DCoE Blog

  • Understanding Cultural Differences and Health Care
    Service members from various branches at ceremony at stadium.
    U.S. Army National Guard photo by 1st Lt. Aaron Ritter

    Cultural identity can affect how service members and their families engage with their health care providers. A recent Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) webinar addressed these impacts and how health care providers can help minimize them.

    Our Diverse Military

    Like the larger American population, those who serve their country in the military represent an intersection of people from every race, class, gender and sexual orientation.

     

  • Learn to Recognize, Control Post-Deployment Anger
    U.S. Air Force photo by Tech. Sgt. Zachary Wolf

    Feeling anger is a normal part of your emotional spectrum. Service members may find that anger is a useful emotion during combat. However, once they return home, that anger — and the experiences that come with it — can cause problems. A recent webinar hosted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury addressed these problems and potential solutions.

    Signs of Anger

    Anger can range in intensity from irritation to rage and can be helpful or harmful, depending on the situation. The body reacts to anger with increased adrenaline, alertness, heart rate and blood pressure. Certain physical reactions (a clenched jaw, muscle tension, shakiness, restlessness, agitation, etc.) can help signal feelings of anger, even if you are not aware of those feelings. Over time excessive anger can cause long-term health issues.

  • Seek Help Early for Substance Abuse Following TBI
    Silhouette of man drinking a shot with other shots lined up in front of him
    U.S. Air Force photo by Senior Airman Jarvie Z. Wallace

    Traumatic brain injury (TBI) and substance use disorder share many symptoms, and one condition may often complicate the other. Experts from the Defense and Veterans Brain Injury Center (DVBIC) discussed the problems service members can face when the two conditions intersect during a webinar hosted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

    Research shows that substance misuse is responsible for 37-50 percent of all TBIs. The majority of individuals who experience a TBI have a history of substance misuse, which often continues after the injury. In addition, a TBI itself can lead to substance misuse, said Lars Hungerford, a senior clinical research director for DVBIC.

    “TBI is actually a risk factor for binge drinking, even after controlling for PTSD and demographic factors,” Hungerford said.

    Substance misuse, particularly alcohol use, can complicate TBI in several ways:

    • Increased likelihood of another TBI. That’s because substance misuse can impair balance, coordination and judgment.
    • Lowered seizure threshold. TBI may increase the risk of seizure from drinking, and alcohol can impede anti-seizure medications.
    • Delayed or halted brain recovery. Alcohol can cause inflammation of the brain, which inhibits its ability to heal.
  • Lessons Learned in Sports Concussion Management
    U.S. Air Force photo by Staff Sgt. Michael Ellis

    Defense and Veterans Brain Injury Center (DVBIC) experts discussed how best practices in sports concussion management benefit military medicine during a recent webinar. Just as athletic trainers and civilian sports medicine doctors decide when athletes are ready to get back in the game, military health care providers must assess when a service member can return to duty.

    Concussions make up more than 82 percent of traumatic brain injuries (TBI) in the military. The majority of these injuries happen in non-combat settings. Falls cause approximately 32 percent of concussions, and car accidents, assaults and impacts with objects (combined) account for the other 64 percent. These are similar to the same categories of injury mechanisms as sports-related concussions.

    However, concussions caused by blast exposure are also common in the military, said Dr. Scott Livingston, DVBIC education division director.

  • Clinical Guidelines for Suicide Prevention

    Suicide is a significant problem for the Defense Department. For providers, an essential piece of suicide prevention is a proven, step-by-step approach to treating potentially suicidal patients. A recent webinar presented by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury highlighted how the military constantly updates its suicide clinical practice guidelines.

    Eric Rodgers, director of the evidence-based practice program at the Department of Veterans Affairs (VA), talked about the standards and procedures for updating these guidelines.

    Suicide clinical practice guidelines undergo review by evidence-based practice workgroups. Workgroups include representatives from VA and the Defense Department, as well as individuals from multiple disciplines. They incorporate patient input and identify how new guidelines will affect treatment outcomes. The groups which oversee the suicide guidelines include members specifically chosen to address the subject of suicide.

    Guidelines often need multiple reviews before approval. In some cases they may not meet standards for approval at all.

  • Alcohol Use, PTSD among Combat Servicewomen
    woman in battle dress fatigues briefing service men and women
    U.S. Navy photo by Mass Communication Specialist 3rd Class Amy M. Ressler

    Women didn’t officially serve in ground combat positions until 2013. However, many of them did their jobs in real-time combat settings, often under direct fire. Despite this, research on how deployment affects women is limited. Scientists discussed the need for more research and other post-deployment concerns that affect female service members during a webinar hosted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

    Where’s the Data?

    Almost half of female service members eligible for care through the Defense Health Agency do not use it. This lack of use makes it harder to gather data on their post-combat experiences. Also, most of the post-deployment studies on PTSD and substance use disorder occurred before women openly served in combat. This means most deployment-related studies do not accurately reflect the experiences of women.

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