State VA leads the world as PTSD info resource, Vermont

State VA leads the world as PTSD info resource

By BOB AUDETTE, Reformer Staff



Wednesday, June 25
WHITE RIVER JUNCTION -- Post Traumatic Stress Disorder doesn't just affect soldiers and the victims of war. It also strikes the survivors of natural disasters, childhood abuse, rape, assault and genocide.
And in subtle and not-so-subtle ways, it also hurts the families and friends of those suffering from PTSD.

"Living with someone with PTSD affects families in major ways," said Matthew J. Friedman, the executive director of the National Center for PTSD at the Veterans Affairs Medical Center in White River Junction.

Many family members feel they are walking on eggs around loved ones, afraid of sparking an emotional or mental breakdown, rage, depression or even suicidal ideation. Often, it's those wives, husbands and grandparents who turn to organizations such as the VA for help when sufferers fail or refuse to recognize the despair they are subjecting themselves and their families to.

Over the years, PTSD has been called by many names including nostalgia, shell shock and battle fatigue. Those suffering from the disorder were often labeled as cowards or weaklings.

The symptoms of PTSD have been recorded as far back as the 1800s, said Friedman, especially in relation to the Civil War and the Franco-Prussian War in Europe. In the late 1970s, researchers of what was then three different fields of study -- the trauma of Nazi atrocities, rape and serving in Vietnam -- realized they were all studying


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the same syndrome.
"People began to realize the survivors of different kinds of stress had common symptoms," said Friedman. "(But) we didn't have treatments in those days."

In the early 1970s, Friedman was treating substance abuse in military veterans when he realized for many service members it was a symptom of a deeper problem. Working with his wife, Gayle Smith, who had served as a nurse in Vietnam, Friedman moved away from substance abuse and began to focus on the trauma inflicted on service men and women as a result of serving in a battle zone.

In 1988, a national request for proposals to establish a center focusing on the disorder was announced by Congress. The center would serve as a resource for those researching PTSD and health care professionals treating the sufferers of the affliction. It would also be responsible for training care workers for the Department of Veterans Affairs and other federal and nonfederal service providers.

A year later, the National Center for PTSD was established in White River Junction. The executive division at the VA medical center located there is the center of a "hub-and-spoke" organization that researches and develops educational materials to help health care professionals recognize and treat the various manifestations of PTSD. With the "hub" in White River Junction, "spokes" are located in Boston, West Haven, Conn., Palo Alto, Calif., and Honolulu.

"Our major product is knowledge," said Friedman.

The center is responsible for creating some of the most widely used diagnostic tools in the field of PTSD, including a clinician-administered PTSD scale, the Mississippi Scale for Combat-Related PTSD and a primary care PTSD screening test. It has also conducted the two largest PTSD studies to date.

The center and its affiliates have produced 2,100 articles, chapters or books and 3,600 scientific or educational presentations in the past 19 years. Administrators in White River Junction have cataloged more than 33,000 publications in the Published International Literature on Traumatic Stress database, the go-to guide for health care professionals and those affected by PTSD. The center also issues publications such as the Clinician's Trauma Update and the PTSD Research Quarterly.

In addition to reviewing and assembling the worldwide research on PTSD, the center and its affiliates also conduct their own research and provide educational materials, training, consultation, program evaluation and tools for care providers.

Research conducted at facilities such as the National Center on PTSD has led to new ways to treat the survivors of trauma, including medication and cognitive and group therapy. Central to much of the treatment is the need to discuss the traumatic event and its consequences.

Friedman, the author of books such as "After the War Zone," which he wrote with Laurie Slone, the center's associate director for research and education, and "Treating Psychological Trauma and PTSD," said the stigma of mental illness still gets in the way of treating its victims.

"American society will talk about its medical needs but not its mental health," he said, a condition that has been magnified in the military because of the perception that admitting to having a mental illness could limit a soldier's career.

"Despite the stigma, people are more sophisticated about understanding mental illness. People have recognized that they're not going to get better by themselves."

Nearly 40 percent of the 1.6 million men and women who have served or are serving in Iraq and Afghanistan are seeking some sort of treatment from the VA, said Friedman. Of those, about 8 percent are receiving treatment for PTSD, he said, almost 80,000 soldiers, sailors, marines and airmen.

"The emphasis these days is on having the courage to seek help," he said. "It's a different kind of courage."

There has also been a change in the way the military establishment views those suffering from PTSD, said Friedman. For many service members, seeking help for PTSD is the first step in getting their careers back on track and military supervisors are trained to recognize the symptoms and make referrals.

As with most human experience, people react differently to similar stressful situations. But researchers have learned that those suffering from the syndrome exhibit alterations in body chemistry and brain functions.

"While some people exposed to traumatic events do not develop PTSD, others go on to develop the full-blown syndrome," wrote Friedman, in a fact sheet detailing the history of PTSD. "Such observations have prompted the recognition that trauma, like pain, is not an external phenomenon that can be completely objectified."

To learn more about the center or PTSD, log on to ncptsd.va.gov.

Bob Audette can be reached at raudette@reformer.com or 802-254-2311, ext. 273.

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