Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder's Books

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Final Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

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Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Final Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

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.

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National Academies Press

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ISBN 10

0309301769

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9780309301763

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Final Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

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Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Final Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

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262

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0309301769

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9780309301763

Treatment of Posttraumatic Stress Disorder

An Assessment of the Evidence

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Treatment of Posttraumatic Stress Disorder

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Treatment of Posttraumatic Stress Disorder

An Assessment of the Evidence

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Treatment of Posttraumatic Stress Disorder

Mental disorders, including posttraumatic stress disorder (PTSD), constitute an important health care need of veterans, especially those recently separated from service. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence takes a systematic look the efficacy of pharmacologic and psychological treatment modalities for PTSD on behalf of the Department of Veterans Affairs. By reviewing existing studies in order to draw conclusions about the strength of evidence on several types of treatment, the Committee on the Treatment of Posttraumatic Stress Disorder found that many of these studies were faulty in design and performance, and that relatively few of these studies have been conducted in populations of veterans, despite suggestions that civilian and veteran populations respond differently to various types of treatment. The committee also notes that the evidence is scarce on the acceptability, efficacy, or generalizability of treatment in ethnic and cultural minorities, as few studies stratified results by ethnic background. Despite challenges in the consistency, quality, and depth of research, the committee found the evidence sufficient to conclude the efficacy of exposure therapies in treating PTSD. The committee found the evidence inadequate to determine efficacy of different types of pharmacotherapies, of three different psychotherapy modalities, and of psychotherapy delivered in group formats. The committee also made eight critical recommendations, some in response to the VA's questions related to recovery and the length and timing of PTSD treatment, and others addressing research methodology, gaps in evidence and funding issues.

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224

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National Academies Press

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ISBN 10

0309109264

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9780309109260

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations:

Initial Assessment

By: Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder,Board on the Health of Select Populations,Institute of Medicine

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Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations:

Initial Assessment

By: Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder,Board on the Health of Select Populations,Institute of Medicine

Prior to the military conflicts in Iraq and Afghanistan, wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds. However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD), which affects an estimated 13 to 20 percent of U.S. service members who have fought in Iraq or Afghanistan since 2001. PTSD is triggered by a specific traumatic event - including combat - which leads to symptoms such as persistent re-experiencing of the event; emotional numbing or avoidance of thoughts, feelings, conversations, or places associated with the trauma; and hyperarousal, such as exaggerated startle responses or difficulty concentrating. As the U.S. reduces its military involvement in the Middle East, the Departments of Defense (DoD) and Veterans Affairs (VA) anticipate that increasing numbers of returning veterans will need PTSD services. As a result, Congress asked the DoD, in consultation with the VA, to sponsor an IOM study to assess both departments' PTSD treatment programs and services. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment is the first of two mandated reports examines some of the available programs to prevent, diagnose, treat, and rehabilitate those who have PTSD and encourages further research that can help to improve PTSD care.

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396

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National Academies Press

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ISBN 10

0309387744

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9780309387743

Gulf War and Health

Volume 10: Update of Health Effects of Serving in the Gulf War, 2016

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on the Health of Select Populations,Committee on Gulf War and Health, Volume 10: Update of Health Effects of Serving in the Gulf War

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Gulf War and Health

Volume 10: Update of Health Effects of Serving in the Gulf War, 2016

For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the Institute of Medicine (IOM) has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes. The fourth volume in the series, released in 2006, summarizes the long-term health problems seen in Gulf War veterans. In 2010, the IOM released an update that focuses on existing health problems and identifies possible new ones, considering evidence collected since the initial summary. Gulf War and Health: Volume 10 is an update of the scientific and medical literature on the health effects associated with deployment to the Gulf War that were identified in Volumes 4 and 8. This report reviews and evaluates the associations between illness and exposure to toxic agents, environmental or wartime hazards, or preventive measures and vaccines associated with Gulf War service, and provides recommendations for future research efforts on Gulf War veterans.

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293

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National Academies Press

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ISBN 10

0309380413

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9780309380416

Returning Home from Iraq and Afghanistan

Preliminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

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Returning Home from Iraq and Afghanistan

Preliminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.

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192

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National Academies Press

Published Date

ISBN 10

0309147638

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9780309147637

Nutrition and Traumatic Brain Injury

Improving Acute and Subacute Health Outcomes in Military Personnel

By: Institute of Medicine,Food and Nutrition Board,Committee on Nutrition, Trauma, and the Brain

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Nutrition and Traumatic Brain Injury

Improving Acute and Subacute Health Outcomes in Military Personnel

By: Institute of Medicine,Food and Nutrition Board,Committee on Nutrition, Trauma, and the Brain

Traumatic brain injury (TBI) accounts for up to one-third of combat-related injuries in Iraq and Afghanistan, according to some estimates. TBI is also a major problem among civilians, especially those who engage in certain sports. At the request of the Department of Defense, the IOM examined the potential role of nutrition in the treatment of and resilience against TBI.

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444

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National Academies Press

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ISBN 10

0309210089

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9780309210089

Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Population Health and Public Health Practice,Committee on the Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

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Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work.

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271

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National Academies Press

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ISBN 10

0309679109

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9780309679107

Preventing Psychological Disorders in Service Members and Their Families

An Assessment of Programs

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Resiliency and Prevention Programs for Mental and Behavioral Health in Service Members and Their Families

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Preventing Psychological Disorders in Service Members and Their Families

An Assessment of Programs

Being deployed to a war zone can result in numerous adverse psychological health conditions. It is well documented in the literature that there are high rates of psychological disorders among military personnel serving in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq as well as among the service members' families. For service members' families, the degree of hardship and negative consequences rises with the amount of the service members' exposure to traumatic or life-altering experiences. Adult and child members of the families of service members who experience wartime deployments have been found to be at increased risk for symptoms of psychological disorders and to be more likely to use mental health services. In an effort to provide early recognition and early intervention that meet the psychological health needs of service members and their families, DOD currently screens for many of these conditions at numerous points during the military life cycle, and it is implementing structural interventions that support the improved integration of military line personnel, non-medical caregivers, and clinicians, such as RESPECT-Mil (Re-engineering Systems of Primary Care Treatment in the Military), embedded mental health providers, and the Patient-Centered Medical Home. Preventing Psychological Disorders in Service Members and Their Families evaluates risk and protective factors in military and family populations and suggests that prevention strategies are needed at multiple levels - individual, interpersonal, institutional, community, and societal - in order to address the influence that these factors have on psychological health. This report reviews and critiques reintegration programs and prevention strategies for PTSD, depression, recovery support, and prevention of substance abuse, suicide, and interpersonal violence.

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304

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National Academies Press

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ISBN 10

0309297184

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9780309297189

The Health Effects of Cannabis and Cannabinoids

The Current State of Evidence and Recommendations for Research

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Population Health and Public Health Practice,Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda

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The Health Effects of Cannabis and Cannabinoids

The Current State of Evidence and Recommendations for Research

Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.

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487

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National Academies Press

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ISBN 10

0309453070

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9780309453073

Capturing Social and Behavioral Domains and Measures in Electronic Health Records

Phase 2

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records

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Capturing Social and Behavioral Domains and Measures in Electronic Health Records

Phase 2

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records

Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 identifies domains and measures that capture the social determinants of health to inform the development of recommendations for the meaningful use of EHRs. This report is the second part of a two-part study. The Phase 1 report identified 17 domains for inclusion in EHRs. This report pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. This book includes three chapters from the Phase 1 report in addition to the new Phase 2 material. Standardized use of EHRs that include social and behavioral domains could provide better patient care, improve population health, and enable more informative research. The recommendations of Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 will provide valuable information on which to base problem identification, clinical diagnoses, patient treatment, outcomes assessment, and population health measurement.

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287

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National Academies Press

Published Date

ISBN 10

0309312450

ISBN 13

9780309312455

PTSD Compensation and Military Service

By: National Research Council,Institute of Medicine,Board on Behavioral, Cognitive, and Sensory Sciences,Board on Military and Veterans Health,Committee on Veterans' Compensation for Posttraumatic Stress Disorder

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PTSD Compensation and Military Service

The scars of war take many forms: the limb lost, the illness brought on by a battlefield exposure, and, for some, the psychological toll of encountering an extremely traumatic event. PTSD Compensation and Military Service presents a thorough assessment of how the U.S. Department of Veterans Affairs evaluates veterans with possible posttraumatic stress disorder and determines the level of disability support to which they are entitled. The book presents a history of mental health disability compensation of military personnel and reviews the current compensation and pension examination procedure and disability determination methodology. It offers a number of recommendations for changes that would improve the fairness, consistency, and scientific foundation of this vital program. This book will be of interest and importance to policy makers, veterans affairs groups, the armed forces, health care organizations, and veterans themselves.

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263

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National Academies Press

Published Date

ISBN 10

0309105528

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9780309105521

Posttraumatic Stress Disorder

Diagnosis and Assessment

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Gulf War and Health: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress,Subcommittee on Posttraumatic Stress Disorder

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Posttraumatic Stress Disorder

Diagnosis and Assessment

In response to growing national concern about the number of veterans who might be at risk for posttraumatic stress disorder (PTSD) as a result of their military service, the Department of Veterans Affairs (VA) asked the Institute of Medicine (IOM) to conduct a study on the diagnosis and assessment of, and treatment and compensation for PTSD. An existing IOM committee, the Committee on Gulf War and Health: Physiologic, Psychologic and Psychosocial Effects of Deployment-Related Stress, was asked to conduct the diagnosis, assessment, and treatment aspects of the study because its expertise was well-suited to the task. The committee was specifically tasked to review the scientific and medical literature related to the diagnosis and assessment of PTSD, and to review PTSD treatments (including psychotherapy and pharmacotherapy) and their efficacy. In addition, the committee was given a series of specific questions from VA regarding diagnosis, assessment, treatment, and compensation. Posttraumatic Stress Disorder is a brief elaboration of the committee's responses to VA's questions, not a detailed discussion of the procedures and tools that might be used in the diagnosis and assessment of PTSD. The committee decided to approach its task by separating diagnosis and assessment from treatment and preparing two reports. This first report focuses on diagnosis and assessment of PTSD. Given VA's request for the report to be completed within 6 months, the committee elected to rely primarily on reviews and other well-documented sources. A second report of this committee will focus on treatment for PTSD; it will be issued in December 2006. A separate committee, the Committee on Veterans' Compensation for Post Traumatic Stress Disorder, has been established to conduct the compensation study; its report is expected to be issued in December 2006.

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National Academies Press

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ISBN 10

0309102073

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9780309102070

Gulf War and Health

Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Gulf War and Health: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress

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Gulf War and Health

Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Gulf War and Health: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress

The sixth in a series of congressionally mandated reports on Gulf War veterans' health, this volume evaluates the health effects associated with stress. Since the launch of Operation Desert Storm in 1991, there has been growing concern about the physical and psychological health of Gulf War and other veterans. In the late 1990s, Congress responded by asking the National Academy of Sciences (NAS) to review and evaluate the scientific and medical literature regarding associations between illness and exposure to toxic agents, environmental or wartime hazards, and preventive medicines or vaccines in members of the armed forces who were exposed to such agents. Deployment to a war zone has a profound impact on the lives of troops and on their family members. There are a plethora of stressors associated with deployment, including constant vigilance against unexpected attack, difficulty distinguishing enemy combatants from civilians, concerns about survival, caring for the badly injured, and witnessing the death of a person. Less traumatic but more pervasive stressors include anxiety about home life, such as loss of a job and income, impacts on relationships, and absence from family. The focus of this report, by the Institute of Medicine (IOM) Committee on Gulf War and Health: Physiologic, and Psychosocial Effects of Deployment-Related Stress, is the long-term effects of deployment-related stress. Gulf War and Health: Volume 6. Physiologic, and Psychosocial Effects of Development Related Stress evaluates the scientific literature regarding association between deployment-related stressors and health effects, and provides meaningful recommendations to remedy this problem.

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358

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National Academies Press

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ISBN 10

0309101778

ISBN 13

9780309101776

An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Developing a Protocol to Evaluate the Concomitant Prescribing of Opioids and Benzodiazepine Medications and Veteran Deaths and Suicides

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An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides

Opioid prescriptions for acute and chronic pain increased dramatically from the late 1990s into the current decade in both the civilian and the Department of Veterans Affairs and Department of Defense treatment environments. Similarly, prescriptions for benzodiazepines also increased significantly for anxiety and insomnia. Combinations of opioid and benzodiazepines have proven fatal when taken concurrently, with research demonstrating this phenomenon for nearly 40 years. This issue is exacerbated within the veteran population because of higher rates of pain, anxiety and other related health issues due to military life. An evaluation of the relationship between opioid and benzodiazepine medication practices at the VA is necessary to improve treatment for mental health and combat-related trauma for veterans. An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides investigates the effects of opioid initiation and tapering strategies in the presence of benzodiazepines in veterans. This report explores neurobiology and the principles of addiction and tolerance, in addition to the current use of opioids and benzodiazepines for treating pain and anxiety in both the veteran and general population. It also provides a protocol to evaluate the relationship between opioid and benzodiazepine medication practices. This framework is a critical foundation for further research to improve concomitant opioid and benzodiazepine medication practices for veterans and the general population.

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111

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National Academies Press

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ISBN 10

0309496020

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9780309496025

Cancer Care for the Whole Patient

Meeting Psychosocial Health Needs

By: Institute of Medicine,Board on Health Care Services,Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting

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Cancer Care for the Whole Patient

Meeting Psychosocial Health Needs

By: Institute of Medicine,Board on Health Care Services,Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting

Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. Psychological and social problems created or exacerbated by cancer-including depression and other emotional problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and disruptions in work, school, and family life-cause additional suffering, weaken adherence to prescribed treatments, and threaten patients' return to health. Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to address patients' psychosocial health needs. All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators, health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.

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455

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National Academies Press

Published Date

ISBN 10

0309134161

ISBN 13

9780309134163

Veterans at Risk

The Health Effects of Mustard Gas and Lewisite

By: Institute of Medicine,Committee on the Survey of the Health Effects of Mustard Gas and Lewisite

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Veterans at Risk

The Health Effects of Mustard Gas and Lewisite

By: Institute of Medicine,Committee on the Survey of the Health Effects of Mustard Gas and Lewisite

Recently, World War II veterans have come forward to claim compensation for health effects they say were caused by their participation in chemical warfare experiments. In response, the Veterans Administration asked the Institute of Medicine to study the issue. Based on a literature review and personal testimony from more than 250 affected veterans, this new volume discusses in detail the development and chemistry of mustard agents and Lewisite followed by interesting and informative discussions about these substances and their possible connection to a range of health problems, from cancer to reproductive disorders. The volume also offers an often chilling historical examination of the use of volunteers in chemical warfare experiments by the U.S. militaryâ€"what the then-young soldiers were told prior to the experiments, how they were "encouraged" to remain in the program, and how they were treated afterward. This comprehensive and controversial book will be of importance to policymakers and legislators, military and civilian planners, officials at the Department of Veterans Affairs, military historians, and researchers.

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448

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National Academies Press

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ISBN 10

030904832X

ISBN 13

9780309048323

Treatment of Posttraumatic Stress Disorder

An Assessment of the Evidence

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Treatment of Posttraumatic Stress Disorder

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Treatment of Posttraumatic Stress Disorder

An Assessment of the Evidence

By: Institute of Medicine,Board on Population Health and Public Health Practice,Committee on Treatment of Posttraumatic Stress Disorder

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224

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National Academies Press

Published Date

ISBN 10

0309109264

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9780309109260

The National Children's Study Research Plan

A Review

By: National Research Council,Institute of Medicine,Board on Population Health and Public Health Practice,Division of Behavioral and Social Sciences and Education,Board on Children, Youth, and Families,Committee on National Statistics,Panel to Review the National Children's Study Research Plan

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The National Children's Study Research Plan

A Review

The National Children's Study (NCS) is planned to be the largest long-term study of environmental and genetic effects on children's health ever conducted in the United States. It proposes to examine the effects of environmental influences on the health and development of approximately 100,000 children across the United States, following them from before birth until age 21. By archiving all of the data collected, the NCS is intended to provide a valuable resource for analyses conducted many years into the future. This book evaluates the research plan for the NCS, by assessing the scientific rigor of the study and the extent to which it is being carried out with methods, measures, and collection of data and specimens to maximize the scientific yield of the study. The book concludes that if the NCS is conducted as proposed, the database derived from the study should be valuable for investigating hypotheses described in the research plan as well as additional hypotheses that will evolve. Nevertheless, there are important weaknesses and shortcomings in the research plan that diminish the study's expected value below what it might be.

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166

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National Academies Press

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ISBN 10

0309185920

ISBN 13

9780309185929

Adolescent Suicide

By: Group for the Advancement of Psychiatry. Committee on Adolescence

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Adolescent Suicide

By: Group for the Advancement of Psychiatry. Committee on Adolescence

Even the most skilled therapist may underestimate suicide potential. Careful assessment and competent psychiatric intervention cannot always predict the suicidality of a particular person. Adolescent Suicide (GAP Report 140) presents techniques that allow psychiatrists and all those caring for the health and welfare of adolescents to respond to signals of distress with timely therapeutic intervention. It also suggests measures of anticipatory prevention. Adolescent Suicide presents an overview of adolescent suicidal behavior. It explores risk factors, the identification and evaluation of the suicidal adolescent, and approaches to therapy. It offers both historical and cross-cultural perspectives, the relevance of suicide to adolescent development, mental health training needs regarding suicidality, and related issues such as public health policies and medicolegal concerns. The risk of suicide presents a unique crisis in adolescent development. For this reason, all mental health professionals will find this report an indispensable tool in the treatment of adolescents at risk for suicide. Drawing from years of combined experience, this committee has applied its expertise on adolescent development to the sobering problem of suicide.

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226

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American Psychiatric Pub

Published Date

ISBN 10

0873182081

ISBN 13

9780873182089

Book's by Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder

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