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Battling PTSD


As Krista points out, Austin, Texas saw a temporary bump in its population of science writers during the past few days. Being a newly minted Texan, I was able to attend, and I can affirm that, yes, the talk titled "Why Women have Sex" was particularly popular. (The answer? Mostly for the same reasons men do. Sorry to all the Mars/Venus theorizers out there.)

But it wasn't all sex talks at Science Writers '09. We also talked about war.

We've all heard the stories. Soldiers return from Iraq and Afghanistan to the United States only to find that haunting memories of combat have followed them home. Between 13 and 18 percent of Iraq veterans develop full-blown post-traumatic stress disorder. In an environment where 90 percent of soldiers report being shot at, mental health problems aren't such a surprise. What researchers don't know is why some people struggle to cope with trauma while others sail through combat relatively unscathed.

To find out, Michael Telch, a UT Austin psychologist and Stanford alum, came up with a novel idea: Look at soldiers before they're deployed. Previous researchers have questioned veterans after their return from combat, but such retrospective studies are limited because the respondents' memories of their experiences may be flawed.

So Telch worked with the army to find volunteers who would be deployed within the next 60 days. These soldiers went through a battery of tests, surveys and psychological assessments to measure their baseline responses to stress. They also gave saliva samples for genetic testing, had their brains imaged and inhaled a mixture of 35 percent carbon dioxide and 65 percent oxygen to induce breathlessness and lightheadedness, which many people find very frightening. Telch and his team measured changes in the participants' levels of the stress hormone cortisol in response to the test.

The hope, Telch said, was that the diversity of data would help psychologists pinpoint subtle risk factors for later psychological problems. "What we've done is to try to go beyond," he said. "The kind of data we're collecting cuts across multiple systems of human functioning."

Next, the researchers set up an online "stress log" for deployed soldiers to fill out every 30 days. These logs captured information on the soldiers' experiences and their responses to those experiences. Though you might expect participation in this step to be low - war can be chaotic, after all - 162 of the 178 deployed soldiers completed all of their logs.

The yet-unpublished results have Telch and his fellow researchers excited. Several of their pre-deployment tests did indeed predict later mental health during and after combat. A prior history of mental illness put soldiers at a greater list of both combat-related PTSD and depression. Soldiers who had strong reactions to the carbon dioxide breathing test were significantly more likely to have problems with stress and PTSD upon deployment. And those who showed high "anxiety sensitivity" - fear of experiencing anxiety, or anxiety about anxiety - also had increased risk for both anxiety and depression.

Many of these tests take just minutes to complete and could easily be used to screen for vulnerable soldiers, Telch said. Then, instead of trying to pick up the pieces after a soldier already has PTSD, army psychologists could work to prevent the disorder in the first place, perhaps by better preparing the soldiers for the emotional side of combat and keeping a close eye on them in the field.

"Some of these risks really are modifiable," Telch said. "One could actually begin to identify soldiers in-theatre who are starting to have problems."

Photo via the U.S. Army

For more on mental health and veterans, see this story in Inside Stanford Medicine.

Stephanie Pappas is a guest blogger based in Houston, Texas. She was formerly an intern for the Stanford School of Medicine Office of Communication and Public Affairs.

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