Monday, January 31, 2011

Prison, corrections staff & PTSD

I wouldn't want to work in a prison. Would you? Talk about a stressful job. In fact, working as a corrections officer is so stressful that some people come down with PTSD just from doing their jobs.

In fact, according to a nationwide survey, 39% of corrections workers met the criteria for having PTSD, while another 15-20% showed signs of being at risk of PTSD.

The PTSD risk comes from seeing violence, having violence committed against you, and the constant fear ("prolonged exposure") of what could happen next.

From a report on the study: "Of the 720 anonymous corrections employees from across the country who took part in the survey, 99.9 percent had witnessed violence at work, and almost 56 percent experienced one or more physical assaults."

Read more here: 
Desert Waters looks at PTSD in corrections staff

Wednesday, January 26, 2011

Could bartenders help diagnose depression and PTSD?

The old saw is that your local bartender will listen to your problems when nobody else will.

But what if they could do more than listen to your problems? What if they could provide answers?

That's the idea behind a new study published in the Journal of Military and Veterans' Health.

Let's go to the press release:

A pilot study suggests that some bartenders may be in a good position to identify veterans in need of mental health services and help connect them to the appropriate agency.

Researchers at Ohio State University surveyed 71 bartenders employed at Veterans of Foreign Wars posts in Ohio.

The results showed that bartenders felt very close to their customers and that these customers shared their problems freely with them, said Keith Anderson, lead author of the study and assistant professor of social work at Ohio State.

"Many of the bartenders said that their customers were very much like family," Anderson said.

"Given the closeness of the relationships, these bartenders are in a really great position to help these veterans – if they are given the right training and the right tools."

Of the bartenders surveyed, 73 percent said their role with their customers was "like family." And about 70 percent of the bartenders said that the veterans they interacted with "always" or "often" shared their problems with them.
Encouragingly, 80 percent of the bartenders said they would be willing to refer veterans to services at the U.S. Department of Veterans Affairs.

These results show why bartenders may be especially well-suited to help troubled veterans, Anderson said.

"We need to find the veterans where they are. Many of them may not be willing to go to a VA clinic to seek out help on their own. The VFW bartenders may be one of our best chances to reach some of these veterans," he said.

Part of this study looked into whether bartenders might already have the sensitivity to notice problems that others might not see:

About two-thirds of those surveyed rated their ability to recognize depression in their patrons as "moderate," while the remaining third rated their ability as "high."

Only 14 percent rated their ability to recognize symptoms of post-traumatic stress disorder as "high" while 43 percent rated their ability as low.

Two small quibbles: 1) We hope bartenders can be trained to tell trauma to stop drinking, and 2) younger vets simply aren't joining their local VFW or American Legion these days. But if you could take this further to all bartenders, it might help make them a very good resource for people who would otherwise be drowning their sorrows.

Read the whole release about this pilot study here:

Bartenders may have role in assisting troubled war veterans

Tuesday, January 25, 2011

PTSD and Worker's Comp

Research has consistently shown that trauma causes physical changes to the human brain. (See the PTSD News archive for several examples.) But if you are traumatized by your job, can you claim worker's comp?

In Wyoming, the answer is no. That state's Supreme Court ruled in December that the biological changes to the brain are not the same as physical injuries and are therefore not eligible for worker's comp.

The case came up when a volunteer firefighter experienced PTSD after seeing two of his coworkers burned and killed during a fire. The court called these "mental injuries" and said the law did not offer compensation for these types of wounds.

Read more: Risk & Insurance Online - Biological roots of PTSD don't trigger comp for physical injuries

What do you think? Should firefighters, police personnel, rescue workers and others be eligible for worker's comp due to PTSD? How about victims of workplace bullying or sexual harassment? Should PTSD be considered a physical injury? Let us know your thoughts.

Monday, January 24, 2011

Must-read: The Neuroscience of Fear and Loathing

What happens to your brain -- physically -- during moments of extreme stress and fear? Dario Dieguez, Jr, Ph.D. gives you the latest science:

The Neuroscience of Fear and Loathing

Wednesday, January 19, 2011

Military's prescription drug policy criticized - especially for Seroquel

In the first part of an ongoing investigative series, news site Nextgov reports that the U.S. military's prescription drug policies puts its soldiers and its veterans at risk.

"A June 2010 internal report from the Defense Department's Pharmacoeconomic Center at Fort Sam Houston in San Antonio showed that 213,972, or 20 percent of the 1.1 million active-duty troops surveyed, were taking some form of psychotropic drug: antidepressants, antipsychotics, sedative hypnotics, or other controlled substances."

Many of these soldiers and veterans are on multiple anti-psychotics, which one doctor said is not necessary.

Most of the criticism comes down on the use of the anti-psychotic Seroquel, which the military allows to be prescribed as a sleep aid -- which is not one of the uses the FDA has approved for the drug.

"Smith said he was "flabbergasted" that military doctors prescribed Seroquel as a sleep aid, as the Food and Drug Administration has not approved such a use and other drugs are more effective. Breggin agreed, calling Seroquel "very dangerous, expensive and not proven to be more beneficial than other drugs."

Jackson noted Seroquel has the addictive potential of opioids, such heroin."

Nextgov also spoke to Stan White, whose son Andrew suffered from PTSD and was prescribed multiple medications, but barely had access to talk therapy:

"White said Andrew was so befuddled by his drug cocktail, which included Klonopin, a benzodiazepine, and hydrocodone, an opiate, that his wife, Shirley, had to dole them out forAndrew. White said Seroquel did not diminish Andrew's nightmares at even such a high dosage.

While talk therapy is widely viewed as one of the most effective treatments for some mental health problems, including PTSD, White said Andrew had only a few such sessions, primarily with a local veterans' peer therapy group. It was not until the week Andrew died that a VA psychiatrist decided to begin intensive sessions with him."

You can (and should) read Nextgov's entire report here:

Military's drug policy threatens troops' health, doctors say

Thursday, January 13, 2011

Can a Positive Attitute Prevent PTSD?

Can you train soldiers to be more optimistic in the face of traumatic events, and can that help to prevent them from developing PTSD?

Researchers from Michigan State University asked those questions as they examined the data from a 2004 study of Iraq veterans.

According to a report on their work, the researchers "found that soldiers who are trained to be more optimistic in traumatic situations are less likely to develop mental health problems, such as depression, anxiety or PTSD."

"There is evidence that if we can train people to be more psychologically resilient — that is, less catastrophic in their thinking and more optimistic and more hopeful — then they function better when they encounter traumatic situations," said John Schaubroeck, lead author of the study.

Their work will be published in the January issue of the Journal of Occupational Health Psychology, which is not yet online.

According to the report in "Personal Liberty Digest" (an "ultra-conservative" publication), "Schaubroeck added that military leaders play an important role in sending a message of hope and optimism to their troops. He said it is important for officials to provide immediate support for an individual who experiences trauma because by the time they consult a health professional, mental problems may already escalate to severe levels."

What say you to this theory?

Wednesday, January 12, 2011

PTSD in Firefighters, First Responders & Other Rescuers

Two recent news stories highlight the oft-forgotten sufferers of PTSD: First responders, firefighters and other rescue workers.

First up, an NPR article about how the constant threat of working as a first responder or other rescue worker can build up until PTSD symptoms develop.

"Little by little, it just started to build, and then one day, the slideshow that was all these events started running in my head and I couldn't control it," Michael Ferrara told NPR. It all came to a head for him when a friend of his was killed while on duty.

According to NPR (itself covering a story from Outside magazine), PTSD often goes undiagnosed in these occupations because the men who fill these jobs do not like to admit when they are in emotional pain.

But better understanding of PTSD allows both managers and rescue workers to not only deal with their symptoms better, but to recognize them when they first show up.

An Ontario-based newspaper called Cottage Country Now also discusses how volunteer firefighters can be ill-equipped to deal with the trauma of their jobs. Part of this comes from constantly working with survivors -- or seeing those who did not survive. "You're seeing people on the worse day of their life; their house burnt down, they had a heart attack, something bad happened," researcher Brad Campbell told the paper. Campbell's study is one of the first major studies of PTSD in firefighters.

Tuesday, January 11, 2011

96% of 9/11 Survivors Suffer PTSD Symptoms

A survey of 3,271 evacuees of the World Trade Center found that almost all of them -- 95.6% -- had displayed at least one symptom of PTSD.

A full 15% of survivors tested positive for PTSD in the 2-3 years following 9/11.

"PTSD risk was greater among survivors who experienced serious life threat as defined by location in the towers, time of evacuation initiation, or dust cloud exposures," said the study's first author, Laura DiGrande, in a prepared release. "As one would expect, individuals who were exposed to several of the most troubling and life-threatening events during the disaster were at the greatest risk of PTSD."

The study found a few interesting statistics: lower-income survivors were more likely to develop PTSD, as were blacks and Hispanics. People whose employers were killed also seemed to develop PTSD at a greater rate.

Meanwhile, exactly what each of these survivors encountered seemed to affect their changes of developing PTSD. Some where injured, some saw "horror," others were caught in the dust cloud, some were on very high floors of the Twin Towers. Those who experienced more than one of these situations had significantly greater levels of PTSD, to the point where the authors could even come up with a mathematical formula for the risk of PTSD based on the number of factors the individuals encountered.

The study appears in the online edition of the American Journal of Epidemiology. The full paper is behind a subscription firewall, but you can read the abstract here.

Monday, January 3, 2011

Sexual Harassment and PTSD

A new study in the Journal of Interpersonal Violence examines why (and how) sexual harassment can cause PTSD.

The paper is behind a subscription firewall, but here's the abstract:

Researchers have compiled significant evidence demonstrating that sexual harassment leads to psychological harm, including the full symptom picture of PTSD, but few have examined the psychological processes involved. Research on attributions among trauma victims would suggest that causal attributions and perceptions of control may be important predictors of outcomes. The authors discuss a study involving a path model that used data from 189 women involved in sexual harassment litigation. Results indicate that both self-blame and harasser blame were positively related to PTSD symptoms. Control over recovery and the perception that future harassment is unlikely were both related to fewer PTSD symptoms. Unexpectedly, perceived control over future harassment is related to higher levels of PTSD symptoms. Implications for research and practice are discussed.

Here's the link:

PTSD Symptoms and Sexual Harassment: The Role of Attributions and Perceived Control — J Interpers Violence