Treatment Of Ptsd And Traumatic Brain Injury Among Veterans

Two combat-related conditions that affect some veterans who have served in Iraq and Afghanistan and that have generated widespread concern among policymakers are post-traumatic stress disorder (PTSD), and traumatic brain injury (TBI). This book explores the clinical care that the Veterans Health Administration (VHA), the health care system within the Department of Veterans Affairs, provides for recent combat veterans; VHA's co-ordination with the Department of Defense for the care of service members returning from Iraq and Afghanistan; the prevalence of PTSD and TBI among veterans of those conflicts and the occurrence of those conditions among recent combat veterans using VHA's services; and the costs to VHA of providing care and management to recent combat veterans for these conditions.

Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the development of new diagnostic and therapeutic approaches has been disappointingly slow. Translational Research in Traumatic Brain Injury attempts to integrate expertise from across specialties to address knowledge gaps in the field of TBI. Its chapters cover a wide scope of TBI research in five broad areas: Epidemiology Pathophysiology Diagnosis Current treatment strategies and sequelae Future therapies Specific topics discussed include the societal impact of TBI in both the civilian and military populations, neurobiology and molecular mechanisms of axonal and neuronal injury, biomarkers of traumatic brain injury and their relationship to pathology, neuroplasticity after TBI, neuroprotective and neurorestorative therapy, advanced neuroimaging of mild TBI, neurocognitive and psychiatric symptoms following mild TBI, sports-related TBI, epilepsy and PTSD following TBI, and more. The book integrates the perspectives of experts across disciplines to assist in the translation of new ideas to clinical practice and ultimately to improve the care of the brain injured patient.

Two combat-related conditions that affect some veterans who have served in Iraq and Afghanistan and that have generated widespread concern among policymakers are post-traumatic stress disorder (PTSD), and traumatic brain injury (TBI). This book explores the clinical care that the Veterans Health Administration (VHA), the health care system within the Department of Veterans Affairs, provides for recent combat veterans; VHA's co-ordination with the Department of Defense for the care of service members returning from Iraq and Afghanistan; the prevalence of PTSD and TBI among veterans of those conflicts and the occurrence of those conditions among recent combat veterans using VHA's services; and the costs to VHA of providing care and management to recent combat veterans for these conditions.

Two combat-related conditions that affect some veterans who have served in Iraq and Afghanistan and that have generated widespread concern among policymakers are posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). In response to a request from the Ranking Member of the House Committee on Veterans' Affairs, this Congressional Budget Office (CBO) study examines the following: - The clinical care that the Veterans Health Administration (VHA), the health care system within the Department of Veterans Affairs, provides for recent combat veterans; - VHA's coordination with the Department of Defense for the care of service members returning from Iraq and Afghanistan; - The prevalence of PTSD and TBI among veterans of those conflicts and the occurrence of those conditions among recent combat veterans using VHA's services; and - The costs to VHA of providing care to recent combat veterans for those conditions. In keeping with CBO's mandate to provide objective, impartial analysis...

T wo combat-related conditions that affect some veterans who have served in Iraq and Afghanistan and that have generated widespread concern among policymakers are post- traumatic stress disorder (PTSD) and traumatic brain injury (TBI). In response to a request from the Ranking Member of the House Committee on Veterans' Affairs, this Congressional Budget Office (CBO) study examines the following: The clinical care that the Veterans Health Administration (VHA), the health care * system within the Department of Veterans Affairs, provides for recent combat veterans; VHA's coordination with the Department of Defense for the care of service members * returning from Iraq and Afghanistan; The prevalence of PTSD and TBI among veterans of those conflicts and the occurrence * of those conditions among recent combat veterans using VHA's services; and The costs to VHA of providing care to recent combat veterans for those conditions. * In keeping with CBO's mandate to provide objective, impartial analysis, this study makes no recommendations. Elizabeth Bass and Heidi Golding of CBO's National Security Division prepared the study under the general supervision of David Mosher and Matthew Goldberg. Allison Percy served as the internal reviewer. Lindsay Coleman, Juan Contreras, Sunita D'Monte, and Ann Futrell provided thoughtful comments on a draft of the study, as did external reviewer Rajeev Ramchand of RAND Corporation. (The assistance of an external reviewer implies no responsibility for the final product, which rests solely with CBO.) Adebayo Adedeji fact- checked the manuscript. The authors wish to thank the Department of Veterans Affairs and the Department of Defense for providing data used in the analysis. Juyne Linger edited the study, and John Skeen proofread it. Cindy Cleveland produced drafts of the manuscript. Maureen Costantino prepared the paper for publication and designed the cover. Monte Ruffin printed the initial copies, and Linda Schimmel handled the print distri- bution.

Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq, but it affects veterans of all eras. It is estimated that 7-20% of service members and veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom may have the disorder. PTSD is characterized by a combination of mental health symptoms - re-experiencing of a traumatic event, avoidance of trauma-associated stimuli, adverse alterations in thoughts and mood, and hyperarousal - that last at least 1 month and impair functioning. PTSD can be lifelong and pervade all aspects of a service member's or veteran's life, including mental and physical health, family and social relationships, and employment. It is often concurrent with other health problems, such as depression, traumatic brain injury, chronic pain, substance abuse disorder, and intimate partner violence. The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide a spectrum of programs and services to screen for, diagnose, treat for, and rehabilitate service members and veterans who have or are at risk for PTSD. The 2010 National Defense Authorization Act asked the Institute of Medicine to assess those PTSD programs and services in two phases. The Phase 1 study, Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment, focused on data gathering. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment is the report of the second phase of the study. This report analyzes the data received in Phase 1 specifically to determine the rates of success for each program or method. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment considers what a successful PTSD management system is and whether and how such a system is being implemented by DoD and VA. This includes an assessment of what care is given and to whom, how effectiveness is measured, what types of mental health care providers are available, what influences whether a service member or veteran seeks care, and what are the costs associated with that care. This report focuses on the opportunities and challenges that DoD and VA face in developing, implementing, and evaluating services and programs in the context of achieving a high-performing system to care for service members and veterans who have PTSD. The report also identifies where gaps or new emphases might be addressed to improve prevention of, screening for, diagnosis of, and treatment and rehabilitation for the disorder. The findings and recommendations of Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment will encourage DoD and VA to increase their efforts in moving toward a high-performing, comprehensive, integrated PTSD management strategy that addresses the needs of current and future service members, veterans, and their families.

More than 2 million service members have deployed in support of overseas contingency operations (OCO) in Iraq and Afghanistan since October 2001. Two combat-related conditions that affect some OCO veterans and that have generated widespread concern among policymakers are post-traumatic stress disorder (PTSD, an anxiety disorder induced by exposure to a traumatic event, such as witnessing injury or death) and traumatic brain injury (TBI, which is caused by sudden trauma to the head and is commonly sustained by service members exposed to explosions).In a study requested by the Ranking Member of the House Committee on Veterans' Affairs, CBO analyzes VHA's care of OCO patients diagnosed with PTSD or TBI and compares the reported rates of occurrence of those conditions within VHA with estimates of the prevalence of those conditions in the broader population of service members who have deployed to recent overseas contingency operations. The study also examines the costs that VHA has incurred in treating patients diagnosed with PTSD and TBI.

The Veterans Benefits Administration (VBA) provides disability compensation to veterans with a service-connected injury, and to receive disability compensation from the Department of Veterans Affairs (VA), a veteran must submit a claim or have a claim submitted on his or her behalf. Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans reviews the process by which the VA assesses impairments resulting from traumatic brain injury for purposes of awarding disability compensation. This report also provides recommendations for legislative or administrative action for improving the adjudication of veterans' claims seeking entitlement to compensation for all impairments arising from a traumatic brain injury.