A Sample of the Latest PTSD Study Results

Two new studies have arrived on the scene this first week of the New Year. Main findings:

A groundbreaking study of 1,946 male veterans of World War II and Korea suggests that veterans with symptoms of post-traumatic stress disorder are at greater risk of heart attacks as they age. The new study is the first to document a link between the stress disorder symptoms and future heart disease, and joins evidence that veterans with the stress disorder also have more autoimmune diseases such as arthritis and psoriasis.

A second study, funded by the Army, found that soldiers returning from combat in Iraq with post-traumatic stress disorder reported worse physical health, more doctor visits, and more missed workdays. The Army study is based on a survey of 2,863 soldiers one year after combat.

"The burden of war may be even greater than people think," said the first study's lead author, Laura Kubzansky of the Harvard School of Public Health.

Kubzansky goes on to say that the results may be due to the repeated release of adrenaline in those who deal with PTSD after a traumatic event. This may end up wearing down the cardiovascular system over time.

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Another study, looking at the link between memory and trauma via experiences of those closest to the World Trade Center on September 11, may shed some light on PTSD flashbacks:

Most Americans remember where they were on the morning of Sept. 11, 2001. But a new brain-scan study suggests that not all those memories were created equally. "If you were near the World Trade Center, your memories are qualitatively different from other people -- even those who were elsewhere in Manhattan," said lead researcher Elizabeth Phelps, a professor of psychology at New York University.

Specifically, people who were within about two miles of Ground Zero on that day now retain especially vivid, detailed recollections of the scenes and events of that morning -- a kind of recall that experts call "flashbulb memories." Brain imaging suggests that these memories are especially strong because the amygdala -- a brain area focused on fear and memory -- kicked into high gear as these people watched that morning's catastrophic events unfold.

Nearly all of the study participants who had been in lower Manhattan on 9/11 said they experienced first-hand the sights, sounds and smells of that day. And many said they feared for their own safety. All of that may have played a role in imprinting these highly potent memories in their brains, Phelps said. "This isn't unique to 9/11," she added, noting that flashbulb memories can be laid down in any kind of traumatic event, be it personal or very public....

The subdued parahippocampal function seen in the Downtown group might play a role in PTSD, Phelps said. "The amygdala helps you form a very strong memory," she explained. But in the normal brain, the hippocampus acts as a counterweight, "giving you the ability to keep it all in the right context."

With PSTD, the hippocampus' ability to reign in frightening memories may get lost. "We know that there are differences in the hippocampus in people that will go on to develop PTSD and those who will not," Phelps said.

Researchers are also examining the relationship between PTSD and pain:

PTSD may alter the way the brain handles pain, a new study shows. The researchers included Elbert Geuze, PhD, of the Netherlands' Department of Military Psychiatry. Their study appears in the Archives of General Psychiatry.

Geuze and colleagues studied 24 male Dutch veterans who had served on U.N. peacekeeping missions in Lebanon, Cambodia, or Bosnia. ... The veterans rated how much pain they felt when their hands were briefly subjected to heat at temperatures ranging from 104-118 degrees Fahrenheit. Those with PTSD had a higher tolerance for the heat, compared to those without PTSD.

The veterans also got brain scans using functional magnetic resonance imaging (fMRI) while they took the heat test. Those brain scans showed different patterns of brain activity between the veterans with and without PTSD. For instance, the veterans with PTSD showed less activity in part of their amygdala, a brain area that's involved in the brain's pain response.

Last week, the Army released the following "snapshot of the morale and mental health" of our troops:

The recent data on troops who have deployed to Iraq, released in a Dec. 19 report, paints a stark picture. For example, the suicide rate among soldiers supporting Operation Iraqi Freedom almost doubled in 2005, going up to 19.9 per 100,000 troops from 10.5 per 100,000 the year before.

Yet the data from 2003 show the rate that year to be 18.8 per 100,000 troops, which makes officials cautious about drawing conclusions. “We haven’t made a connection between the stress on the force with a significant increase in suicides,” said Lt. Gen. Kevin Kiley, Army surgeon general, who discussed the data Dec. 20 at the Pentagon. “That isn’t to say there aren’t any. [But] I don’t have any evidence that there is a correlation between PTSD and suicides.”

The report also found that troops who have deployed to Iraq more than once reported higher levels of acute stress symptoms as well as higher levels of anxiety and depression than those serving their first tours. Almost 19 percent of troops with at least one prior tour in Iraq reported acute stress symptoms, compared with 12.5 percent on their first tour.

On the plus side, troops say getting help in theater is now easier and the stigma of seeking that help is decreasing. The study was compiled the Mental Health Advisory Team III, established at the request of Multi-National Force-Iraq, using data collected in October and November 2005 in theater. Similar assessments were made in late 2003 and 2004.

Last year, European researchers measured the effect personality has on the incidence of PTSD:

[O]ne study suggests that, whether a veteran of combat or a victim of accident or crime, your chances of facing the anxiety or depression of post-traumatic stress disorder (PTSD) may hinge as much on your personality as on your experience.

Inge Bramsen, a psychologist at Vrije Universiteit in Amsterdam, tested 572 men who participated in the United Nations Peacekeeping Force in the former Yugoslavia for PTSD. Men who reported seeing the highest number of stressful events—shootings or dead people, for example—showed the most severe symptoms. But those who rated highest on personality traits such as negativism and paranoia before deployment also tended to show more signs of PTSD later. A hostile person may see more personal menace in events than others do, says Bramsen. An anxious person may also cope with stressful situations less effectively.

Another study appears to show the gradual development of PTSD over time:

A study released in October by the American Journal of Psychiatry .. of 613 U.S. soldiers revealed that as time goes by after war service, PTSD becomes more evident, particularly in veterans with physical injuries. When the soldiers in the study first returned from overseas, the level of PTSD was 4 percent. After four months, that rate rose to 12 percent. Of those who were diagnosed with PTSD after seven months, 78.8 percent had screened negative for the condition at one month.

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