- Family-Based Intervention with Traumatized Service Members and Their Young Children
- Deployment-Related Mild Traumatic Brain Injury (mTBI): Incidence, Natural History, and Predictors of Recovery in Soldiers Returning from OIF/OEF
The ongoing wars in Iraq and Afghanistan (OEF/OIF) have been especially challenging for military families with very young children (birth-5 years) due to more frequent and lengthier deployments and a higher exposure to combat amongst deployed personnel. Young children and parents in OEF/OIF families are faced with prolonged deployment-related separation, and the child-parent relationship may be compromised when a Service Member parent returns from war with combat stress or other deployment-related difficulties. Thus, with funding from a Fiscal Year 2007 Intramural PTSD Investigator-Initiated Research Award, Dr. Ellen DeVoe is investigating the impact of PTSD and deployment separation on very young children in OEF/OIF families.
The primary aim of this project is to develop and test the effectiveness of a home-based reintegration program, entitled Strong Families Strong Forces, to mitigate the impact of deployment separation and the legacy of combat in Service Members returning from war on young children and on the child-parent relationship. Dr. DeVoe and her team have conducted over 80 interviews with Service Members, their spouses and partners, and with key informants to explore the effects of war zone-related trauma on reintegration, parenting, and child-parent relationships. Findings from these interviews have informed the development of the Strong Families Strong Forces Program and a pilot test of the program has been completed. A randomized clinical trial is underway in which 128 OEF/OIF families with young children are assigned either to the treatment group or to a wait-list comparison group. Assessments, including a videotaped structured play observation of the Service Member parent and his or her young child, are conducted pre-, post-, and 3 months following treatment to evaluate the quality of child-parent relationships, parental mental health, parenting, and child developmental status. The outcomes of this research will assist in elucidating the impact of war-related trauma and deployment separation on very young children and their relationships with their military parent(s), and will result in a military relevant intervention which may benefit parents with PTSD and their young children.
Data collected from OIF/OEF veterans indicate that approximately 14%-23% of Soldiers sustain a TBI during deployment. The majority of these injuries are classified as mTBI. While most individuals with mTBI recover within days to a couple of months following the injury, some report injury-related sequelae persisting beyond 3 to 6 months. The high prevalence of mTBI among OIF/OEF veterans highlights the need to better understand the effect of pre-existing and comorbid conditions on the natural history and prognosis of mTBI. Dr. Karen Schwab at the Defense and Veterans Brain Injury Center and collaborators from multiple Military Treatment Facilities, is conducting a prospective longitudinal study of deployment-related mTBI.
The study proposes to collect data from a total of 750 OIF/OEF veterans with mTBI and 750 uninjured Soldiers from Fort Bragg and Fort Carson. All individuals returning from deploy- ment are routinely screened for TBI, and the results of these questionnaires will be used to identify potential cases for the study. Participation in this study will not interfere with routine medical care, and Soldiers with mTBI will receive the usual standard of care treatment. Once enrolled in this study, subjects will participate in a clinical interview, and additional information will be collected related to TBI, neuropsychological status, and pre-existing or comorbid conditions. Telephone inter- views will be conducted at 3, 6, and 12 months after baseline assessment to collect follow-up data on the status of TBI sequelae, issues with employment or functional status, depression, anxiety, and PTSD. Study accrual is ongoing. The data collected in this study will provide important epidemiologic information about the long-term functional effects of deployment-related mTBI.