococcaceae, with functional alterations despite accounting for prior hepatic encephalopathy, psychoactive drug use, or model for end-stage liver disease score. Given the suboptimal response to current therapies for PTSD, targeting the gut microbiota could benefit the altered gut-brain axis in these patients.

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Averill, Lynnette A., Chadi G. Abdallah, Robert H. Pietrzak, Christopher L. Averill, Steven M. Southwick, John H. Krystal, and Ilan Harpaz-Rotem. "Combat Exposure Severity Is Associated With Reduced Cortical Thickness in Combat Veterans: A Preliminary Report." Chronic Stress 1 (February 2017): 247054701772471. http://dx.doi.org/10.1177/2470547017724714.

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Background Chronic stress and related physiological responses are known to have deleterious effects on neural integrity. Combat exposure is a notoriously pathogenic stressor, and with over 2 million U.S. troops deployed to active combat zones since 2001, there is an urgent need to advance our understanding of its potential neural impact. Previous evidence suggests structural alterations in posttraumatic stress disorder (PTSD) and more recent studies have explored cortical thinning specifically. This preliminary study investigates the impact of combat exposure on cortical thickness, controlling for history of early life stress and age. Methods Twenty-one combat-exposed Veterans with PTSD and 20 non-PTSD combat-exposed controls (mean age 32.7) completed the Combat Exposure Scale, Childhood Trauma Questionnaire, and structural magnetic resonance imaging in a Siemens 3T TIM trio system. General linear model was used to examine the effect of combat exposure on cortical thickness, controlling for early life trauma exposure and age using cluster-wise correction ( p < 0.05). Results This preliminary study found a negative correlation between combat exposure severity (CES) and cortical thickness in the left superior temporal and left rostral middle frontal regions, as well as an interaction between PTSD diagnosis status and CES, in the superior temporal/insular region showing a stronger negative correlation between CES and cortical thickness in the non-PTSD group. Conclusions Though caution should be taken with interpretation given the preliminary nature of the findings, the results indicate combat exposure may affect cortical structure beyond possible alterations due to early life stress exposure or PTSD psychopathology. Though replication in larger samples is required, these results provide useful information regarding possible neural biomarkers and treatment targets for combat-related psychopathology as well as highlighting the pathogenic effects of combat.

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Alderman, Christopher P., Linda C. McCarthy, John T. Condon, Anita C. Marwood, and Judith R. Fuller. "Topiramate in Combat-Related Posttraumatic Stress Disorder." Annals of Pharmacotherapy 43, no. 4 (March 31, 2009): 635–41. http://dx.doi.org/10.1345/aph.1l578.

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Background: Posttraumatic stress disorder (PTSD) is a disabling psychiatric disorder that is common among combat veterans and may lead to very poor sleep and disturbing nightmares. Objective: To examine the safety and effectiveness of topiramate as add-on therapy for the management of combat-related PTSD and to examine the effects of topiramate on sleep and alcohol consumption. Methods: We conducted an 8-week open-label pilot study of topiramate (or male combat veterans (N = 43) with PTSD, with analysis of veterans who completed the protocol. Psychometric, sleep, and alcohol consumption assessments were conducted at baseline and at week 8. Results: Twenty-nine subjects completed the 8-week study. Significant reductions in Clinician Administered PTSD Scale scores were observed at the 8-week endpoint (from 86,3 ± 21.1 to 67.1 ± 25.1; p < 0.01). Decreases were seen in both Stanford Sleepiness Scale scores (from 10.5 ± 0.72 to 9.0 ± 0.58; p = 0.08) and Mississippi PTSD scores (from 120.4 ± 6.5 to 111.5 ± 20.9; p = 0.08), but the extent of the changes did not attain statistical significance for either scale. There was a significant reduction in the proportion of patients with nightmares (from 100% to 62%; p < 0.001) and patients who experienced anxiety that interfered with falling asleep (from 90% to 62%; p < 0.05). The proportion of patients with high-risk drinking patterns also decreased (from 31% to 14%). Two serious adverse events were reported during the study: an increase in tow back pain and an episode of acute confusion. Conclusions: When used in addition to other empiric therapy, topiramate may be effective at reducing general symptoms of combat-related PTSD and reducing high-risk alcohol intake and nightmares. Further randomized controlled trials of topiramate for the treatment of combat-related PTSD are warranted.

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Wallace, Duncan, and Kristi Heffernan. "The changing face of posttraumatic stress disorder in modern warfare." Australasian Psychiatry 25, no. 4 (March 21, 2017): 336–38. http://dx.doi.org/10.1177/1039856217695707.

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Objectives: This study examined aspects of modern warfare and determined whether they have changed the clinical presentation of posttraumatic stress disorder (PTSD). Conclusions: The relationship between PTSD, mild traumatic brain injury, unmanned aerial vehicle operations and women in combat examined. It was concluded that there are significant changes in how contemporary combat veterans may present with PTSD.

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Blau, Gary, and Glen Miller. "Comparing Three Distinct Samples on Traumatic Events, Post Traumatic Stress Disorder and Dysfunctional Coping Styles." Journal of Educational and Developmental Psychology 11, no. 1 (January 4, 2021): 1. http://dx.doi.org/10.5539/jedp.v11n1p1.

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The purpose of this study was to compare three distinct United States (US) samples on traumatic events, dysfunctional coping styles and Post Traumatic Stress Disorder (PTSD). The samples were: civilian (n = 97); non-combat military veterans (n=61) and combat military veterans (n = 91). An online survey was used to collect all the data. The average age across all participants was 29 years old. For the overall combined sample, three avoidance coping styles, venting, denial, and dark humor, were each positively related to Post Traumatic Stress Disorder (PTSD). Looking at differences between the three samples, the combat veteran sample had more traumatic events (TEs), with the most recent TE being longer ago, then the non-combat veteran and civilian samples. There were no sample differences in PTSD. However, the non-combat veteran sample had higher levels of denial, venting and dark humor in dealing with their most recent TE, than the other two samples. This research draws needed attention to helping non-combat military veterans cope in a more positive way with their most recent TE. Future research directions and study limitations are discussed.

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Elbogen, Eric B., Sally C. Johnson, H. Ryan Wagner, Connor Sullivan, Casey T. Taft, and Jean C. Beckham. "Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans." British Journal of Psychiatry 204, no. 5 (May 2014): 368–75. http://dx.doi.org/10.1192/bjp.bp.113.134627.

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BackgroundViolence towards others in the community has been identified as a significant problem for a subset of Iraq and Afghanistan veterans.AimsTo investigate the extent to which post-traumatic stress disorder (PTSD) and other risk factors predict future violent behaviour in military veterans.MethodA national, multiwave survey enrolling a random sample of all US veterans who served in the military after 11 September 2001 was conducted. A total of 1090 veterans from 50 US states and all military branches completed two survey waves mailed 1 year apart (retention rate = 79%).ResultsOverall, 9% endorsed engaging in severe violence and 26% in other physical aggression in the previous year, as measured at Wave 2. Younger age, financial instability, history of violence before military service, higher combat exposure, PTSD, and alcohol misuse at Wave 1 were significantly associated with higher severe violence and other physical aggression in the past year at Wave 2. When combinations of these risk factors were present, predicted probability of violence in veterans rose sharply. Veterans with both PTSD and alcohol misuse had a substantially higher rate of subsequent severe violence (35.9%) compared with veterans with alcohol misuse without PTSD (10.6%), PTSD without alcohol misuse (10.0%) or neither PTSD nor alcohol misuse (5.3%). Using multiple regression, we found that veterans with PTSD and without alcohol misuse were not at significantly higher risk of severe violence than veterans with neither PTSD nor alcohol misuse. There was a trend for other physical aggression to be higher in veterans with PTSD without alcohol misuse.ConclusionsCo-occurring PTSD and alcohol misuse was associated with a marked increase in violence and aggression in veterans. Compared with veterans with neither PTSD nor alcohol misuse, veterans with PTSD and no alcohol misuse were not significantly more likely to be severely violent and were only marginally more likely to engage in other physical aggression. Attention to cumulative effects of multiple risk factors beyond diagnosis – including demographics, violence history, combat exposure, and veterans' having money to cover basic needs like food, shelter, transportation, and medical care – is crucial for optimising violence risk management.

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Hyer, Lee, and Ellen Stanger. "Interaction of Posttraumatic Stress Disorder and Major Depressive Disorder among Older Combat Veterans." Psychological Reports 80, no. 3 (June 1997): 785–86. http://dx.doi.org/10.2466/pr0.1997.80.3.785.

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This study investigated the interaction of PTSD and major depressive disorder with common aging-related variables for a community sample of older World War II and Korean War veterans. Older veterans ( N = 139) were divided into PTSD and depressed groups on the basis of interviewers' measures and compared on overall adjustment, social support, and health status. Only PTSD affected adjustment and health status.

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Crocker, L., A. Keller, S. Jurick, V. Merritt, S. Hoffman, and A. Jak. "A-18 Executive Dysfunction is Associated with Suicidal Ideation in Iraq/Afghanistan-era Combat-exposed Veterans." Archives of Clinical Neuropsychology 34, no. 6 (July 25, 2019): 877. http://dx.doi.org/10.1093/arclin/acz034.18.

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Abstract Objective Suicidal ideation (SI) is highly prevalent in Veterans and reducing Veteran suicide is a national priority. The present study examined factors associated with SI in combat-exposed Veterans in order to inform suicide prevention efforts. Method Combat-exposed Iraq/Afghanistan-era Veterans (N = 77) completed questionnaires detailing demographic characteristics and combat-related experiences, as well as structured interviews assessing history of mild traumatic brain injury (mTBI), current posttraumatic stress disorder (PTSD), and suicidality in the past month. Veterans also underwent a comprehensive neuropsychological assessment. Analyses examined differences between endorsers versus non-endorsers of current SI, as well as predictors of SI, with a focus on cognitive variables. Results There were no SI group differences in demographic variables, levels of combat exposure, or rates of PTSD, or mTBI history. However, independent samples t-tests indicated that those who endorsed SI demonstrated worse executive functioning relative to those who denied SI (t(75) = 2.74, p = .008), whereas no group differences were observed on measures of attention/processing speed or memory. A logistic regression analysis predicting SI indicated that executive functioning remained a significant predictor of SI (B = .94, OR = 2.55, p = .047) even when adjusting for age, years of education, level of combat exposure, history of mTBI, and PTSD diagnosis. Conclusions Executive dysfunction may make it difficult for Veterans to inhibit maladaptive negative thoughts (particularly suicidal thoughts), regulate emotions, and problem solve in stressful situations, thus contributing to suicidality. Interventions addressing executive dysfunction in combat-exposed Veterans with SI may be a promising adjunct to current suicide prevention efforts.

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Elliott, Richard L. "Does Combat Trauma Cause a Majority of PTSD Symptoms in Combat Veterans?" Journal of Clinical Psychiatry 72, no. 05 (May 15, 2011): 724–25. http://dx.doi.org/10.4088/jcp.11lr06851.

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Goodson, Jason, Amy Helstrom, Jacqueline M. Halpern, Michael P. Ferenschak, Seth J. Gillihan, and Mark B. Powers. "Treatment of Posttraumatic Stress Disorder in U.S. Combat Veterans: A Meta-Analytic Review." Psychological Reports 109, no. 2 (October 2011): 573–99. http://dx.doi.org/10.2466/02.09.15.16.pr0.109.5.573-599.

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Among U.S. veterans who have been exposed to combat-related trauma, significantly elevated rates of posttraumatic stress disorder (PTSD) are reported. Veterans with PTSD are treated for the disorder at Veterans Affairs (VA) hospitals through a variety of psychotherapeutic interventions. Given the significant impairment associated with PTSD, it is imperative to assess the typical treatment response associated with these interventions. 24 studies with a total sample size of 1,742 participants were quantitatively reviewed. Overall, analyses showed a medium between-groups effect size for active treatments compared to control conditions. Thus, the average VA-treated patient fared better than 66% of patients in control conditions. VA treatments incorporating exposure-based interventions showed the highest within-group effect size. Effect sizes were not moderated by treatment dose, sample size, or publication year. Findings are encouraging for treatment seekers for combat-related PTSD in VA settings.

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Frueh, B. Christopher, Mark B. Hamner, Shawn P. Cahill, Paul B. Gold, and Kasey L. Hamlin. "Apparent symptom overreporting in combat veterans evaluated for ptsd." Clinical Psychology Review 20, no. 7 (October 2000): 853–85. http://dx.doi.org/10.1016/s0272-7358(99)00015-x.

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Frueh, B. Christopher, Samuel M. Turner, Deborah C. Beidel, and Shawn P. Cahill. "Assessment of social functioning in combat veterans with ptsd." Aggression and Violent Behavior 6, no. 1 (January 2001): 79–90. http://dx.doi.org/10.1016/s1359-1789(99)00012-9.

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David, Daniella, Ludmila De Faria, Olga Lapeyra, and Thomas A. Mellman. "Adjunctive Risperidone Treatment in Combat Veterans With Chronic PTSD." Journal of Clinical Psychopharmacology 24, no. 5 (October 2004): 556–59. http://dx.doi.org/10.1097/01.jcp.0000138771.46353.59.

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Robert, Sophie, Mark B. Hamner, Samet Kose, Helen G. Ulmer, Sarah E. Deitsch, and Jeffrey P. Lorberbaum. "Quetiapine Improves Sleep Disturbances in Combat Veterans With PTSD." Journal of Clinical Psychopharmacology 25, no. 4 (August 2005): 387–88. http://dx.doi.org/10.1097/01.jcp.0000169624.37819.60.

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FRUEH, B. CHRISTOPHER, KAREN L. PELLEGRIN, JON D. ELHAI, MARK B. HAMNER, PAUL B. GOLD, KATHRYN M. MAGRUDER, and GEORGE W. ARANA. "Patient Satisfaction Among Combat Veterans Receiving Specialty PTSD Treatment." Journal of Psychiatric Practice 8, no. 5 (September 2002): 326–32. http://dx.doi.org/10.1097/00131746-200209000-00010.

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Galor, Sharon, and Uwe Hentschel. "PTSD and Depression Among Combat and Noncombat Israeli Veterans." Military Behavioral Health 1, no. 2 (July 2013): 159–66. http://dx.doi.org/10.1080/21635781.2013.839323.

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Journal articles on the topic 'Delayed ptsd in combat veterans'

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