Post-traumatic stress disorder and traumatic brain injury

Anthropologist working with the VA

Definitions / Interests / Key Problems and Issues

Previous Work Performed by Anthropologists in this Area

The Employment Situation, Current Salaries and Opportunities for Advancement

Bibliography of the most important books, chapters and articles

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The wars in Iraq and Afghanistan had a dramatic impact on the way someone sees themselves and the world around them. This is because many veterans have been forced to serve multiple tours and are still dealing with the lasting experiences from them. Two of primary injuries most are suffering from are post traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Anthropologists are seeking to understand the issues and how they impact the individual. This paper is about these issues and how they are effecting stakeholders. (Golding 2011)

According to statistics provided by the Veterans Administration (VA), there are total of 2.3 million veterans who have served in Iraq or Afghanistan. Out of this number 20% will suffer from PTSD. While at the same time, 19% of vets will be impacted by TBI. These issues are problematic, because if they are left untreated, this will have an adverse impact on person's mental well-being. In the majority of cases, these individuals will experience greater amounts of depression and anti-social behavior. (Golding 2011)

To make matters worse, 50% of all PTSD cases are under or not treated. Over the course of time, this has the capacity to add to the overall amounts of suffering experienced by these veterans. At the same time, there is the possibility they could have other complications. This could lead to increased amounts of suicides and deviant behavior. When this happens, the condition may not be effectively treated and the individual will have trouble adjusting with these changes. (Golding 2011)

To deal with these challenges, more studies must be conducted to understand what is happening and the lasting effects it is having on stakeholders. This is because most information is focusing one either condition. These differences limit the ability to study both and determine how they can have an impact on the patient's well-being. (Golding 2011)

In this case, there will be a focus on how these two areas are related to each other and the long-term impacts they are having on stakeholders. This will determine the overall scope of the problem and the best way to deal with them in the longer term. A good example of this can be seen with a study conducted by Lew (2009). He determined that PTSD is a condition which can lead to other injuries. The problem is that these issues are often ignored in the longer term. This is because many researchers will look at certain aspects of certain problem (not PTSD and TBI together).

Evidence of this can be seen with Lew saying, "This study examines the prevalence with which returning Operation Iraqi Freedom (OIF) / Operation Enduring Freedom (OEF) veterans were reporting symptoms consistent with chronic pain, posttraumatic stress disorder (PTSD), and persistent post concussive symptoms (PPCS). The medical records of 340 OIF/OEF veterans seen at a Department of Veterans Affairs Polytrauma Network Site were comprehensively reviewed. Analyses indicated a high prevalence of all three conditions in this population, with chronic pain, PTSD, and PPCS present in 81.5%, 68.2%, and 66.8%, respectively. Only 12 of the veterans (3.5%) had no chronic pain, PTSD, or PPCS. The frequency at which these three conditions were present in isolation (10.3%, 2.9%, and 5.3%, respectively) was significantly lower than the frequency at which they were present in combination with one another, with 42.1% of the sample being diagnosed with all three conditions simultaneously. The most common chronic pain locations were the back (58%) and head (55%). These results underscore the complexity of the presenting complaints in OIF/OEF veterans and support the importance of a multidisciplinary team approach to assessment and treatment." (2009: 697) This is illustrating how various studies will look at one or the other problem. Yet, they will not carefully examine the two and the lasting impacts they are having on stakeholders.

What makes this research project different; is there will be a focus on using a variety of sources to establish key patterns and what is happening in the longer term. This enhances everyone understanding of these issues and the best approaches for dealing with them. These ideas can be used by officials, to create a program which is more effective in dealing with these issues. (Lawhorne 2011) (Driscoll 2010)

Definitions / Interests / Key Problems and Issues

The main segment of the population which is being focused on is veterans who are within the ages of 18 to 60. This can include both men and women who served one or several tours in Iraq / Afghanistan. In the majority of cases, the men were exposed to some kind of violence. This occurs with them not being physically injured. Yet, the individual will have lingering mental scares that will have an impact on their ability to adapt, control their emotions and live ordinary lives. This is what happens to someone who is being impact by PTSD. (Lawhorne 2011) (Driscoll 2010)

In the case of TBI, these injuries are caused by some kind of explosion. The person may not to appear to have some physical wound. However, they will be adversely impacted by the lingering effects from their injury. This can include the inability to focus on key tasks, a loss of motor skills and they cannot recall specific places and events. (Lawhorne 2011) (Driscoll 2010)

In general, most studies have focused on one or the other condition. They have not considered the possibility that someone could be suffering from both. This means that there is very little research to understand what is taking place and the lasting impacts it is having on the person. This study is focusing on these segments of veterans and it is seeking to expand research in these areas. (Lawhorne 2011) (Driscoll 2010)

Once this takes place, is the point these insights can be used to illustrate the scope of the problem. This is when new solutions can be introduced for addressing these challenges in the longer term. At which point, a shift can take place in how the problem is looked at and what steps must be taken. In the future, these insights can be used to create a working strategy everyone is satisfied with. (Lawhorne 2011) (Driscoll 2010)

Previous Work Performed by Anthropologists in this Area

Previous research on the subject is showing how the individual is negatively impacted by PTSD or TBI. In the case of PTSD, they have the potential to experience anger and feelings of hostility. If left unaddressed, these challenges can become more severe. When this happens, it is difficult to control the situation and the lasting effects it is having on stakeholders.

A good example of this can be seen with a study that was conducted by Jakupcak who said, "Iraq and Afghanistan War veterans were grouped by level of posttraumatic stress disorder (PTSD) symptomatology and compared on self-report measures of trait anger, hostility, and aggression. Veterans who screened positive for PTSD reported significantly greater anger and hostility than those in the sub-threshold-PTSD and non-PTSD groups. Veterans in the sub-threshold-PTSD group reported significantly greater anger and hostility than those in the non-PTSD group. The PTSD and sub-threshold-PTSD groups did not differ with respect to aggression, though both groups were significantly more likely to have endorsed aggression than the non-PTSD group. These findings suggest that providers should screen for anger and aggression among Iraq and Afghanistan War veterans who exhibit symptoms of PTSD and incorporate relevant anger treatments into early intervention strategies." (2007: 945) This is indicating how PTSD can lead to feelings of anger and frustrations. Over time, this can cause sudden out bursts which will have a negative impact on the person's life.

Moreover, Elliot determined that individuals with one or the other condition will have trouble adjusting to civilian life. This is because they hurt their ability to adapt and understand with the world around them by placing added amounts of stress on them. These changes increase the chances that they will have some kind of episode where they will lash out at people. In many situations, the person must seek out support to address these challenges. Otherwise, the condition will continue to linger and become worse. (2011: 279-296)

In a study that was conducted by Elliot of veteran college students. She found that both make it difficult for someone to adjust and adapt to the various challenges they are facing. Evidence of this can be seen with her saying, "U.S. universities are witnessing an influx of student veterans who have been under chronic stress, have suffered injuries, and currently exhibit symptoms of Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). This study utilized quantitative survey data to test a model of what causes alienation on campus among student veterans. We then present quotations from student veterans describing the types of situations they find alienating. The results have direct implications for how student affairs professionals may help veterans succeed in college." (2011: 279)

These insights are illustrating how there has been very little research conducted in these areas by anthropologists. This is because most data that is collected is based upon looking at specific sources vs. corroborating the result. When this occurs, it means that select areas have been addressed. While at the same time, others are being effectively ignored. In this case, Elliot provides a good starting point. However, she does not do anything to back up these ideas, other than provide a general outline of the problem by looking at a specific demographic. (2011: 279)

To corroborate these views, Sayer found that both PTSD and TBI are connected with each other. This is taking place with each one having unique variables which are having an impact on the ability of the individual to understand and address unique threats. This is because both are known to occur and compound the problem for many veterans. (2012: 405-419)

A good example of this can be seen with Sayer saying, "The post -- September 11, 2001 wars in and around Afghanistan and Iraq have increased awareness of traumatic brain injury (TBI), particularly blast-induced mild TBI. This article provides an overview of TBI and its neuropsychiatric sequel in U.S. war veterans who participated in the current operations in and around Afghanistan and Iraq, with particular emphasis on blast-related mild TBI. Psychiatric disorders, particularly posttraumatic stress disorder, pain, and sensory impairments are prevalent in war veterans with TBI. Research is needed to more definitively characterize the epidemiology of TBI-related functional difficulties, the effects of blasts compared with other mechanisms of injury, recovery trajectories, and treatment outcomes in this population." (2012: 405)

These insights are illustrating how the both conditions are known to be prevalent among Iraq War and Afghanistan veterans. This means that the individual could have even worse symptoms if they are left untreated. However, more research is necessary in order to understand what is taking place and address these issues over the long-term. (2012: 405)

As a result, the overview of the work performed by anthropologists is based upon looking at the long-term effects of both conditions. The problem is that no real studies have been completed to show how this will impact the individual. In most cases, the available evidence is demonstrating that the two are connected. Yet, very little research is completed to determine the causes and the lasting effects on stakeholders.

The Employment Situation, Current Salaries and Opportunities for Advancement

The current employment situation for most anthropologists is expected to remain very competitive. This is because the field is considered to be relatively small with opportunities for continuing growth. According statistics provided by the Bureau of Labor, they found that these amounts are expected to increase by 19% between 2014 and 2022. However, a total of 1,400 positions will be created. This means that despite the tremendous opportunities, there is still the possibility of the sector remaining very competitive. (Summary 2014)

The median salary is averaging is $57 thousand per year. In general, most individuals must have masters or PHD in this discipline. These insights are demonstrating how the field requires specialized training and skills. This is why demand is so high and the competition for available jobs is very tight. (Summary 2014)

Evidence of this can be seen with observations provided by the Bureau of Labor which says, "Anthropologists and archeologists study the origin, development, and behavior of humans. They examine the cultures, languages, archeological remains, and physical characteristics of people in various parts of the world. Although most anthropologists and archeologists work in an office, some analyze samples in laboratories or work in the field. They typically work in research organizations, colleges and universities, museums, consulting firms, private corporations, and government. Fieldwork in remote areas usually requires travel for extended periods. Anthropologists and archeologists need a master's degree or Ph.D. In anthropology or archeology. Experience doing anthropological or archeological fieldwork is also important. Bachelor's degree holders may find work as assistants or fieldworkers. The median annual wage for anthropologists and archeologists was $57,420 in May 2012. Employment of anthropologists and archeologists is projected to grow 19% from 2012 to 2022, faster than the average for all occupations. However, because it is a small occupation, the fast growth will result in only about 1,400 new jobs over the 10-year period. Jobseekers will likely face very strong competition." (Summary 2014)

These insights are showing how there is limited interest in the field for various opportunities. This is because of the specialized training. The result is that there is the opportunity for growth. However, the pool of labor is so small, that there is more competition for these positions. In this case, anthropologists require a higher salary and may or may not have to travel. (Summary 2014)