The proposed research is to conduct 5 sub-studies within the Research to Improve Emotional Health and Quality of Life Among Service Members with Disabilities (RESTORE LIVES) Center. This Center is housed at the University of South Florida (USF), in Tampa, FL. Dr. Kevin E. Kip, Executive Director of the Research Center at the USF College of Nursing will serve as Principal Investigator.
The focus of the 5 sub-studies to be carried out within a 2-year performance period will be 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.
Substudy #2. (Co-PIs: Dr. Kip, Ms. Rosenzweig) In-person Accelerated Resolution Therapy (ARTTM) for Psychological Trauma. Hypotheses: Compared to waitlisted controls, service members and veterans with symptoms of PTSD who receive ARTTM will show greater acute and sustained improvements in: self-report measures of PTSD, sleep quality, depression, anxiety, guilt, hopelessness, and quality of life.
Substudy #3. (PI: Dr. Belanger) Web-based Mild Traumatic Brain Injury (TBI) Tele-rehabilitation. Hypotheses: 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.
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.
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.
Public Health Relevance
This project has the potential to provide significant benefits to the general public. First, several of the interventions to be evaluated may have applicability to psychological trauma experienced outside of combat and military settings. Second, whether for direct treatment of the active duty soldier or veteran, if shown to be effective, these therapies will likely extend to the family unit as a whole. This includes minimizing some of the negative family-related consequences that extend from emotional problems of the solider to the spouse and/or children including increased rates of depression, anxiety, and substance use, marital difficulties, behavioral, social, and educational problems in younger children, adolescent behavioral and disciplinary concerns, and maltreatment of children. Finally, this project may result in future training of therapists in novel therapies, including ACT and ART, which may be used as part of the treatment armamentarium in the general population.