Restoring ill and injured Veterans from our wars in Iraq and Afghanistan to their highest level of functioning and helping to create the best life possible for them when they return home—these are two of the most important challenges VA researchers face today.
This newest generation of Veterans is characterized by an increased number of Reservists and National Guard members who served in combat zones; a higher proportion of women; and different patterns of injuries, such as multiple injuries from explosions, than were seen among Veterans of previous wars.
VA researchers are seeking new ways to address these Veterans' mental health issues, including posttraumatic stress disorder (PTSD). They are also researching traumatic brain injury (TBI) and its treatment, and are developing and testing prostheses that will allow Veterans with amputations or other issues to live as independently as possible.
VA researchers are also helping Veterans with multiple complex, severe injuries (called polytrauma), to recover as much function as possible.
America's Veterans make great sacrifices for our nation. These sacrifices often include temporary or permanent changes to their physical and mental health status. VA has a comprehensive research agenda to address the deployment-related health issues of Veterans who have returned from the wars in Afghanistan and Iraq. Some key topics are outlined below. More detail on VA research involving OEF-OIF Veterans can be found on several of our other topic Web pages, including mental health, PTSD, prosthetics, spinal cord injury, suicide prevention, and TBI.
Military personnel face challenges during their tours of duty that can make it difficult to readjust to life back home. Many service members may need mental health care after returning from duty in Afghanistan or Iraq. Service members may experience symptoms of psychological distress, such as PTSD. Other issues may include stress, mood, anxiety, sleep, psychotic, and addictive disorders.
Among many other VA studies in this area, VA Cooperative Study #566 is examining the health effects of the Iraq war on participants, especially those effects involving mental health. More than 800 service members and Veterans are participating in this study. The researchers hope to learn more about the longer lasting effects of war on mood and stress symptoms, thinking and reaction skills, and different aspects of daily life such as work and daily activities.
VA has a continuing commitment to fund scientifically meritorious efforts to understand, prevent, and treat PTSD. VA research overwhelmingly focuses on potential treatment advances, especially those related to new drugs.
In the 1980s, Patricia Resick, PhD, developed cognitive processing therapy (CPT), a 12-session cognitive behavioral treatment that can be administered to individuals or to groups, to help victims overcome symptoms of sexual trauma.
In 2006, a study led by Candice M. Monson, PhD, of the National Center for PTSD found that the symptoms of Veterans with PTSD were significantly reduced in those who received CPT. CPT is now one of two of the most effective treatments used by VA clinicians for the illness; the other is prolonged exposure therapy.
In September 2012, VA and the Department of Defense (DoD) announced that the two departments were combining more than $100 million to fund two new consortia aimed at improving diagnosis and treatment of PTSD and mild traumatic brain injury (mTBI).
These consortia are bringing together leading scientists and researchers, and are part of VA and DoD's response to President Obama's executive order to improve access to mental health services for Veterans, Service members, and military families.
The study of neurotrauma is an important priority of VA researchers. Veterans wounded in Iraq and Afghanistan are surviving in greater numbers than in previous conflicts due to advances in body armor, battlefield medicine, and medical evacuation transport. As a result, more Veterans are living with disabling injuries, including the often-lifelong effects of TBI.
VA research has shown that the effects of TBI on Veterans often lead to long-term mental and physical health problems that cause problems with their employment, family relationships, and their ability to live in their communities.
Researchers have also shown that most Veterans with confirmed TBI have accompanying psychiatric illnesses, such as PTSD, depression, or anxiety. . VA is working jointly with DoD, the Department of Health and Human Services, and the Department of Education on an action plan to address the long-term issues of TBI that affect the psychological health and overall well-being of Veterans.
Current projects range from basic injury research through long-term health outcomes studies in Veterans. They include examining screening approaches to determine TBI; looking for biomarkers (measurable signs) to detect mild TBI; and using pictures from magnetic resonance imaging and diffusion tensor imaging to evaluate long-term structural and functional changes to the brain after TBI.
Researchers are also looking at drugs to block pathways that program cells to die, and medication to improve recovery of brain function after injuries occur.
VA supports a wide array of research in engineering and technology to improve the lives of Veterans with disabilities. Several centers of excellence provide environments for investigators to collaborate with and mentor young scientists. The centers are organized around specific areas of investigation critical to the rehabilitation of Veterans with disabilities.
Within the centers, research is being carried out on a number of cutting-edge technologies, including advanced wheelchair designs. VA is also looking at ways to regrow vital nerve connections and body tissues and to prevent limb loss.
VA researchers are creating advanced prosthetic limbs that are controlled by computer microprocessors, which will allow the patient's own brain to direct movement. Some researchers are looking at how the body can rehabilitate or repair itself after a stroke or a TBI. Others are looking at new therapies for spinal cord injury and the medical complications that spinal-cord-injured Veterans often develop.
VA's Polytrauma System of Care is the largest integrated system of care dedicated to the medical rehabilitation of Veterans and service members with combat and non-combat related traumatic brain injuries and multiple other injuries.
Today, PSC includes specialized rehabilitation programs at 109 VA medical facilities. The system is dedicated to providing comprehensive, evidence based rehabilitation services to improve and maintain the ability to function of all patients in its care.
One recent study in this area involves looking at a screening tool for visual problems in war-injured Veterans with TBI. Another study is reviewing best practices for insomnia treatment in Veterans with TBI. (Insomnia is a highly prevalent problem in this group.) A third is evaluating the practice of involving families in health care decision-making, care plans, and educational efforts for their loved ones.
It's about trust: VA study yields ideas on how to make suicide assessment more effective (Research Currents, Fall 2013)
Inexpensive generic drug shown effective for nightmares, other PTSD symptoms (Research Currents, Fall 2013)
Hormone findings point to possible TBI therapy (Research Currents, Summer 2013)
Study links combat injuries to changes in brain's cortex (Research Currents, Summer 2013)
'Mantram' technique benefits Veterans with PTSD (Research Currents, May 2013)
Study yields potential biomarker for PTSD-resistant brains (Research Currents, March-April 2013)
Trial yields hope for blast-related auditory problems (Research Currents, February 2013)
Automated way to identify Veterans at risk of suicide? (Research Currents, February 2013)
Study looks at link between substance abuse, PTSD and mortality (Research Highlights, January 29, 2013)
Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Monson CM, Schnurr PP, Resick PA, Friedman MJ, Young-Xu Y, Stevens SP. VA researchers find encouraging results in the use of cognitive processing therapy for Veterans with PTSD. J Consult Clin Psychol. 2006 Oct;74(5):898-907.
Bionic ankle-foot prosthesis normalizes walking gait for persons with leg amputation. Herr HM, Grabowski AM. Using a bionic ankle foot prostheses results in metabolic energy costs, preferred walking velocities, and biomechanical patterns not significantly different from people without an amputation. Proc Biol Sci. 2012 Feb 7;279(1728):457-64.
Do users want to receive a DEKA Arm and why? Overall findings from the Veterans Affairs Study to optimize the DEKA Arm . Resnik L., Latlief G., Klinger SL, Sasson N, Walters LS. The DEKA arm is a new upper-limb prosthetic enabling amputees to perform a wide range of tasks, which VA is testing for the Department of Defense. Most users either wanted to receive, or might want to receive, the new prosthetic. Prosthet Orthot Int, 28 Nov 13, epub ahead of print.
A qualitative study of chronic pain in operation enduring freedom/operation iraqi freedom veterans: "a burden on my soul". Matthias MS, Miech EJ, Myers LJ, Sargent C, Bair MJ. In depth-interviews with Veterans who participated in an intervention for chronic pain. Mil Med. 2014 Jan;179(1):26-30.
Complex Comorbidity Clusters in OEF/OIF Veterans: The Polytrauma Clinical Triad and Beyond . Elizondo B, Pugh JA, Pugh, MJ, Finley EP, Copeland LA, Wang CP, Noel PH, Amuan ME, Parsons HM, Wells M. A discussion of the kinds of chronic conditions that often exist simultaneously in patients with TBI, PTSD, and pain. Med Care. 2014 Feb;52(2):172-81.