Military & Military Families
Ten years after the 9/11 terrorist attacks many people continue to struggle with symptoms of anxiety, stress and even posttraumatic stress disorder, or PTSD.
Real Warriors provides brochures, videos, and other free tools to service members, veterans, and their families. They are designed to promote help-seeking behavior and address psychological health concerns.
Richard A. Bryant, PhD
Director, Traumatic Stress Clinic
Scientia Professor of Psychology, University of New South Wales
Dr. Bryant talks about the intersection of traumatic brain injury (TBI) and PTSD, including treatment and how therapy needs to be adapted for TBI survivors.
This study uses functional magnetic resonance imaging (fMRI) to learn how the brain functions in adolescents receiving fluoxetine (Prozac) or cognitive behavioral therapy (CBT) for anxiety or depression in children/adolescents. All participants will receive interviews to assess how they are doing in general, including his or her general mood, degree of nervousness and behavior. Each participant and one of his or her parents will be interviewed separately and together.
Age: 8 to 17
Consent: Can give consent/assent. (Parents will provide consent; minors will provide assent.)
IQ: All subjects will have IQ greater than 70 (Assessment relies on WASI)
SUBJECTS WITH AN ANXIETY DISORDER
Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, or Generalized Anxiety Disorder (Based on K-SADS)
Symptom Severity: Score greater than 9 on PARS (This score was used to enroll subjects in previous trial demonstrating efficacy of an SSRI in pediatric anxiety.)
Clinical Impairment: CGAS less than 60
SUBJECTS WITH A MOOD DISORDER
Diagnosis: Current Diagnosis of Major Depression (Based on K-SADS (juveniles) or SCID (adults))
Clinical Impairment: CGAS less than 60 (juveniles) GAS less than 70 (adults)
Symptom Severity: CDRS Score greater than 39 (juveniles) (This score was used to enroll subjects in previous trials demonstrating efficacy of an SSRI in pediatric depression.)
Consent: Can give consent/assent.
IQ: All subjects will have IQ greater than 70. Assessment relies on WASI.
Any serious medical condition or condition that interferes with fMRI scanning, and for patients electing medication, any condition that increases risk of SSRI treatment. All patients will have complete physical examination. Healthy volunteer participants will be medication-free and have no current serious medical conditions, based on a review of their medical history.
Current use of any psychoactive substance; current suicidal ideation; current diagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severity to require pharmacotherapy. These factors could complicate treatment with an SSRI. No subject on medication will be accepted into the trial. Subjects will not be taken off of medications to enter the trial.
Current diagnoses: Tourette's, OCD, posttraumatic distress disorder, conduct disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Past or current history of mania, psychosis, or pervasive developmental disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Recent use of an SSRI: All subjects must have been free of any SSRI use for at least one month (fluoxetine six months) and must not have been treated with an SSRI for their current depressive episode. This is designed to exclude subjects who have failed a trial of an SSRI for their current episode of major depression.
HEALTHY ADULT SUBJECTS
Any current psychiatric diagnosis. Assessment relies on SCID.
SUBJECTS WITH AN ANXIETY DISORDER
Current Major Depressive Disorder
Female Vets: Greater Likelihood of Suicide
The suicide rate among young (18 to 34 age group) female U.S. military veterans is nearly three times higher than among civilian women, a new study has found. Clinicians should inquire about military service among women and should recognize that suicide-prevention practices pertain to female veterans. (Psychiatric Services, 61:1177, December 2010) Read more.
Roberto Lewis-Fernández, MD
Director of the Hispanic Treatment Program, New York State Psychiatric Institute
Associate Professor of Clinical Psychiatry, Columbia University
Lecturer on Social Medicine, Harvard University