College, Veterans and PTSD
A RAND study revealed that “42% of soldiers joined up to get the hell out of Dodge. . . The kids that I grew up with, out of the group that I hung out with, two of them are in jail and then the three either passed away or disappeared" (“The Top 5 Reasons, 2018). Upon entering the service, recruits are rigorously trained to participate as team members in a highly structured, male orientated organization, putting their own needs secondary to those of the comrades they serve with. This training experience includes females who rapidly learn to ‘man up’ and suppress feminine aspects of their personality including denial of their emotional needs. It has become apparent that the experiences and norms of male-dominant military service shape women's attitudes toward seeking help particularly when it is emotionally based (DiRamio, et al., 2015).
The repudiation of weakness is particularly found in matters pertaining to mental health issues as a particular stigma of personal weakness is associated with complaints related to this matter. A recent study examining differences in the perception of stigma for those thought to have received mental health treatment was conducted on veterans and civilian students among 57 post-secondary institutions across the US. Those in the military evidenced greater degrees of stigma towards others who seek mental health assistance. In addition, they believed that counseling and psychotropic medications were generally not helpful for their particular needs (Currier, et al., 2018). This attitude persists long after separation from the military wherein the paradox is that student veterans see themselves as “not the same people they had been prior to deployment (Heitzman et al., 2015 p. 22).
Veterans entering college since 2002 have almost doubled although 30-40% of them fail to complete their degree (McGuffin, et al., 2017). This figure is startling and of immense concern! Recent investigators concluded that reported barriers to academic success include the presence of stress, financial concerns, depression and sleep difficulties (O’Connor et al., 2018).
Semi-structured interviews were conducted with 19 student veterans who were adjusting to civilian life following their service in Iraq or Afghanistan. A number of themes emerged surrounding the primary issue of adjusting to the culture of civilian life. Additionally, the existentialist issue of finding new meaning and purpose was also a salient identified focus (Kato, et al., 2016). These issues become particularly prominent among those former service members who seek additional educational experiences.
For those veterans who bring with them the effects of chronic stress in the form of PTSD, adjustment to civilian life appears to be even more difficult. In addition to the issues listed above, the ‘Signature Wounds’ of Post-Traumatic Stress Disorder (PTSD), and Traumatic Brain Injury (TBI) further complicate the adjustment process. A quite recent study investigated the role of resilience in veterans who sought to adapt to civilian society once again. The authors found that disruption in the academic setting was associated with depressive trends whereas disruption among experienced veterans was more linked to symptoms of TBI (Shackelford, et al., 2019).
It is critical to note that suicidal ideation is frequently present among Iraq/ Afghanistan-era veterans who return with Mild Traumatic Brain Injury (mTBI), and/or multiple mTBIs. Recent investigators explored cognitive mechanisms that may be associated with increased risk of suicidality in this vulnerable population. The authors found that impairment in both memory abilities and processing speed negatively impact problem solving abilities (Crocker et al., 2019). This issue is particularly pertinent to those who involve in college focused efforts.
The issue of high risk drinking and/or drug usage is another factor that likely contributes to a failure to complete selected academic programs (Grossbard J., et al., 2014). Finally, sleep difficulties (insomnia) have been found at high levels (upwards of 90%) in those with PTSD and up to 72% in those with substance problems. With both disorders present, the incidence is even higher. The presence of sleep disorder is predictive of poorer treatment outcome as well as the increased likelihood of relapse among those with substance disorders. Study results revealed that symptoms of insomnia did not improve over time with the authors perceiving that the condition is unremitting unless directly addressed (Colvonen, et al., 2018).
In contrast, we have found in our Pilot Study results (Figure 1.) that when PTSD symptoms are remediated, sleep disturbance trends towards normalization as well among the majority of treated individuals. The material provided below represents changes in sleep activity among combat-veterans representing three eras including Vietnam (V), Gulf Wars (GW), Iraq/Afghanistan (IA). These veterans received only four RESET Therapy sessions focused solely on traumatic combat related incidents. Four of the six evidence change in ratings. With specific focus on sleep issues, we would expect increased improvement in all of the volunteers.