A Meta-Analysis of the Effectiveness of Military and Veterans Affairs (VA) Combat-Related PTSD Programs

A meta-analysis was conducted to examine the effectiveness of 55 treatment outcomes reported by military and Veterans Affairs (VA) treatment centers for combat-related posttraumatic stress disorder (PTSD). The analysis includes 46 tested treatment outcomes derived from 21 psychotherapy studies, and nine tested treatment outcomes derived from seven pharmacotherapy studies, which were obtained through PsychINFO and PsychARTICLES database searches, as well as a reference search. Analysis of all treatment outcomes suggested a statistically significant, and meaningful, decrease in PTSD symptoms between baseline and post-treatment time points, t(54) = 9.27, p < .001, d = 0.35. Additionally, analysis of outcomes between psychotherapy and pharmacotherapy treatments resulted in statistically significant differences in PTSD assessment scores at post-test, indicating a greater degree of change for psychotherapy than for pharmacotherapy.

Back in Blue: The Successful Reintegration of Combat Veteran Law Enforcement Officers.

In the past ten plus years, several million national guard and reserve component military personnel have been deployed in support of the global war on terrorism. Tens of thousands of those personnel also serve as full-time law enforcement officers in police and sheriff's offices around the country. Life as a law enforcement officer is tough enough, but when combined with the psychological baggage brought on by months of war, reintegrating into civilian life and the role of a law enforcement officer can be extremely difficult. This article discusses a reintegration program specifically for law enforcement agencies that is designed to promote long-term psychological and social health in combat veteran officers. The program's costs are offset by the many assets (leadership, tactical training, etc.) these men and women bring to the department. By committing to the long-term successful reintegration of these individuals, departments enhance their own forces and improve community safety.

The Perpetration of Spousal Abuse by Male Combat Veterans: Recommendations for Individualized Group Domestic Violence Treatment for Veterans

Recent estimates suggest that spousal abuse is, in fact, on the rise in the U.S. military (The Miles Foundation, 2005). As research specific to the impact of posttraumatic stress disorder (PTSD) on U.S. soldiers has grown since the Vietnam War, clinicians and researchers have begun to investigate how combat-related trauma affects veterans in terms of aggression, hostility and social/emotional functioning. The training and stressors experienced by soldiers in the military are unique and affect all aspects of the veteran's functioning. This paper discusses questions related to why combat veterans may be at increased risk to commit spousal abuse (verbal, psychological, and physical), the relationship between PTSD, substance use, and violence, and the advantages to individualizing group domestic violence (DV) treatment programs for combat veterans. Recommendations will be made for a DV treatment program specifically for combat veterans who also suffer from PTSD.

I'm Not Who I Thought I Was: A Contextual Resolution to the Identity Loss of Combat PTSD.

Given the historical rates of combat post-traumatic stress disorder (PTSD), one can expect 30% of soldiers returning from current military conflicts to suffer from PTSD. For these individuals, various cognitive behavioral therapies (CBT) are the most commonly employed treatments. Unfortunately, however, symptom relapse can be expected with the various CBT approaches, as traumatic memories remain. Soldiers are imbued with a militarized identity, and the identity loss experienced by those soldiers who suffer from PTSD is particularly painful for this population, as the militarized identity effectively disavows personal suffering. For this reason, many combat veterans diagnosed with post-traumatic stress disorder experience undue, prolonged suffering as they struggle to make sense of the different person they fear they have become. This paper contrasts certain versions of Western philosophy, which view the self as a fixed and reified entity with certain versions of Eastern philosophy, which view the self as more contextual and fluid, in order to illuminate the value of employing third wave behavioral treatments, specifically Acceptance and Commitment Therapy (ACT), to treat the identity loss experienced by military veterans with PTSD. ACT echoes the Buddhist principle that attachment to verbally-constructed conceptual notions of self contribute to undue suffering, and that more vital living can be achieved by assuming a more contextual and experiential perspective on identity. Research and anecdotal accounts are cited to illustrate why treatment for identity loss associated with combat PTSD should be less focused on reconstructing a historically substance-oriented self and more focused on an epistemological reorientation to a deconstructed, contextual self.

Everyday Indivisibility: How Exclusive Religious Practices Explain Variation in Subnational Violence Outcomes

This project explores the puzzle of religious violence variation. Religious actors initiate conflict at a higher rate than their secular counterparts, last longer, are more deadly, and are less prone to negotiated termination. Yet the legacy of religious peacemakers on the reduction of violence is undeniable. Under what conditions does religion contribute to escalated violence and under what conditions does it contribute to peace? I argue that more intense everyday practices of group members, or high levels of orthopraxy, create dispositional indivisibilities that make violence a natural alternative to bargaining. Subnational armed groups with members whose practices are exclusive and isolating bind together through ritual practice, limit the acceptable decisions of leaders, and have prolonged timeframes, all of which result in higher levels of intensity, intransigence and resolve during violent conflict. The theory challenges both instrumentalist and constructivist understandings of social identity and violence. To support this argument, I construct an original cross-national data-set that employs ethnographic data on micro-level religious practices for 724 subnational armed groups in both civil wars and terror campaigns. Using this data, I build an explanatory “religious practice index” for each observation and examine its relationship with conflict outcomes. Findings suggest that exclusive practice groups fight significantly longer with more intensity and negotiate less. I also apply the practice model to qualitative cases. Fieldwork in the West Bank and Sierra Leone reveals that groups with more exclusive religious practicing membership are principle contributors to violence, whereas those with inclusive practices can contribute to peace. The project concludes with a discussion about several avenues for future research and identifies the practical policy applications to better identify and combat religious extremism.