Posttraumatic stress disorder among veterans of the Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) wars: Psychological comorbidities, postdeployment social support and unit support

Much attention has been given to treating Operation Iraqi Freedom/Operation Enduring (OIF/OEF) Veterans with posttraumatic stress disorder (PTSD). However, little attention is given to those Veterans who do not meet diagnostic criteria for PTSD but who may still benefit from intervention. Research is needed to investigate the impact of how different racial/ethnic backgrounds, different levels of social support and comorbid mental health disorders impact OIF/OEF Veterans with varying levels of PTSD. The purpose of this dissertation is to examine the association of comorbid Axis I disorders, race/ethnicity, different levels of postdeployment social support and unit support on OIF/OEF Veterans with varying levels of PTSD. Data for this dissertation were from postdeployment screenings of OIF/OEF Veterans from a large Veterans Affairs hospital in southeast Texas. To examine the study hypotheses, we conducted multinomial logistic regressions of the clinician reported data. ^ The first article examined the prevalence of subthreshold and full levels of PTSD and compared Axis I and alcohol use comorbidity rates among 1,362 OIF/OEF Veterans with varying levels of PTSD. Results suggest that OIF/OEF Veterans with subthreshold PTSD experience similar levels of psychological distress as those with full PTSD and highlight the need to provide timely and appropriate mental health services to individuals who may not meet the diagnostic criteria for full PTSD. ^ These results suggest that OIF/OEF Veterans of all race/ethnicities can benefit from strong social support systems. Postdeployment social support was found to be a protective factor against the development of PTSD among White, Black and Hispanic veterans while deployment unit support was a protective factor only among Black Veterans. The second article investigated the association between postdeployment social support and unit support with varying levels of PTSD by race/ethnicity among 1,115 OIF/OEF Veterans. ^ The results of this study can help to formulate treatment and interventions for OIF/OEF Veterans with varying levels of PTSD and social support systems.^

Treatment modalities of female Operation Iraqi Freedom/Operation Enduring Freedom Veterans with posttraumatic stress disorder: A systematic review of the literature

Objective. To review professional literature regarding treatment modalities of post-traumatic stress disorder (PTSD) amongst female Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans, to assess the efficacy of these treatment options, and to summarize implications of the findings from this literature. Design. Systematic review of published literature. Data sources. Medline, Pubmed, Psycinfo. Review Methods. Articles selected for the literature review pertain to the treatment options of female OIF or OEF veterans who have a diagnosis of PTSD. In addition, other relevant articles, such as articles that discuss the prevalence of the problem, access to care, and similar treatment modalities for PTSD in other war settings, were selected for background information for the review. Results. The search strategy identified 1,305 potential journal articles, taken from thorough searches in Medline, Pubmed, and Psycinfo. These articles were then imported into Refworks. Following final screening, there were 18 articles included in the systematic review and 28 articles used as background information. The remaining articles were excluded following screening of abstract and/or full text of articles. Treatment modalities presented in these trials include: Exposure Therapy (average of 68% reduction in PTSD symptoms), Imagery Rehearsal Therapy (23% reduction), Body-Oriented Therapy (57% reduction), Electroconvulsive Therapy (35% reduction), Holographic Reprocessing (47% reduction), a self-defense training program (13% reduction), Cognitive Behavioral Therapy (65% reduction) and a variety of pharmacotherapies (antipsychotics at 81% reduction, sympatholytic drug at 100% reduction). Outcomes of the studies included in this systematic review were measured by using personal assessment of whether there was a reduction in symptoms of PTSD, based on the results in each study. Conclusion. Overall, all of the treatment modalities investigated in the systematic review proved to be somewhat effective in relieving the burden of symptoms of PTSD amongst female veterans of OIF/OEF. In addition to pharmacotherapy, which had the highest reduction in PTSD symptoms, both the Exposure Therapy and the Cognitive Behavioral Therapy techniques proved to have the most positive results. As all of the therapies had a positive effect on this population, to some degree, a study needs to be done in the future to compare and contrast the efficacy of each therapy intervention when applied to a standardized population.^

A Qualitative Study of Potential Suicide Risk Factors Among Soldiers Transitioning From Operation Iraqi Freedom/Operation Enduring Freedom

Using qualitative methods, this study explored potential risk factors for suicide, as defined by Joiner's Interpersonal-Psychological Theory of Suicide (IPTS), in a population of Soldiers returning from deployment in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF). Sixty-eight Soldiers participated in semi-structured interviews during the period of transition from deployment to the garrison environment. These Soldiers were asked about changes in perception of pain, experiences of perceived burdensomeness, and lack of belonging. Interviews were transcribed and analyzed. A phenomenological methodology was employed (Creswell, 2006). In response to questions about perception of pain, Soldiers discussed both positive and negative changes in their experience of physical and emotional pain. When asked about experiences of perceived burdensomeness, Soldiers described changes related to deployment, such as injuries and combat related guilt, as well as changes related to transition from combat, including care seeking, reintegration into family and society, and emotional distancing. Regarding the experience of lack of belonging, Soldiers described difficulties related to the deployment, such as combat injuries, leadership roles, and individual differences, as well as difficulties related to reintegration such as symptoms of emotional numbing and distancing. Findings highlight the potential utility of IPTS in exploring both acute and chronic suicide risk factors associated with deployment and transition, as well as potential treatment strategies that may reduce suicide risk in the population of Soldiers during reintegration.

Miehittämättömän ilma-aluksen hyödyt ja haitat ilmatiedustelussa operaatio Enduring Freedomissa

Tämän tutkielman tarkoituksena on kirjallisuuskatsauksen keinoin luoda käsitys miehittämättömän ilma-aluksen ilmatiedustelukäytön hyödyistä ja haitoista operaatio Enduring Freedomissa. Tutkielmassa pohditaan lisäksi UAV:iden tulevaisuuden näkymiä ja kehityssuuntia ilmatiedustelun kannalta. Tämä tutkielma sisältää kvalitatiivisen tutkimuksen piirteitä ja tutkimusmetodina käytetään narratiivista kirjallisuuskatsausta. Tutkielman pääluvuissa tutustutaan UAV-konseptiin sekä tutkitaan UAV:n hyötyjä ja haittoja ilmatiedustelussa operaatio Enduring Freedomissa. Tutkielmassa on pyritty tutustumaan aihealueeseen kokonaisvaltaisesti ja sen pohjalta luomaan teoreettinen kokonaisuus tutkimuskysymyksiin vastaten. Operaatio Enduring Freedom alkoi 7.10.2001, kun Yhdysvaltain johtama liittouma hyökkäsi Afganistaniin vastauksena 11.9.2001 tehtyihin terrori-iskuihin. Operaation tavoitteena oli tuhota terroristien koulutusleirit ja infrastruktuuri Afganistanin alueella, pidättää al-Qaidan johto sekä lopettaa terrorismitoiminta Afganistanissa. Yhdysvaltain ilmavoimat on käyttänyt operaation alusta alkaen ilmatiedustelussa pääasiassa kahta UAVtyyppiä, jotka ovat RQ/MQ-1 Predator ja RQ-4 Global Hawk. Tutkielmassa perehdytään näiden kahden UAV:n hyötyihin ja haittoihin. Vertailupohjana käytetään miehitettyjä ilma-aluksia. Tutkielmassa käytettyjen lähteiden perusteella voidaan todeta, että miehittämättömillä ilma-aluksilla on etuja, joita ei voi saavuttaa miehitettyjä ilma-aluksia käyttäen. Hyödyt on jaettu tässä tutkielmassa rakenteellisiin, kustannuksellisiin ja tehtäväkohtaisiin hyötyihin. UAVkäytön merkittävin haitta lienee maa-aseman ja ilma-aluksen välisen datalinkin aiheuttamat haasteet ja rajoitteet. Lisäksi miehittämättömän ilma-aluksen haavoittuvuus ilmatorjuntatulten ja ilmasta ilmaan -ohjusten vaikutuspiirissä on vielä tällä hetkellä haaste. Tutkielmassa käsitellyt hyödyt ja haitat on todettu operaatio Enduring Freedomin kaltaisessa epäsymmetrisessä toimintaympäristössä, joten niiden soveltuvuutta symmetriseen toimintaympäristöön ei ole juurikaan arvioitu. Miehittämättömien ilma-alusten kehitystä todennäköisesti jatketaan tulevaisuudessa, ja kehityksen painopiste tullee olemaan monikäyttöisten UAV:iden kehityksessä. UAV:t tullee tulevaisuudessa korvaamaan miehitetyt ilma-alukset ilmatiedustelun ja ilmasta maahan -toiminnan osalta.

A Exploração Aeroespacial no Âmbito da Segurança e da Defesa. O Caso da China

Dissertação de Mestrado em Ciência Política e Relações Internacionais Área de Especialização: Relações Internacionais

Aseistettujen UAV:iden käyttö Afganistanin sodassa

Nykyajan sodankäynnissä jatkuvan tilannekuvan ylläpitäminen, kaukovaikuttaminen ja täsmäiskut ovat nousseet tärkeisiin rooleihin. Perinteisten lentokoneiden rinnalle taistelukentille ovat tulleet miehittämättömät ilma-alukset, joiden käyttö on lisääntynyt valtavasti 2000-luvun puolella. Tutkimuksessa tarkastellaan Afganistanin sodassa käytettyjä miehittämättömiä ilma-aluksia ja niiden käyttöperiaatteita. Tutkielma on laadullinen eli kvalitatiivisin menetelmin tehty tutkimus, jonka menetelmät painottuvat asiakirja- ja tekstianalyysiin. Päätutkimuskysymyksenä on ”Mitä taktisia elementtejä UCAV tuo taisteluun?”. Tutkimuksessa esitellään UAV yleisesti sekä Afganistanin sodassa käytetyt mallit. Tutkielma jakautuu lukuihin, joista ensimmäisessä esitellään UAV:ta teknisesti ja toisessa luvussa tarkastellaan UAV:iden käyttöä Afganistanissa. Kolmannessa pääluvussa tarkastellaan UAV:iden etuja ja heikkouksia lentokoneisiin verrattuna. Johtopäätöksissä saadut tulokset tiivistetään vastauksiksi tutkimuskysymyksiin. Tutkielman ajankohtaisuutta korostaa UAV-operaatioiden lisääntyminen sodissa jatkuvasti ja niiden lentotuntimäärien huomattava kasvu verrattuna lentokoneisiin. Myös Suomen Puolustusvoimat on päättänyt hankkia lisää tiedusteluun sopivia kevyitä UAV:ita.

An Acceptance and Commitment Approach to Issues of Behavioral Health Care in Soldiers

For over a decade, the U.S. military has been engaged in two distinct, yet equally deadly conflicts: Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). There are many physical and psychological effects of war necessitating the activation and interventions of a myriad of behavioral health professionals. The purpose of the paper was to understand how and if contemporary military culture may work to support or hinder application of an Acceptance and Commitment Therapy (ACT) approach to issues of psychological health among Soldiers. While the empirical research on efficacy with Soldiers is limited, a review of military culture revealed the promotion of rigid rule following, although effective in combat, influences the emotional control agenda and stigma while in garrison. However, empirical research demonstrating the clinical benefits and flexibility of ACT is rapidly emerging with civilian and Veteran populations. Suggested as a prevention technique utilized early in Soldier's training to increase psychological flexibility, ACT appears to demonstrate much promise in ameliorating the psychological consequences of war.

DUI program as OEF/OIF Veterans Outreach: Descriptive Data from Two Community-Based Outpatient Clinics

Although initially conceived as providing simply the preventive portion of an extended continuum of care for veterans, the Driving Under the Influence (DUI) program has turned out to be an important outreach service for active duty or recently discharged OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) veterans. Veterans receive empirically-based, state-mandated education and therapy under the only Department of Veterans Affairs (VA) - sponsored DUI program in the State of Colorado, with the advantage of having providers who are sensitive to symptoms of Post-Traumatic Stress Disorder (PTSD) and other relevant diagnoses specific to this population, including Traumatic Brain Injury (TBI). In this paper, the rapid growth of this program is described, as well as summary data regarding the completion, discontinuation, and augmentation of services from the original referral concern. Key results indicated that for nearly one third (31.9%) of the OEF/OIF veterans who were enrolled in the DUI program, this was their initial contact with the VA health care system. Furthermore, following their enrollment in the DUI program, more than one fourth (27.6%) were later referred to and attended other VA programs including PTSD rehabilitation and group therapy, anger management, and intensive inpatient or outpatient dual diagnosis programs. These and other findings from this study suggest that the DUI program may be an effective additional pathway for providing treatment that is particularly salient to the distinctive OEF/OIF population; one that may also result in earlier intervention for problem drinking and other problems related to combat. Relevant conclusions discussed herein primarily aim to improve providers' understanding of effective outreach, and to enhance the appropriate linkages between OEF/OIF veterans and existing VA services.

Hostages to Moscow, clients of Beijing. Security in Central Asia as the role of the West diminishes. OSW Study 10/2014

The goal of this publication is to attempt to assess the thirteen years (2001- -2014) of the West’s military presence in the countries of post-Soviet Central Asia, closely associated with the ISAF and OEF-A (Operation Enduring Freedom – Afghanistan) missions in Afghanistan. There will also be an analysis of the actual challenges for the region’s stability after 2014. The current and future security architecture in Central Asia will also be looked at closely, as will the actual capabilities to counteract the most serious threats within its framework. The need to separately handle the security system in Central Asia and security as such is dictated by the particularities of political situation in the region, the key mechanism of which is geopolitics understood as global superpower rivalry for influence with a secondary or even instrumental role of the five regional states, while ignoring their internal problems. Such an approach is especially present in Russia’s perception of Central Asia, as it views security issues in geopolitical categories. Because of this, security analysis in the Central Asian region requires a broader geopolitical context, which was taken into account in this publication. The first part investigates the impact of the Western (primarily US) military and political presence on the region’s geopolitical architecture between 2001 and 2014. The second chapter is an attempt to take an objective look at the real challenges to regional security after the withdrawal of the coalition forces from Afghanistan, while the third chapter is dedicated to analysing the probable course of events in the security dimension following 2014. The accuracy of predictions time-wise included in the below publication does not exceed three to five years due to the dynamic developments in Central Asia and its immediate vicinity (the former Soviet Union, Afghanistan, Pakistan, Iran), and because of the large degree of unpredictability of policies of one of the key regional actors – Russia (both in the terms of its activity on the international arena, and its internal developments).

Transformation for what? /

One of the most significant of global security reassessments is currently underway, driven by Operations IRAQI FREEDOM and Operation ENDURING FREEDOM, continuing technological developments, budget constraints, and the debate associated with the 2005 Quadrennial Defense Review. To provide senior defense leaders with ideas on security transformation, the Strategic Studies Institute has joined with the Belfer Center for Science and International Affairs at Harvard University's John F. Kennedy School of Government to bring together top experts on an annual basis. For the third meeting in this series--held in November 2004--the National Defense University joined as a partner. The informed and free flowing debate at this conference generated a range of frank assessments and creative ideas about the status of security transformation. This report summarizes the debates and findings of the November session.