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Emotional turmoil following the Vietnam War has taken its toll on U.S. veterans. Too many have turned to alcohol and drugs to help relieve the pain they experienced. Not only did many feel abandoned by their country, but some by their own family members who didn't know how to help with war-related health problems, specifically posttraumatic stress disorder (PTSD).

Currently, there are about 500,000 Vietnam War veterans with chronic PTSD, and the U.S. government spends more than $4 billion per year in disability payments, according to University of Texas Health Sciences Center researchers.

Research with civilians with noncombat-related PTSD, such as a motor vehicle accidents (MVA), has shown most can be treated successfully with a type of counseling called "exposure therapies."

Symptom reductions are large and fairly permanent, said Col. Stacey Young-McCaughan, PhD, RN, AOCN, who recently retired after 29 years in the U. S. Army Nurse Corps and now serves as chief of the department of clinical investigation and co-chair institutional review board, Brooke Army Medical Center, Fort Sam Houston, San Antonio.

However, the same exposure therapies approach hasn't been as successful with most veterans, she added.

"Treating combat-related PTSD in military veterans from previous conflicts, such as Vietnam, can be difficult, when treated after discharge from active duty and after a significant amount of time has passed between when the trauma occurred and the counseling is started," said Young-McCaughan, who is also a professor at the school of medicine, department of psychiatry, The University of Texas Health Science Center at San Antonio (UTHSCSA).

A Different Strategy

However, the U.S. Department of Defense (DoD) is determined to help a new generation of veterans by intervening earlier with specific treatments for military veterans exhibiting PTSD and traumatic brain injury (TBI), Young-McCaughan said.

With Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) veterans, the U.S. has adopted a different strategy designed to facilitate better long-term health. The DoD has deployed nearly 2 million military personnel in support of OIF/OEF since 2001, with one in six returning veterans presenting with symptoms of PTSD.

"It is currently estimated that up to 300,000 OIF/OEF veterans are at significant risk for developing chronic PTSD," Young-McCaughan said.. 

In 2008, the DoD granted $35 million to establish a PTSD Research Consortium administered through the U.S. Army Medical Research and Materiel Command Congressionally-Directed Medical Research Program and funded by the DoD's Psychological Health and Traumatic Brain Injury Research Program

One PTSD Research Consortium was funded, namely the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR) which is a multi-disciplinary and multi-institutional research group centered in San Antonio.

STRONG STAR multidisciplinary PTSD research consortium director, Stacey Young-McCaughan, PhD, RN, meets with (left) consortium director, retired U.S. Air Force Lt. Col. Alan Peterson, PhD, professor, department of psychiatry, University of Texas Health Science Center San Antonio, to discuss the consortium's numerous clinical trials on PTSD. courtesy UTHSCSA

Young-McCaughan coordinates the clinical trials associated with STRONG STAR, which is led by consortium director, retired U.S. Air Force Lt. Col. Alan Peterson, PhD.

"Congress has appropriated a one-time award set aside for 5 years of research," Young-McCaughan said. "This is a rigorous infrastructure that will benefit both military and civilian patients."

A Team Effort

As the consortium coordinator, Young-McCaughan and STRONG STAR investigators hope to improve countless lives by preventing the onset of chronic PTSD in younger veterans.

The objective is to develop and evaluate the most effective early-interventions possible for the detection, prevention and treatment of combat-related PTSD in active-duty and recently discharged OIF/OEF veterans, she said.

Under the leadership of UTHSCSA, the consortium is a team of military, civilian and Veterans Affairs (VA) institutions and investigators, as well as one of the largest populations of active-duty and recently discharged OIF/OEF combat veterans in the nation.

"We have organized a team to create and implement a centralized, coordinated, health services research program to identify and solve many of the problems related to causes, diagnoses, treatment and rehabilitation of PTSD and other trauma-related disorders," Young-McCaughan said.

Combating PTSD & TBI

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The VA/DoD Clinical Practice Guidelines are available on-line for anyone caring for veterans of combat. Evidence-based guidelines addressing PTSD, mild traumatic brain injury, substance use disorder, amputation, and post-deployment health as well as other commonly occurring conditions can be found at Many of the references and tools developed for use implementing the guidelines can be downloaded directly from this site. You are correct that the challenges these individuals can be daunting. Thank you for your work caring for our nation’s heroes.

Stacey November 12, 2009

Is there any additional resources that we civilian healthcare providers in private psychiatric facilities can employ while treating active duty members or veterans suffering from PTSD , TBI and Substance Abuse. Some individuals are very challenging....

Edison October 15, 2009
San Antonio, TX


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