Invisible Wounds Research Articles

The Veteran Student Experience and the Academic Librarian

With the increase of student veteran enrollment under the Post 9/11 Veterans Education Assistance Act of 2008, colleges and university campuses are beginning to accommodate the needs of this population. Student veterans present unique challenges to institutions of higher education as they are adjusting to a new culture and coping with both visible and invisible injuries. Some of these war-related injuries affect behavior in both classroom and extracurricular settings and some result in learning disabilities. Librarians who understand the experiences of student veterans can better assist these students with their academic goals.

Traumatic brain injury among women veterans: an invisible wound of intimate partner violence.

Intimate partner violence (IPV) is prevalent among women Veterans and is known to increase women's risk for traumatic brain injury (TBI). IPV-related TBI has not been examined in the women Veteran population. To identify the occurrence of IPV-related TBI in a sample of women Veterans and examine the associations of IPV-related TBI with sociodemographic characteristics, health symptoms, health care utilization, and IPV experiences. Cross-sectional mail survey conducted in 2013. The sample comprised 176 New England Department of Veterans Affairs (VA) women Veteran patients. Self-reported IPV-related TBI was assessed with a modified VA TBI screening tool. The survey included validated measures of depression (Center for Epidemiologic Studies Depression Scale) and posttraumatic stress disorder (PTSD; Posttraumatic Disorder Checklist) symptoms, as well as overall mental and physical health (SF-12), and IPV (Conflict Tactics Scales-Revised-2). Questions assessed past-year VA and non-VA health care use. A total of 18.8% (n=33) met screening criteria for IPV-related TBI history. Women who experienced IPV-related TBI reported significantly higher depression (mean Center for Epidemiologic Studies Depression Scale scores: 26.6 vs. 20.7, P<0.0001) and PTSD (mean Posttraumatic Disorder Checklist scores: 53.2 vs. 34.1, P<0.0001) symptoms, and poorer perceptions of physical health (mean SF-12 34.6 vs. 42.3, P<0.01) than women who experienced IPV to the head without TBI. IPV-related TBI was also associated with poorer perceptions of mental health, as well as more frequent VA health care utilization and overall IPV. IPV-related TBI is associated with poorer mental and physical health in women Veterans. This invisible injury is associated with greater VA health care utilization and IPV exposure. Implications for VA practice and policy are discussed.

Promoting coping for children of hospitalized service members with combat injuries through creative arts engagement

Background: Over 50,000 US service members have been physically wounded in combat – even more with invisible injuries – since current conflicts began in 2002, creating a crisis of substantial magnitude for their families. A great proportion of injured service members are mothers or fathers as well. A parent's combat injury can have a profound effect on his or her children. Methods: Appreciative inquiry, a qualitative methodology, was used alongside participant observation and document review. Results: Findings indicate that the program addressed children's needs at a number of points in time with six themes that have emerged from the data. These include, visits with the injured parent, self-expression, distraction and respite, parental engagement, normalization and empowerment. Conclusions: The findings lend support on ways an artists-in-residence program uses creative arts engagement to promote coping for children of hospitalized wounded service members and to encourage ongoing participation in the arts upon discharge.

Allsopp, M. Emotional Abuses and Other Psychic Harms: Invisible Wounds and Their Histories. Basingstoke: Palgrave Macmillan. 2013. 280pp £66 ISBN 978–0‐23030302–7(hbk)

Allsopp, M. Emotional Abuses and Other Psychic Harms: Invisible Wounds and Their Histories. Basingstoke: Palgrave Macmillan. 2013. 280pp £66 ISBN 978–0‐23030302–7(hbk)

A high-definition fiber tracking report for patients with traumatic brain injury and their doctors.

We have developed a tablet-based application, the High-Definition Fiber Tracking Report App, to enable clinicians and patients in research studies to see and understand damage from Traumatic Brain Injury (TBI) by viewing 2-dimensional and 3-dimensional images of their brain, with a focus on white matter tracts with quantitative metrics. The goal is to visualize white matter fiber tract injury like bone fractures; that is, to make the "invisible wounds of TBI" understandable for patients. Using mobile computing technology (iPad), imaging data for individual patients can be downloaded remotely within hours of a magnetic resonance imaging brain scan. Clinicians and patients can view the data in the form of images of each tract, rotating animations of the tracts, 3-dimensional models, and graphics. A growing number of tracts can be examined for asymmetry, gaps in streamline coverage, reduced arborization (branching), streamline volume, and standard quantitative metrics (e.g., Fractional Anisotropy (FA)). Novice users can learn to effectively navigate and interact with the application (explain the figures and graphs representing normal and injured brain tracts) within 15 minutes of simple orientation with high accuracy (96%). The architecture supports extensive graphics, configurable reports, provides an easy-to-use, attractive interface with a smooth user experience, and allows for securely serving cases from a database. Patients and clinicians have described the application as providing dramatic benefits in understanding their TBI and improving their lives.

Military Culture Implications for Mental Health and Nursing Care

With over 13 years of war and military combat operations, the number of veterans, military families, and service members with mental health needs continues to increase across civilian and federal healthcare services. Knowledge about severe battle wounds, traumatic brain injury, and traumatic stress has influenced the delivery of healthcare. The invisible wounds of war associated with brain injury and traumatic stress will increase clinical care challenges into the foreseeable future. The purpose of this article is to describe two interrelated concepts, military cultural competence and stress injuries. The authors also differentiate stress reactions versus stress injury. Nurses with military cultural competence and knowledge about stress injuries will be better able to deliver patient-centered care to patients with military culture experiences.

Senators, Vets, Families Push VA for Better Mental Health Care

Senators, Vets, Families Push VA for Better Mental Health Care

The stress experience of the wives of service personnel

There is a paucity of research exploring the mental health of military spouses and partners. This article seeks to answer the question: what is the stress experience of the wives of British Army personnel serving in Germany? Methods included a critical literature review and reflections from the author's own practice as a community psychiatric nurse working with this community. It was found that military spouses are presented with a number of situations and stressors associated with, and unique to, their husbands' job. Increased stress among military families on a day-to-day basis is a potential trigger for the development of mental health problems. While the association between stress and mental disorders is well-documented, it is not well studied in British military families. Key issues identified include: communication, visible and invisible wounds, fatalities and homecoming. It can be concluded that current, limited research tends to focus on the stress and coping of spouses and partners during operations but not on the day-to-day stresses faced. Further research is needed into the impact of isolation, deployment, mobility and military culture on partners, and indeed, wider families.

The Lived Experience of Female Veterans Deployed to the Gulf War II.

The purpose of this inquiry is to discover the experiences of female veterans in order to understand the impacts of combat on their physical and mental health, and to shed light on directions for future research. The research question for this inquiry is: What is the lived experience of female combat veterans who deployed to Iraq and Afghanistan from 2001 through 2013? The methodology used in this qualitative inquiry is a descriptive phenomenological approach using Husserl's philosophical framework. Colaizzi's method was used for data analysis. Analysis revealed seven themes: living in constant fear while deployed, combat has different meanings, bringing the war home, fear of being forever changed, disrespect from fellow military members, physical health-for better or worse, and combat has rewarding experiences. Early detection and assessment is crucial to providing interventions to military veterans to reduce the invisible wound of war, posttraumatic stress disorder, and ultimately increase the quality of life.

Impact of Cement Industry Pollution on Morphological Attributes of Wheat (Triticum Species) Kodinar Gujarat, India

This study was aimed to know the effect of cement industry pollutants viz. SO2, NOx and PM, on morphological as well as yield characteristics of wheat (Triticum sp.) plants grown at different distance from the cement industry at Kodinar, Gujarat, India. The wheat plant near the industry showed deterioration in morphological characteristics. The study indicated that parameters reductions in wheat correlated directly with particulate pollutant which led to lower yield at more polluted site. Increased concentration of cement dust pollutant causes invisible injuries like progressive decline in photosynthetic ability and closure of leaf stomata and it affect the growth and productivity of plant. It was observed that wheat plants near the cement industry were having morphological reduction in growth and yield and as the distance from industry increases growth and yield also increases. Overall study shows that control plants were healthier in term of morphological and yield parameter. It was found that wheat plant growing near the cement industry was adversely affected.

Understanding concussive injuries using investigational imaging methods.

Concussions have long been understood to be an invisible injury. Indeed, conventional imaging techniques [computed tomography and magnetic resonance imaging (MRI)] are largely ineffective in elucidating concussive injuries. More advanced techniques are being used experimentally to help delineate the underlying pathophysiology of concussive injuries on metabolic as well as ultrastructural levels. The current report reviews the data from several of these techniques including functional MRI, single-photon emission computed tomography, positron emission tomography, diffusion tensor imaging, and magnetic resonance spectroscopy. Each technique is briefly described, followed by a summary of the findings specific to concussive injuries. Overall, there is mounting evidence to suggest that each technique has utility in describing and explaining postinjury changes in the brain. Overall, concussive injuries are evident using the various aforementioned neuroimaging modalities and suggest at a minimum the concussed brain is different in the acute and subacute postinjury phases with several other studies suggesting that changes are persistent well beyond, especially in those patients with persistent symptoms.

The invisible wounds of war: Caring for women veterans who have experienced military sexual trauma

The purpose of this case study is to raise awareness about military sexual trauma (MST) and posttraumatic stress disorder (PTSD), and the physical and psychological comorbidities associated with MST. Health Science Data Sources-PubMed and authors' experiences. Women veterans are the fastest growing segment of the veteran population. Approximately 200,000 of the 2.6 million veterans who have deployed in support of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) are women. Many are seeking care in both the Veteran Administration and the civilian sector. It is estimated that upwards of 26,000 women have experienced some form of sexual assault in the military. MST can lead to multiple deleterious physical and psychological comorbidities. It is imperative that nurse practitioners (NPs) ask women about military service and utilize the Military Health History Pocket Card for Clinicians to ascertain service-connected health risks, primarily MST and PTSD. Prompt identification and intervention is key to reducing physical and psychological comorbidities. This case study emphasizes the need for NPs to ask all women about military service and potential exposure to sexual trauma. It provides guidance on how to incorporate the Military Health History Pocket Card for Clinicians into practice.

When a parent is injured or killed in combat.

When a service member is injured or dies in a combat zone, the consequences for his or her family can be profound and long-lasting. Visible, physical battlefield injuries often require families to adapt to long and stressful rounds of treatment and rehabilitation, and they can leave the service member with permanent disabilities that mean new roles for everyone in the family. Invisible injuries, both physical and psychological, including traumatic brain injury and combat-related stress disorders, are often not diagnosed until many months after a service member returns from war (if they are diagnosed at all-many sufferers never seek treatment). They can alter a service member's behavior and personality in ways that make parenting difficult and reverberate throughout the family. And a parent's death in combat not only brings immediate grief but can also mean that survivors lose their very identity as a military family when they must move away from their supportive military community. Sifting through the evidence on both military and civilian families, Allison Holmes, Paula Rauch, and Stephen Cozza analyze, in turn, how visible injuries, traumatic brain injuries, stress disorders, and death affect parents' mental health, parenting capacity, and family organization; they also discuss the community resources that can help families in each situation. They note that most current services focus on the needs of injured service members rather than those of their families. Through seven concrete recommendations, they call for a greater emphasis on family-focused care that supports resilience and positive adaptation for all members of military families who are struggling with a service member's injury or death.

What Process is Due? Reversal of Diagnosis in Veterans Benefits Claims and Procedural Due Process

An increasing number of service members who have been deployed now suffer from invisible wounds of war including Post-Traumatic Stress Disorder (PTSD). Some of those veterans' diagnoses were reversed through nothing but a review by a team of psychologists who never personally met or examined the veterans. This paper examines the general attitude towards PTSD at a particular Army medical center, the PTSD diagnostic criteria, and the reasons for diagnosis reversals. And due process and VA administrative procedures are analysed and applied to diagnosis reversals. Lastly, an additional layer of due process for veterans with PTSD is suggested.

Words and accounts to deal with invisible wounds

Face aux blessures invisibles, nous disposons, toujours et encore, du pouvoir de la parole. Dire, se dire, se raconter. Cette mise en récit revient à introduire une fissure entre soi et soi-même pour permettre l’ouverture d’une sorte de brèche intérieure de réconciliation. Il faut se diviser pour mieux se retrouver. Décoller de soi le malheur pour mieux l’éloigner. Mettre des mots sur ses maux pour tenter de les cicatriser. Là est la puissance formidable des mots agencés en récit qui peuvent nous acheminer jusqu’au pardon, jusqu’à retrouver la confiance indispensable – confiance en soi, confiance de soi, confiance pour refaire corps avec le monde.

Diffusion Tensor Imaging and Mild Traumatic Brain Injury in Soldiers: Abnormal Findings, Uncertain Implications

Diffusion Tensor Imaging and Mild Traumatic Brain Injury in Soldiers: Abnormal Findings, Uncertain Implications

Blast induced mild traumatic brain injury/concussion: A physical analysis

Currently, a consensus exists that low intensity non-impact blast wave exposure leads to mild traumatic brain injury (mTBI). Considerable interest in this “invisible injury” has developed in the past few years but a disconnect remains between the biomedical outcomes and possible physical mechanisms causing mTBI. Here, we show that a shock wave travelling through the brain excites a phonon continuum that decays into specific acoustic waves with intensity exceeding brain tissue strength. Damage may occur within the period of the phonon wave, measured in tens to hundreds of nanometers, which makes the damage difficult to detect using conventional modalities.

A window into the invisible wound of war: Functional neuroimaging of REM sleep in returning combat veterans with PTSD

Relative regional cerebral metabolic rate of glucose in rapid eye movement (REM) sleep and wakefulness was explored in combat veterans with and without posttraumatic stress disorder PTSD, using positron emission tomography. Hypermetabolism in brain regions involved in arousal regulation, fear responses, and reward processing persist during REM sleep in combat veterans with PTSD.

The invisible wound: Veterans' art therapy

On Armistice Day 2011, BBC2 broadcast a Culture Show special, entitled ‘Art for Heroes’, about art therapy with veterans who have post-traumatic stress disorder (PTSD). It involved the filming of an art therapy group at a Surrey treatment centre for veterans. This article is based on the transcript of that group and takes a thematic analysis approach towards understanding the benefits of art therapy for those veterans. It also explores the neurobiological processes involved in PTSD and in art therapy, examining how the latter might assist recovery on a structural level. Through examination of recent studies and the observations made by those who have participated in the process of art therapy, it is hoped that this article will add to the discussion about the effectiveness of art therapy as a treatment for veterans' PTSD.

Treating the Signature Injury

Treating the Signature Injury