Combat Stress Injury Theory Research and Management 1st Edition by Charles Figley, William Nash 1138871605 9781138871601

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ISBN 10: 1138871605

ISBN 13: 9781138871601

Author: Charles R. Figley, William P. Nash

Combat Stress Injury represents a definitive collection of the most current theory, research, and practice in the area of combat and operational stress management, edited by two experts in the field. In this book, Charles Figley and Bill Nash have assembled a wide-ranging group of authors (military / nonmilitary, American / international, combat veterans / trainers, and as diverse as psychiatrists / psychologists / social workers / nurses / clergy / physiologists / military scientists). The chapters in this volume collectively demonstrate that combat stress can effectively be managed through prevention and training prior to combat, stress reduction methods during operations, and desensitization programs immediately following combat exposure.

Combat Stress Injury Theory Research and Management 1st Table of contents:

1 Introduction: For Those who Bear the Battle

References

Section I Theoretical Orientation to Combat Stress Management

2 The Stressors of War

Military Attitudes Toward Combat Stress

Combat Stress as a Weapon

Combat Stress as “Friction” to Be Overcome and Banished from Awareness

Combat Stress as a Leadership Challenge

Combat Stress as a Test of Personal Competence

The Specific Stressors of Deployment and Combat in Modern Military Operations

Physical Stressors

Cognitive Stressors

Emotional Stressors

Social Stressors

Spiritual Stressors

Conclusions

References

3 Combat/Operational Stress Adaptations and Injuries

Problems with Labeling Combat/Operational Stress Reactions

The Ethics of Labeling Combat/Operational Stress Reactions

Shifting Theories About the Causes of Operational Stress Casualties

Conceptual Foundation: Defining Stress and Adaptation

Stress and Adaptation as Biological Processes

Time Course of Adaptation

Stress and Adaptation as Psychological Processes

Stress and Adaptation as Social Processes

Stress Adaptation Summed Up

Three Tactics of Adaptation: Accommodate, Neutralize, or Disengage

The Stages of Adaptation: Dread, “in the Groove,” and Rebound or Fatigue

The Reversibility of Adaptation

Stress Injuries: Beyond the Limits of Adaptation

Traumatic Stress: An Impact Injury

Operational Fatigue: A Wear-and-Tear Injury

Grief: A Loss Injury

Summary and Conclusions

References

4 Competing and Complementary Models of Combat Stress Injury

Character-Leadership Model of Combat/Operational Stress Injury

Psychological Models of Combat/Operational Stress Injury

Psychoanalytic Perspectives on “War Neurosis”

Learning Theory Perspectives on Conditioned Fear Responses

Cognitive Theory Perspectives on Erroneous or Damaged Beliefs

Biological Models of Stress and Stress Injury

Patterns of Biological Response: Hard Wired and Fixed, or Learned and Plastic

Hard-Wired Stress Response Systems

Brain Stress Response Systems Involved in Learning

Biological Models of Stress Injury

Conclusion: “Everybody has Won, and all Must have Prizes”

References

Section II Research Contributions to Combat Stress Injuries and Adaptation

5 The Mortality Impact of Combat Stress 30 Years After Exposure: Implications for Prevention, Treatment, and Research

Study Overview

Review of Existing Research

Research Methods for Current Study

Ascertainment of Veterans’ Vital Status

Assessment of Veterans’ PTSD Status

Controlling for Study Bias, Confounding, and Combat Exposure

Statistical Methods

Study Results

Discussion of Study Findings

Implications for Current Study

References

6 Combat Stress Management: The Interplay Between Combat, Physical Injury, and Psychological Trauma

Traumatic Physical Injury: A Risk or a Protective Factor in the Development of Psychological Trauma?

Posttraumatic Stress Disorder Following Physical Injury: What is Known?

Posttraumatic Reactions Among Warfighters Injured During Combat in Lebanon

What can (and cannot) Be Learned from the Findings

Help-Seeking Behavior Among Injured Warfighters

Conclusions, Unresolved Issues, and Future Directions

References

Endnotes

7 Secondary Traumatization Among Wives of War Veterans with PTSD

Descriptive Accounts of Living with Traumatized Veterans

Empirical Findings of Secondary Traumatization in Wives of PTSD Veterans

The Wife’s Distress

The Marital Relationship

Separation and Divorce

Predictors of Secondary Traumatization Among Wives of PTSD Veterans

Predictors Pertaining to the Husband’s PTSD

Predictors Pertaining to the Wife

Predictors Pertaining to the Marital Relationship

Theoretical Explanations

Treatment

Summary and Recommendations for Further Study

References

Section III Combat Stress Management Programs

8 Historical and Contemporary Perspectives of Combat Stress and the Army Combat Stress Control Team

Introduction: Casualties of War

History of Combat Stress

Soldier’s Heart

Shell Shock

Battle Fatigue

Posttraumatic Stress Disorder

Combat-Operational Stress Reaction

Summary

The Army Combat Stress Control Team: A Look at its History, Mission, Configuration, and Professionals

History

Mission and Purpose

Configuration of the CSC Unit

Roles of the CSC Members

Summary

Case Studies

Case 1: Preventing Exacerbation of Combat Stress Symptoms

Case 2: Treatment in Theater—Preventing Unnecessary Evacuations

Case 3: Command Contributions—The Role of Leaders in Managing Combat-Operational Stress

Conclusion

Acknowledgments

References

9 Virtual Reality Applications for the Treatment of Combat-Related PTSD

Introduction

Virtual Reality

Rationale for Treatment of PTSD in VR

Virtual Reality Exposure Therapy for Combat-Related PTSD

Design and Development of the Full-Spectrum Virtual Iraq or Afghanistan PTSD Therapy Application

Technical Background and Development History

Clinical Application Control Options: Scenario Settings, User Perspectives, Trigger Stimuli, and the Clinical Interface

Scenario Settings

User Perspective Options

Trigger Stimuli

The Clinical Interface

Conclusions

Acknowledgment

References

Endnotes

10 Experiential Methods in the Treatment of Combat PTSD

Introduction

PTSD Symptom Clusters

Medication Treatments for PTSD by Symptom Cluster

Traditional Psychotherapy Treatments for PTSD

Reflective Psychotherapies

Combination Reflective and Experiential Psychotherapies

Experiential Psychotherapies

Virtual Reality–Assisted Exposure Therapy

Conclusion

Acknowledgments

References

11 Medication Management of Combat and Operational Stress Injuries in Active Duty Service Members

History of Pharmacotherapy for Combat/Operational Stress

Selective Serotonin Reuptake Inhibitors

How SSRI Antidepressants Work

Symptoms Relieved by SSRI Antidepressants

Practical Considerations in the use of SSRI Antidepressants

First Generation Antidepressants

Newer Antidepressants

Antiadrenergic Antihypertensives

How Antiadrenergic Antihypertensives Work, and how they Help

Anticonvulsants/Mood Stabilizers

How Anticonvulsants and Mood Stabilizers Work, and how they Help

Practical Considerations in the use of Anticonvulsants and Mood Stabilizers

Antipsychotics

How Atypical Antipsychotics Work, and how they Help

Practical Considerations for the use of Atypical Antipsychotics

Hypnotic and Sedative Medications

Benzodiazepines

Nonbenzodiazepine Hypnotics

Miscellaneous Medications which are Sedating as a Side Effect

Alcohol

Practical Considerations in the use of Alcohol.

Novel Classes of Medication

Conclusion

References

12 The Royal Marines’ Approach to Psychological Trauma

Historical Development

The MoD PTSD Case

Trauma Risk Management (Trim)—The Background

Psychological Management Following a Traumatic Event

Traumatic Stressors

TRiM—The Three Pillars

The Before–During–After Matrix

The Before–During–After Phases

The two TRiM Assessments

The 3-Day TRiM Risk Assessment.

The TRiM Scoring System

TRiM Risk Factors

TRiM Risk Assessment—The Structure

Summary

References

13 The Operational Stress Injury Social Support Program: A Peer Support Program in Collaboration Between the Canadian Forces and Veterans Affairs Canada

Introduction

The Creation of Operational Stress Injury Social Support

Lieutenant Colonel Grenier’s Experience

Definition

Peer Support

The Operational Stress Injury Social Support Program— A Peer Support Model

Research Component

Stigma and Operational Stress Injuries

Changing Attitudes—The Osiss Speakers Bureau

Combining Peer Support and Clinical Treatment

Conclusions

Acknowledgment

In memory

References

Endnotes

14 Spirituality and Readjustment Following War-Zone Experiences

Reflections on the Spiritual Effects of the War on Returning Troops: Commander Mark W. Smith (Navy Chaplain)

How Spirituality May Promote Trauma Recovery

Review of Recent Research on the Spirituality-Trauma Link Among Combat Veterans

Reasons why Soldier Reactions to this War May be More Varied

Guidelines for Incorporating Spirituality into Trauma Recovery

Specific Suggestions for Topics/Activities that Address Spiritual Needs

References

15 The Returning Warrior: Advice for Families and Friends

The Warrior

Recognizing and Anticipating Common Problems

Individual Relationships and Private Settings

Problems in Public Settings

Fluctuations in Problems

Resources and Services

The Positives

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