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Boska RL, Bishop TM, Capron DW, Paxton Willing MM, Ashrafioun L. Difficulties with emotion regulation within PTSD clusters and moral injury subtypes. Mil Psychol 2024:1-9. [PMID: 38421375 DOI: 10.1080/08995605.2024.2322904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
Treatment and research centered on trauma-related mental health issues have largely focused on posttraumatic stress disorder (PTSD); however, moral injury is another important mental health concern requiring attention. There is a paucity of research examining how PTSD and moral injury affect emotion regulation. The current investigation examined how PTSD clusters and moral injury subtypes were uniquely associated with difficulties with emotion regulation. Participants consisted of 253 previously deployed military personnel who were recruited online. To be included in the study, participants had to verify that they had served in the U.S. Military, had been deployed as part of their military service, and endorsed elevated levels of symptoms associated with PTSD and/or moral injury. A hierarchical linear regression was conducted to examine the association between PTSD symptom clusters, moral injury subtypes, and difficulties with emotion regulation. Results indicated that alterations in arousal and reactivity was the only PTSD symptom cluster associated with difficulties with emotion regulation. Self-transgressions was the only facet of moral injury significantly associated with difficulties with emotion regulation. This is the first study to examine the association between emotion dysregulation, PTSD symptom clusters, and moral injury in previously deployed U.S. Military.
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Affiliation(s)
- Rachel L Boska
- The War Related Illness and Injury Study Center, The VA New Jersey Healthcare System, East Orange, New Jersey
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, New York
| | - Todd M Bishop
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, New York
- Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, New York
| | - Daniel W Capron
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana
| | - Maegan M Paxton Willing
- Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Lisham Ashrafioun
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, New York
- Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, New York
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Danahy MP, Paxton Willing MM, Tate LL, Shuping E, Riggs DS. Associations between psychological and respiratory distress in post-deployment Veterans. Mil Psychol 2023; 35:529-538. [PMID: 37903168 PMCID: PMC10617378 DOI: 10.1080/08995605.2022.2131189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/23/2022] [Indexed: 10/17/2022]
Abstract
Since September 11, 2001, over 2.7 million United States service members have deployed to South-West Asia and the Middle East and have been exposed to environmental hazards and psychological trauma. Many of these service members have returned with medical and psychological illnesses, some of which have proved complex and resistant to treatment. One notable constellation of symptoms is post-deployment respiratory illness, which has become a focus of research and policy efforts. The present study sought to examine the impact of post-deployment psychological distress on respiratory symptom severity. Data were obtained from the Veterans Affairs Airborne Hazards and Open Burn Pit Registry (AHOBPR) health surveillance database (N =107,403). Psychological factors were compared against common organic and environmental predictors of post-deployment respiratory distress. Psychological distress following deployment was a stronger predictor of 12-month shortness of breath severity than general respiratory pathology or level of exposure to environmental hazards, controlling for gender, age, race, and tobacco use. Additionally, psychological distress was a better predictor of shortness of breath severity than documented respiratory illnesses including asthma, chronic obstructive pulmonary disease, and chronic bronchitis. Implications and directions for future research are discussed, as well as potential alterations to existing treatment and health surveillance paradigms.
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Affiliation(s)
- Murphy P. Danahy
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Maegan M. Paxton Willing
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Henery M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
- Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Larissa L. Tate
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Eric Shuping
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Post-Deployment Health Services, Patient Care Services, Veterans Health Administration, Washington, DC
| | - David S. Riggs
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Center for Deployment Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Paxton Willing MM, Srikanchana R, Pickett TC, Ollinger JM, Riggs DS, Werner JK, Sours Rhodes C. An examination of volumetric and cortical thickness correlates of posttraumatic nightmares in male active duty service members. Psychiatry Res Neuroimaging 2022; 327:111546. [PMID: 36302277 DOI: 10.1016/j.pscychresns.2022.111546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022]
Abstract
Posttraumatic nightmares commonly occur after a traumatic experience. Despite significant deleterious effects on well-being and their role in posttraumatic stress disorder, posttraumatic nightmares remain understudied. The neuroanatomical structures of the amygdala, medial prefrontal cortex, hippocampus, and anterior cingulate cortex constitute the AMPHAC model (Levin and Nielsen, 2007), which is implicated in the neurophysiology of disturbing dreams of which posttraumatic nightmares is a part. However, this model has not been investigated using neuroimaging data. The present study sought to determine whether there are structural differences in the AMPHAC regions in relation to the occurrence of posttraumatic nightmares. Data were obtained from treatment-seeking male active duty service members (N = 351). Posttraumatic nightmares were not significantly related to gray matter volume, cortical surface area, or cortical thickness of any the AMPHAC regions when controlling for age and history of mild traumatic brain injury. Although the present analyses do not support an association between structural measures of AMPHAC regions and posttraumatic nightmares, we suggest that functional differences within and/or between these brain regions may be related to the occurrence of posttraumatic nightmares because functional and structural associations are distinct. Future research should examine whether functional differences may be associated with posttraumatic nightmares.
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Affiliation(s)
- Maegan M Paxton Willing
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; Center for Deployment Psychology, USU, Bethesda, MD United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, MD United States.
| | - Rujirutana Srikanchana
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - Treven C Pickett
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - John M Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - David S Riggs
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; Center for Deployment Psychology, USU, Bethesda, MD United States
| | - J Kent Werner
- Uniformed Services University of the Health Sciences (USU), Bethesda, MD United States; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States
| | - Chandler Sours Rhodes
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD United States; University of Maryland School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Bethesda, MD United States
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Paxton Willing MM, Tate LL, O'Gallagher KG, Evatt DP, Riggs DS. In-Theater Mental Health Disorders Among U.S. Soldiers Deployed Between 2008 and 2013. MSMR 2022; 29:11-17. [PMID: 36790903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Deployed service members regularly undergo demanding and stressful experiences that can contribute to mental health difficulties; however, there is a scarcity of studies examining rates of mental health disorders in-theater. The current study examined case rates of mental health disorders among deployed U.S. Army Soldiers using diagnostic encounter data from the Theater Medical Data Store. Case rates were calculated across 12 categories of mental health disorders. While in theater, soldiers' highest rates were for stress reactions and adjustment disorders, depression, anxiety, and sleep disorders. The lowest rates in theater were for psychosis, bipolar, somatic, and eating disorders. Notably, female soldiers had higher rates than their male counterparts for disorders in each of the 12 diagnostic categories. Results provide crucial information to aid in decision making about necessary interventions and provider competencies in deployed settings. Knowledge gained from these data may improve force readiness, help lessen disease burden, and inform military policy and prevention efforts.
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Affiliation(s)
- Maegan M Paxton Willing
- Uniformed Services University of the Health Sciences.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc
| | | | | | | | - David S Riggs
- Uniformed Services University of the Health Sciences
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Tate LL, Paxton Willing MM, French LM, Law WA, Bennion LD, Sullivan KW, Riggs DS. The effect of mTBI and PTSD symptoms on computerized cognitive performance: Results from a sample of treatment-seeking active duty US service members. Military Psychology 2020. [DOI: 10.1080/08995605.2020.1842037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Larissa L. Tate
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Maegan M. Paxton Willing
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Louis M. French
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- National Intrepid Center of Excellence/Walter Reed National Military Medical Center, Bethesda, Maryland
- Defense and Veterans Brain Injury Center, Silver Spring, Maryland
| | - Wendy A. Law
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- National Intrepid Center of Excellence/Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Layne D. Bennion
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Katherine W. Sullivan
- National Intrepid Center of Excellence/Walter Reed National Military Medical Center, Bethesda, Maryland
| | - David S. Riggs
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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