Healing Combat Trauma

Traumatic War Experiences Predict Future Health Woes, Study of Civil War Vets Shows

In some medical news that you might have missed, a study came out that was published in the February, 2006 issue of the Archives of General Psychiatry that studied historical records pertaining to Civil War veterans, the amount of trauma they experienced in combat, and what the after-effects were in later years to their health.  Fascinating stuff, of course.

According to the article, "An archival examination of military and medical records of Civil War veterans was conducted. Degree of trauma experienced (prisoner-of-war experience, percentage of company killed, being wounded, and early age at enlistment), signs of lifetime physician-diagnosed disease, and age at death were recorded." Additionally, "The US Pension Board surgeons conducted standardized medical examinations of Civil War veterans over their postwar lifetimes. Military records of 17,700 Civil War veterans were matched to postwar medical records."

The conclusion?  "Greater exposure to death of military comrades and younger exposure to war trauma were associated with increased signs of physician-diagnosed cardiac, gastrointestinal, and nervous disease and more unique disease ailments across the life of Civil War veterans." In other words, younger soldiers were at greater risk; and the more brother (or today, also sister) soldiers who died, the harder it was for the combat veterans.  Makes sense, doesn't it?

Editor's note: The study's citation is: Arch Gen Psychiatry. 2006 Feb;63(2):127-8, and it's linked here. 

The Dept. of "No Real Surprises Here": Chiropractic Doesn't Help Veterans Suffering from PTSD

An article in the current issue -- June, 2009 -- of Military Medicine takes a look at the effects of chiropractic on veterans with PTSD, and finds the results lacking.  The study is called "A cross-sectional analysis of clinical outcomes following chiropractic care in veterans with and without post-traumatic stress disorder,” and it was authored by Drs. Andrew Dunn, Steven Passmore, Jeanmarie Burke and New York Chiropractic College student David Chicoine.

According to an article in trade publication ChiroEco.com, that study "investigates clinical outcomes for 130 veteran patients with neck or low back complaints at the VA of Western New York. This study found that patients with post-traumatic stress disorder had significantly lower lower levels of improvement than those without post-traumatic stress disorder on self-reported outcome measures of neck and low back disability."

These results are not really surprising, because -- unlike another form of bodywork, massage therapy, which does have proven results for helping PTSD symptoms -- there's nothing about chiropractic per se that indicates it would be helpful. Spinal subluxations, while combat veterans may be experiencing them, aren't really part of the PTSD profile, and relieving them wouldn't necessarily have any effect whatsoever on reducing PTSD symptoms.  They're just not related. That said, it's progress that chiropractic is offered in military health care settings, and we're sure it brings combat veterans some relief -- in the appropriate context, which PTSD is not.

For a look at complementary and alternative medicine therapies ("CAM") that have shown benefit in treating PTSD, click here.  For a look at bodywork therapies, click here.  For a look at mind-body medicine approaches, click here.  To read the article in ChiroEco.com, click here.

Let's Hope This Isn't More "Blame the Victim" Thinking on Combat Veterans with PTSD, But...

A recent medical study, published in the British Medical Journal and reported on Friday, suggests that "the risk of combat-related post-traumatic stress disorder (PTSD) increased by two- to threefold in military personnel who had significant mental or physical problems before deployment, according to a study of 5,400 veterans."  In other words, those who were vulnerable beforehand, were even more susceptible to PTSD than their peers.  Hmmmn.

It's always interesting, and is going to stay interesting, to contemplate what, if any, predictive or predisposing factors there are for who develops later develops combat-based PTSD and why.  At the very least, this study throws yet more analysis into the mix, in a story that will continue developing for years.

According to the BMJ, the conclusion of the study was that:

"Low mental or physical health status before combat exposure significantly increases the risk of symptoms or diagnosis of post-traumatic stress disorder after deployment. More vulnerable members of a population could be identified and benefit from interventions targeted to prevent new onset post-traumatic stress disorder."

The study, which was supported by the U.S. Department of Defense, reported that:

"More than half of post-combat PTSD diagnoses involved veterans who ranked below the 15th percentile in mental or physical health at baseline, Cynthia LeardMann, of the Naval Health Research Center in San Diego, and colleagues reported online in BMJ.

"We have identified an at-risk population whose functional health seems to predict vulnerability to PTSD after combat deployment," the authors said. "In theory, such a population could be targeted for PTSD prevention programs, early intervention after exposures to stress, or even protection from stressful exposures, when possible."

The findings came from the Millennium Cohort Study, which has accumulated data on military personnel since 2001, before the wars in Afghanistan and Iraq. Investigators collected follow-up data from June 2004 to February 2006.

A previous report based on the study suggested that combat exposure -- as opposed to deployment -- significantly increased the risk of new-onset PTSD. Building on that observation, the authors examined the association between baseline mental and physical health and the risk of new symptoms or a diagnosis of PTSD.

The current analysis involved 5,410 combat veterans who completed baseline and follow-up questionnaires. The questionnaire includes a 17-item self-report measure of PTSD symptoms.

Baseline health status was determined by participants' scores on the mental and physical summaries of the SF-36V (veterans) health survey. A new PTSD diagnosis was based on DSM-IV criteria (derived from the questionnaires) or self-reported physician diagnosis.

The analysis showed that 7.3% of the participants had new-onset symptoms or a diagnosis of PTSD at follow-up by DSM-IV criteria. When self-reported physician diagnosis was included, the rate increased to 8.6%.

The authors stratified the participants into three groups according to mental and health status scores: below the 15th percentile, 15th to 85th percentile, and above the 85th percentile.

Combat veterans who scored below the 15th percentile of the mental summary had a relative risk of PTSD of 3.51 compared with those in the 15th to 85th percentile.

A score below the 15th percentile of the physical summary more than doubled the risk of PTSD (RR 2.22).

Overall, 58% of new PTSD diagnoses involved combat veterans who were below the 15th percentile for either summary.

Subgroups at increased risk for new PTSD symptoms or diagnosis included:

• ≥3 combat exposures during deployment, 2.60
• Women, 2.33
• Current smokers, 1.56
• Non-officers, 1.77
• Reserve/National Guard members, 1.85
• Army veterans, 2.04"

Editor's Note: The full reference is: LeardMann CA, et al "Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: Prospective U.S. military cohort study."  The full citation is: BMJ 2009; 339: DOI:10.1136/bmj.b1273. For the link to the full article, click here.

Suicide Predictors in Young Men -- Combat Trauma Not Included

We've talked on the blog before about "suicide maps" and various predictors of suicide, however imperfect they may be.  Today there's an item from a medical journal that details a Finnish study -- aka, a medical study performed in Finland -- which essentially says, adolescent boys and young men who committed suicide frequently also showed some form of psychiatric illness at age 8 -- which happened to be the age where they were first evaluated, in the study.  Young women who killed themselves, didn't show this particular trend. Now, not to say that this study is in any way conclusive about PTSD -- since obviously it didn't even touch on that as a topic -- but it is interesting, since some of the research indicates that PTSD can be particularly difficult if it is "laid on top of" a previous, significant traumatic experience (often in childhood). In some ways, this study may not be all that germane to our topic, but it's interesting to note, in any case, since there are obviously a number of young men (and women) who commit suicide in the armed forces, and as veterans -- and it's always worthwhile to comb the scientific literature for any other reasons, or contributing factors into, why this might actually be.  Here's the info from the study:

Childhood Psychiatric Problems May Predict Suicide Attempts in Males

Most males who commit suicide or need hospital care for suicide attempts during their teen or early adult years appear to have high levels of psychiatric problems at the age of 8, according to a report in the Archives of General Psychiatry. However, later suicide attempts in females are not predicted by mental health issues at this age.
 
Andre Sourander, MD, of Turku University Hospital in Finland, and colleagues studied 5,302 Finnish individuals born in 1981. Eight years later, information about psychiatric conditions, school performance, and family demographics was gathered from children, parents, and teachers. Participants were then tracked through national registers through 2005.
 
Between the ages of 8 and 24, 40 participants died, including 24 males and 16 females. Of those, 13 males and two females died from suicide. A total of 54 males and females (1%) either completed suicide or made a suicide attempt serious enough to result in hospitalization.
 
Of the 27 males who either seriously attempted or completed suicide, 78% screened positive for psychiatric conditions at the age of 8, compared with 11% of 27 females who had serious or completed suicide attempts. In addition, males who would go on to make life-threatening or completed suicide attempts were more likely at the age of 8 to live in a family that did not consist of two biological parents, have psychological problems as reported by a teacher or have conduct, hyperactive, or emotional problems. However, none of these factors at 8 predicted later suicidal behavior in females, and depression at age 8 was not associated with suicide attempts for either sex.
 
Previous research has shown that in females, suicide is associated with depression and other affective disorders, which increase sharply after the beginning of puberty. This may explain why childhood psychiatric conditions do not predict later suicidal behavior in girls, the authors noted.
 

— Source: American Medical Association

Ethnic Disparities in Incidence of PTSD and Suicide among Combat Veterans

The topic of "culture, race, ethnicity and PTSD" is a complicated subject, with great potential to offend, so it has to be covered delicately, and slowly, over time.

There is a concern that ethnic minorities or non-white populations experience PTSD at greater rates than whites, but this concept is not without its detractors, who frankly disagree. 

It would be interesting to learn more about this phenomenon, and learn if the data really supports it, or if it's just an assumption.  If it turns out to be true, then it might be useful to map it against the prevalence of ethnic minorities who serve in the armed forces, in order to guesstimate more accurately future numbers of veterans who are likely to be affected by PTSD, and predict the resources that will be needed for their effective care in their home communities.  On the one hand, you would hope that these estimates were already being made; on the other hand, it doesn't seem that they are. Consequently, in this post we're unfortunately raising more questions than answers.

To narrow the focus here enough for discussion, let's take a look at just one ethnicity among many from which we could choose -- one that's on the rise in the United States (and in the U.S. military) -- Hispanics (aka Latinos). Observe how cultural issues may come into play with their incidence of PTSD, as the study indicates. (The same questions that are raised here could apply, in turn, to other ethnic minorities, and ideally, all should be studied.)

Re: Hispanics/Latinos:

"Several studies have found that Hispanic Americans have higher rates of post-traumatic stress disorder (PTSD) than non-Hispanic Caucasian and Black Americans. The authors identified predictors of PTSD symptom severity that distinguished Hispanic police officers (n=189) from their non-Hispanic Caucasian (n=317) and Black (n=162) counterparts and modeled them to explain the elevated Hispanic risk for PTSD. The authors found that greater peri-traumatic dissociation, greater wishful thinking and self-blame coping, lower social support, and greater perceived racism were important variables in explaining the elevated PTSD symptoms among Hispanics. Results are discussed in the context of Hispanic culture and may be important for prevention of mental illness in the fastest growing ethnic group in the United States." (Source.)

Hispanics/Latinos in the military. Do figures exist for how many Hispanics/Latinos are currently serving in the military; and/or are veterans of the Vietnam war, the Gulf war, the Iraq war, or Afghanistan? Are more Hispanics/Latinos joining the military?

I've seen a copy of a report that the state of Massachusetts has for number of veterans by zip code across the state.  Not surprisingly, a quick glance through that report impresses the casual reader that numbers of veterans are highest in poorer communities than wealthier communities. (You'd have to know Massachusetts for the examples to make sense, but say, the difference between Brockton or Fall River, MA and Wellesley or Osterville, MA.) A similar trend may also exist for communities with higher concentrations of ethnic minorities.

Hispanic/Latinos military suicides. Similarly, do figures exist that break out the ethnicity of active duty servicemembers or veterans who have committed suicide? Seemingly, the data to this point has not been this specific, but it needs to be.

Ironically, an unrelated study (circa 2002) done at the VA showed that with regard to being misdiagnosed with a particular mental illness (in this case, schizophrenia), you were more likely to be misdiagnosed if you were black or Hispanic than if you were white.  Also, if you were single, male, and lived in a rural area.

A study published in the American Journal of Public Health, Dec. 2007, Vol. 97, No. 12 offered some conflicting findings.  Their study, done with the VA system in the Ann Arbor, Michigan area, suggested that suicide rates for Hispanic veterans were actually LOWER than those of whites.  According to the study's authors:

"When the researchers calculated suicide rates over the entire 5.5 year study period, they were much higher for men (89.5 per 100,000 person-years) than for women (28.9), and higher for whites (95 per 100,000 PY) than for African Americans (27) and veterans of other races (56.1). Veterans of Hispanic origin had a lower rate (46.28 per 100,000 PY) of suicide than those not of Hispanic origin (86.8)."

The study had other unusual findings, including that vets with service-connected disabilities committed suicide less frequently than those without, and, most interestingly, that veterans with PTSD diagnoses committed suicide less frequently than those without such diagnoses(!).

However, the study's methodology was such that "the researchers analyzed comprehensive data from 807,694 veterans of all ages diagnosed with depression and treated at any Veterans Affairs facility nationwide between 1999 and 2004." In other words, before any significant number of OEF/OIF vets could be included in the study, a group whose rate of suicide is markedly higher than expected. In fact, during the course of the study, only "1,683 of the [over 800,000] depressed veterans committed suicide," a figure which represents "0.21 percent of the depressed veterans studied." Clearly, suicide figures among veterans today are higher than this study indicated, and it would be worthwhile redoing the study with a more current population of veterans.

Study Shows Young Adults with PTSD More Likely to Commit Suicide

On the one hand, this sounds like fairly self-explanatory science.  So why the inclusion on this blog?  Because of the (young) age of many active duty military, and even recent veterans -- news like this is relevant.

Young Adults With PTSD May Be More Likely to Attempt Suicide

"Posttraumatic stress disorder (PTSD)—but not exposure to traumatic events without the development of PTSD—may be associated with subsequent attempted suicide in young adults, according to a report in Archives of General Psychiatry.

Approximately 421,200 to 842,400 Americans aged 15 to 24 attempt suicide every year, according to background information in the article. Holly C. Wilcox, PhD, of Johns Hopkins Children’s Center, Baltimore, and colleagues studied 1,698 young adults of a group of 2,311 who had been tracked since entering the first grade in Baltimore public schools. Fifteen years later, 90-minute interviews were conducted with the participants (average age of 21) to assess the occurrence of traumatic experiences, suicide attempts, and the development of PTSD.

Of the participants interviewed, 1,273 (81%) had been exposed to a traumatic event and 100 (6%, or 8% of those exposed to trauma) developed PTSD. Suicide had been attempted by 10% of those with PTSD, compared with 2% of those who were exposed to trauma but did not develop PTSD and 5% of those who had never been exposed to traumatic events.

“The mechanisms involved in the association between PTSD and suicide attempts are not known,” the authors wrote. “There could be a common pre-existing predisposition to PTSD and suicide attempts that was present before the trauma occurred. Studies of early trauma and suicidal behaviors have implicated depression and impulsivity as possible mediators or possible pre-existing susceptibility traits.”

— Source: American Medical Association

Veterans Sought for National Clinical Study on EFT and Combat Trauma

Veterans sought for combat stress study

Veterans from wars in Vietnam, Iraq and Afghanistan may be eligible to participate in a clinical study investigating the effectiveness of Emotional Freedom Technique (EFT) at releasing combat-related stress, trauma and memories.

Qualifying veterans will receive six free private sessions of EFT with a professionally trained coach, including follow-up assessments after 3-6 months.

Combat-related conditions include insomnia and/or nightmares, drug and/or alcohol dependencies, anger, anxiety, depression, paranoia, obsessive compulsive behavior, panic attacks, phobias, rage, grief, survivor’s guilt, feelings of isolation or jumpiness around people.

The study is organized and sponsored by the Iraq Vets Stress Project (http://www.StressProject.org), a project of Soul Medicine Institute, a nonprofit research corporation.

For more information contact Susan Maloney, an integral life coach and EFT practitioner, at (707) 888-0246 or susan@susanmaloney.com.

What Would Hope Regained Do for Combat Veterans?

I was in a conversation the other day with a Vietnam era psychologist, who I respect and admire a great deal, but who was nonetheless giving me static for the way I talked about "hope" in a previous blog post, as it concerned combat veterans.  "You talk about it as though it's an abstract, but then immediately move into talking about its RESULTS," he said (I'm paraphrasing.)  Rrrright.  And that would be exactly the point.  Hope is a great and a necessary thing -- but our goal here is to find ways to get over combat trauma, to the extent possible -- at least to reduce its effects on veterans -- and in that regard, yes, we're all about the results.  Are there any?  And what can those be?  Because if they're legitimate at all, in the vacuum of hope-lessness and despair created by a complete lack of reasonable solutions, let's figure out what those are, and let's try them out.  Are combat veterans game?  Many are.

Here's something I ran across the other day, in the middle of a [draft] journal article.  The author was talking about a type of therapy he used -- a therapy he's famous for developing, and which has been around and in use for decades -- on combat veterans, mostly from the Vietnam era, and the results he was able to achieve with them.  I have some inside knowledge of his program, but this was the first time I'd read something in print about it.  In the middle of quite an extensive article, charting this result and that, he happened to mention the results of one of the tests he did on the 22 vets, both before and after the two weeks of treatment.  This is what he wrote:

"Scores on the Beck Hopelessness Scale fell from an average of 11 before treatment to 3 following treatment.  In clinical practice, scores of 9 or more are used to indicate serious hopelessness.  A score of 4 is expected in the general population.  The veterans went from having pre-test scores characteristic of hopelessness, suicidal ideation and predictive of suicide attempts, to having scores typical of the general population.  Thirteen veterans had scores above 9 before treatment, one had a score above 9 after treatment. (That individual's score had dropped from 17 to 10.)  Nineteen out of 22 scores dropped; two remained the same (scores of 1 and 2); and one score increased [negligibly] (from 4 5o 5).  Marked decreases in pessimism are indicated, and it seems safe to conclude that the treatment group felt considerably more hopeful at the program's conclusion."

Do you see what's embedded in that, if true?  In two weeks of treatment, combat veterans with PTSD that went back decades started feeling better to a degree, on average, better than the general population?  That's remarkable...

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So I ask you, what would HOPE do for veterans today, and their families?  It's pretty clear that when it comes to suicide, people are able to go forward with the act because they've given UP hope.  (That's why the Beck test, for example, is able to link the two: hopelessness and suicide, both ideation and attempts.)  We've seen in previous blog posts how the "focus" of a suicidal person becomes narrower -- it's not that they "don't love their family" or "aren't thinking about the consequences to others," they simply have narrowed their focus down to an either/or choice, and the rest of the considerations, no matter how otherwise dear, are simply "not in the picture." 

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Now it's entirely possible that the veterans in the above-mentioned program didn't functionally "stay" that perky and optimistic, and that's why more follow-up studies, such as retests at longer intervals, would have contributed more information worth knowing.  Many times, at the end of a program, irrespective of what type of program it is, participants feel most buoyed and optimistic about future performance, lighter about their burdens, and more likely to discount the negative effect of future obstacles they may encounter.  However, even so it's significant to note how good those scores seemed to be, given the great degree of difficulty the same participants had having hope beforehand.

It's not just veterans -- it's also their families.  How often do family members say things like, "But you were only in the war for two years...how can you let it affect you for the whole rest of your life?"

If combat veterans are able to access health care that adequately deals with their symptoms, and reduces their symptom load to a manageable extent, and gives them back HOPE -- they will have the ability to resume their lives with some degree of normality, and prevent any number of negative consequences that come from NOT having hope, from having given up.  The tremendous societal costs from combat trauma we have to start understanding not only affect the veterans involved -- they affect their families, the communities in which they live, future generations, etc.  Veterans with hope -- who get their hope back -- will be functional and integrated into all aspects of their lives, and actively participate in their various roles as spouses, parents, employees, citizens, etc.  Veterans who lose hope, and who we do not help to regain hope, will lose out.  And this loss will affect them first, and then like the ripple effect of a pebble thrown into a pond, concentric circles of effect will spread out from them to others in their lives: their immediate families, their workplaces, their schools, their communities, even future generations in their families.

Far from being an abstraction, I believe HOPE is pretty central to the whole concept of "healing combat trauma."  We've got to help combat veterans to hang on and have some, and they themselves have to believe it's possible to get better.  Then we have to make sure we're connecting them with the very resources that can deliver the results.

Chronic Life Stress as a Predictor of Illness: How Much is Too Much?

In the annals of stress management studies is a particular test called the Holmes and Rahe Social Readjustment Scale.  It assigns "points" to major and minor life stressors a person may have experienced over the past year, and then has you total up the points at the end of the test to get a "total score." That total score can be used to predict the likelihood of illness, whether mild or severe, because chronic stress is well known to reduce immune function.

(Of course, stress management skills, such as what we've been discussing on this blog for a while, in the "mind-body medicine" category, linked here, are very helpful in reducing symptoms of stress.  But conscious awareness and the willingness to make life changes are also crucial.)

Veterans may be under chronic stress; but their families -- partners, significant others, children -- may also be under chronic stress.  Partners and children of deployed servicemembers may also have very high scores.  And care-givers for injured veterans (combat trauma, TBI, PTSD, amputations -- veterans suffer any number of serious injuries) are also at increased risk for stress-related illness.

Ideally this is a case where "knowledge is power" -- being able to quantify the stress you're under could help you to ask for help, make better choices, and prioritize self care.  Let's hope so... In the meantime, here's the test:

In the past 12 months, which of the following major life events have taken place in your life?

1. Print out this form

2. Make a mark next to each event that you have experienced this year.

3. When you're done, add up the points for each event.

4. Check your score at the bottom.

_____ Death of Spouse 100
_____ Divorce 73
_____ Marital Separation 65
_____ Jail Term 63
_____ Death of close family member 63
_____ Personal injury or illness 53
_____ Marriage 50
_____ Fired from work 47
_____ Marital reconciliation 45
_____ Retirement 45
_____ Change in family member's health 44
_____ Pregnancy 40
_____ Sex difficulties 39
_____ Addition to family 39
_____ Business readjustment 39
_____ Change in financial status 38
_____ Death of close friend 37
_____ Change to a different line of work 36
_____ Change in number of marital arguments 35
_____ Mortgage or loan over $10,000 31
_____ Foreclosure of mortgage or loan 30
_____ Change in work responsibilities 29
_____ Trouble with in-laws 29
_____ Outstanding personal achievement 28
_____ Spouse begins or stops work 26
_____ Starting or finishing school 26
_____ Change in living conditions 25
_____ Revision of personal habits 24
_____ Trouble with boss 23
_____ Change in work hours, conditions 20
_____ Change in residence 20
_____ Change in schools 20
_____ Change in recreational habits 19
_____ Change in church activities 19
_____ Change in social activities 18
_____ Mortgage or loan under $10,000 17
_____ Change in sleeping habits 16
_____ Change in number of family gatherings 15
_____ Change in eating habits 15
_____ Vacation 13
_____ Christmas season 12
_____ Minor violations of the law 11

______ Your Total Score

Now, take the total score and look at the following key:

LIFE STRESS SCORES

0-149 Low susceptibility to stress-related illness.

150-299 Medium susceptibility to stress-related illness.

300 and over High susceptibility to stress-related illness.

Now is the time to look into techniques to reduce stress loads, and to practice better self-care (to the extent possible.)

Pilot Study on Mind-Body Medicine Intervention Techniques Looking for Oregon Veterans

A study of mind-body medicine getting underway in Portland, Oregon will test whether veterans with post-traumatic stress disorder can benefit from meditation, neurofeedback and other healing alternatives.

Researchers at Oregon Health & Science University are seeking 45 volunteers, including combat veterans troubled by PTSD and veterans who lack combat experience or have never suffered from PTSD.  They are accepting veterans between the ages of 18 and 70 who are in good health.

The pilot study, which could lead to a larger clinical trial, will measure how stressful and relaxing situations change a subject's hormone levels, heart rate, brain activity, and immune system functioning.  Helané Wahbeh, a naturopathic doctor and postdoctoral fellow at OHSU, is leading the study with funding from OHSU's department of neurology as well as the National Institutes of Health (NIH).

 “Mind-body medicine appears to be an ideal way to help people with PTSD because the disorder affects the body’s immune system, hormone system and nervous system,” says Helané Wahbeh, N.D., a naturopathic physician researcher at OHSU. “I don’t believe you can effectively treat PTSD by only focusing on one aspect of the illness. For example, if we only give people suffering from PTSD anti-depressants, we may only be treating one aspect of the illness.”

The first phase of the OHSU study will measure changes in hormones, heart rate, brain activity and the immune system in both relaxing and stressful situations. Mary Lu, M.D., a psychiatrist with the Portland VA Medical Center, will provide PTSD screening.

Veterans interested in volunteering for the study, which will take up to about six hours of their time (probably broken up over time) can call (503) 494-3528 for more information.

Editor's note: If the study will measure hormone levels, undoubtedly it will measure cortisol levels -- and we've talked about cortisol, stress and sleep quite a bit previously on this blog. Unfortunately, good luck to the study's researchers on finding older vets who are also in "good health," especially ones who suffer from combat-based PTSD. Typically this creates a cascade of other physiological problems as veterans age -- however, on the plus side, mind-body relaxation techniques ideally will help even older veterans with health problems to achieve greater quality of life.  Either way it's an interesting study.

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Additionally, here's a little more about the study from OHSU's own site, including some goals and a short video, linked here. And here's a description of the study (confusingly saying that it's not yet open for participation yet -- call the phone number instead to be sure) from the NIH's own Clinical Trials site, linked here.