(Photo by Randy Dockendorf/P&D)
BY RANDY DOCKENDORF
For many combat veterans, the battle doesn't end when they return home.
They find themselves torn between the war they left behind — or can't leave behind — and trying to deal with family, jobs and other issues on the homefront.
And often, no one else seems to understand them or their situation.
Now, University of South Dakota researchers at Vermillion are seeking new insights into the complex issues surrounding Post-Traumatic Stress Disorder (PTSD).
Drs. Jeffrey Simons and Raluca Gaher of the USD psychology department are part of the multidisciplinary study. The project is made possible by a $1.7 million grant from the National Institutes of Health (NIH). The grant will cover equipment, salaries and reimbursement for participants.
The study focuses on Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans, Simons said. The ultimate goal of the researchers is to improve care for the country's newest generation of veterans.
"It's a rolling experiment over four years. We are following a particular subject for 18 months," he said. "By time we are done, we will have followed 250 people over the four-year period."
The research is being conducted with partners at the Veterans Affairs (VA) Medical Center in Sioux Falls and the Veteran Health Care System in Bay Pines, Fla.
Simons and Gaher are also working with a behavioral geneticist at the University of Nebraska-Lincoln, an electrochemical engineering firm in Boston and a leading expert in longitudinal modeling at the University of California-Davis.
The researchers are studying the link between traumatic stress and health, Simons said.
"The subjects give us a saliva sample for the genetics study, which is related to specific neurotransmitters in the brain," he said. "It's not like there's a gene for PTSD. It's more related to reactivity and control. We are looking at self-regulation and emotions."
The researchers are also studying a veteran's surroundings. They are examining social, psychological and environmental factors. In turn, those factors contribute to individual differences in resilience and vulnerability.
"Some of what we do tries to look at what extent someone is isolated or in supportive — and non-supportive — relationships," Simons said.
The project uses advanced data collection, including real-time monitoring of veterans' behavior with palmtop computers.
"We get assessments of their behavior on a day-to-day basis," he said. "We understand the factors that contribute to their patterns of good days and bad days. We understand the factors that lead to positive growth over time."
Using the palmtop computers, the veterans answer specific questions on a variety of topics, Simons said.
"We have a whole series of questions that provide a rating to their various moods, and we ask about their symptoms," he said. "It's programmed to ask them questions at a random time throughout the day, and it records data. We are able to quantify things."
The veterans are asked about their experiences at the moment, Simons said.
"We start off asking where the person is at in a given point in time. Are they at work or at home? What is their social environment like? Whether they are with people or not?" he said. "We also ask questions about experiences that might have reminded them of the war."
The real-time information, along with the randomness of the calls, provide a much clearer picture than asking veterans to remember past moods, Simons said.
"People have all kinds of biases in how they recall information. If you ask them today, 'How was your week?,' in part they will be influenced by how they are today," he said. "By knowing how they are feeling in each point in time, we can quantify it as opposed to getting your perceptions about a more remote time."
After one to two weeks, the South Dakota veterans come to the USD campus in Vermillion or to a VA office in Sioux Falls to download their data. The veterans are also interviewed, giving researchers a chance for face-to-face interaction.
The Florida veterans visit offices in their state, Simons said, noting Gaher has contacts among the Florida researchers.
"By having both South Dakota and Florida, we have a wider variety of subjects and we're able to have a sufficient number of people," Simons said. "It's more inclusive and adds to the study."
The researchers will start recruiting subjects in the near future, Simons said.
"We have referrals from within the VA system and are also using advertisements and local media," he said. "Another way is we try to access various veterans groups directly. We're trying to cast a wide net."
The study will hopefully create better awareness of PTSD, defined as a reaction to severe stress, Simons said. In that respect, the research can create a wide-ranging impact for future generations.
"This study will help veterans not only now but in the future," Simons said.