Ignoring the Evidence

There is a "widening gulf between clinical practice and science."

Why do psychologists reject science?

Sharon Begley - NEWSWEEK
Published Oct 2, 2009
From the magazine issue dated Oct 12, 2009

It's a good thing couches are too heavy to throw, because the fight brewing among therapists is getting ugly. For years, psychologists who conduct research have lamented what they see as an antiscience bias among clinicians, who treat patients. But now the gloves have come off. In a two-years-in-the-making analysis to be published in November in Perspectives on Psychological Science, psychologists led by Timothy B. Baker of the University of Wisconsin charge that many clinicians fail to "use the interventions for which there is the strongest evidence of efficacy" and "give more weight to their personal experiences than to science." As a result, patients have no assurance that their "treatment will be informed by science." Walter Mischel of Columbia University, who wrote an accompanying editorial, is even more scathing. "The disconnect between what clinicians do and what science has discovered is an unconscionable embarrassment," he told me, and there is a "widening gulf between clinical practice and science."

The "widening" reflects the susbstantial progress that psycho-logical research has made in identifying the most effective treatments. Thanks to clinical trials as rigorous as those for, say, cardiology, we now know that cognitive and cognitive-behavior therapy (teaching patients to think about their thoughts in new, healthier ways and to act on those new ways of thinking) are effective against depression, panic disorder, bulimia nervosa, obsessive-compulsive disorder, and -posttraumatic-stress disorder, with multiple trials showing that these treatments—the tools of psychology—bring more durable benefits with lower relapse rates than drugs, which non-M.D. psychologists cannot prescribe.

(click here for complete story)
http://www.newsweek.com/id/216506

PTSD: New War on An Old Foe

Big changes underway at the VA could mean better treatment for thousands of vets. A bureaucracy in transition.

By Jamie Reno Newsweek Web Exclusive
October 1, 2009

They are the invisible wounds of war, the battered minds and bruised spirits we have come to recognize as posttraumatic stress disorder, or PTSD. By one estimate, more than 300,000 of the nearly 2 million U.S. servicemen and -women deployed since 9/11 suffer from the often-debilitating condition, with symptoms that include flashbacks and nightmares, emotional numbness, relationship problems, trouble sleeping, sudden anger, and drug and alcohol abuse. The number of cases is expected to climb as the war in Afghanistan continues, and could ultimately exceed 500,000, according to a new study by researchers at Stanford University. Mental-health experts say PTSD is the primary reason suicides in the military are at an all-time high; 256 soldiers took their own lives in 2008, the highest number since that data was first tracked, in 1980.

As NEWSWEEK and others have reported, the Department of Veterans Affairs has struggled to address this mental-health crisis, and thousands of veterans have suffered as a result. Now, thanks to new leadership and a new openness to collaboration, things appear to be changing at the VA, if slowly. Veterans still often face insufferably long waits for treatment and steep bureaucratic hurdles when filing disability claims. But there is a new sense of urgency under Eric Shinseki, the retired four-star Army general appointed to head the agency by President Obama, to change the culture within the 77-year-old VA. Shinseki has made PTSD a priority, with efforts underway to address concerns from the way claims are processed to the development of new, more effective treatments. "Brain injuries and the psychological consequences of battle are not new to combat," Shinseki tells NEWSWEEK. "We know from past wars that with early diagnosis and treatment, people can get better."

(click here for complete story)
http://www.newsweek.com/id/216534/page/1

Benzodiazepines may not be the answer for soldiers suffering stress from the horrors of war

The US Department of Veterans Affairs says it will consider this and other studies when preparing new guidelines on treatments for post-traumatic stress disorder (PTSD)

New Scientist
01 October 2009 by Linda Geddes

Sleeping pills may interfere with the ability to consolidate memories and recover from flashbacks

GIVING sleeping pills to soldiers and earthquake victims is common practice, yet it could be doing more harm than good. That's the suggestion from a study of traumatised rats, which seemed to show that the drugs suppressed the rodent's natural mechanisms for coping with trauma.

The US Department of Veterans Affairs says it will consider this and other studies when preparing new guidelines on treatments for post-traumatic stress disorder (PTSD). If their results are strong enough, it may recommend withholding sedatives in the aftermath of traumatic events. The findings are also throwing up new possibilities for preventing PTSD (see "Fight stress with stress").

(Click here for complete story)
http://www.newscientist.com/article/mg20427284.600-sedatives-may-slow-recovery-from-trauma.html

New evidence on how the brain reacts to fear

Computational Models Used To Study Fear; Could Help PTSD Victims

ScienceDaily (2009-10-01) --

The brain is a complex system made of billions of neurons and thousands of connections that relate to every human feeling, including one of the strongest emotions, fear. Most neurological fear studies have been rooted in fear-conditioning experiments. Now, University of Missouri researchers have started using computational models of the brain, making it easier to study the brain’s connections. Guoshi Li, an electrical and computer engineering doctoral student, has discovered new evidence on how the brain reacts to fear, including important findings that could help victims of post-traumatic stress disorder (PTSD).

(click here to read full article)
http://www.sciencedaily.com/releases/2009/09/090930165034.htm

Indiana Guard: Standoff Highlights Need for Soldier Help

Written by The Indy Channel
Wednesday, 30 September 2009 08:56

September 29, 2009, Indianapolis, IN - A police standoff involving an Iraq war veteran in Indianapolis highlights the need for programs to help soldiers deal with combat stress, Indiana National Guard leaders said Tuesday.

National Guard Sgt. Jason Carrera, 26, who served two tours in Iraq, eventually surrendered peacefully to police after barricading himself in his apartment for seven hours Tuesday.

Members of the guard's Crisis Intervention Team, which includes a medical doctor, a psychologist and a chaplain, made contact with Carrera's family as soon as they could, 6News' Renee Jameson reported.

(click here for complete story)
http://www.veteransforcommonsense.org/index.php/veterans-category-articles/1403-the-indy-channel

Researchers develop an integrated treatment for veterans with chronic pain and posttraumatic stress

Public release date: 30-Sep-2009

(Boston) – The wars in Iraq and Afghanistan have resulted in a growing number of soldiers evacuated to the United States for comprehensive care for physical and psychological trauma. Given the number of physical injuries often experienced by soldiers, it is not surprising that chronic pain is a frequent problem among returning soldiers from Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF). Common sources of pain are in the head (traumatic-brain injury or post-concussion syndrome), legs (fractures, amputations, burns) and shoulders. Other physical injuries include spinal-cord and eye injuries as well as auditory trauma. In addition, veterans are reporting high rates of mental health issues, including posttraumatic stress disorder (PTSD), depression and alcohol use disorders.

Boston University School of Medicine (BUSM) researchers have developed an integrated treatment program for veterans with comorbid chronic pain and PTSD. This study appeared in the October issue of Pain Medicine.

(click here for complete story)
http://www.eurekalert.org/pub_releases/2009-09/bumc-rda092909.php#

As the target of Kate’s sarcasm and put-downs on "Jon & Kate Plus 8" -- Jon Gosselin was basically a poster boy for PTSD???

(Surely - you must be kidding??.....)

By Vicki Hyman/The Star-Ledger
September 29, 2009, 4:50 pm

'Kate Plus 8': Jon apologizes for blonde-bedding, then says Kate made him do it

Jon Gosselin, who just lost top billing in "Kate Plus 8," tells In Touch magazine that he regrets his conduct since splitting with wife Kate — “I used poor judgment in publicly socializing with other women so soon” — and wants to delay the divorce proceedings so he and Kate can “restore our relationship as cooperative parents and to open up our lines of communication. I hope that she will be as receptive and enthusiastic as I am to do what is best for our family.”

She would probably be more receptive had he left out this last bit: He claims that Kate practically forced him into chasingby refusing to go into counseling with her when she told him she wanted a divorce. “I think I was reacting to the pain I have been suffering as a result of Kate’s rejection of me.”

Nice.

As the target of Kate’s sarcasm and put-downs -- he was basically a poster boy for PTSD -- Jon garnered a lot of sympathy as his marriage broke down on camera, but he rapidly squandered the public goodwill after their by squiring a series of blondes across two continents.

(for the rest of this 'story' about "PTSD" - click below)
http://www.nj.com/entertainment/celebrities/index.ssf/2009/09/kate_plus_8_jon_apologizes_for.html

The Limits of Charisma

.....Mr. President, please stay off TV.

"Doing Letterman again won't help. It may boost the host's ratings, Mr. President, but probably not your own."

Howard Fineman
Published Sep 26, 2009
From the magazine issue dated Oct 5, 2009

"Members of Obama's own party know who Obama is not; they still sometimes wonder who he really is."

If ubiquity were the measure of a presidency, Barack Obama would already be grinning at us from Mount Rushmore. But of course it is not. Despite his many words and television appearances, our elegant and eloquent president remains more an emblem of change than an agent of it. He's a man with an endless, worthy to-do list—health care, climate change, bank reform, global capital regulation, AfPak, the Middle East, you name it—but, as yet, no boxes checked "done." This is a problem that style will not fix. Unless Obama learns to rely less on charm, rhetoric, and good intentions and more on picking his spots and winning in political combat, he's not going to be reelected, let alone enshrined in South Dakota.

The president's problem isn't that he's too visible; it's the lack of content in what he says when he keeps showing up on the tube. Obama can seem a mite too impressed with his own aura, as if his presence on the stage is the Answer. There is, at times, a self-referential (even self-reverential) tone in his big speeches. They are heavily salted with the words "I" and "my." (He used the former 11 times in the first few paragraphs of his address to the U.N. last week.) Obama is a historic figure, but that is the beginning, not the end, of the story.

(I wonder: If our President does not have the ability to be "Commander in Chief", how much help will there be for our VETERANS.......)

(click here for complete story)
http://www.newsweek.com/id/216210?GT1=43002

Veterans in Australia - PTSD and the failure of that country to treat its Vets

"Veterans abandoned to private hells"

Paul Toohey September 28, 2009
Article from: The Australian

IT hurts "Jim" that when he was medically discharged from the army with psychiatric problems in 2007, he was left for six weeks without any money.

It pains him that he was asked to work 20-hour days in Iraq, facing constant mortar barrages without any protective armour.

But what plays most on his mind is that since returning from Iraq in 2006, when he crashed into a depression that has seen him attempt suicide more than 10 times -- including by trying to hang himself in full uniform -- no one from the army has ever rung him.

No one -- not from his unit, not from the command -- has ever called to say: "How are you going, mate?"

He does not feel part of the brotherhood. He does not feel he can talk to veterans his own age.

The army has washed its hands of him. He is seen as a head case. And those who have taken an interest in this young man -- namely, veterans from earlier conflicts -- are now seeing great numbers of Iraq and Afghanistan veterans with post-traumatic trauma syndrome and major depression.

(click here for complete story)
http://www.theaustralian.news.com.au/story/0,25197,26133430-5013404,00.html