This research consists of 5 sub-studies within the Research to Rehabilitate/Restore the Lives of Veterans, Service Members and their Families (RESTORE LIVES Center). This Center is housed in the College of Nursing at the University of South Florida (USF), in Tampa. Dr. Kevin Kip, Executive Director of Research at the USF College of Nursing is the Principal Investigator.
The focus of the 5 sub-studies to be carried out within a 2-year performance period is to collect clinical, epidemiological, and biological data and evaluate treatment protocols to complement services to the VA Healthcare System, TRICARE, and U.S. service members and veterans at large. These sub-studies will focus on service members and veterans with symptoms of post-traumatic stress disorder (PTSD) and/or mild traumatic brain injury (TBI).
The 5 sub-studies to be carried out and corresponding proposed hypotheses are as follows:
Substudy #1. (Co-PIs: Drs. Forsyth & Hickling).
Modular Online Acceptance & Commitment Therapy (ACT) Intervention for OIF/OEF Veterans.
Hypotheses: (i) The web-based ACT program will improve mental health functioning in veterans, as indexed by validated and evidence-based measures of PTSD, anxiety-related distress, depression, and substance abuse; (ii) quality of life and family functioning will also be improved through ACT.
Expected Results: Evidence of efficacy for ACT as a non-intrusive, self-paced, web-based therapy for veterans with impaired mental health functioning, distress, and post-deployment adjustment difficulties.
Substudy #2. (Co-PIs: Dr. Kip, Dr. Elk, Ms. Rosenzweig)
In-person Accelerated Resolution Therapy (ART) for Psychological Trauma.
CURRENTLY ENROLLINGHypotheses: Compared to waitlisted controls, service members and veterans with symptoms of PTSD who receive ART will show greater acute and sustained improvements in: self-report measures of PTSD, sleep quality, depression, anxiety, guilt, hopelessness, and quality of life.
Expected Results: Evidence of efficacy for ART as a novel psychotherapeutic regimen for rapid resolution of symptoms of PTSD.
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Substudy #3. (PI: Dr. Belanger)
Web-based Mild Traumatic Brain Injury (TBI) Tele-rehabilitation.
CURRENTLY ENROLLINGHypotheses: The web-based intervention will be feasible and effective among active duty, veteran, and civilian participants, as defined as follows: (i) participant recruitment and retention will be successful, as evidenced by 80% completion of follow-up at all time points; (ii) the web-based intervention will result in increased knowledge of symptoms and self-efficacy, relative to baseline, at immediate follow-up; (iii) relative to the control group, participants will have significantly reduced symptom reporting at 6-month follow-up; (iv) relative to the control group, participants will report significantly enhanced quality of life at 6 month follow-up; and (v) reduction of symptoms will be moderated by presence of PTSD symptoms and degree of self-efficacy.
Expected Results: (i) The web-based protocol for delivering a psycho-educational intervention to reduce postconcussive symptoms following mild TBI will be shown to be feasible and effective; (ii) data obtained will justify funding for a randomized control trial to determine relative efficacy, effectiveness, and cost of various treatment approaches aimed at preventing the endurance and escalation of postconcussive symptoms; (iii) The VA, military, and private sector will have at their disposal an efficient, inexpensive, portable, user-friendly, and acceptable means to educate and treat individuals suffering with symptoms following mild TBI.
Substudy #4. (Co-PIs: Drs. Forsyth & Hickling)
Assessment of Base Rates of PTSD, High Risk Behaviors, and Impairment.
Hypotheses: (i) The unmatched count procedure (UCT) will yield more accurate base rates of PTSD, mental health difficulties, and use and abuse of alcohol and controlled substances than those reported in the literature; (ii) Given the stigma associated with endorsing mental health difficulties, underreporting of such behaviors will be greater in active duty relative to veteran samples of military personnel from the Iraq and Afghanistan wars.
Expected Results: Information derived from 1,500 OEF/OIF active duty personnel and veterans will be useful in refining existing early intervention, prevention, and intervention programs, including development of newer programs to more fully meet the needs of active duty military personnel and veterans.
Substudy #5. (PI: Dr. Groer)
Nursing Health Initiative for Empowering Women Veterans.
Hypotheses: This pilot study is cross-sectional without defined hypotheses to be tested. It is postulated that the proposed day of recognition and services for female veterans within the Tampa Bay and Sarasota area will result in a wealth of biobehavioral data on the overall health of female veterans.
Expected Results: (i) Holistic evaluation of life experiences and health status of female veterans; (ii) Appropriate acknowledgement of contributions made by female veterans; (iii) provision of services to female veterans including stress management training, wellness profiling, health risk assessments, screenings for cholesterol, C-reactive protein (CRP), cytokines, stress hormones, nutritional assessment and counseling, massages, facials, pedicures, mental health screening and referral; (iv) job placement services; (v) educational opportunities information and counseling; and (vi) benefits counseling. In addition, this study will collect data on markers of allostasis in these female veterans to help understand their relationships with extreme traumatic experiences, as well as the general health of these women and how they cope with stress.