PTSD Study Examines Iraq Soldiers

During the past few years, soldiers have been bused from Fort Hood to Dr. Michael Telch's anxiety disorders research lab to help determine the factors that may predispose service members to post-traumatic stress disorder (PTSD) as part of the Texas Combat PTSD Risk Project.

More than 160 Iraq soldiers have completed the three-phase study that assesses service members prior to deployment, during deployment and after returning home from combat.

Unlike previous studies that focused on retrospective data, this one is a multisystem approach that allows comprehensive assessment of possible risk factors through every phase of deployment, according to Telch, principal investigator for the study.

"One of the strengths of the study is that unlike just giving a questionnaire when soldiers get back from deployment, we have the opportunity to assess them before they leave," Telch said, a professor in psychology.

The pre-deployment assessment includes full neuroimaging at the Imaging Research Center, comprehensive clinical interviews, dozens of validated questionnaires, an eye tracking assessment and a carbon dioxide stress test where the subjects inhale a mixture of 35 percent CO2 and 65 percent oxygen for 30 seconds.

"It's a major stressor," Telch said. "What we do is we assess their reactions subjectively, and their hormonal response their cortisol and testosterone responses to the challenge and we ultimately want to link their reactions to their risk for developing combat stress problems in theater."

Once deployed, soldiers have access to a Web-based system where they can fill out an online questionnaire every 30 days.

The questionnaire is divided into two parts, the first one assessing any stressors or stress experiences the combatants have been exposed to such as witnessing a car bomb or participating in a firefight. After indicating exposures, soldiers are asked to specify which experience caused them the most stress. Part two of the questionnaire asks about individual stress reactions. Telch said soldiers are provided a list of symptoms related to PTSD, depression and anxiety, and asked to rate each item in terms of how severe they have experienced the symptoms in the previous 30 days.

"Rather than waiting for soldiers to come home and ask them how they have been doing, we are able to track in real time, while they are still in the combat zone, which is a new innovative piece of the puzzle," Telch said.

When they do come home, soldiers return to the anxiety disorders lab to do a full day of assessments similar to the pre-deployment stations. Telch also conducts one-on-one interviews with each participant during the third phase of testing.

During these interviews, Telch has been able to craft inferences that he wasn't expecting, such as how the accessibility to the Internet has cause added stress for combatants.

"When you think about earlier wars, you got a letter once in a while, but the way it is working now, not only are the soldiers having to experience the stress of being away from home and all of the stressors related to combat, but they also get bombarded with the stressors from back home because of the Internet," Telch said. "So they are getting e-mails all of the time, and there have been some real horrendous horror stories."

Telch said the first soldier to return out of the study participants tried to commit suicide because he had heard from a friend via e-mail that while he was gone, his wife had moved in a boyfriend.

Another soldier expressed the guilt he felt after witnessing a car explosion and not being able to help the only survivor.

"There was this little girl that was pinned under the car and this one soldier couldn't come out to help, and just the guilt he felt for watching her die," Telch said. "It was hard not to cry when he was telling me the story."

However, Telch said, "while some soldiers are very much exposed to some really stressful stuff, others are bored most of the time. It just depends on what their missions are."

Telch said he hopes to conduct one-year follow-ups with the soldiers who were deployed to Iraq, and eventually expand the number of service members in the study to 500. He said once his team obtains additional funding, it would switch to soldiers being deployed in Afghanistan.