PTSD Clinical Research

This page features PTSD clinical research updates, specifically addressing treatment for military veterans and their families.

The books, clinical guidelines, and articles published in peer-reviewed scholarly journals are primarily intended for psychologists, psychiatrists, and other mental health professionals.

But anyone interested in the assessment and treatment of military veterans suffering from posttraumatic stress disorder (PTSD) will benefit from reviewing these publications.

PTSD Clinical Research Updates




PTSD and Problem Alcohol Use

Citation

Berke, Danielle S., Julie Yeterian, Candice Presseau, Luke Rusowicz-Orazem, Nora K. Kline, William P. Nash, and Brett T. Litz. Dynamic Changes in Marines’ Reports of PTSD Symptoms and Problem Alcohol Use Across the Deployment Cycle. Psychology of Addictive Behaviors 33, no. 2 (2019): 162-170. https://doi.org/10.1037/adb0000430

Abstract

Posttraumatic stress disorder (PTSD) and alcohol misuse are commonly co-occurring problems in active-duty service members (SMs) and veterans.

Unfortunately, relatively little is known about the temporal associations between these problems in the acute period following exposure to combat stressors.

Discerning the temporal associations between these problems across the deployment cycle could inform prevention and treatment efforts.

In this study, we examined the association between PTSD symptom severity and problem alcohol use in a large cohort of United States Marines (n = 758) evaluated prior to deployment and approximately 1, 5, and 8 months postdeployment.

Results indicate that problem alcohol use was associated with a subsequent exacerbation of PTSD symptoms between the 1st and 2nd and 2nd and 3rd postdeployment assessments.

PTSD symptom severity was associated with increased problem alcohol use between the 1st and 2nd postdeployment assessments.

These findings suggest that problem drinking may lead to new onset or worsening of PTSD symptoms over time and that SMs [Service Members] with greater PTSD symptom severity upon returning from deployment may increase alcohol use in the weeks immediately following homecoming. 

Comment

The relationship between PTSD and substance use disorders is an important factor in PTSD C&P exams. If a veteran's posttraumatic stress disorder is service-connected, and if the veteran also suffers from a substance use disorder, the VA mental health examiner must determine if the substance use disorder is "proximately due to or the result of" PTSD or if PTSD has aggravated a pre-existing substance use disorder.1

This research suggests, at least with this cohort of U.S. Marines, that the causal relationship goes both ways. 


Treating PTSD in Military Personnel

Moore, Bret A. and Walter E. Penk, eds. Treating PTSD in Military Personnel, Second Edition: A Clinical Handbook. New York: Guildford, 2019. [Publication date: 3 Apr 2019] 

Pre-order from Guilford Press for $38.75 (List price: $45.00).

Description (from publisher):

This state-of-the-science guide to assessing and treating posttraumatic stress disorder (PTSD) in active-duty service members and veterans has now been extensively revised with 65% new material.

Leading authorities review available evidence-based treatments, including individual, group, and couple and family therapy approaches.

Knowledge about military culture, the stressors experienced by service members, and common challenges for both military and civilian practitioners is woven through the volume and reflected in the vivid case examples.

Chapters on specific clinical issues delve into co-occurring affective, anxiety, substance use, and sleep disorders; treatment of particular types of trauma; suicide prevention; and more.

New to This Edition

Chapters on additional treatments: mindfulness-based behavioral and cognitive therapies, stress inoculation training, cognitive-behavioral conjoint therapy, group therapy, and complementary and alternative therapies.

Chapters on additional clinical issues: chronic pain, moral injury, complex traumatic stress disorders, and posttraumatic growth.

Updated throughout with the latest treatment research and DSM-5 diagnostic changes.

Review by Dr. Brian Marx

“Moore and Penk have once again assembled a 'who’s who' of leading researchers to present the latest on evidence-based treatments for PTSD in military personnel. The second edition of this handbook is an absolute 'must read' for anyone who provides care to this population. The detailed insights into important considerations for working with military personnel, careful attention to clinical issues that frequently co-occur with PTSD, and clearly presented case examples that illustrate how to implement the various treatments successfully are what make this volume stand apart.”

—Brian P. Marx, PhD, National Center for PTSD, VA Boston Healthcare System; Department of Psychiatry, Boston University School of Medicine.

Footnotes

1. Disabilities that are proximately due to, or aggravated by, service-connected disease or injury, 38 C.F.R. § 3.310



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