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Hope After Combat

Since 2000, more than 300,000 members of the U.S. Armed Forces have sustained a TBI. TBI in combat veterans is strongly associated with Post Traumatic Stress Disorder (PTSD) and other physical health problems.

These medical concerns affect the quality of life not only for veterans, but of their:

  • Spouses
  • Children
  • Extended family
  • Friends
  • Members of their community.

Veterans afflicted with mTBI face higher risks for other psychological problems and suicide. They have higher rates of unhealthy behaviors—smoking, overeating, and unsafe sex—and higher rates of physical health problems and mortality. They also tend to miss more work or report being less productive.

Effects on Relationships

These conditions can impair relationships, disrupt marriages, aggravate the difficulties of parenting, and cause problems in children that may extend the consequences of combat injury and trauma across generations.

Effects on the Community

TBI and PTSD in veterans extends beyond the soldier and family and into the community. One of the strongest indicators between PTSD and criminogenic behaviors in incarcerated veterans was the presence of a TBI. When a veteran suffers from a combination of TBI and PTSD, his/her symptomology often includes irritability, cognitive impairments, insomnia, impaired vision, depression, fatigue, and anxiety. There is also a link between these conditions and homelessness.

The damaging consequences from lack of treatment or under-treatment suggests that those afflicted, as well as society at large, stand to benefit from with access to effective care.

Treatment Options for PTSD and TBI

There are currently no evidenced-based models of treatment to guide clinical practice for this population. There is limited research on treating both PTSD and TBI either psychologically or pharmacologically. These consequences can have a high economic toll; however, most attempts to measure the costs of these conditions focus only on government-sponsored medical/treatment costs. The direct costs of treatment are only a fraction of the total costs related to mental health and cognitive conditions. Far higher are the long-term individual and societal costs stemming from lost productivity, reduced quality of life, homelessness, domestic violence, the strain on families, and suicide. Therefore, it is important to consider the direct costs of care in the context of the long-term, societal costs of providing inadequate care or no care at all.

A RAND Corporation study calculated the cost effect of directing more veterans into treatment and improving the quality of care. The per-case cost of TBI was found to be substantially higher than the cost of PTSD, but costs varied based on injury severity. Estimates of the one-year cost of mTBI ranged from $27,260 to $32,760 per case. Estimates of moderate to severe TBI costs ranged between $268,900 and $408,520 per case. Based on RAND Corporation’s calculations, the total annual cost associated with diagnosed cases of TBI (2,776 total cases through mid-2007) ranged between $591 million and $910 million. Delivering effective care and restoring veterans to full-functioning mental health has the potential to significantly reduce these longer-term costs. Accurate diagnosis of brain injuries is critical in order to improve quality of life for veterans, their families, and our communities.

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CNS’s Initiative to Help Combat Veterans

Through this initiative, CNS will focus on innovation, diagnosis, and hope for combat veterans and others suffering TBI.

Advanced MR imaging, such as SWI and DTI, expands the range of tissue properties “visible” to a clinician, including the detection of important biomarkers and the imaging of tissue function, offering hope to combat veterans and their families through treatment at the Eisenhower Center.

With enhanced diagnosis comes enhanced treatment and hope for combat veterans and their families.

These capabilities provide enhanced diagnostic modalities, more rigorous ways to determine treatment protocols, and to measure a subject’s response to treatment. CNS and the Eisenhower Center will work conjointly to research the efficacy of treatment modalities, including cognitive therapy, neurofeedback, photic and HEG stimulation techniques, and recreational therapy through the Eisenhower Center’s Camp Liberty.

Additional research in diagnosis and treatment of PTSD will also be examined during this study.

The Center for Neurological Studies is using their patented technology to detect mild-to-moderate brain injuries in combat veterans who have been exposed to a bomb blast.