xxxi

Index

Index 

A

AAS. See American Association of Suicidology

Abrams, Gen. Creighton, replacement of Gen. Westmoreland 

with, 18

ACGME. See American Council of Graduate Medical Education

Achilles in Vietnam (Shay), 130

ACS. See Army Community Service

Acute radiation sickness

atomic weapons dropped on Hiroshima and Nagasaki and, 

600

symptoms, 596

Three Mile Island, PA, nuclear accident and, 599

ADAPT. See Alcohol and other Drug Abuse Prevention Training

Adjustment disorder

brief psychotic disorder and, 442

fitness for duty and, 180

homicidal ideation and, 437

prevalence of the diagnosis during Operation Enduring Freedom and Operation Iraqi Freedom, 203, 212

Adler, Dr. Amy, Battlemind program and, 72

Adolescents

books recommended for dealing with trauma and grief, 

559–560

effects of deployment on, 494–495

grief responses, 547

response to a combat-injured parent, 515–516, 518

Aeromedical Evacuation Patient Considerations and Standards of Care

(Air Force Instruction 41-307), 197–198

Aeromedical Evacuation Patient Record (Air Force Form 3899), 198

Aeromedical evacuations

aeromedical evacuation patient classification codes (table), 198

aeromedical evacuation publications (table), 196–197

aeromedical staging facilities, 200–203

aircraft used for, 194–195

behavioral health consultation for medical patients and, 204

carrier psychology program and, 125–126

contingency aeromedical staging facilities, 192, 195, 200–201

Department of Defense Patient Movement System, 195–200

description, 192

historical background, 192–194

Operation Iraqi Freedom and Operation Enduring Freedom 

and, 192, 203–204

patient classification codes, 197–198

patient movement precedence, 195, 197

patient records and, 198, 200

patient-support pallet development, 195

psychiatric patients and, 197–198, 200, 445–446

sample patient movement request (exhibit), 199

survival rate improvement and, 192

by the United Kingdom armed forces for behavioral health 

reasons, 659–660

use of restraints and, 200, 446

Aeromedical staging facilities

contingency aeromedical staging facilities, 192, 200–201

typical mission description, 202–203

Affective disorders. See Mood disorders

Afghanistan. See also Operation Enduring Freedom

contingency aeromedical staging facilities and, 201

history of, 768

U.S. military involvement in, 768–769

Age factors

anorexia, 451

bipolar disorder, 443–444

bulimia, 451

coping with the stress of deployment, 536

divorce, 539

schizophrenia, 442, 707

spouse maltreatment, 537

AH-1W Cobra helicopters, aeromedical evacuations and, 195

AHECs. See Area Health Education Centers, description

Air Force Form 3899: Aeromedical Evacuation Patient Record, 198

Air Force Instruction 41-307: Aeromedical Evacuation Patient Considerations and Standards of Care, 197–198

Air Force Instruction 44-121, drug testing and, 481

al Qaeda, September 11, 2001, terrorist attacks and, 594

Alcohol abuse. See Alcohol use and abuse

Alcohol and other Drug Abuse Prevention Training, description, 

481

Alcohol use and abuse

abstract reasoning abilities and, 474

binge drinking definitions for women and men, 475

blackouts and, 475

bolus drinking, 475

brain volume decrease and, 475

CAGE questionnaire, 475–476

cognitive impairment and, 474

coping with stress and, 260

homicidal ideation and, 437

Land Combat Study and, 78

light, moderate, and heavy drinking amounts, 475

memory impairment and, 475

mild traumatic brain injury and, 233

pain management and, 349

posttraumatic stress disorder and, 305

prevalence of, 475

Quantity Frequency Questionnaire, 475

screening for, 475–476

sleep impairment and, 475

suicide and, 425, 429, 431

Vietnam War and, 17, 152

visual-spatial impairment and, 474

visual tracking of objects and, 474

withdrawal issues, 475

Alcoholics Anonymous, Operation Iraqi Freedom 05-07 and, 142

Alzheimer’s disease

genetic research and, 396

vitamin E and, 396

Ambien, insomnia treatment, 159, 160, 250

Ambiguous Loss: Learning to Live With Unresolved Grief (Boss), 560

AMEDD. See Army Medical Department

AMEDD C&S. See Army Medical Department Center & School

American Academy of Child and Adolescent Psychiatry, description and Web site, 556

American Academy of Pediatrics

description and Web site, 556

use of lithium during pregnancy, 709

American Articles of War, birth of American military law and, 694

American Association of Suicidology

Suicide Prevention: A Resource Manual for the United States Army,

405

suicide prevention efforts, 404, 405

American Board of Medical Specialties, core competencies program, 676

American Council of Graduate Medical Education

accreditation history of U.S. military psychiatry residencies 

(table), 671

accreditation role, 670, 671, 681, 688

competencies (exhibit), 675

core competencies, 675, 676
xxxii

Combat and Operational Behavioral Health 

fellowship programs and, 680

program leadership requirements, 673

Residency Review Committee requirements for psychiatry 

residents, as of 2007 (exhibit), 678

supervisor meetings, 678

time requirements for rotations, 678

American Medical Association, criminal execution role for physicians, 737

American Psychiatric Association. See also Diagnostic and Statistical 

Manual of Mental Disorders

anti-Vietnam War stance, 25

founding of, 671

guidelines that forbid psychiatrists from being directly involved in interrogations, 736, 737

American Psychological Association

anti-Vietnam War stance, 25

participation of providers in interrogations and, 736

resilience self-help Web site, 50

Task Force on Promoting Resilience in Response to Terrorism, 

45

American Red Cross. See also International Red Cross and Red 

Crescent Movement

occupational therapy and, 359

September 11, 2001, terrorist attack response, 583

American Revolutionary War, military medical evacuations and, 

192

American Society of Addiction Medicine, treatment decision making, 481

Amphetamines. See also Stimulants; specific drugs

World War II use of, 152

AN. See Anorexia nervosa

Anderson, A.E., eating disorder research, 454

Andrews Air Force Base, MD

aeromedical staging facility role, 201–203

Air Force Family Liaison Officer program and, 201

Annie Loses Her Leg But Finds Her Way (Philipson and Takatch), 

558

Anorexia nervosa

age of onset, 451

bingeing/purging type, 451

comorbid psychiatric disorders, 453, 455

course and prognosis, 455

deployment and, 463

differential diagnosis, 455

DSM-IV definition, 451

families characteristics and, 453

functional impairment and, 455

hospitalization and, 458, 459

indications for hospitalization in (exhibit), 459

laboratory findings, 455

medical assessment, 458

medical findings, 454

medications effective as mono-therapy in placebo-controlled 

trials for (exhibit), 460

medications for, 460–461

military population statistics, 456

mortality rates, 454, 455, 459

oral health effects, 263–264

outpatient treatment, 459

poor insight and, 458

prevalence of, 450

psychotherapy, 459

rapid refeeding and, 459

recovery rate, 455

restricting type, 451, 454

treatment, 458–459

vitamin supplementation and, 459

warning signs of (exhibit), 451

Anthrax attacks

delayed recognition of, 594

long-term effects, 601

media and, 598

physiological effects, 581

Anticonvulsants

binge eating disorder treatment, 462

obesity treatment, 462

pain management and, 344, 347

Antidepressants. See also Tricyclic antidepressants; specific drugs

anorexia nervosa treatment, 460

binge eating disorder treatment, 462

major depressive disorder treatment, 444, 445

obesity treatment, 462

pain management and, 246, 344, 347

posttraumatic stress disorder treatment, 303

Antipsychotic drugs. See also specific drugs

anorexia nervosa treatment, 460

availability in the field, 443

bipolar disorder treatment, 158

pain management and, 347

schizophrenia treatment, 443, 707

side effects, 443, 460

trauma patients and, 249

women and, 707

Antisocial personality disorder, suicide and, 426

Anxiety disorders

combat and operational stress continuum model red zone and, 

112

complex humanitarian emergency survivors and, 627

exercise and, 705

fitness for duty and, 180

in-theater treatment, 159

posttraumatic stress disorder and, 298, 305–306

prevalence of the diagnosis during Operation Enduring Freedom and Operation Iraqi Freedom, 203–204, 212

sleep disturbances and, 252

symptoms, 251

traumatic injuries and, 251–253

treatment, 304

uncontrolled pain and, 246

women and, 709–710

Anxiolytics. See also specific drugs

indications for use of, 153

Vietnam War use, 11–12, 34

Appenzeller, G.N., articles on the roles and responsibilities of 

division mental health units, 92

Applied Suicide Intervention Skills Training program, description, 406

Area Health Education Centers, description, 335

Aripiprazole, bipolar disorder treatment, 158

Arlington National Cemetery Commemorative Project, For Children of Valor: Arlington National Cemetery gift book, 554

Armed Forces Health Surveillance Center, EPICON responsibilities, 415

Armed Forces Mortuary, Dover Air Force Base, DE, behavioral 

health consultations for workers at, 204

Armed Service Vocational Aptitude Battery

job assignments and, 705

lowering scores on to meet recruitment goals, 728

Army Center for Substance Abuse Programs, information paper 

on challenges of substance abuse issues, 481

Army Central Registry, reports of family maltreatment, 536–537, 

538

Army Community Service

behavioral health liaison project and, 571, 572–574

deployment of the 25th ID and, 565

“Ready 4 Reunion” DVD, 574
Index

xxxiii

Army Health Promotion (Army Regulation 600-63), 397, 408

Army Medical Command

child maltreatment prevention program, 539

EPICON responsibilities, 415

Fatality Review Board findings on family maltreatment, 539

guidelines on screening for depression in spouses of service 

members, 538

suicide prevention and, 406–407

Suicide Risk Management and Surveillance Office, 407

Army Medical Department

Behavioral Health Proponency, 748

career course, 98, 103

general officers behavioral health summit, 81

psychiatrist training and preparation for the Vietnam War, 

14–15

Army Medical Department Center & School

Battlemind program and, 73, 74, 80

Professional Quality of Life Scale and, 382–384

Provider Resiliency Training and, 376

Army Medical Support in Vietnam (Neel), 16, 28

Army Medical Surveillance Activity, population-wide assessment 

of the Post-Deployment Health Assessment, 79

Army Military Family Research Institute, Web site, 501

Army Physical Disability Evaluation System, improvement initiative for, 328

Army Regulation 40-5: Preventive Medicine, 415

Army Regulation 40-216: Neuropsychiatry and Mental Health, 90, 91

Army Regulation 40-501: Standards of Medical Fitness, 180

Army Regulation 190-8: Enemy Prisoners of War, Retained Personnel, 

Civilian Internees, and Other Detainees, 101

Army Regulation 600-63: Army Health Promotion, 397, 408

Army Regulation 600-85, drug testing and, 479, 481

Army Regulation 608-18, Family Advocacy Program and, 536

Army Substance Abuse Program

Alcohol and other Drug Abuse Prevention Training and, 481

clinical role of providers, 481–482

employee assistance program model, 480–481

number of soldiers enrolled in, 480

treatment recommendations, 481

unit commanders and, 481–482

Army Suicide Event Reports

analysis of data, 145

command POCs and, 397–398

data collection (figure), 398

data collection process, 398

description, 397

improving accessibility of ASER data, 399, 400

replacement of “psychological autopsies” by, 404

required source information and, 399

source information required to complete (table), 399

variables, 398–399

Army Suicide Prevention Program

Applied Suicide Intervention Skills Training, 406

Army National Guard efforts, 408–409

Army Reserves efforts, 409

Army Suicide Prevention Task Force, 409

Behavioral and Social Health Outcomes Program, 409

Chief of Chaplains and, 405

community health promotion councils, 408

G-1 and, 405, 406, 409

gatekeepers and, 406

initiatives and efforts to minimize suicidal behavior, 406–409

Installation Management Command, 408

Medical Command and, 406–407

Office of The Surgeon General and, 405

Operation Iraqi Freedom theater suicide assessment, 409–412

psychiatric epidemiological consultations, 412–418

QPR Institute and, 406

Suicide Prevention and Psychological Autopsy (PAM 600-24) and, 

405

Suicide Prevention Campaign Plan, 405

Suicide Prevention Task Force, 405

Army Suicide Prevention Task Force, description, 409, 749

Army Surgeon General. See Office of The Surgeon General; specific 

Surgeons General

Army War College, Carlisle Barracks, PA, Spouses’ Project recommendation for a care team, 545

ARNG. See U.S. Army National Guard

Arnold, Caroline, What We Do When Someone Dies, 559

ARS. See Acute radiation sickness

Artiss, Lt. Col. Kenneth, textbook on military psychiatry and, 5, 6

ASAP. See Army Substance Abuse Program

Asaro, Regina, Military Widow: A Survival Guide, 551

ASERs. See Army Suicide Event Reports

ASFs. See Aeromedical staging facilities

ASIST program. See Applied Suicide Intervention Skills Training 

program

ASPP. See Army Suicide Prevention Program

ASPTF. See Army Suicide Prevention Task Force

Assisting Marsh Arabs and Refugees, medical civil-military operations in Operation Iraqi Freedom 05-07 and, 616

ASVAB. See Armed Service Vocational Aptitude Battery

Attention-deficit hyperactivity disorder, clearance for deployment 

and, 157

Atypical antipsychotic drugs. See also specific drugs

bipolar disorder treatment, 303–304

borderline personality disorder treatment, 303–304

pain management and, 347

posttraumatic stress disorder treatment, 303–304

trauma patients and, 249

Aum Shinrikyo cult’s sarin attack on the Tokyo subway system, 

594, 597, 598, 599, 601–602

AusAID. See Australian Agency for International Development

Australian Agency for International Development, Indian Ocean 

tsunami disaster relief and, 637–639

Australian Council for International Aid, complex humanitarian 

emergencies and, 621

Authentic Happiness: Using the New Positive Psychology to Realize 

Your Potential for Lasting Fulfillment (Seligman), 560

B

Bachman, J.G., draft issues during the Vietnam War, 23–24

Bacon, B.L.

guidelines for psychiatry residents on becoming a division 

psychiatrist, 92

use of psychotropic medications during the Persian Gulf War, 

153

Baghdad ER HBO program, 147–148, 777–778

Baker, Col. Stewart L., Jr., survey of illegal drug use in the Vietnam War, 11

Balkin, J.J., review of the demoralization of troops fighting in 

Vietnam, 26

Bamber, M., stressors for staff working with trauma victims, 255

Bandura, A., resilience research, 46

Barbiturates. See also specific drugs

World War II and use of, 152

Bascaglia, Leo, The Fall of Freddie the Leaf, 557

Battlemind training program

acronym explanation, 332

Army Medical Department Center & School and, 73, 74, 80

background of, 72

Basic Battlemind, 73

Battlemind First Aid, 73

Battlemind for Leaders, 73

Battlemind Warrior Resiliency Training, 73
xxxiv

Combat and Operational Behavioral Health 

command-requested mental health training, 72

components (exhibit), 283

continuum of care for veterans and their families and, 332

current status, 73–74

deployment-cycle training and, 65, 73, 80–81

description, 65, 72, 80, 332

dynamic nature of, 74

event-driven psychological debriefing and, 80

focus of, 80, 283

fundamental principles, 73, 332

life-cycle training and, 65

Mental Health Advisory Team IV report and, 73

modules under development, 73

objectives of, 65

postdeployment training, 72–73, 80

predeployment modules, 73, 80

resetting the force and, 283–284

soldier support training and, 65

state and community partnerships and, 336

“Steel Your Battlemind” video, 73

targets of, 65

time-driven psychological debriefing and, 80

training for spouses, 72, 80–81, 332

training videos, 72–73

use by other nations, 73

Walter Reed Army Institute of Research and, 72–74, 80–81

BCT BHOs. See Division psychiatrists and brigade behavioral 

health officers

Beardslee, W.R., Out of the Darkened Room: When a Parent is Depressed, 517

Becker, C.B., barriers to clinician use of exposure therapy for 

PTSD, 311

BED. See Binge eating disorder

Behavioral and Social Health Outcomes Program, description, 

409, 749

Behavioral health. See also Operational behavioral health; specific 

aspects of the topic

discussion about this text’s title, 6

recent initiatives, 748–750

stigma and barriers to care, 4, 78, 117, 126, 327, 425, 564

stigma associated with seeking behavioral healthcare (exhibit), 

411

Behavioral health consultations for medical patients, Operation 

Enduring Freedom and Operation Iraqi Freedom and, 204

Behavioral health issues for detained individuals. See also Hunger 

strikes

acting-out behavior and, 650, 651

Bureau of Prisons standard operating procedures and, 646

clinical process, 648–649

cognitive disorders, 653

common syndromes, 653

context of care and, 647

corrections staff and, 650–651

cultural factors, 647, 650, 654

distribution of medications, 652

emergence as a critical issue, 646

“equivalent care” mandate, 646, 647

functional impairment and, 650

hoarding medications and, 652

interacting with other sites, 652–653

medical record management and, 653

medication distribution process for detainees (exhibit), 652

medication management, 651–652

nongovernmental organizations and, 646, 649

observation and, 651

predeployment preparation, 646–648

primary care providers and, 649, 654–655

privacy and confidentiality and, 653, 654

review of the active caseload and, 648

screening for behavioral health risk factors, 648

secondary gain and, 650

security issues, 647–648, 649

self-injurious behavior, 647, 649, 651

Task Force Medical 115 and, 646–656

Task Force Medical 344 and, 646–656

therapeutic trust and, 648

training the team, 646–649

translators and, 649–650

treatment planning and, 650–653

24-hour nature of care, 648–649

unique nature of the setting, 651, 656

unit transition and, 649

Behavioral health liaison project

aim of, 571

Army Community Service and, 571, 572–574

Army Community Service support, 572

“communities of practice” concept and, 565, 574–575

community town hall meetings and, 573

deployment sustainment and, 573

emotional cycle of deployment briefing and, 572

family readiness group briefing topics (exhibit), 572

family readiness groups and, 572, 573

initial challenges, 571

job fairs for military spouses, 572–573

lessons learned, 574–575

predeployment support, 572–573

quality of welcome by unit in the behavioral health liaison 

project (figure), 572

redeployment and reintegration and, 573–574

team composition, 571

training and education opportunities, 573

Tropic Lighting University reunion program and, 574

unit welcome and, 571–572

video teleconferencing for soldiers and families, 573

Behavioral Health Proponency, description, 748

Behavioral Science Consultation teams

“behavioral drift” and, 699

description and role, 699

detainees and, 699

global war on terror and, 699

mission and objectives, 699–700

Belanger, H.G., traumatic brain injury research, 231

Belenky, G.L., use of tricyclic antidepressants by Israeli forces, 153

Bell, C.C., resilience program, 51

Benadryl, agitation treatment, 159

Benedek, D.M.

integrated use of combat stress detachments and division 

mental health assets during Operation Joint Endeavor, 153

rationale for using a formulary for military operations, 

153–154

Benight, C.C., resilience research, 46

Benzodiazepines. See also specific drugs

anxiety disorder treatment, 159, 304

indications for use of, 153

pain management and, 344, 347, 348

posttraumatic stress disorder and, 253, 304

potential for abuse of, 158, 159, 253, 304

Bereavement. See also Children and families of fallen service 

members

adult grief responses, 546–547

bereavement reaction to traumatic injury, 246

children’s grief responses, 547–549

88th Regional Readiness Command COSC program and, 

365–366

posttraumatic stress disorder and, 306

prolonged grief disorder and, 348
Index

xxxv

reaction to acute pain, 348

Bessler, M., overview of problems in civil-military cooperation, 

623

BHL. See Behavioral health liaison project

Bhopal, India, chemical accident, 620

BICEPS principles. See Brevity, immediacy, centrality, expectancy, 

proximity, and simplicity

Bill and Melinda Gates Foundation, humanitarian role, 622

Binge eating disorder

oral health effects, 264

prevalence of, 450

proposed DSM-IV category for, 452

treatment, 462

Biofeedback, occupational therapy and, 369

Biological and Toxin Weapon Convention, 594

Biological weapons. See Chemical, biological, radiological, nuclear 

and explosive weapons

Bipolar disorder

age of onset, 442, 443–444

bimodal onset, 443

evacuation from the combat zone and, 158

fitness for duty and, 180

in-theater treatment, 158

pharmacological treatment, 444

presentation of, 444

prevalence of the diagnosis during Operation Enduring Freedom and Operation Iraqi Freedom, 212

recurrent episodes and, 444

treatment, 303–304

type I, 444

type II, 444

women and, 709

Birgenheier, P.S., women in the military, 493

Birmingham, C.L., zinc deficiency in anorexia nervosa and, 460

Blank, Capt. A.S., Jr.

antiwar sentiment effect on soldiers, 18

posttraumatic stress disorder diagnosis and, 30

Bloch, Capt. H.S., antiwar sentiment effect on soldiers, 18

Blum, H.P., loss of self-identity in trauma victims, 246

BMI. See Body mass index

BN. See Bulimia nervosa

Boake, C., postconcussive disorder research, 232

Body mass index, eating disorders and, 452, 454, 458

Bolton, E.E., posttraumatic stress disorder program evaluation, 

310

Bombardier, C.H., posttraumatic stress disorder link with traumatic brain injury, 233

Bonn, R., How to Help Children Through a Parent’s Serious Illness,

517

Borderline personality disorder

bulimia nervosa and, 453

treatment, 304

Bosnia

gender-based violence and, 626

Operation Joint Endeavor and, 76, 79, 153

Boss, Pauline, Ambiguous Loss: Learning to Live With Unresolved 

Grief, 560

Boston Publishing Company, historical series on the Vietnam War, 

25–26

Bourne, Maj. Peter

“combat provincialism” of troops fighting in Vietnam, 17

comparison of U.S. Army psychiatric hospitalization rates in 

Vietnam with those of the Army of the Republic of Vietnam, 

16

incidence of combat psychiatric casualties, 18

marijuana use by troops in the Vietnam War, 17

one-year tours of duty in Vietnam, 17

study of physiological, psychological, and social correlates of 

stress, 11

BRAC. See U.S. Department of Defense Base Realignment and 

Closure Act

Bradley, Gen. Omar, division psychiatrist position and, 90

Bradley, J.C., rationale for using a formulary for military operations, 153–154

Bradley, R., PTSD treatment outcome studies, 308

Brain Injury Association, 88th Regional Readiness Command 

COSC program and, 365

Breslau, N., major depression in soldiers with PTSD, 305

Brevity, immediacy, centrality, expectancy, proximity, and simplicity

combat and operational stress control and, 66–68, 108

Operation Iraqi Freedom 05-07 and, 148

unit watch and, 424

Brief psychotic disorder

description and symptoms, 442

progression to schizophrenia, 443

Brief therapies, psychiatry residency programs and competency 

in, 677

Brigade behavioral health officers. See Division psychiatrists and 

brigade behavioral health officers

Brooke Army Medical Center, San Antonio, TX

merger with Wilford Hall Air Force Medical Center, 672

Parent Guidance Assessment--Combat Injury instrument and, 

513, 521–532

specialized burn care, 508

Brown, Marc, When Dinosaurs Die: A Guide to Understanding Death,

557

Brusher, Maj. Edward, Battlemind program and, 73

Bryan, C.J., suicide research, 395

Bryant, R., mild traumatic brain injury and posttraumatic stress 

disorder, 307

BSCs. See Behavioral Science Consultation teams

Buddy watch, unit watch component, 428–431, 432

Building Strong and Ready Families Program, description, 501

Buildup phase of the Vietnam War, 1965-1967

alcohol use and abuse, 17

combat exhaustion casualties and, 15–16

evacuations for psychiatric reasons, 17, 34

hospital psychiatrists, 15

morale during, 16–17

Neuropsychiatric Consultants and, 15, 35

organization and preparation of Army psychiatrists, 14–15

phasic nature of moods and attitudes affecting soldiers, 17–18

psychiatric overview, 17–18

psychiatrists reports, 18

transition from buildup to drawdown, 1968-1969, 18–21

U.S. Army medical and psychiatric support, 14

Bulimia nervosa

age of onset, 451

comorbid psychiatric disorders, 453, 455

compared with bingeing/purging type of anorexia nervosa, 

451

deployment and, 463

description, 450

differential diagnosis, 455

DSM-IV definition, 451

families characteristics and, 453

hospitalization and, 461

indications for hospitalization (exhibit), 460

laboratory findings, 455

medical findings, 454–455

medications effective in placebo-controlled trials for (exhibit), 

461

military population statistics, 456

mortality rate, 455

nonpurging type, 451
xxxvi

Combat and Operational Behavioral Health 

normal weight and, 454

oral health effects, 263, 264

prevalence of, 450

psychotherapy, 461

purging type, 451

recovery rate, 455

relapse and, 455, 462

Russell sign and, 455

treatment, 461–462

warning signs of (exhibit), 452

A Bunch of Balloons (Ferguson), 556

Bunting, Eve

Memory String, 558

The Wall, 557

Bupropion

bulimia nervosa treatment, 462

depressive disorder treatment, 158

posttraumatic stress disorder treatment, 303

safety of use during pregnancy, 709

side effects, 462

Bureau of Prisons, standard operating procedures and detained 

individuals, 646, 647

Burn casualties

Brooke Army Medical Center’s specialized care, 508

control of metabolic and stress responses and, 340

hyperalgesia and, 343

stress of treatment, 345

Burnout

definition, 377

synergistic effects of primary, secondary, and operational 

stress, combined with burnout symptoms, on providers 

(figure), 380

Bush, Pres. George W., importance of healthcare in medical civilmilitary operations, 610–611

Byrdy, Capt. H.S.R., rate of combat stress reactions in his unit, 16

C

C-17 Globemaster aircraft, aeromedical evacuations and, 195

C-130 Hercules aircraft, aeromedical evacuations and, 195

C-9 Nightingale aircraft, aeromedical evacuations and, 195

CAGE questionnaire, alcohol use and abuse and, 475–476

Campbell, S.J., article on division mental health units, 92

Canadian International Development Agency, complex humanitarian emergencies and, 621

Canadian Medical Education Directions for Specialists, 676

CAPS. See Child and Adolescent Psychiatry Service

Cardiac disorders, anorexia nervosa and, 454, 455

Caregivers. See also Provider fatigue

combat and operational first aid and, 132

deployment as individual augmentations, 131–132

mission and personnel, 131–132

OSCAR communication strategy, 132–133

self-help barriers, 132

trauma exposure and intervention strategies, 132

U.S. Navy support for, 131–133

Carlton, J.R., eating disorders in the U.S. Navy population, 458

Carrier psychology program

cost savings examples, 126

historical background, 125–126

prevented medevacs and, 125–126

prevention of chronic psychological problems, 126

stigma reduction and, 126

Casey, Gen. George W., Jr., Comprehensive Soldier Fitness program and, 748

CASFs. See Contingency aeromedical staging facilities

Caspi, A., role of serotonin metabolism in stress reactivity, 46

Castro, Maj. Carl, Battlemind program and, 72, 73

CBRNEs. See Chemical, biological, radiological, nuclear and 

explosive weapons

CBT. See Cognitive-behavioral therapy

CDC. See Centers for Disease Control and Prevention

Celecoxib, pain management and, 344

Celexa, depressive disorder treatment, 158

Center for Excellence in Disaster Management and Humanitarian 

Assistance, civil-military operations centers and, 624

Center for Health Promotion and Preventive Medicine. See U.S. 

Army Center for Health Promotion and Preventive Medicine

Center for Mental Health Services, Web site, 500

Center for the Intrepid rehabilitation facility, description, 328

Center for the Study of Traumatic Stress

dealing with the death of a service member, 555

Parent Guidance Assessment--Combat Injury, 513, 521–532

Web site, 555

Centers for Disease Control and Prevention

course on emergency risk communication training, 595

EPIAID and, 413

estimates of traumatic brain injury prevalence and mortality, 

226

Gulf War syndrome research, 600

Hurricanes Katrina and Rita health surveillance, 586–587

Injury Statistics Query and Reporting System, 399–400

obesity in the U.S. population, 452

PsySTART program, 636, 640

risk and protective factors for suicide, 411–412

Web site, 595

CH-47 Chinook helicopters, aeromedical evacuations and, 

194–195

CH-46 Sea Knight helicopters, aeromedical evacuations and, 

194–195

Chaplains. See also Religious and spiritual issues; U.S. Army 

Chaplain Corps

Army Suicide Prevention Program and, 405

Chaplain Annual Sustainment Training course, 408

children and families of fallen service members and, 549

Combat and Operational Stress/Staff Resiliency program and, 

219, 220, 221

88th Regional Readiness Command COSC program and, 365, 

366

Landstuhl Regional Medical Center role, 211

outreach to couples struggling in their marriages, 539

provider fatigue and, 380

public health model for deployment mental health and, 331

September 11, 2001, terrorist attack response, 583

state and community partnerships and, 336

“Strong Bonds” program, 407, 539

suicide awareness training kits, 406–407

suicide prevention, 407–408

Charney, D.S., neurobiological factors in resilience, 46–47

CHCS-ITT. See Composite Health Care System-Interactive Training Tool

Chemical, biological, radiological, nuclear and explosive weapons

acute effects, 597–600

acute radiation sickness and, 596

availability of, 594

biological agents, 598, 601, 602

catastrophe description, 595

chemical warfare agents, 598, 599, 600–602

disaster description, 595

disaster fatigue and, 594

emergencies description, 595

estimating psychological casualties, 597, 602–603

explosives, 599, 602

lack of provider preparedness for psychological symptoms, 

596–597

long-term effects, 600–602
Index

xxxvii

mass casualty events, 595

mass hysteria description, 594

mass panic and, 595, 597, 602

mass psychogenic illness description, 594

media and, 595, 596

mental disorders and, 599–600, 601–602

military experience, 600

nuclear weapons, 599–600, 601

outbreaks of multiple unexplained symptoms and, 594, 

597–599, 600–601

psychological effects, 596–597, 602–603

“radiation response syndrome” and, 600

radiological agents, 599, 601, 602

risk communication, 595

risk perception, 595–596, 603

terminology, 594–595

triage and issues of differential diagnosis, 596–597

“worried well” persons and, 594

Chernobyl nuclear accident

description, 599, 620

mental disorders and, 602

psychoneurological syndromes following, 601

CHEs. See Complex humanitarian emergencies

Child abuse and neglect. See Family maltreatment

Child and Adolescent Psychiatry Service

children of combat-injured service members and, 511

integrated behavioral health services at Schofield Barracks, HI, 

and, 565, 569

Solomon Wellness Educational Program and, 569, 570

Child maltreatment. See Family maltreatment

Children. See also Deployment impact on military families and 

children; Family maltreatment; specific age groups

COMFORT scale for pain assessment, 346–347

effect of the death of a child on a service member, 552

Faces Scale for assessing pain, 347

pain evaluation and management, 340, 346–347, 349

Poker Chip Tool for assessing pain, 347

posttraumatic stress disorder and, 345

Children and families of combat-injured service members

case studies, 508, 509

Child and Adolescent Psychiatry Service support, 511, 512–513

child response to events resulting from combat injury (figure), 

505

children in the hospital setting and, 510–512

children’s activity level and, 511

comorbid psychiatric symptoms and, 505

cultural factors, 510

developmental factors in children’s responses, 513–516

drawing by the 3-year-old son of severely injured service 

member (figure), 514

drawing by the 5-year-old son of severely injured service 

member (figure), 515

effect of the injury on the parent/service member, 516–518

family function effects, 504

Girls Time Out program, 510

goals for children of injured service member parents (exhibit), 

516

hospitalization phase of recovery, 508–512

lack of research on, 504–505

language barriers and, 510

level of parental disability and, 504

limiting and structuring hospital visits for children, 511–512

long-term rehabilitation and transitions, 517–518

monitoring children who are vulnerable, 516

moving from known communities and, 518

nontraditional families and, 508

notification of injury, 505–508

parent-child interaction and, 516–517

Parent Guidance Assessment--Combat Injury instrument, 513, 

521–532

percentage of service members with children, 504

presence of children as a complicating factor in care, 508

Preventive Medical Psychiatry role, 509–510

“Principles of Caring for Combat-Injured Families and Their 

Children,” 517, 533–534

principles of caring for families and children of the combat 

injured (exhibit), 517

resources (exhibit), 517

support to, 512–513

traumatic brain injury and, 504–505

treatment facilities’ support of families of the combat injured 

(exhibit), 512

vignettes, 507–508, 509, 510, 511–512

Children and families of fallen service members

adult grief responses, 546–547

adult grieving process timeline (table), 546

Casualty and Mortuary Affairs operation center and, 545

casualty assistance call officers and, 544

casualty assistance officers and, 544

children’s emotional and behavioral responses to death (exhibit), 548

children’s grief responses, 547–549

death, illness, or injury of a leader, 551

death of a spouse or child, 552

ensuring the accuracy of death notices, 545

Families First Casualty Call Center and, 545

grief responses, 546–551

grief symptoms, 546–547

health grieving, 546

literature on, 551, 556–562

mass casualties, 551

media and, 552

military care team, 545–546

military funerals, 549

military response to the death of a service member, 544–545

missing in action, 551

number of service members who have died in Iraq and Afghanistan as of October 2007, 544

percentage of service members who are parents, 544

prisoners of war, 551

protecting children from media exposure, 547

resources, 554–562

special circumstances, 551–552

suicide, 551

support services and organizations, 550–551, 554–556

survivor benefits changes, 545

traumatic death compared with anticipated death, 549

traumatic grief, 549–550

unique aspects of military family loss, 547

Chloral hydrate, World War I and use of, 152

Chlorine gas, attacks with during World War I, 597

CHPPM. See U.S. Army Center for Health Promotion and Preventive Medicine

Cigarette smoking. See Tobacco use

Cisapride, anorexia nervosa treatment, 460

Citalopram

anxiety disorder treatment, 253

bulimia nervosa treatment, 462

posttraumatic stress disorder treatment, 303

Civil-Military Relationship in Complex Emergencies, 620

Civil War, medical evacuations and, 192

Clark, D.M.

cognitive model of trauma, 45

Cognitive Theory of PTSD, 299–300

social support effect on posttraumatic stress disorder, 46

Clifton, Lucille, Everett Anderson’s Goodbye, 557
xxxviii

Combat and Operational Behavioral Health 

Clonazepam, insomnia treatment, 159–160

Clonidine, posttraumatic stress disorder treatment and, 304

Cocaine, patterns of use, 477

Cody, Col. Samuel F., use of aircraft for medical evacuations and, 

192

Cognitive-behavioral therapy

anorexia nervosa, 459

bulimia nervosa, 461, 462

panic disorder, 710

premenstrual dysphoric disorder treatment, 708

psychiatry residency programs and competency in, 677

Cognitive disorders

detained individuals and, 653

traumatic injuries and, 245–246, 253–254

Cognitive impairment

alcohol use and abuse and, 474

traumatic brain injury and, 231–235, 253

Cognitive processing therapy, posttraumatic stress disorder, 302, 

308, 309, 311

Cognitive therapy

pain management and, 246

posttraumatic stress disorder, 302, 304

traumatic injury patients and, 252

Cohen, Judith, Treating Trauma and Traumatic Grief in Children and 

Adolescents, 562

Cohn, Janice, I Had a Friend Named Peter: Talking to Children About 

the Death of a Friend, 556

Colbach, Col. Edward, overview of U.S. Army mental health 

activities in Vietnam, 16

Combat and operational stress behavior

adaptive stress reactions, 63

combat and operational stress reaction and, 63–64

description, 61, 62

impact of combat and operational experiences on all soldiers, 

62

misconduct behaviors, 64

overlap with combat and operational stress reaction, posttraumatic growth, and posttraumatic stress disorder, 64

physical and behavioral effects of stress, 61–62

postcombat and operational stress and, 62–63, 64

potentially traumatic events and, 62

Combat and operational stress continuum model

background and development, 108–110

chaplain’s role, 117

the combat and operational stress continuum model with its 

four color-coded stress zones (figure), 110

the combat and operational stress decision matrix flowchart 

(figure), 115, 123

core leader functions, 112–117, 122, 132

decision flowchart for, 114–116, 123

“demedicalized” model of combat stress reactions and, 108, 

109

description, 122

distinguishing between normative and abnormal stress reactions, 122–123

first aid for stress injuries, 116

green “ready” zone description and attributes, 110, 112, 114, 

117, 122

leadership and, 113

“leaky bucket” metaphor for stress (figure), 114

“operational stress injury” concept and, 109–110

orange “injured” zone description and attributes, 111–112, 115, 

117

psychological or medical treatment for stress injuries, 116–117

red “ill” zone description and attributes, 112, 115–116, 117

reintegration of stress casualties, 117

stigma and, 117

stress mitigation and, 113–114

training to strengthen service members, 113

unit cohesion and, 113

yellow “reacting” zone description and attributes, 110–111, 

112, 114–115, 117, 122

Combat and operational stress control

adaptive stress reactions, 63

assessments for, 66

Battlemind program, 65, 72–74

behavioral health treatment component, 69

BICEPS principles, 66–68, 108

cohesion and morale and, 65

combat and operational stress behavior and, 61–64

combat and operational stress intervention model (figure), 67

combat and operational stress reactions, 63–64

combat and operational stressors (exhibit), 61

consultation and education component, 68

continuum of behaviors, 64

definition, 60, 108

“demedicalized” model of combat stress reactions and, 108

deployment cycle support phases (figure), 65

description, 64–65, 69–70

88th Regional Readiness Command COSC program for soldiers and their families, 361–366

examples of combat and operational stressors (exhibit), 62

functional areas, 68–69

goal of, 60, 64

indicated interventions, 66

interventions, 66–69

leadership component, 66, 70

management principles, 66–68

mental and physical stressors, 61

misconduct stress behaviors, 64

model of stress and its potential soldier and family outcomes 

(figure), 63

occupational therapy and, 360, 361–366

Operation Iraqi Freedom 05-07 and, 142, 143–144

postcombat and operational stress and, 64

posttraumatic growth and, 62, 64

potentially traumatic events and, 61, 62

professional disciplines and, 66, 70

purpose of, 65

reconstitution support and, 69

religious and spiritual support and, 66, 70

return to duty and, 66, 67, 69

selective interventions, 66

soldier reconditioning component, 69

soldier restoration component, 69

sources of stress, 61, 123

stabilization component, 69

stress threat and, 60–61

traumatic events management, 68–69

treatment interventions, 66

triage for, 69

unit needs assessment and, 68

universal interventions, 66

Combat and Operational Stress Control (Field Manual 4-02.51), 60, 

91, 154, 175, 219

Combat and Operational Stress Control Manual for Leaders and Soldiers (Field Manual 6-22.5), 60

Combat and operational stress first aid, principles of, 116, 117

Combat and operational stress reactions

combat and operational stress behavior and, 64

incidence of during the Vietnam War, 16

new pharmacologic agent use during the Vietnam War, 11–12

Operation Iraqi Freedom 05-07 and, 144, 146

percentage of battlefield casualties due to, 60

return to duty and, 60

symptoms, 60
Index

xxxix

Combat and Operational Stress/Staff Resiliency program

central point of contact for, 222

challenges and future directions, 221–222

chaplains’ role, 219, 220, 221

committee meetings, 221

confidential visits and, 220

daily operations, 221

data collection and, 222

debriefings, 220–221

director for, 220, 221

growth of, 222

hallway consultations versus office visits, 220

member dispersal, 221

operational stressors and, 219, 222

staff resiliency and, 221–222

stigma and, 222

structure and focus of, 219–221

surveys, 221, 222

team membership, 220

Combat driving behaviors, modification of for the home front, 372

“Combat Duty in Iraq and Afghanistan, Mental Health Problems, 

and Barriers to Care” (Hoge), 326

Combat/Operational Stress Control Workload Activity Reporting 

System, Operation Iraqi Freedom 05-07 and, 139, 144

Combat Psychiatry (Glass), 91–92

Combat Stress Control in a Theater of Operations: Tactics, Techniques, 

and Procedures (Field Manual 8-51), 91, 154

Combat stress control teams

chaplains and, 168–169

preventive psychiatry missions, 175–176

COMFORT scale, pain measurement in children, 346–347

Command interest profile. See Unit watch

Compassion fatigue. See also Provider fatigue

definition, 378

description and causes, 219, 376

Figley’s model of, 377–378, 385, 387–388

Compassion stress

definition, 377, 378

factors contributing to, 378–380

provider fatigue and, 378, 379

Compassion trap, definition, 378

Compassionate Therapy (Kottler), 377

Compazine, as most commonly used psychotropic medication 

during the Vietnam War, 152

Complex humanitarian emergencies

acute phase issues, 627–628

civil-military coordinations: four approaches to liaison arrangements (figure), 624

civil-military operations centers and, 623–624

clinical expertise and, 629

cultural competence and, 620, 629

environmental threats and, 626–627

event descriptions, 620

factors influencing survivor psychic distress, 625

gender-based violence and, 626

gradient of exposure and, 625

grief issues, 627

high-risk groups and, 626–627

humanitarian space and, 620, 629

importance of behavioral health services, 620

information sharing and, 623

international community and, 621–622

key players and, 620–622, 629

living conditions and, 626

magnitude of personal loss and, 625, 626

military support to other players, 622

most common behavioral health diagnoses, 627

nongovernmental organizations and, 620, 622, 623

ongoing threat of armed aggression and, 625

operating principles learned from successful civil-military 

operations centers (exhibit), 624

politically mediated excess mortality and morbidity and, 625

postconflict environment and, 625–626

practical considerations, 623–624

principles and practice of civil-military collaboration in behavioral health, 622–624

principles of behavioral healthcare in humanitarian environments, 627–628

psychic trauma and, 621

psychological first aid and, 628

reconsolidation phase issues, 628

reestablishment of basic services and, 627–628

reopening of schools and, 628

retributive violence and, 625–626

security needs and, 623

special behavioral health considerations, 624–627

survivor characteristics, 625

sustainable economic support programs and, 628

Composite Health Care System-Interactive Training Tool, Operation Iraqi Freedom 05-07 and, 140

Comprehensive Behavioral Health System of Care, description, 

749–750

Comprehensive Soldier Fitness program, description, vision, and 

mission, 748–749

Computed tomography, traumatic brain injury and, 230

Concussion. See Mild traumatic brain injury

Confidentiality issues. See Privacy and confidentiality issues

Connor, K., Connor-Davidson Resilience Scale and, 49

Connor-Davidson Resilience Scale, description, 49

Consultant to The Surgeon General, U.S. Army. See also Office of 

The Surgeon General

assignments and, 184

key functions, 184–185

location, 184

mental health record reviews, 185

position description, 184

strategic communications, 185

tasking for deployment, 184–185

Contingency aeromedical staging facilities

in Afghanistan, 201

attendants for psychiatric patients, 200

description, 192

in Kuwait, 201

locations for, 200–201

mission of, 200

Ramstein Air Base, Germany, facility, 201

restraints and, 200

staffing composition, 200

Continuum of care for veterans and their families

Battlemind training program and, 332

Department of Defense role, 326–336

Department of Veterans Affairs role, 326–336

Joint Conference on Postdeployment Mental Health and, 330

Mental Illness Research, Education, and Clinic Center, 333

new programs, 330–333

overview of the Department of Veterans Affairs, 326–328

Post-Deployment Health Reassessment and, 331–332

provisional mental health diagnoses among OEF/OIF veterans presenting for VA medical care (table), 329

public health model for deployment mental health, 330–331

seamless transition, care management and social work, 

327–328

Services for Returning Veterans-Mental Health, 332–333

services for veterans of OIF and OEF, 329–336

state and community partnerships, 334–336

U.S. Congress’s Handoff or Fumble? Do DoD and VA Provide 
xl

Combat and Operational Behavioral Health 

Seamless Health Care Coverage to Transitioning Veterans? and, 

326

Vet Centers and, 327

Controlled Substances Act, 477

Conversion disorders, traumatic injuries and, 253–254

Coping skills training, posttraumatic stress disorder and, 301–302

Coping with Death and Grief (Heegaard), 558

Core leader functions for psychological health

identify stress reactions, injuries, and illnesses, 114–116

mitigate stressors, 113–114

reintegrate stress casualties, 117

strengthen service members, 113

treat stress injuries and illnesses, 116–117

Cornum, Brig. Gen. Rhonda, Battlemind program and, 74

Corson, Lt. Col. (Ret.) William, demoralization of soldiers during 

the drawdown phase of the Vietnam War, 26

COSB. See Combat and operational stress behavior

COSC. See Combat and operational stress control

COSC-WARS. See Combat/Operational Stress Control Workload 

Activity Reporting System

COSFA. See Combat and operational stress first aid, principles of

COSR/SR. See Combat and Operational Stress/Staff Resiliency 

program

COSRs. See Combat and operational stress reactions

Covey, Dr. Jane, reunion after deployment workshops and, 574

Covey, Dr. John, reunion after deployment workshops and, 574

Cox, Lt. Col. Anthony, Battlemind program and, 72

COX-2 inhibitors. See Cyclooxygenase-2 inhibitors

CPT. See Cognitive processing therapy

Creamer, M., posttraumatic stress disorder program evaluation, 

310

Criminal Investigations Division, “Summary of Theater Suicides” 

and, 410–412

Criminal justice system. See Forensic mental health care

Croatia, Operation Provide Promise and, 76

CSCTs. See Combat stress control teams

CT. See Cognitive therapy

Cultural factors

care of combat-injured service members, 510

detained individuals and, 647, 650, 654

eating disorders, 453

hunger strikes and, 654, 655

presentation of psychosis and, 647

Cyclooxygenase-2 inhibitors. See also specific drugs

pain management and, 343, 344

Cymbalta, depressive disorder treatment, 158

Cyprohepadine, anorexia nervosa treatment, 460

D

Dads at a Distance, Web site, 501

Datel, W.E.

epidemiological data on the effects of the Vietnam War on the 

U.S. Army as a whole, 32

use of psychotropic medications by physicians deployed to 

Vietnam in 1967, 152–153

Davidson, J.R., Connor-Davidson Resilience Scale and, 49

Davison, E., late-onset stress symptomatology, 306–307

DCoE. See Defense Centers of Excellence

DCSP. See Deployment Cycle Support Program

DD Form 2624, Specimen Custody Document: Drug Testing, 

479–480

Deceased service members. See Children and families of fallen 

service members; Operations involving death and the dead

Defense and Veterans Brain Injury Center

in-theater management of TBI, 233, 253

traumatic brain injury definition, 226–227

Defense Centers of Excellence, mission statement, 748

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, combat and operational stress continuum 

model, 108–117

Dehydroepiandrosterone, resilience and, 46, 47

Dementia, suicide and, 426

Dental caries

causes, 261

extensive accumulation of bacterial plaque after cessation of 

oral hygiene (figure), 261

fluoride and, 261, 264

plaque accumulation, tobacco staining, gingival inflammation, 

and generalized caries resulting from a combination of inadequate oral hygiene, tobacco use, and refined carbohydrate 

intake (figure), 260

sugar consumption and, 261

Dental erosion, description and causes, 262

Deployment Cycle Support Program

behavioral health surveillance, 281

description, 276

families and, 278–279

reentry challenges and, 278–281

return-to-readiness period, 278

suicide prevention and, 169

Deployment Health Clinical Center, phone number and Web site, 

501

Deployment impact on military families and children. See also

Family maltreatment

children’s developmental responses, 493–495, 496

common emotional reactions to each stage of deployment 

(figure), 489

“deployment” definition, 488

deployment stage, 490–491

effects on spouses, 493, 564

foreign-born or non-English-speaking spouses and, 488

intergenerational transmission of the effects of war and combat trauma, 495–497

late deployment stage, 491–492

negative emotional and behavioral changes in children during 

deployment (table), 489

postdeployment stage, 492–493

predeployment stage, 489–490

resources for military families, 500–501

school enrollment issues, 488

stages of the deployment cycle, 488–493

sustainment stage, 491

varying length of missions, 488

Deployment Risk and Resilience Inventory

postwar factors, 49

prewar factors, 48–49

war-zone factors, 49

Deployment Risk and Resilience Inventory, posttraumatic stress 

disorder and, 301

Depression. See also Major depressive disorder; Postpartum depression; Premenstrual dysphoric disorder

age of onset, 442

anorexia nervosa and, 453

combat and operational stress continuum model red zone and, 

112

complex humanitarian emergency survivors and, 627, 628

deployment-related stress and, 60

exercise and, 705

guidelines on screening for depression in spouses of service 

members, 538

oral hygiene and, 264

percentage of soldiers returning from combat in Iraq and 

Afghanistan with, 78

Persian Gulf War veterans with PTSD and, 305

posttraumatic stress disorder and, 298, 305
Index

xli

prevalence during Operation Iraqi Freedom, 153

prevalence of the diagnosis during Operation Enduring Freedom and Operation Iraqi Freedom, 212

social support and, 46

suicide and, 395, 410

symptoms, 707

traumatic injuries and, 251

uncontrolled pain and, 246

Vietnam veterans with PTSD and, 305

women and, 707–709

Detainees

behavioral health issues, 646–656

Behavioral Science Consultation teams and, 699

ethical issues, 731–742

hunger strikes and, 653–656, 739–742

interrogation and, 732–739

medical treatment of, 738–739

nonmedical treatment of, 732–735

occupational therapy issues, 366–368

sanity boards on, 695–696

Developmental responses of children

to a combat-injured parent, 513–516

to deployment, 493–495, 496

Devilly, G., eye movement desensitization and reprocessing, 309

Dexedrine. See Dextroamphetamine

Dexmedetomidine, pain management and, 344

Dextroamphetamine, Vietnam War and use of, 152

DHEA. See Dehydroepiandrosterone

Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, 

posttraumatic stress disorder and, 30, 33

Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, 

revised, prevalence of mental health problems in the U.S. Navy 

and, 122

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition

anorexia nervosa definition, 451

bulimia nervosa definition, 451

postconcussive disorder diagnosis, 232

posttraumatic stress disorder and, 109

secondary trauma and, 377

severe psychiatric diagnosis basis, 442–446

Diebold, Col. C.J., Soldier Assistance Center and, 568

Diphenhydramine agitation treatment, 159

Disaster psychiatry

areas for future research, 587–588

community support, education, and definitive care and, 582

disaster stress reaction relation to physiological symptoms, 580

education of disaster psychiatrists and, 588

essential domains of disaster mental health interventions 

(table), 581

evolution of the field, 580

historical background, 580–582

mental health of disaster workers and, 582

Project Liberty and, 582

psychiatric conceptualization of trauma and response, 581–582

recent missions, 582–587

research needs, 588

self-soothing and, 582

self-triage and, 582

September 11, 2001, terrorist attacks and, 582, 583–585

Uniformed Services University of the Health Sciences Disaster 

Psychiatry Fellowship, 680

Disaster relief. See Complex humanitarian emergencies; Humanitarian assistance missions

Disengagement/detachment

definition, 378

provider fatigue and, 378, 379

Dissociative disorders, fitness for duty and, 180

Division mental health units

Army regulation outlining responsibilities, 90

combat operational stress course and, 98

current structure of (figure), 91

future directions for, 102

Military Medicine articles, 92

mission and role of, 91

modular structure, 90–91, 92, 102

“ownership” by the division and, 101

pre- and post-deployment screening and, 96

preventive psychiatry missions, 175–176

prior structure of (figure), 90

responsibilities, 92

traumatic event response and, 97

Division psychiatrists and brigade behavioral health officers

access to mental health technicians and, 101

administrative duties, 99–100

advice and consultant role, 93

AMEDD principles of treatment, evacuation, and restoration 

and, 93

Army Behavioral Health Short Course and, 98

Army regulation outlining responsibilities, 90

assumption of unanticipated roles and, 101

case studies, 94, 97

challenges of the position, 100–103

clinician role, 93

commanders’ expectations, 93–94

consultations to commanders and command surgeons on 

behavioral health trends and issues and, 97–98

continuing education and, 98

coordination of behavioral health resources and, 101

coordination of external resources and, 96–97

direct care of patients and, 99

discretionary and nondiscretionary referrals and, 99–100

distribution of resources and, 94

doctrine on responsibilities, 91–92

duties and responsibilities, 94–100, 185

duties and responsibilities of the unit behavioral health officer 

(exhibit), 95–96

future directions for, 102

as junior officers, 93, 100–101

licensure requirements, 93

personnel issues, 101–102

perspectives on the position of the division psychiatrist (figure), 93

perspectives on the positions, 92–94

planning and oversight for behavioral healthcare and, 94, 

96–97

pre- and post-deployment screening and, 96

primary care providers and, 98–99

psychotropic medications and, 94, 96

role as officers in the unit, 100

supervision of enlisted mental health technicians and, 98

Divorce

hospitalization of combat-injured service members and, 

508–509

Operation Iraqi Freedom and Operation Enduring Freedom 

and rates of, 277

posttraumatic stress disorder and, 307

“stress hypothesis” of, 538–539

suicide and, 426

DMHs. See Division mental health units

DoD. See U.S. Department of Defense

DoDSERs. See U.S. Department of Defense, Suicide Event Reports

Domestic violence. See Family maltreatment

Donald J. Cohen National Child Traumatic Stress Initiative, description of services, 500

Dopamine, eating disorders and, 452

Drawdown phase of the Vietnam War, 1969-1972
xlii

Combat and Operational Behavioral Health 

behavior problems and misconduct, 27, 32, 33

biopsychosocial stressors and, 25–26

cultural polarization and, 22–24

demoralization of soldiers and, 25–26

ethics of combat psychiatry and, 24–25

evacuations for psychiatric reasons, 26–27, 34

heroin epidemic, 27–28

My Lai massacre and, 22

negative effects of the abandonment of hopes for military 

victory, 22

Nixon’s “peace with honor,” 21

psychiatric overview, 26–28

psychiatrist reports, 28–29

“Vietnamization” concept, 21

Drinking behavior. See Alcohol use and abuse

DRRI. See Deployment Risk and Resilience Inventory

DSM-III. See Diagnostic and Statistical Manual of Mental Disorders,

3rd Edition

DSM-III-R. See Diagnostic and Statistical Manual of Mental Disorders,

3rd Edition, revised

Dual agency

graduate medical education and, 670, 679, 686

malingering and, 697–698

psychiatric consultation to command and, 182–183

Duckworth, Liz, Ragtail Remembers--A Story That Helps Children 

Understand Feelings of Guilt, 556–557

Duloxatine

pain management and, 344

posttraumatic stress disorder treatment, 303

Dunmore, E., social support effect on posttraumatic stress disorder, 46

Durkheim, Emile, suicide research, 404

DVBIC. See Defense and Veterans Brain Injury Center

Dyergrov, A., support for disaster workers, 255

Dysthymic disorder, in-theater treatment, 158–159

E

Earthquake disaster relief, description and factors in, 641

EAT model

description, 385

visual description (figure), 385

Eating disorder not otherwise specified

binge eating disorder and, 452, 462

deployment and, 463

examples of, 452

military population statistics, 456

mortality rate, 455–456

normal weight and, 454

prevalence of, 450, 452

treatment, 462

Eating disorders. See also specific disorders

biological factors, 452–453

body mass index and, 452, 454, 458

body weight “set point” or “settling point” and, 453

clinical features, 454–455

course and prognosis, 455–456

cultural factors, 453

deployment issues, 450, 463–464

description, 450

differential diagnosis, 455

etiology of, 452–454

excessive exercise and, 454

family factors, 453

future research needs, 463–464

genetic factors, 452–453

hidden nature of, 454

ideal body image as portrayed in the media, 450

laboratory studies, 455

medical and psychiatric treatment, 458–462

medical findings, 454–455

mortality rates, 464

obesity increase, 450

oral health effects of, 263–264

overview of, 450–452

personal fitness assessments and, 450, 456, 457, 463, 704

posttraumatic stress disorder and, 464

psychological factors, 453

rate of in the military, 450

research on abnormal eating in the military, 456–458

social factors, 453

summary of abnormal eating behavior studies in military 

populations (table), 457

treatment issues in the combat environment, 462–463

underdiagnosing of, 450

EDNOS. See Eating disorder not otherwise specified

Education and training

behavioral health liaison project, 573

disaster psychiatrists, 588

military psychiatrist graduate medical education, 670–689

Ehlers, A.

cognitive model of trauma, 45

Cognitive Theory of PTSD, 299–300

social support effect on posttraumatic stress disorder, 46

88th Regional Readiness Command COSC program

activity summary, April 2003-December 2006 (table), 364

bereavement support, 365–366

community outreach and, 366

core features, 364

deployment cycle support briefings (exhibit), 367

description, 363

educational stress briefings, number of participants, 2003-2007 

(figure), 363

expected outcomes, 363–364

family readiness groups and, 364

first responder training (exhibit), 365

goals of, 363

stress reduction techniques and, 364

well-being program, 364–365

Ellison, Chaplain James, death of a parent as a life-changing experience on three levels, 549

EMDR. See Eye movement desensitization and reprocessing

Emotional contagion, definition, 376, 377

Empathic ability

definition, 378

provider fatigue and, 378, 379

Empathic concern, definition, 377

Empathic responses

definition, 378

provider fatigue and, 378, 379

Empathic supportive exposure therapy, trauma patients and, 249, 

252

Employment issues

job fairs for military spouses, 572–573

provider fatigue, 382

work reintegration programs, 361, 369–371

Enemy Prisoners of War, Retained Personnel, Civilian Internees, and 

Other Detainees (Army Regulation 190-8), 101

Engel, C.C., article on division mental health units, 92

EPICONS. See Epidemiological consultations

Epidemiological consultations

activities on the ground, 416

agencies involved, 415

basic questions, 417–418

basic strategies, 417

common behavioral health epidemiological consultation 
Index

xliii

themes (table), 413

common findings, 418

daily situation reports and, 417

data sources, 416–417

description and background, 412–415, 418–419

“epi-curve” and, 418

Fort Bragg, NC, 414

Fort Campbell, KY, 414

Fort Leonard Wood, MO, 413–414

Fort Riley, KA, 414

G-1 responsibilities, 415

index cases, 418

initiation of, 415–416

media attention and, 418

methods in, 417–418

operational support for, 415–416

psychiatric EPICONS in the U.S. Army, 412–418

resources for, 414–415

results and lessons learned, 418

of suicide and homicide clusters, 77

suicide prevention, 406

team membership, 415

timeline for, 415

writing the report for, 418

Equanil, use of during the Vietnam War, 152

Escitalopram, posttraumatic stress disorder treatment, 303

Ethical issues

deployment phase, 731–742

detainees, 731–742

distress of deployment, 730

ethics of combat psychiatry, 24–25

interrogation of detainees, 732–739

medical treatment of detainees, 738–739

pain management, 349–350

postdeployment phase, 742–744

predeployment phase, 728–731

psychiatric consultation to command and, 182–184

psychotropic medication prescribing, 160

recruitment goals, 728–729

traumatic brain injury, 743

treatment concerns, 729–731

treatment decisions made “outside the box,” 743–744

verbal dissent by soldiers, 742

vignettes, 731

Ethnic factors. See Racial/ethnic factors

European Community Humanitarian Office, complex humanitarian emergencies and, 621

Everett Anderson’s Goodbye (Clifton), 557

Eye movement desensitization and reprocessing, posttraumatic 

stress disorder treatment, 302, 304, 308, 309

F

Faces Scale, pain assessment, 347

Facing Change: Falling Apart and Coming Together Again in the Teen 

Years (O’Toole), 560

The Fall of Freddie the Leaf (Bascaglia), 557

Fallen service members. See Children and families of fallen service 

members; Operations involving death and the dead

Families. See also Children; Children and families of combatinjured service members; Children and families of fallen service 

members; Deployment impact on military families and children

Battlemind program for spouses, 72, 80–81, 332

continuum of care for veterans of OIF and OEF and, 326–336

eating disorders and, 453–454

88th Regional Readiness Command COSC program and, 

363–366

family support link to resilience, 52

model of stress and its potential soldier and family outcomes 

(figure), 63

posttraumatic stress disorder and, 306, 307, 312

prolonged grief disorder and, 348

resetting the force and, 276, 277, 280–281, 284

supportive counseling for, 254–255

traumatic injuries and, 247, 253–255

United Kingdom armed forces’ research on the impact of 

military service on family life, 663

Family Advocacy Program

case review process, 536–537

description, 536

New Parent Support Program, 539

objective of, 536

sources of reports of abuse incidents, 536

Family maltreatment. See also Deployment impact on military 

families and children

Army’s response to family stress and deployment, 539–540

chaplains and, 539

child maltreatment, 537–538

child neglect, 538

communicating with the deployed person and, 536

definition of, 536

domestic violence, 306, 536–537

Family Advocacy Program and, 536–537, 538, 539, 540

family readiness support assistants and, 539

marriage and family therapy, 540

military life effect on, 537–538

prevalence of, 537–538

respite care for parents of children while the other parent is 

deployed, 540

“stress hypothesis,” 538–539

stress of deployment and, 536–540

traumatic brain injury and, 711

Family readiness groups

behavioral health liaison project and, 572, 573

88th Regional Readiness Command COSC program and, 364

family readiness group briefing topics (exhibit), 572

Family therapy

anorexia nervosa, 459

family maltreatment and, 540

FAP. See Family Advocacy Program

Farberow, Norman, key concepts in suicide, 404, 405

Farmer, Maj. Gen. Kenneth, Jr., Suicide Risk Management and 

Surveillance Office and, 397

FDA. See U.S. Food and Drug Administration

Federal Child Abuse Prevention and Treatment Act, 536

Federal Tort Claims Act, malpractice lawsuits and, 436

Fellowship programs

child and adolescent psychiatry, 680

geriatric psychiatry, 680

Military Forensic Psychiatry, 697

Fenfluramine, bulimia nervosa treatment, 462

Fentanyl, drug tests and, 477

Feres doctrine, malpractice lawsuits and, 436, 437

Ferguson, Dorothy, A Bunch of Balloons, 556

Field, N.P., bereavement and posttraumatic stress disorder, 306

Field Manual 6-22.5: Combat and Operational Stress Control Manual 

for Leaders and Soldiers, 60

Field Manual 8-51: Combat Stress Control in a Theater of Operations: 

Tactics, Techniques, and Procedures, 91, 154

Field Manual 4-02.5l: Combat and Operational Stress Control, 60, 91, 

144, 154, 175, 219

Figley, Charles, compassion fatigue model, 377–378, 385, 387–388

Finding My Way: A Teen’s Guide to Living With a Parent Who Has 

Experienced Trauma (Sherman and Sherman), 560

Fire in My Heart, Ice in My Veins--A Journal for Teenagers Experiencing Loss (Traisman), 559
xliv

Combat and Operational Behavioral Health 

Firearms access

posttraumatic stress disorder and, 306

unit watch and, 424, 425, 435

Fisher, Lt. Cdr. H.W., account of his Vietnam War experience, 29

Fitzgerald, Helen, The Grieving Teen: A Guide for Teenagers and Their 

Friends, 559

Fluoxetine

anorexia nervosa treatment, 460

bulimia nervosa treatment, 462

depressive disorder treatment, 158

posttraumatic stress disorder treatment, 303, 308

safety of use during pregnancy, 709

Flutamide, bulimia nervosa treatment, 462

Fluvoxamine, bulimia nervosa treatment, 462

Foa, E.

fear-related memories and PTSD, 299

prolonged exposure treatment, 302

Forbes, D., imagery rehearsal therapy, 309

Force feeding, hunger strikes and, 655–656, 739–742

Forensic mental health care

Article 32 investigations, 695

behavioral science consultation teams, 699–700

board certification requirements, 697

case studies, 695, 697, 698, 699

core topics, 694

criminal justice system and, 694–697

detainees and, 695–696

expert consultants and expert witnesses, 696–697

Fifth Amendment of the Constitution and, 695

forensic psychiatry in the military compared with the civilian 

world, 694

insanity defense and, 695

levels of courts-martial and, 694–695

malingering, 697–698

military law and, 694–695

Military Rules of Evidence and, 694, 696

psychological autopsies after suicides, 698–699

“sanity boards” and, 695–696

Formulary of medications

example psychiatric formulary for deployment (table), 155

Operation Iraqi Freedom 05-07 and, 139

pain management medications, 348

rationale for using for military operations, 153–154

Fort Bragg, NC

cluster of suicides and homicides, 77

EPICON following two murders and two murder-suicides, 

414, 418

Fort Campbell, KY, EPICON following 14 soldier suicides between 2006 and 2007, 414, 418

Fort Carson, CO, EPICON focusing on homicides, 414

Fort Hood, TX, EPICON following 22 suicides between 2003 and 

2005, 414, 418

Fort Leonard Wood, MO, EPICON following the deaths of two 

recruits by suicide, 413–414, 418

Fort Lewis, WA, Soldier Wellness Assessment Pilot Program, 

282–284

Fort Riley, KA, EPICON following six suicides in 14 months, 414, 

418

Fractures, anorexia nervosa and, 454

Frank, Jerome, resilience and, 330

Freedom of Information Act, 698

Freud, Sigmund, psychiatric conceptualization of trauma and 

response, 581–582

FRGs. See Family readiness groups

Friedman, Matthew, M.D., PhD., instruction of primary care providers at Schofield Barracks and, 568

Friedman, M.J., disaster psychiatry research, 581

Fry, Virginia Lynn, Part of Me Died, Too: Stories of Creative Survival 

Among Bereaved Children and Teenagers, 559

Fullerton, C.S., disaster psychiatry research, 581

G

G-1

Army Suicide Prevention Program, 405, 406, 409

epidemiological consultations, 415

Gabapentin

mechanism of action, 344

pain management and, 343, 344

Gabriel, R.A., incidence of soldiers attacking their superiors 

(“fragging”), 25

Galai-Gat, T., uncontrolled pain as a stressor, 246, 249

Galanin, resilience and, 46, 47

Galveston Orientation and Amnesia Test, traumatic brain injury 

and, 231

Gambling. See Pathological gambling

Garfield, R.M., World War I and World War II casualty rates, 625

Gastroesophageal reflux disease

oral health and, 262

treatment, 262

Gastrointestinal disorders

anorexia nervosa and, 454

bulimia nervosa and, 455

Gaynes, B.N., suicide research, 395

GCS. See Glascow Coma Scale

Gender factors. See also Men; Women

anxiety disorders, 709

bipolar disorder, 709

depression, 707

personal fitness assessments, 704

posttraumatic stress disorder, 709

seasonal affective disorder, 707

traumatic brain injury, 710–711, 710–712

Generalized anxiety disorder. See also Anxiety disorders

in-theater treatment, 159

percentage of soldiers returning from combat in Iraq and 

Afghanistan with, 78

posttraumatic stress disorder and, 303, 305

prevalence during Operation Iraqi Freedom, 153

treatment, 253, 303

Genetic factors

Alzheimer’s disease, 396

eating disorders, 452–453

pain management, 345–346

posttraumatic stress disorder, 46

Geneva Agreement, Vietnam War and, 12

Geneva Conventions, treatment of POWs, 731

Geodon, psychotic disorder treatment, 159

Geranium Morning (Powell), 557

GERD. See Gastroesophageal reflux disease

Gingivitis

management of, 265–266

oral hygiene and, 265

Ginsburg, Kenneth R., A Parent’s Guide to Building Resilience in 

Children and Teens: Giving Your Child Roots and Wings, 561

Girls Time Out program, mission and description, 510

Giuliani, Mayor Rudolph, effectiveness of communications after 

the September 11, 2001, terrorist attacks, 595

Glascow Coma Scale, traumatic brain injury and, 227, 231

Glass, Col. Albert

Combat Psychiatry, 91–92

combat stress control teams and, 176

Neuropsychiatry in World War II, 5, 91

PIES principles, 5, 6, 108

Glicken, D., Learning from Resilient People: Lessons We Can Apply to 

Counseling and Psychotherapy, 168
Index

xlv

Gliko-Brado, Majel, Grief Comes to Class: An Educator’s Guide, 561

Global Patient Movement Requirements Center

coordination with the Joint Patient Movement Requirement 

Centers to establish CONUS destinations for patients, 202

role and responsibilities, 195

Global war on terror

behavioral science consultation teams and, 699

graduate medical education and, 673

increase in behavioral health problems and, 672

posttraumatic stress disorder treatment and, 688

resetting the force and, 276, 284

special forces operations, 278

Support Assignment orders, 131

U.S. Navy and, 122, 128

Glynn, S.M., imaginal exposure for PTSD, 309

GME. See Graduate medical education

GOAT. See Galveston Orientation and Amnesia Test

Goiania, Brazil, radiological contamination accident

depression and anxiety in victims, 599

long-term effects, 601

outbreak of multiple unexplained symptoms and, 598

psychological casualties, 597

screening for radiation exposure and, 599

Gold Star Wives of America

description and services, 550, 555

Web site, 555

Goldberg, G., provider fatigue and, 381–382

Goldman, Linda

Life and Loss: A Guide to Help Grieving Children, 560

Raising Our Children to Be Resilient, 560

Goldstein, R.B., suicide research, 395

Gonzales, L., survival skills, 51

A Good Day (Henkes), 556

Gootman, Marilyn, When a Friend Dies: A Book for Teens about 

Grieving and Healing, 559

Gourevitch, P., gender-based violence in Rwanda, 626

Government Accountability Office

COSC-WARS reporting system and, 144

pre- and post-deployment screening and, 96

GPMRC. See Global Patient Movement Requirements Center

Graduate medical education

ACGME competencies and, 675

American Council of Graduate Medical Education accreditation and, 670, 671, 673, 675, 676, 678, 680, 681, 688

American Council of Graduate Medical Education Accreditation history of U.S. military psychiatry residencies (table), 

671

American Council of Graduate Medical Education competencies (exhibit), 675

as an essential aspect of military medicine, 670, 688

annual common task training, 670

case studies, 683–684, 687

characteristics of military psychiatrists, 686–687

closure of psychiatry residency programs, 671–672

completion requirements, 678

contracting to civilian schools, 687–688

core competencies, 676–677

curriculum, 675–680

Department of Defense command-directed mental health 

evaluations and, 683

deployment to combat zones and, 673

development of appropriate attitudes, 686–687

didactic learning and, 678

documents and reports prepared by military psychiatrists 

(exhibit), 685

dual agency and, 670, 679, 686

faculty development, 674–675

general psychiatry residency curriculum, 677–678

a graphic timeline of accredited U.S. military psychiatry programs (figure), 672

historical background, 670–672

interpersonal skills and, 684

issues emphasized in the military psychiatry curriculum, 679

knowledge aspects, 681–684

length of residency programs, 677

managed care and, 673, 677

military performance rating system and, 685–686

military psychiatrists as military officers, 679

military psychiatrists compared with civilian psychiatrists, 

684–685

military psychiatry curriculum, 679–680

military structure and, 679

military-unique tasks, 670

mission performance relevance, 680–687

official documents with which U.S. Army psychiatrists should 

be familiar (table), 682

postresidency fellowships, 680

primary mission of, 670

program director role, 673–674

program leadership, 672–675

psychotherapy competencies, 677

recruitment and retention of faculty and, 673–675, 688–689

research and scholarly activity, 678–679

residency review committees and, 676, 678, 680

Rule for Court-Martial 706 evaluations and, 670

skills required of military psychiatrists, 684–686

summary of American Council of Graduate Medical Education 

Residency Review Committee requirements for psychiatry 

residents, as of 2007 (exhibit), 678

team learning, practice, and interpersonal communication, 

676–677

technical skills requirements, 685

unique skills required of military psychiatrists (exhibit), 684

unit commanders and, 684

unit structure and dynamics and, 679

vignettes, 686, 687

Grenier, Lt. Col. Stephane, “operational stress injury” concept 

and, 109

Grief. See Bereavement; Children and families of fallen service 

members

Grief Comes to Class: An Educator’s Guide (Gliko-Brado), 561

The Grieving Teen: A Guide for Teenagers and Their Friends (Fitzgerald), 559

Gritzner, S., zinc deficiency in anorexia nervosa and, 460

Gross, Michael, military medical ethics, 732, 733

Group for the Advancement of Psychiatry, effectiveness of preventive psychiatry, 172

Group therapy, trauma patients and, 249, 252

GTO program. See Girls Time Out program

Guanfacine, posttraumatic stress disorder treatment and, 304

A Guide for the Survivors of Deceased Army Members, 544

Guide to the Prevention of Suicide and Self-Destructive Behavior (PAM 

600-70), 405

Guidelines on the Use of Military and Civil Defence Assets in Disaster 

Relief, 622

Gulf War syndrome

description, 600

expert witness testimony and, 696

Gull, Sir William, anorexia nervosa description, 450

Gusman, Frederick, MSW, instruction of primary care providers 

at Schofield Barracks and, 568

GWOT. See Global war on terror

H

Haas, D.M., survey of pregnant military and civilian women to 
xlvi

Combat and Operational Behavioral Health 

measure stress levels, 493

Haiti, Operation Uphold Democracy and, 76

Haldol, psychotic disorder treatment, 159

Hall-Jones, P., nongovernmental organizations, 622

Haloperidol

pain management and, 348

psychotic disorder treatment, 159

Hanson, Frederick, forward treatment of combat stress, 5

Harman, D.R., aeromedical evacuation of psychiatric patients, 203

Harris Poll, of Vietnam veterans, 30

Harvey, C., supportive counseling for families, 254–255

Hatkoff, Craig, Owen & Mzee, 558

Hatkoff, Isabella, Owen & Mzee, 558

Hawaii, integrated behavioral health services at Schofield Barracks, 564–575

The Healing Your Grieving Heart Journal for Teens (Wolfelt and 

Wolfelt), 559

Health Affairs Policy 9700029, substance abuse care for active 

duty service members, 481

Health Insurance Portability and Accountability Act, impact on 

psychiatric consultation to command, 183–184

Health Risk Appraisal questionnaires, description, 281

Heegaard, Marge Eaton, Coping with Death and Grief, 558

Helicopter ambulances, Vietnam War and, 14

Helping Children Cope With the Loss of a Loved One: A Guide for 

Grownups (Kroen), 560

Helping Children Grieve & Grow--A Guide for Those Who Care

(O’Toole), 561

Henkes, Kevin, A Good Day, 556

The Hero in My Pocket (Lee), 558

Heroin

drug tests and, 477

postdeployment effects of use, 28

Vietnam War and use of, 24, 25, 27–38, 34, 152

Heyman, R.E., relationship between the length of deployment and 

spousal aggression, 537

Hill, J.V., guidelines for psychiatry residents on becoming a division psychiatrist, 92

Hillbom, M., relationship of alcohol use to trauma, 233

HIPAA. See Health Insurance Portability and Accountability Act

Historical background

aeromedical evacuations, 192–194

Army psychiatry in the Vietnam War, 11–12

Battlemind program, 72

chaplains, 164–165

combat and behavioral health, 4–7

combat and operational stress continuum model, 108–110

community mental healthcare in the military, 564

disaster psychiatry, 580–582

family notification of combat deaths, 544

graduate medical education, 670–672

humanitarian assistance missions, 610–615

occupational therapy, 358–359, 373

Operational Stress Control and Readiness program, 126–127

pain management, 347

psychiatric command consultation, 172–173

psychiatry volumes of the textbooks of military medicine, 5–6

Special Psychiatric Rapid Intervention Teams, 124

suicide prevention in the Army, 404–405

Suicide Risk Management and Surveillance Office, 397

United Kingdom armed forces behavioral health, 658–660

U.S. Navy carrier psychology program, 125–126

use of psychotropic medications, 152–154

Hoge, Col. Charles

Battlemind program and, 72, 332

“Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care,” 326, 330

posttraumatic stress disorder research, 233, 329

prevalence of mental health problems among soldiers returning from OEF, 333, 564

stigma attached to seeking help, 568

trauma patients’ perception of psychiatry, 246

Holloway, Col. Harry C., survey of illegal drug use in the Vietnam 

War, 11, 28

Homicide

access to lethal means and, 437

EPICONs concerning, 414

managing suicide and homicide risk during deployment 

(table), 435

managing suicide and homicide risk in garrison (table), 427

“military-specific homicidal ideation” and, 425

risk factors, 437

suicidal or homicidal thoughts association with diagnosable 

mental illness, 424

unit watch concept and, 424–438

WRAIR epidemiological consultations of homicide clusters, 77

HOOAH4HEALTH--Deployment, Web site, 501

Horowitz, M.J., bereavement reaction to traumatic injury, 246

How Do We Tell Children: Helping Children Understand and Cope 

When Someone Dies (Lyons and Schaefer), 561

How It Feels When a Parent Dies (Krementz), 558–559

How to Go on Living When Someone You Love Dies (Rando), 561

How to Help Children Through a Parent’s Serious Illness (Bonn and 

McCue), 517

HRA I and II. See Health Risk Appraisal questionnaires

Huebner, A.J., adolescents’ responses to deployment, 494

Hughes, J., provider fatigue and, 381–382

Hughes, Lynne, You Are Not Alone: Teens Talk About Life After the 

Loss of a Parent, 559–560

Humanitarian assistance missions. See also Complex humanitarian emergencies; Medical civil-military operations in Operation 

Iraqi Freedom 05-07; specific missions and locations

civil dimensions, 611

earthquake disaster relief, 641

historical background, 610–615

importance of healthcare and, 610–611

purpose of, 610

Hunger strikes

assessment issues, 654–655

autonomy of the individual and, 739–742

behavioral healthcare providers and, 739–742

competence to fast and, 654

consultation with command, 655–656

cultural factors, 654, 655

daily reassessment of emotional and cognitive status, 654–655

depression and, 655

differential diagnosis, 653

ethical issues, 739–742

focus of psychological management, 655

follow-up assessments, 655

force feeding and, 655–656, 739–742

informed consent and, 654

initial interview and, 654

international standards for treatment, 654

intervention, 655

observation and, 654

political nature of, 654

primary care providers and, 654–655

reactive food refusal and, 654

theater policy and, 654

typical protocol for, 654

Hurricane Andrew, Special Psychiatric Rapid Intervention Teams 

role, 124

Hurricane Ivan, Special Psychiatric Rapid Intervention Teams 

role, 124

Hurricane Rita. See Hurricanes Katrina and Rita
Index

xlvii

Hurricanes Katrina and Rita

disaster response, 586

Disaster Response Teams and, 636

health surveillance by the CDC, 586–587

Mercy model of population-based disaster relief and, 635

Project Recovery and, 587

Special Psychiatric Rapid Intervention Teams role, 124

Hyams, K.C., reporting of mental health problems by OIF/OEF 

veterans, 329

Hydromorphone, drug tests and, 477

Hypnotherapy, trauma patients and, 249

I

I Don’t Have an Uncle Phil Anymore (Pellegrino), 557

I Had a Friend Named Peter: Talking to Children About the Death of a 

Friend (Cohn), 556

I Miss You--A First Look at Death (Thomas), 557–558

ICD-CM. See International Classification of Disease, 9th Edition, 

Clinical Modification

Illegal drugs. See also Substance use and abuse; specific drugs

“Amnesty Program” and, 28

Army Forensic Drug Testing Program, 141–142

Controlled Substances Act and, 477

Korean conflict and use of, 32

urine drug screening system and, 25, 28

Vietnam War and use of, 11, 17, 20–21, 24, 25, 27–28, 32, 34, 152

Imagery rehearsal therapy, posttraumatic stress disorder and, 309

In an Instant: A Family’s Journey of Love and Healing (Woodruff and 

Woodruff), 517

Indian Ocean tsunami

description, 634, 639

just-in-time training and, 586

Mercy model of population-based disaster relief and, 634–644

number of dead and missing, 585

operating environment, 620

Operation Unified Assistance and, 585, 634, 636

Project HOPE and, 585, 587

Individual augmentation

administrative issues, 131

description, 128–129

distance from Navy Medicine infrastructure and, 131

family support and, 131

isolation issues, 130–131

training and deployment cycle and, 129–130

unit cohesion and, 130–131

Warrior Transition Program and, 129–130

Indonesia. See Indian Ocean tsunami; Mercy model of populationbased disaster relief

Infants. See also Pregnancy

effects of deployment on, 493

grief responses, 547

response to a combat-injured parent, 513–514

Informed consent

hunger strikes and, 654

use of psychotropic drugs during pregnancy and, 708

Ingraham, L.H., heroin use during the Vietnam War, 27–28

Ingram, Lee M., That’s My Hope: Featuring a Gallery of Multigenerational Artwork, 517

Insanity Defense Reform Act, provisions, 695

Insomnia

behavioral interventions for, 159

in-theater treatment, 159–160

nursing care and, 250, 252

relaxation techniques and, 250

sleep hygiene and, 250

trauma patients and, 250

uncontrolled pain and, 246

Institute of Medicine

Committee on Treatment of Posttraumatic Stress Disorder, 309

Web site, 501

Integrated behavioral health services at Schofield Barracks, HI

ages and gender of children evaluated at Solomon Elementary 

School in the Solomon Wellness Educational Program, from 

August 2001 to February 2007 (figure), 571

algorithms for calculating provider numbers (exhibit), 567

allocation of mental health resources within the Army system 

and, 575

Army Community Service and, 565, 571

behavioral health liaison project, 571–575

Child and Adolescent Psychiatry Service and, 565

conflict within, 575

early efforts, 565–566

family readiness group briefing topics (exhibit), 572

family readiness groups and, 565, 572

monthly patient or client visits in the three Soldier and Family 

Assistance Center clinics, January 2005 to November 2006 

(figure), 569

projected demand for providers based on population (table), 

568

quality of welcome by unit in the behavioral health liaison 

project (figure), 572

recommendations developed from the program, 575

school-based mental healthcare, 569–571

Soldier and Family Assistance Center and, 565, 566–569, 575

Soldier and Family Assistance Center five areas of care (exhibit), 567

Solomon Wellness Educational Program, 569–571

Tripler Army Medical Center and, 565

InterAction, description, 622

Intergenerational trauma transmission

family communication patterns and, 496–497

Holocaust survivors and, 495

mechanisms of, 496

veterans’ posttraumatic stress disorder and, 495–496

International Association for the Study of Pain, pain definition, 

341

International Classification of Disease, 9th Edition, Clinical Modification, posttraumatic stress disorder and, 30, 77

International Classification of Disease, 10th Edition, Clinical Modification, postconcussive disorder and, 232

International Medical Corps, medical civil-military operations in 

Operation Iraqi Freedom 05-07 and, 616

International Organization for Migrations, complex humanitarian 

emergencies and, 621

International Red Cross and Red Crescent Movement. See also

American Red Cross

complex humanitarian emergencies and, 621

entities comprising, 621–622

observer status at the United Nations, 622

Interpersonal therapy, anorexia nervosa, 459

Interpreters. See Translators

Interrogation of detainees

improving conditions over time, 734–735

international codes and, 735

limits on, 733–734

military medical care provider involvement and, 735–739

permitted interrogation approaches, 732–734

persons’ dignity and, 733

IPT. See Interpersonal therapy

Iraq. See also Operation Iraqi Freedom; Operation Telic

civilian deaths in Haditha, 148, 778

IRCRCM. See International Red Cross and Red Crescent Movement

Ireland, UK Operation Banner and, 658

Israel, symptoms of Israeli civilians near Scud missile attacks, 580, 
xlviii

Combat and Operational Behavioral Health 

596, 598

Israeli Defence Forces

anorexia nervosa among female soldiers, 459

combat stress reactions and casualty rate, 52

operational use of tricyclic antidepressants during the war 

with Lebanon, 153

posttraumatic stress disorder and, 496

Iverson, G.L., traumatic brain injury research, 231

Ivins, B.J., trends in TBI-related hospitalizations, 226

J

Janet, Pierre, psychiatric conceptualization of trauma and response, 581–582

Japan

atomic weapons dropped on Hiroshima and Nagasaki, 

599–600, 601

Aum Shinrikyo cult’s sarin attack on the Tokyo subway system, 594, 597, 598, 599, 601–602

Japanese International Cooperation Agency, complex humanitarian emergencies and, 621

Jaycox, L., prolonged exposure treatment, 302

Jensen, P.S., children’s responses to deployment, 494

Jobs. See Employment issues

Johnson, A.W., Jr.

overview of Army psychiatry in Vietnam, 11, 15, 26, 27

use of psychotropic medications by physicians deployed to 

Vietnam in 1967, 152–153

Johnson, D.R., inpatient program for posttraumatic stress disorder 

among Vietnam veterans, 310

Johnson, Joy, What Does That Mean? A Dictionary of Death, Dying 

and Grief Terms for Grieving Children and Those Who Love Them,

558

Johnson, Pres. Lyndon, Vietnam War and, 13, 18

Johnston, J., draft issues during the Vietnam War, 23–24

Joinson, C., provider fatigue description, 376–377

Joint Commission, pain management and, 340

Joint Conference on Postdeployment Mental Health, description 

and participants, 330

Joint Patient Movement Requirement Centers

coordination with the Global Patient Movement Requirements 

Center to establish CONUS destinations for patients, 202

tracking of patients, 195

Jones, Col. Franklin Del

“evacuation syndromes,” 32–33

military psychiatry textbook, 5–6

overview of Army psychiatry in Vietnam, 11, 15, 26, 27, 30, 

32–33

War Psychiatry, 108

Just the Facts...Dealing With the Stress of Recovering Human Dead 

Bodies, 52

K

Kahumbu, Paula, Owen & Mzee, 558

Kang, H.K., reporting of mental health problems by OIF/OEF 

veterans, 329

Kanyer, Laurie A., 25 Things to Do: Activities to Help Children Suffering Loss or Change, 561

Kauffman, J., social support effect on the development of depression in traumatized foster children, 46

KBR, Operation Iraqi Freedom 05-07 and, 140, 142

KC-135 Stratotanker aircraft, aeromedical evacuations and, 195

KC-10A Extender aircraft, aeromedical evacuations and, 195

KCMHR. See King’s Centre for Military Health Research

Kelley, M.L., children’s responses to deployment, 494

Kennedy, Pres. John F., assassination of, 22, 23

Kennedy, Robert, assassination of, 23

Ketamine, pain management and, 344, 348

Kiley, Lt. Gen. Kevin, Baghdad ER HBO program and, 147

King, Rev. Martin Luther, assassination of, 23

King’s Centre for Military Health Research, description and 

research subjects, 663

Kirk, Donald, demoralization of troops fighting in Vietnam, 20, 26

Kirkland, Faris, War Psychiatry, 276–277

Kleiger, J.H., reintegration stress in families, 488

Kobasa, D.M., “mental toughness” models, 45

Koenen, K.C., PTSD among Vietnam War veterans, 298

Kolk, B.A., PTSD treatment modalities, 308

Korean War

Americans wounded in action, 13, 14

combat stress control teams and, 176

communication issues, 536

family notification of combat deaths, 544

fixed tours and, 18

helicopters used for aeromedical evacuations, 192–193

illegal drug use and, 32

indifference of the public toward returning soldiers, 277

psychiatric casualties, 11, 26

psychological casualties, 5

survival rates of those injured in, 226

Koren, D., posttraumatic stress disorder rates in injured Israeli 

war veterans, 233

Kosovo, Operation Joint Guardian and, 76

Kottler, J.A., Compassionate Therapy, 377

Kozak, M., fear-related memories and PTSD, 299

Krasney, Laurie, When Dinosaurs Die: A Guide to Understanding 

Death, 557

Krementz, Jill, How It Feels When a Parent Dies, 558–559

Kroen, William, Helping Children Cope With the Loss of a Loved One: 

A Guide for Grownups, 560

Kudler, Dr. Harold, Joint Conference on Postdeployment Mental 

Health and, 330

Kulka, R.A., Vietnam veterans with comorbid PTSD and alcohol 

abuse, 305

Kurds, Operation Provide Comfort and, 622

Kussman, Dr. Michael J., VA Seamless Transition Office and, 327

Kuwait

arrival of troops for Operation Iraqi Freedom One, 753–754

contingency aeromedical staging facility, 201

Saddam Hussein’s invasion of, 659

L

Lamberg, L., school enrollment issues, 488

Land Combat Study

Battlemind program and, 73

description, 77–78

posttraumatic stress disorder diagnosis and, 78

stigma and barriers to care and, 78

use in other research areas, 81

Landsman, I.S., bereavement reaction to traumatic injury, 246

Landstuhl Regional Medical Center

augmentees as staff, 214–215

case studies, 212–213, 216–217

catchment area, 210

challenges of providing psychiatric care to evacuees, 212–217

characteristics of psychiatric evacuees, 211–212

circumventing mental healthcare in theater (figure), 215

circumvention of evacuation channels and, 214

Combat and Operational Stress/Staff Resiliency program, 

219–222

comparison between Operation Iraqi Freedom/Operation 

Enduring Freedom evacuations and available clinicians at 

Landstuhl Outpatient Behavioral Health Clinic (figure), 215

compassion fatigue and, 219

dangerous patients, 212
Index

xlix

Deployed Warrior Medical Management Center, 211

emergency mental health model, 215–217

evacuation of patients to, 201

impact of Operation Iraqi Freedom and Operation Enduring 

Freedom on patient load: a typical day at Landstuhl. Comparison between 2001 and 2006 (table), 211

initial assessments, 210–211

inpatient psychiatry, 217–219

Joint Patient Movement Requirement Center coordination 

with the Global Patient Movement Requirements Center to 

establish CONUS destinations for patients, 202

Landstuhl Regional Medical Center inpatient admissions, 2002 

through July 2007 (figure), 218

Landstuhl Regional Medical Center inpatient admissions, 2003 

through July 2007 (figure), 218

Landstuhl Regional Medical Center psychiatric consultation to 

medical and surgical wards, September 1, 2006, to February 

1, 2007 (figure), 216

local area support area, 217

location of, 210

medical and surgical evacuees, 211

Medical Transient Detachment, 211

mission of, 210

nonactive duty patients and, 218

nursing personnel and, 217

Operation Enduring Freedom/Operation Iraqi Freedom 

evacuations by year (figure), 212

Operation Iraqi Freedom/Operation Enduring Freedom total 

evacuations compared to return to duty by year until February 2007 (figure), 214

outreach to wounded warriors, 215

patient actions and behaviors, 212–214

potential harm to self or others of psychiatric patients, 213

psychiatric patient load increase, 217–218

psychiatrist role in inpatient care, 217–218

psychological stressors for staff, 218–219

rear-echelon presentation of psychiatric patients, 214

resilience of staff and, 219

returning soldiers to combat duty stations for psychiatric care, 

214

rotating staff, 214–215

staff characteristics and actions, 210, 214–215

supervision of psychiatric patients, 212–213

top five Landstuhl Regional Medical Center outpatient psychiatry diagnoses for Operation Iraqi Freedom and Operation Enduring Freedom (figure), 212

wartime role, 210–212

Lange, C., guidelines for psychiatry residents on becoming a division psychiatrist, 92

Lao Tzu, Mercy model of population-based disaster relief and, 

634, 635

Lauder, T.D., eating disorders in military populations, 456

Learning from Resilient People: Lessons We Can Apply to Counseling 

and Psychotherapy (Glicken), 168

Lee, Marlene, The Hero in My Pocket, 558

Legal issues

Feres doctrine, 436, 437

medical decision-making by family members, 508

unit watch, 436–437

Leskin, Gregory, PhD, instruction of primary care providers at 

Schofield Barracks and, 568

Letterman, Dr. Jonathan, medical evacuation program and, 192

Letterman Army Medical Center, San Francisco, CA, behavioral 

health liaison project, 571

Librium, use of during the Vietnam War, 152

Lieberman, Alicia, Losing Parents to Death in the Early Years,

561–562

Life and Loss: A Guide to Help Grieving Children (Goldman), 560

Life disruptions

definition, 378

provider fatigue and, 378, 380

LIFELines organizations, help in dealing with issues facing children in military families, 500

Lifton, Robert Jay, atrocities during war, 148

Limited wars, description and reentry/reintegration responsibilities, 277

Lincoln, Pres. Abraham, Veterans Administration establishment, 

326

Linden, E., incidence of soldiers attacking their superiors (“fragging”), 26

LINN. See Living in the New Normal initiative

Lithium, safety of use during pregnancy, 709

Living in the New Normal initiative

description, 550, 554

Web site, 554

Living Works programs, suicide prevention and, 406

Llewellyn, Capt. D.M., support for Mercy model of populationbased disaster relief, 636–637

Lorazepam, insomnia treatment, 159–160

Los Angeles Suicide Prevention Center, description, 404

Losing Parents to Death in the Early Years (Lieberman), 561–562

LRMC. See Landstuhl Regional Medical Center

Lyons, Christine, How Do We Tell Children: Helping Children Understand and Cope When Someone Dies, 561

M

MACE. See Military Acute Concussion Evaluation

Maddi, S.R., “mental toughness” models, 45

Madigan Army Medical Center, Tacoma, WA, Army Family 

Readiness Course, 280

Magnetic resonance imaging, traumatic brain injury, 230

Major depressive disorder. See also Depression

effect on performance, 444–445

environmental stress and, 444

in-theater treatment, 158–159

posttraumatic stress disorder and, 298, 303

treatment, 444, 445

Major wars, description and reentry/reintegration responsibilities, 277

Malcolm Grow Air Force Hospital, National Capital Area Consortium and, 672

Malingering

challenge for forensic psychiatrists, 697

description, 697

diagnosis of compared with the criminal offense of, 698

dual agency and, 697–698

as a maladaptive response to stress, 697

posttraumatic stress disorder and, 694

reluctance to diagnose, 697

treatment of, 697–698

Man Against Himself (Menninger), 404

Mancini, J.A., adolescents’ responses to deployment, 494

Mann, J.J., suicide prevention research, 406

Marijuana

patterns of use, 477

Vietnam War and use of, 17, 20, 24, 152

Mark, M., anorexia nervosa treatment protocol, 459

Marrazzi, M.A., eating disorder treatment research, 460–461

Marriage therapy, family maltreatment and, 540

Marshall, Brig. Gen. (Ret.) S.L.A.

debriefing process, 175 

morale of troops fighting in Vietnam, 17

Marshall, Gen. George C., importance of religion to soldiers, 167

Marvingt, Marie, use of aircraft for medical evacuations and, 192

Mass casualties, effect on family members, 551
l

Combat and Operational Behavioral Health 

Mass panic

description, 595, 5997

mass anxiety compared with, 597

McBride, Lt. Col. Sharon, Battlemind program and, 73

McCue K., How to Help Children Through a Parent’s Serious Illness,

517

MCEC. See Military Child Education Coalition

McFall, M., smoking cessation intervention for PTSD, 305

McGurk, Maj. Dennis, Battlemind program and, 73

McHale, S., security and informational requirements in complex 

humanitarian emergencies, 623

McNulty, P.A., abnormal eating behaviors in military populations, 

456, 458

McVeigh, Timothy, Oklahoma City (OK) Murrah Federal Building 

bombing and, 594

MEDCAPS. See Medical civic action programs

MEDCOM. See Army Medical Command

Medevac program. See Aeromedical evacuations

Media

anthrax attacks and, 595, 598

Baghdad ER HBO program and, 147–148, 777–778

basics of interacting with, 776

epidemiological consultations and, 418

fallen service members and, 552

Haditha civilian deaths and, 148, 778

ideal body image portrayed in, 450

issues and concerns with behavioral health reporting on Iraq, 

776–778

Operation Iraqi Freedom 05-07 and, 6–7, 146–148, 776–779

pre- and post-deployment screening and, 96

protecting children from media exposure, 547

September 11, 2001, terrorist attacks and, 598

suicide rate increase and, 147

terrorism and chemical, biological, radiological, nuclear and 

explosive weapons and, 595, 596, 598

Medical civic action programs, Operation Iraqi Freedom 05-07 

and, 611, 613

Medical civil-military operations in Operation Iraqi Freedom 

05-07

assumptions made, 611–612

building projects focus, 611

compared with humanitarian missions in the 1990s, 611

cooperative medical engagements and, 613

eight tasks for, 612

G-5 role, 612–613

goals of, 613

historical background, 610–615

Iraqi healthcare officials’ involvement and, 613

Iraqi medical facilities takeover of the health “battlespace” 

and, 616

medical civic action programs, 611, 613

mission statement for, 612

Nine Principles of Reconstruction and Development (exhibit), 

613, 614–615

nongovernmental organizations and, 610, 616, 617

peacetime concepts and, 612

sewer, water, electricity, and trash projects, 616

Medical malpractice, lawsuits concerning, 436–437

Medical profiling

commanders and, 180–181

conditions that require a rating, 180

profile serial system, 180

Medical Record Consultation Sheet (Standard Form 513), 478

Medical review officers, role in substance abuse treatment, 

477–480

Memory String (Bunting), 558

Men. See also Gender factors; Women

age of onset for schizophrenia, 442

binge drinking definition, 475

drinking alcohol as a way to cope with stress, 260

eating as a way to cope with stress, 260

eating disorders and, 450, 455–456

heavy drinking amount, 475

light drinking amount, 475

moderate drinking amount, 475

periodontal disease prevalence (figure), 266

PTSD rates, 298

smoking as a way to cope with stress, 260

temporomandibular dysfunction and, 268

Menninger, Dr. William C.

failure to meet basic needs as a contributor to the incidence of 

psychiatric casualties in combat, 173

Psychiatry in a Troubled World, 33–34

Menninger, Karl, Man Against Himself, 404

Mental Health Advisory Team II Report, 101

Mental Health Advisory Team IV

Battlemind and, 73

findings in Operation Iraqi Freedom 05-07, 139

Haditha civilian deaths and, 148

mail system reliability and, 140–141

Mental Health Advisory Team V, Operation Iraqi Freedom suicide 

prevention and surveillance program, 409–412

Mental Health Advisory Teams

composition of, 185

key recommendations, 185

responsibilities, 185

Mental Health Casualty Tracker for OIF

information sources, 145

suicide rates, 147

Mental Illness Research, Education, and Clinic Centers, role of, 

333

Mercy model of population-based disaster relief

“assembly line” for choosing program content, 639, 644

case study, 637–638

description, 634–635, 643

“diplomatic pants” incident, 637–638

evaluation of, 644

final preparation, 639

focus on paraprofessionals and nonprofessionals, 643–644

future planning needs, 636

“Go West and Do Good Things” precept, 636–639, 643

initial assessments and collaboration, 637

initial decision points, 637

integrating USPHS teams, 638

“Leadership of the Open Hand” concept, 635–636

mission definition and, 636

nongovernmental organizations and, 634, 637

partnering with Indonesian colleagues and, 638–639

precepts of, 635, 643–644

program development and delivery, 638–639

PsySTART program and, 636, 640

public health leadership approach, 635

sensitivity of the behavioral health climate, 637

Sternberg’s “wisdom, intelligence, and creativity, synthesized” 

model and, 636

success of the program, 640

support for, 636–637

suspicion of U.S. personnel and efforts, 637, 639–640, 643

training programs, 639

western psychological/psychiatric interventions and, 637, 641

Messer, Dr. Steven, Battlemind program and, 72

Methylphenidate, Vietnam War and use of, 152

Meyer, Adolf, occupational therapy and, 358

MHATs. See Mental Health Advisory Teams

MHCTO. See Mental Health Casualty Tracker for OIF

Mild traumatic brain injury
Index

li

cognitive sequelae, 231–235, 253

comorbidity with other physical injuries, 505

educational interventions, 235

Galveston Orientation and Amnesia Test and, 231

hormonal issues, 710

in-theater management of, 233

initial management of concussion in a deployed setting (figure), 234–235

postconcussive disorder, 231–233

postconcussive symptoms, 230–231, 710–711

posttraumatic stress disorder and, 233, 307, 711

psychological therapies for, 235

rest and, 235

return-to-duty and, 235

Standardized Assessment of Concussion, 233

substance abuse and, 233

symptom treatment, 235

underreporting of, 230

variability in rate of recovery, 231

women and, 710–711

Military Acute Concussion Evaluation

form (exhibit), 236–237

mild traumatic brain injury and, 230, 233

Military Assistance Program, description of services, 500

Military care team, children and families of fallen service members and, 545–546

Military Child Education Coalition

Living in the New Normal initiative, 550, 554

recommended books for children coping with trauma, grief, 

and loss, 556–562

Military children and families

combat-injured service members and, 504–534

fallen military service members and, 544–562

family maltreatment and military deployment, 536–540

impact of deployment, 488–501

integrated behavioral health services at Schofield Barracks, 

564–575

Military funerals

children and families of fallen service members and, 549

dignified care for the dead and, 724

Military Homefront, description and Web site, 554

Military Life: The Psychology of Serving in Peace and Combat, 81

Military Medicine, articles on division mental health units, 92

Military OneSource

combat driving behavior modification brochures, 372

description and services, 331, 335, 336, 554

88th Regional Readiness Command COSC program and, 365

phone number, 501

resource for identifying community services for families, 551

services offered to Army Reserves and Army National Guard 

service members, 409, 554

Sesame Workshop Talk, Listen, Connect: Deployments, Homecomings, Changes DVD, 517

support for soldiers and their families, 500

Web site, 500, 501, 517, 554

Military Psychiatry: Preparing in Peace for War, 6

role of division psychiatrists, 92

Military Support for Stability, Security, Transition, and Reconstruction 

Operations (Department of Defense Directive 3000.05), 586

Military training

physical fitness component, 52, 450, 456, 457, 463, 704–705, 706

resilience and, 51–52

Military Widow: A Survival Guide (Steen and Asaro), 551, 560

Millikin, Col. Charles S., Battlemind program and, 72–73

Mimesulide, pain management and, 344

MIRECCs. See Mental Illness Research, Education, and Clinic 

Centers

Mirtazapine

insomnia treatment, 250

posttraumatic stress disorder treatment, 303

Missing in action soldiers, effect on family members, 551

Mississippi, Project Recovery and, 587

MNC-I. See Multi-National Corps-Iraq

MNF-I. See Multi-National Force-Iraq

Monoamine oxidase inhibitors

bulimia nervosa treatment, 461–462

posttraumatic stress disorder treatment, 303

Mood disorders. See also specific disorders

bulimia nervosa and, 453

complex humanitarian emergency survivors and, 627

fitness for duty and, 180

in-theater treatment of, 158–159

prevalence of the diagnosis during Operation Enduring Freedom and Operation Iraqi Freedom, 203

suicide and, 395, 426

traumatic injuries and, 251

Morphine

nonmedical use of, 477

pain management and, 344

Mortuary operations. See Operations involving death and the 

dead

Moskos, Charles, morale of troops fighting in Vietnam, 17

Mott, R., humanitarian assistance missions, 610, 611, 612, 613

Mozambique, kidnapping and induction of male adolescents, 626

MRI. See Magnetic resonance imaging

MROs. See Medical review officers

mTBI. See Mild traumatic brain injury

Multi-National Corps-Iraq

Focused Stabilization Task Force, 610

Humanitarian Assistance Working Group, 616

medical civil-military operations in Iraq and, 610–617

Operation Iraqi Freedom 05-07 and, 142, 143, 146, 147

Operation Iraqi Freedom theater suicide prevention, 410–412

Multi-National Force-Iraq, Operation Iraqi Freedom 05-07 and, 

139, 140, 144

Muriel, Anna C., Raising an Emotionally Healthy Child When a Parent Is Sick, 517, 560

Myers, Charles S., military psychologist role, 658

N

Naltrexone, bulimia nervosa treatment, 462

Narcotics. See Illegal drugs; specific drugs

National Association of State Directors of Veterans Affairs, program description, 334

National Athletic Trainers’ Association, traumatic brain injury 

definition, 227

National Capital Area Consortium

medical centers participating in, 672

Military Forensic Psychiatry Fellowship Program, 697

National Cemetery Administration, description of services, 326

National Center for Grieving Children and Families, 35 Ways to 

Help a Grieving Child, 561

National Center for Posttraumatic Stress Disorder

combat and operational stress first aid and, 116

instruction of primary care providers at Schofield Barracks, 

568

long-term tasks for behavioral health providers in complex 

humanitarian emergencies, 628

Response to Stressful Experiences Scale, 49

Web site, 501

National Center on Shaken Baby Syndrome, awareness campaign, 

539

National Child Traumatic Stress Network

description and services, 555

online guideline for help with children’s responses to trauma, 
lii

Combat and Operational Behavioral Health 

500

psychological first aid and, 116

Web site, 555

National Comorbidity Survey, PTSD findings, 298

National Comorbidity Survey Replication, prevalence of bulimia 

nervosa in men, 450

National Defense Authorization Act, 545

National Geographic Society, For Children of Valor: Arlington National Cemetery gift book, 554

National Guard. See U.S. Army National Guard

National Guard Bureau, partnership with the Department of 

Veterans Affairs, 328

National Institute of Mental Health, Behavioral and Social Health 

Outcomes Program and, 409

National Long Distance Relationship Building Institute, Dads at a 

Distance Web site, 501

National Mental Health Act, provisions, 671

National Military Family Association

description and services, 550, 555

Web site, 555

National Naval Medical Center, National Capital Area Consortium and, 672

National Practitioner Data Bank, adverse privileging information 

and, 437

National Survey on Drug Use, patterns of illegal drug use, 477

National Vietnam Veterans Readjustment Study

findings, 333, 495

posttraumatic stress disorder rates among veterans, 30, 298

purpose of, 495

Natsios, A.

local ownership, capacity building, and sustainability as the 

“iron triad” of successful reconstruction and development 

projects, 628

Nine Principles of Reconstruction and Development (exhibit), 

613, 614–615

NE. See Norepinephrine

Necrotizing ulcerative gingivitis, prevention and treatment, 268

Neel, Maj. Gen. Spurgeon, Army Medical Support in Vietnam, 16, 28

Nefazodone

in-theater treatment and, 159

posttraumatic stress disorder treatment, 303

Neidig, P.H., relationship between the length of deployment and 

spousal aggression, 537

NES. See Night-eating syndrome

Neugut, A.E., World War I and World War II noncombatant casualty rates, 625

Neuroleptics. See also specific drugs

use of during Operation Restore Hope, 153

Vietnam War use, 11–12, 34

Neuropeptide Y, resilience and, 46–47

Neuropsychiatry and Mental Health (Army Regulation 40-216), 90, 

91

Neuropsychiatry in World War II (Glass), 5, 91

New Parent Support Program, description of services, 539

New York University Child Study Center, Web site dedicated to 

advancing the field of child mental health, 500

Nichols, Terry, Oklahoma City (OK) Murrah Federal Building 

bombing and, 594

Niemela, O., relationship of alcohol use to trauma, 233

Night-eating syndrome, description and prevalence of, 452

Nightingale, L., guided imagery and, 368

Nixon, Pres. Richard, Vietnam War and, 21, 22

Nongovernmental organizations. See also specific organizations

behavioral health issues for detained individuals and, 646, 649

complex humanitarian emergencies and, 620, 622, 623

Indian Ocean tsunami and, 585, 587

medical civil-military operations in Operation Iraqi Freedom 

05-07 and, 610, 616, 617

Mercy model of population-based disaster relief and, 634, 637

neutrality of, 616, 620

World Bank definition of, 622

Nonsteroidal antiinflammatory drugs, pain management and, 

344, 347

Norepinephrine

eating disorders and, 452

resilience and, 47

North, C.S., elevated rates of posttraumatic stress disorder following the Oklahoma City bombing, 580

North Carolina, Governor’s Focus on Returning Combat Veterans 

and Their Families, 335

Nortriptyline, posttraumatic stress disorder treatment, 303

Norwood, A.E., disaster psychiatry research, 581

Notification of service member’s injury

communicating with children about, 506–507

effect of adults’ reactions on children, 506–507

family separations and, 507–508

process of, 505–506

travel to military medical facilities and, 507

vignettes, 507–508

withholding information from children, 507

NPDB. See National Practitioner Data Bank

NPSP. See New Parent Support Program

NPY. See Neuropeptide Y

Nuclear weapons. See Chemical, biological, radiological, nuclear 

and explosive weapons

NVVRS. See National Vietnam Veterans Readjustment Study

O

Obesity

binge eating disorder and, 452

body mass index and, 452

night-eating syndrome and, 452

prevalence of, 452

social and cultural factors, 453

Obsessive-compulsive disorder

in-theater treatment, 159

posttraumatic stress disorder and, 305

Occupational therapy

combat and operational stress control and, 360, 361–363

combat driving behavior modification and, 372

current services, 359–363

description, 358, 374

educational component, 359, 362

88th Regional Readiness Command COSC program for soldiers and their families, 363–366

functional approach of, 373

historical background, 358–359, 373

on the home front, 372

job task analysis and, 359

mission of, 360

observation component, 362

occupational therapy assistant role, 361

Operation Iraqi Freedom detainee healthcare and, 366–368

peak performance training and, 360–361, 368–369

recreational programs and, 359

service-dog training and, 361

specialty areas, 360

stressor identification and, 362

therapeutic riding programs and, 361

training and licensure of practitioners, 361, 371

unit needs assessment and, 362–363

U.S. Army occupational therapy scope of practice (exhibit), 

360

warrior transition units and, 361, 363, 369–372

work reintegration programs, 361, 369–372
Index

liii

Wounded Warrior Clothing Support Program and, 361

Office of The Surgeon General. See also Consultant to The Surgeon 

General, U.S. Army

Army Suicide Prevention Program and, 405, 406–407

Division of Physical Reconstruction, 358

EPICON responsibilities, 415

occupational therapy and, 358

survey instrument assessing the mental health effects of employees after the September 11, 2001, terrorist attacks, 77

OIH. See Opioid-induced hyperalgesia

Oklahoma City (OK) Murrah Federal Building bombing

description, 594

posttraumatic stress disorder following, 580, 602

Olanzepine

anorexia nervosa treatment, 460

bipolar disorder treatment, 158

psychotic disorder treatment, 159

Olson, Maj. Gen. Eric, integrated behavioral health services at 

Schofield Barracks, HI and, 565–566

OMUS. See Outbreaks of multiple unexplained symptoms

Ondansetron, bulimia nervosa treatment, 462

ONE. See Operation Noble Eagle

Operation Banner, United Kingdom armed forces behavioral 

health and, 658

Operation Enduring Freedom

aeromedical evacuations and, 192, 203–204, 244

case studies, 773–774

casualty rates, 203, 244

the characteristics of major wars, limited wars, and rapid 

deployment operations overlap in Operation Iraqi Freedom 

and Operation Enduring Freedom (figure), 277

clinical operations, 771

common mental health presentations, 771

communication issues, 772

consultation with command, 771, 772

continuum of care for veterans of, 326–336

data collection, 772

divorce rate for soldiers, 277

documentation of medical information, 772

eating disorders and, 462–463

education plan, 771

logistical issues, 772

mental health operations in Afghanistan, 771–772

mental health operations in deployment, 769–771

most common health problems of veterans, 329

operational psychiatry in, 768–774

outreach efforts, 769–770

peak performance training and, 368

Pincus’s emotional cycle of deployment and, 488

Post-Deployment Health Assessment and, 79, 203, 327, 

331–332

posttraumatic stress disorder and, 564

predeployment planning, 769

prevalence of mental health problems, 122, 203

prevention of mental health issues, 770–771

principles of forward treatment of casualties and, 6

returning home after combat and, 276

survival rates of those injured in, 226, 244

traumatic brain injury and, 710

traumatic event management and, 770, 771

travel through the area of operations, 772

treatment at Landstuhl Regional Medical Center, 210, 211

Walter Reed Army Institute of Research and, 76–82

Web site, 501

Operation Granby, United Kingdom armed forces behavioral 

health and, 659

Operation Iraqi Freedom

aeromedical evacuations and, 192, 203–204, 244

casualty rates, 203, 244

the characteristics of major wars, limited wars, and rapid 

deployment operations overlap in Operation Iraqi Freedom 

and Operation Enduring Freedom (figure), 277

continuum of care for veterans of, 326–336

detainee healthcare and, 366–368

divorce rate for soldiers, 277

eating disorders and, 462–463

media coverage and, 6–7, 776–779

most common health problems of veterans, 329

occupational therapy in support of detainees and, 366–368

peak performance training and, 368

Pincus’s emotional cycle of deployment and, 488

Post-Deployment Health Assessment and, 79, 203, 327, 

331–332

posttraumatic stress disorder and, 299, 564

prevalence of mental health problems, 122, 203

principles of forward treatment of casualties and, 6

released psychiatric inpatients and, 646

returning home after combat and, 276

review of psychiatric service use during, 153

suicide assessment, 409–412

survival rates of those injured in, 226, 244

traumatic brain injury and, 710

treatment at Landstuhl Regional Medical Center, 210, 211

Walter Reed Army Institute of Research and, 76–82

Web site, 501

Operation Iraqi Freedom 05-07

Baghdad ER special on HBO and, 147–148, 777–778

BICEPS principles and, 148

casualty statistics and, 144–145

changing dynamics of the conflict, 138–146

civilian deaths in Haditha reports, 148, 778

clinical environments for mental health services, 139

Combat/Operational Stress Control Workload Activity Reporting System and, 139, 144

command and control of echelon-above-division stress control 

personnel improvements, 142–143

communications improvements, 140

Composite Health Care System-Interactive Training Tool, 140

convoy procedure standardization, 138

documentation of COSR cases, 144

DoD policy changes, 141–142

enemy sophistication and, 138

formulary for medications, 139

forward operating base developments and, 138–141

increase in psychiatric patients, 139

increased mental health services, 140–141

KBR employees and, 140, 142

living and working condition improvements, 138–140

mail system reliability and, 140–141

media and, 6–7, 146–148, 776–779

medical civil-military operations, 610–617

Mental Health Advisory Team IV and, 139, 148

Mental Health Casualty Tracker for OIF, 145, 147

Multi-National Corps-Iraq and, 142, 143, 146, 147

Multi-National Force-Iraq and, 139, 140, 144

multiple deployments and, 141

Operational Stress Control and Readiness teams and, 142

peer review of mental health charts and, 146

planning improvements, 142–143

psychotropic medication prescribing guidelines, 145

psychotropic prescription data challenges, 139–140

quality of care and, 145–146

sexual assault and, 141

situational awareness improvement, 142

staff assistance visits, 145–146

standardization of practices and, 143–145
liv

Combat and Operational Behavioral Health 

suicide rate and, 145, 147, 777

Operation Iraqi Freedom One

arrival in Kuwait, 753–754

behavioral health service provision during, 752–766

case studies, 758–759, 760, 763

combat stress control units and, 759–762

combat support hospitals and, 754–759

division mental health sections, 762–765

echelons in treatment in the combat theater, 752–753

Operation Joint Endeavor

integrated use of combat stress detachments and division 

mental health assets during, 153

psychological health of soldiers and, 76, 79

Operation Joint Guardian, psychological health of soldiers and, 76

Operation Just Cause, psychological health of soldiers and, 76

Operation Noble Eagle

Pincus’s emotional cycle of deployment and, 488

Web site, 501

Operation Provide Comfort, description, 622

Operation Provide Promise, psychological health of soldiers and, 

76

Operation Restore Hope

psychological health of soldiers and, 76

use of psychotropic medications during, 153

Operation Solace, description, 77, 679–680

Operation Special Delivery, services for pregnant women, 500–501

Operation Unified Assistance

division into three groups, 585

Mercy model of population-based disaster relief and, 634–644

providing care in situ and, 585

telecommunications and, 586

USNS Mercy and, 585–586

Operation Uphold Democracy, psychological health of soldiers 

and, 76

Operational behavioral health

behavioral health issues for detained individuals, 646–656

complex humanitarian emergencies, 620–629

disaster psychiatry, 580–588

medical civil-military operations in Operation Iraqi Freedom 

05-07, 610–617

Mercy model of population-based disaster relief, 634–644

terrorism and chemical, biological, radiological, nuclear, and 

explosive weapons, 594–603

United Kingdom armed forces and, 658–664

Operational Navy Instruction 5350.4C, drug testing and, 481

Operational Stress Control and Readiness program

capabilities, 127–128

historical background, 126–127

Operation Iraqi Freedom 05-07 and, 142

staffing issues, 127

team design, 128

U.S. Marine Corps and, 102, 116, 126–128

U.S. Navy and, 126–128

Operational stress injuries

elements of, 109

“injury” definition, 109

working group on, 109–110

Operations Desert Shield/Storm

aeromedical evacuations and, 193

reintegration stress in families and, 488

Operations involving death and the dead

Army Quartermaster Corps and, 718–719

assisting soldiers with exposure to mass death, 722–724

emotional involvement and, 720–721

“exposure to death” definition, 718

“exposure to the dead” definition, 718

guidelines for assisting soldiers and commanders in caring for 

the dead (exhibit), 722

how do mortuary affairs soldiers say they deal with stress 

(exhibit), 722

level of exposure relationship to level of distress, 721

logistical support for workers, 724

military care-of-the-dead policy and training, 718–719

organizational support for workers, 723–724

personal effects of the deceased and, 720–721

personal safety issues, 720

personal support for workers, 723

physical characteristics of remains and, 719–720

psychological effects of caring for remains, 721

reasons why mental health personnel should be familiar with 

the topic, 718

reinforce the positive (exhibit), 723

role of the mental healthcare provider in mass death situations, 721–724

signs of stress, 721–722

signs of stress in mortuary operations and coping with the 

work (exhibit), 722

social effects of proper care of the dead, 724

stresses of exposure to remains, 719–721

terminology, 718

types of remains causing the most distress, 720

Opiates. See also specific drugs

nonmedical use of, 477

opioid-induced hyperalgesia and, 344

pain management and, 340, 344, 347

Opioid-induced hyperalgesia, description and effects of, 344

Oral contraceptives

periodontitis and, 267–268

temporomandibular dysfunction and, 268–269

Oral health effects of combat stress

beverages and, 260, 262, 265

a case of gingivitis (figure), 266

causes of oral disease, 260

dehydration and, 261

dental caries, 261

dental emergency rates in combat, 260

dental erosion, 262

dental hard-tissue diseases and, 261–265

Department of Defense Survey of Health-Related Behaviors 

Among Active-Duty Military Personnel findings, 260

Department of Defense Survey of Health-Related Behaviors in 

the Reserve Component findings, 260

dietary changes during deployment and, 261

duty performance and, 260

eating disorders and, 263–264

eating habits and, 260, 265

erosion of enamel and exposure of the dentin layer in a patient 

with GERD (figure), 262

erosion of the facial enamel and exposure of the underlying 

dentin (figure), 264

erosion of the lingual, occlusal, and incisal surfaces of the 

maxillary teeth in a patient with bulimia (figure), 263

extensive accumulation of bacterial plaque after cessation of 

oral hygiene (figure), 261

fluoride and, 261, 264

foods and, 260, 265

gastroesophageal reflux disease and, 262

generalized demineralization and loss of enamel on the facial 

surfaces of teeth (figure), 262

gingival edema, erythema, and cratering of the interdental 

papilla and purulent exudate are visible in this patient with 

acute necrotizing ulcerative gingivitis (figure), 268

gingival erythema edema, and recession...in patient with periodontal disease (figure), 266

gingivitis, 265–266

health literacy and, 260
Index

lv

necrotizing ulcerative gingivitis, 268

occlusal wear and dentin exposure due to erosion in a patient 

with bulimia (figure), 263

oral disease prevalence as nonbattle injuries, 260

oral hygiene effects, 260–261, 264

periodontal disease, 265–268

periodontitis, 266–268

plaque accumulation, tobacco staining, gingival inflammation, 

and generalized caries resulting from a combination of inadequate oral hygiene, tobacco use, and refined carbohydrate 

intake (figure), 260

prevalence of periodontal disease (figure), 266

prevention strategies, 260, 264–265

refined carbohydrates as a cause of oral disease, 260

temporomandibular dysfunction, 268–269

tobacco use and, 260

translucency of the maxillary central incisors due to erosion in 

a patient with bulimia (figure), 263

treatment, 265

undernutrition and, 261

xerostomia, 265

xylitol gum or mints and, 264–265

Orlistat, obesity treatment, 462

Orman, Col. David, Soldier Assistance Center and, 568

OSCAR. See Operational Stress Control and Readiness program

Oslo Guidelines. See Guidelines on the Use of Military and Civil 

Defence Assets in Disaster Relief

Osteoporosis, anorexia nervosa and, 454

OT. See Occupational therapy

O’Toole, Donna

Facing Change: Falling Apart and Coming Together Again in the 

Teen Years, 560

Helping Children Grieve & Grow--A Guide for Those Who Care, 561

OTSG. See Office of The Surgeon General

OUA. See Operation Unified Assistance

Out of the Darkened Room: When a Parent is Depressed (Beardslee), 

517

Outbreaks of multiple unexplained symptoms

chemical, biological, radiological, nuclear and explosive weapons and, 594, 597–599, 600–601

Overweight. See Obesity

Owen & Mzee (Hatkoff, Hatkoff, and Kahumbu), 558

Oxycodone, drug tests and, 477

P

Pain management

acute pain and, 340

adverse effects of pain, 345

amputations of limbs and, 349

anatomic locations and, 340, 341

behavioral measurements, 346–347

benzodiazepines and, 340

biology of pain, 343–344, 350

burn casualties and, 340, 343–344, 345, 349

case studies, 341–342

children and, 340, 346–347, 349

chronic pain and, 340

endogenous opioid pathways and, 344

ethical issues, 349–350

ethnic and social factors, 346

gene therapy, 346

genetic factors, 345–346

hyperalgesia and, 343

inflammation and, 343–344

Joint Commission focus, 340

multidisciplinary teams for, 340, 350

multiple traumas and, 349

nerve blocks and, 340

nociceptors and, 343

nonopiate pain adjuncts, 343

opiates and, 340, 344

opioid system and, 343

overview of methods, 347

pain assessment methods, 346–347

pain definition, 341

pharmacological management of acute pain, 347–348

physiological dependence and, 347

posttraumatic stress disorder and, 340, 350

principles of, 344

prior alcohol or substance addiction, 349

prolonged grief disorder and, 348

psychiatric risk factors for pain complications, 349

psychological effects of pain, 345

psychological management, 340, 348

psychophysiological indices, 346

relief of pain as a primary task of medical personnel, 340

research needs, 340

self-report measures, 346

somatic sensory and association cortex and, 343

special problems, 349

spinthalamic tract and, 343

uncontrolled pain as a stressor, 246, 340

ventilated patients, 349

weaning regimen, 347, 349

PAM 40-11: Preventive Medicine, 415

PAM 600-24: Suicide Prevention and Psychological Autopsy, 405, 406

PAM 600-70: Guide to the Prevention of Suicide and Self-Destructive 

Behavior, 405

Panama, Operation Just Cause and, 76

Panic disorder

in-theater treatment, 159

posttraumatic stress disorder and, 303, 305

treatment, 253, 303, 710

women and, 709–710

Parent Guidance Assessment--Combat Injury, 513, 521–532

A Parent’s Guide to Building Resilience in Children and Teens: Giving 

Your Child Roots and Wings (Ginsburg), 561

Pargament, K.I., The Psychology of Religion and Coping, 168

Paris, J., suicide research, 395

Paroxetine

depressive disorder treatment, 158

posttraumatic stress disorder treatment, 303

safety of use during pregnancy, 709

Parrish, Col. Matthew, overview of U.S. Army mental health 

activities in Vietnam, 16, 20

Parsons, T., disease as a biomedical process, 330

Part of Me Died, Too: Stories of Creative Survival Among Bereaved 

Children and Teenagers (Fry), 559

Pathological gambling, posttraumatic stress disorder and, 305

Patient privacy. See Privacy and confidentiality issues

Pavlov, Ivan Petrovich, psychiatric conceptualization of trauma 

and response, 581–582

PCLS. See Psychiatry Consultation Liaison Service

PCOS. See Postcombat and operational stress

PDHA. See Post-Deployment Health Assessment

PDHRA. See Post-Deployment Health Reassessment

PE. See Prolonged exposure

Peak performance training

biofeedback and, 369

case study, 369

concept of, 368

core elements, 368

group intervention and, 368

individual training and, 368

mental imagery and, 368
lvi

Combat and Operational Behavioral Health 

occupational therapy and, 360–361, 368–369

stress and energy management model, 369

Warrior Training and Rehabilitation Program and, 369, 370

Pechacek, Mary Ann, EAT model and, 385

Pecko, Col. Joseph

Battlemind program and, 73

role of leadership in provider fatigue resolution, 387

Peebles-Kleiger, M.J., reintegration stress in families, 488

Pellegrino, Marjorie, I Don’t Have an Uncle Phil Anymore, 557

Pennsylvania, Three Mile Island nuclear accident and, 599, 601

Periodontitis

bone loss and, 266–267

classification of, 266

description, 266

model of periodontitis depicting the multifactorial nature of 

periodontal disease (figure), 267

oral contraceptives and, 267–268

risk factors, 266

untreated gingivitis and, 266

Persian Gulf War. See also Operations Desert Shield/Storm

Gulf War syndrome and, 600

symptoms of Israeli civilians near Scud missile attacks, 580, 

596, 598

use of psychotropic medications during, 153

younger wives’ ability to cope with the absence of their husbands and, 536

Personal fitness assessments

body fat measurement and, 704

eating disorders and, 450, 456, 457, 463, 704

weight control programs and, 704

women and, 704–705, 706

Personality disorders. See also specific disorders

fitness for duty and, 180

homicidal ideation and, 437

prevalence of the diagnosis during Operation Enduring Freedom and Operation Iraqi Freedom, 203

Peterson, A.L., bulemic weight-loss behaviors in the Air Force, 458

PFAs. See Personal fitness assessments

PGA-CI. See Parent Guidance Assessment--Combat Injury instrument

Phantom limb pain, treatment for, 246

PHC(P). See Public Health Command (Provisional)

Phentermine, obesity treatment, 462

Philipson, Sandra J., Annie Loses Her Leg But Finds Her Way, 558

Phobias. See also Social phobia

posttraumatic stress disorder and, 305

PIES principles. See Proximity, immediacy, expectancy, and simplicity

Pincus, Simon

emotional cycle of deployment concept, 488, 572

integrated use of combat stress detachments and division 

mental health assets during Operation Joint Endeavor, 153

Pivar, I.L., bereavement and posttraumatic stress disorder, 306

Plague outbreaks, effects on behavior, 598

PMDD. See Premenstrual dysphoric disorder

PMP. See Preventive Medical Psychiatry

Poker Chip Tool, pain assessment in children, 347

Pokorny, A.D., suicide research, 395

Policy Guidance for Deployment-Limiting Psychiatric Conditions and 

Medications, 156

Post-Deployment Health Assessment

description, 77, 174, 327

Operation Iraqi Freedom and Operation Enduring Freedom 

and, 79, 203

population-wide assessment, 79

sample form (exhibit), 288–290

timing of the screening process, 79

validation of, 79

Post-Deployment Health Reassessment

DD Form 2900 and, 331

description, 331

development of, 331

goal of, 331–332

local events, 335–336

timing of, 79, 174

validation of, 79

Postcombat and operational stress

combat and operational stress and, 62

combat and operational stress behavior and, 62–63, 64

length of effects, 62–63

posttraumatic stress disorder and, 64

Postconcussive disorder

research criteria for postconcussive disorder (exhibit), 232

scope of, 232–233

symptoms, 231–232

women and, 710–711

Postpartum depression, description and treatment, 709

Postpartum psychosis, description and risks, 709

Posttraumatic growth

combat and operational stress and, 62, 64

combat and operational stress behavior and, 64

description, 64

Posttraumatic stress disorder

active engagement and alliance building and, 300–301

anger and violence and, 306

assessment and monitoring of treatment effectiveness and, 301

barriers to seeking help, 300

basic dimensions of, 298

challenging negative thoughts and, 302

children and, 345

children of combat veterans with, 496

chronic, 299, 309–310

cognitive processing therapy, 302, 308, 309, 311

cognitive theory of, 299–300

cognitive therapy, 302, 304

combat and operational stress behavior and, 64

combat and operational stress continuum model red zone and, 

112

combat-related physical injuries and, 204, 245

comorbid mental health disorders, 298, 304–307, 312, 445

complex humanitarian emergency survivors and, 627, 628

complicated or traumatic bereavement, 306

coping skills training and, 301–302

“copycat” scenario, 742–743

dangerous firearm-related behaviors and, 306

delayed-onset PTSD, 298

Department of Defense and VA Clinical Practice Guidelines for 

Management of Post-Traumatic Stress, 116, 300–301, 311, 326

deployment-related stress and, 60, 298–312, 495

Deployment Risk and Resilience Inventory and, 301

description, 298

Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition and, 30, 33

divorce and, 307

domestic violence and, 306

dual representation theory, 299

early detection and treatment, 126

eating disorders and, 464

emotional processing theory, 299

ethical issues, 742–743

event characteristics that increase the risk for, 298

expert witnesses and, 696

eye movement desensitization and reprocessing and, 302, 304, 

308, 309

families and, 307, 312

functional impairment and, 298, 307–308
Index

lvii

future research needs, 310

genetic factors, 46

imagery rehearsal therapy, 309

imaginal exposure and, 308–309

improvement of services for, 311

in-theater treatment, 159

International Classification of Disease, 9th Edition, Clinical Modification and, 30, 77

Land Combat Study and, 78

late-onset stress symptomatology and, 306–307

level of exposure to combat and, 108

level of traumatic injury and, 249

malingering and, 694

mild traumatic brain injury and, 233

multiple deployments and, 300

Oklahoma City (OK) Murrah Federal Building bombing and, 

580, 602

Operation Enduring Freedom and Operation Iraqi Freedom 

and, 6, 212, 329

outreach interventions, 300–301

pain management and, 340, 345, 350

patient education and, 301

patterns of, 298

percentage of soldiers returning from combat in Iraq and 

Afghanistan with, 78

pharmacotherapy, 303–304

physical health problems and, 306–307

postcombat and operational stress and, 64

program evaluation, 310

prolonged exposure treatment, 302, 308, 309, 311

psychological theories of PTSD and treatment, 299–300

quality of life issues, 304–305

relapse prevention, 304

research with veterans and active duty military personnel, 

308–310

Response to Stressful Experiences Scale, 49

risk factors for developing, 298

sarin attacks on the Tokyo subway system and, 602

screening programs and, 300

sexual trauma and, 298

social connections and, 307

social support and, 46, 53

stigma and, 300, 303, 329

stress inoculation training and, 302, 308

stress reactions and, 47

subthreshold presentations, 298

symptoms, 298, 345, 445

trauma and, 44–45, 48

traumatic brain injury and, 108, 307, 711

traumatic grief and, 550

treatment, 253, 299, 300–304

treatment delivery and accessibility, 311

treatment outcome research, 308–310

uncontrolled pain and, 246

United Kingdom legal case concerning, 661–662

veterans versus civilians with, 310

vicarious victimization and, 377

Vietnam War and, 29–30, 33

workplace and work performance issues, 308

Potentially traumatic events, combat and operational stress 

behavior and, 62

Powell, Sandy, Geranium Morning, 557

Prazosin

anxiety disorder treatment, 159

insomnia treatment, 160, 250

posttraumatic stress disorder treatment, 304, 309

Pre-Deployment Health Assessment, sample form (exhibit), 

286–287

Pregnancy

administrative separation and, 706

bipolar disorder and, 709

deployment and, 706

FDA guidance on safety of medications during, 708–709

maternity leave and, 706

physical fitness requirements and, 706

physical training and, 706–707

postpartum depression and, 709

resentment of the pregnant soldier by the other soldiers in the 

unit, 706

schizophrenia and, 707

schizophrenia treatment and, 707

6-month bonding period and, 706–707

U.S. Food and Drug Administration categories and labeling 

requirements for drug use during pregnancy (exhibit), 708

Premenstrual dysphoric disorder

description, 707–708

emotional symptoms, 708

physical symptoms, 708

treatment, 708

Preparing for deployment

resilience models, 45–53

stress models, 44, 53

trauma models, 44–45, 53

Preschool-age children

effects of deployment on, 494

response to a combat-injured parent, 514

Prescription drugs. See also specific drugs

abuse of, 477

President’s New Freedom Commission on Mental Health, principles of, 330

Preventive Medical Psychiatry

families and, 254–255

follow-up care, 254

goals of, 256

hospitalized combat-injured service members and families 

and, 509–510

Psychiatry Consultation Liaison Service changed to, 246

Therapeutic Intervention for the Prevention of Psychiatric 

Stress model, 247–256

traumatic brain injury and, 253

Preventive Medicine (Army Regulation 40-5), 415

Preventive Medicine (PAM 40-11), 415

Preventive psychiatric consultation

postdeployment psychological screening and, 174

primary prevention, 174

secondary prevention, 174–175

tertiary prevention, 175

Primary traumatic stress, definition, 377

Principi, Anthony, VA Seamless Transition Office and, 327

“Principles of Caring for Combat-Injured Families and Their 

Children,” 517, 533–534

Prisoners of war. See Detainees

Privacy and confidentiality issues

chaplains and, 165–166

Combat and Operational Stress/Staff Resiliency program and, 

220

Composite Health Care System-Interactive Training Tool and, 

140

detained individuals and, 653, 654

hunger strikes and, 654

military rule of evidence and, 166

psychiatric consultation to command and, 183

sanity boards and, 695

Pro-QOL. See Professional Quality of Life Scale

Professional Quality of Life Scale

data analysis, 383–384
lviii

Combat and Operational Behavioral Health 

description, 376, 382

Medical Command observed compassion fatigue cut score 

frequencies compared to expected frequencies based on 

ProQOL data (table), 384

percentage of Medical Command personnel who meet compassion fatigue cut score (table), 383

percentage of ProQOL respondents with compassion fatigue 

compared to U.S. Army Medical Command personnel with 

compassion fatigue (figure), 384

percentage of U.S. Army Medical Command personnel, by 

specialty, who completed the ProQOL survey in 2008 (figure), 383

Trauma/Compassion Fatigue Scale items, 382–383

Project HOPE

Hurricane Katrina response and, 587

Indian Ocean tsunami rescue efforts and, 585

Project Liberty, description, 582

Prolonged exposure

definition, 378

posttraumatic stress disorder treatment, 302, 308, 309, 311

provider fatigue and, 378, 379

Prolonged grief disorder, description and symptoms, 348

Propofol, pain management and, 348

Propranolol, posttraumatic stress disorder treatment and, 304

“Protecting the Force,” 749

Provider fatigue

behavior changes after exposure to trauma, 381–382

behavioral markers for, 381

cognitive markers for, 381

combatting, 385–387

compassion stress and, 378, 379

“cost of caring” and, 376

description, 376–377

detachment and, 378, 379

EAT model and, 385

elements of, 377–378

emotional markers for, 381

emotional renewal and, 386

empathic ability and, 378, 379

empathic concern and, 379

empathic response and, 378, 379

empathy and, 378

exposure to the client and, 379

factors contributing to, 378–380

Figley’s model, 377–378, 385, 387–388

focus on the provider is essential to combating (figure), 385

holistic approach to renewal, 386–387

identification of, 381–384

leadership and, 387

life disruption and, 378, 380

markers for, 381

mental renewal and, 386

military-specific operational stress elements, 380

personal history of trauma and, 378

physical renewal and, 386

posttraumatic stress disorder and, 377

Professional Quality of Life Scale and, 376, 382–384

prolonged exposure and, 378, 379

Provider Resiliency Training and, 376

secondary trauma concept and, 376

sense of achievement and, 378, 379

social markers for, 381

social renewal and, 387

somatic markers for, 381

spiritual markers for, 381

spiritual renewal and, 386–387

synergistic effects of, 380

synergistic effects of primary, secondary, and operational 

stress, combined with burnout symptoms, on providers 

(figure), 380

terms and definitions, 376–377

traumatic recollections and, 378, 379–380

Provider Resiliency Training

focus of, 376

maintenance phase, 376

phases of, 376

Professional Quality of Life Scale and, 376, 382–384

self-care plans and, 376

Proximity, immediacy, expectancy, and simplicity

description, 5, 6, 108

unit watch and, 424

PRT. See Provider Resiliency Training

Psychiatric consultation to command

assignments and, 184

case studies, 177, 178

command-directed evaluations, 182

confidentiality issues, 183

consultant to The Surgeon General, U.S. Army, 184–185

consultative team formation, 176–177

cross-service consultations, 178

deployed versus garrison environment, 174

deployment clearance, 181

development of relationships with commanders, 183

discretionary command-directed referrals, 182

disqualifying conditions, 180

division mental health versus combat stress detachment 

resources, 175–176

division psychiatrist/brigade behavioral health officer role 

and responsibilities, 185

double agency and, 182–183

establishing rapport with the unit, 177

ethical issues, 182–184

explaining the purpose of the consultation, 177–178

factors associated with, 174–176

fitness for duty, 180–182

formulating the consultation question, 177

getting soldiers to “buy in” to the process, 179

impact of HIPAA, 183–184

investigation versus consultation, 183

level of professional degree and, 182

local versus remote behavioral health resource, 176

medical profiling, 180–181

Mental Health Advisory Team membership, 185

mental health records review, 185

nondiscretionary command-directed referrals, 182

objectivity and, 183

origin and history of, 172–173

performing the consultation, 176–180

positions and descriptions of responsibilities, 184–185

preventive consultation level, 174

preventive psychiatry, 173

primary prevention, 174

realistic interventions and, 179

recruiting and retaining medical personnel and, 185

risks to the consultant, 182–184

screening for vulnerability and determining fitness for duty, 

172–173

secondary prevention, 174–175

separation from the military, 181–182

short versus long consultations, 183

tasking for deployment, 184–185

terminating the consultation, 179

terminology and language and, 178

tertiary prevention, 175

uniforms and, 178

unit structures and functions and, 178
Index

lix

written report of the consultation, 179–180

Psychiatry Consultation Liaison Service

description, 244

goal of, 244

goals of PCLS for disaster injured (exhibit), 584

name change to Preventive Medical Psychiatry, 246

PCLS lessons learned in the response to the September 11, 

2001, attacks (exhibit), 585

Preventive Medical Psychiatry service, 509–510

role following the September 11, 2001, attacks on the Pentagon, 244

September 11, 2001, terrorist attacks and, 583, 584

Psychiatry in a Troubled World (Menninger), 33–34

Psychodynamic therapy

psychiatry residency programs and competency in, 677

traumatic injury patients and, 252

Psychoeducation, traumatic injury patients and, 252

Psychological autopsies

cases requiring, 698–699

privacy issues, 698

suicide and, 404, 698–699

Psychological simple triage and rapid treatment program, description, 636

Psychologists. See Division psychiatrists and brigade behavioral 

health officers

The Psychology of Religion and Coping (Pargament), 168

Psychotic disorders. See also specific disorders

cultural factors in the presentation of, 647

early intervention and, 443

fitness for duty and, 180

in-theater treatment, 159

postpartum psychosis, 709

presentation of in the military setting compared with the civilian setting, 443

suicide and, 426

Psychotropic medications. See also specific medications

anxiety disorder in-theater treatment, 159

case studies, 156–157

clearance for deployment and, 156–157

data challenges during Operation Iraqi Freedom 05-07, 

139–140

dispensing in theater, 157–158

doctrine and policy for the use of, 154–156

DoD’s Policy Guidance for Deployment-Limiting Psychiatric Conditions and Medications and, 156

ethical issues, 160

example psychiatric formulary for deployment (table), 155

extrapyramidal side effects, 443

FDA guidance on safety of use during pregnancy, 708–709

history of use of, 152–154

hoarding of, 652

insomnia in-theater treatment, 159–160

key points in the November 2006 Policy Guidance for Deployment-Limiting Psychiatric Conditions and Medications (exhibit), 

156

management and distribution of to detained individuals, 652

mood disorder in-theater treatment, 158–159

oversight and monitoring of, 94, 96

pharmacologic treatment of mental health conditions during 

deployment, 158–160

posttraumatic stress disorder treatment, 303–304

predeployment actions, 156–157

prescribing guidelines, 145

psychopharmacologic planning for deployment, 157

psychotic disorder in-theater treatment, 159

schizophrenia treatment, 443

security issues, 157–158

storage issues, 157–158

trauma patients and, 249

waivers for, 157

“Zoloft with a Rifle” article and, 147

PsySTART program. See Psychological simple triage and rapid 

treatment program

PTG. See Posttraumatic growth

PTSD. See Posttraumatic stress disorder

Public Health Command (Provisional). See also U.S. Army Center 

for Health Promotion and Preventive Medicine

Behavioral and Social Health Outcomes Program, 409

88th Regional Readiness Command COSC program and, 365

EPICON responsibilities, 415

EPICON surveys and, 417

renaming of U.S. Army Center for Health Promotion and 

Preventive Medicine as, 406

Public health model for deployment mental health. See also U.S. 

Public Health Service

allies in, 331

chaplains and, 331

origin of, 330

President’s New Freedom Commission on Mental Health 

principles and, 330

problems in living for veterans and families, 330

“recovery” and, 330

“resilience” and, 330

stigma issues and, 331

traditional medical model and, 330–331

veterans’ families and, 331

Q

QPR Institute. See Question, Persuade, Refer Institute

Quantity Frequency Questionnaire, alcohol use and abuse and, 

475

Question, Persuade, Refer Institute, description, 406

Quetiapine, bipolar disorder treatment, 158

R

Racial/ethnic factors

pain management, 346

spouse maltreatment, 537

Radiological weapons. See Chemical, biological, radiological, 

nuclear and explosive weapons

Ragtail Remembers--A Story That Helps Children Understand Feelings 

of Guilt (Duckworth), 556–557

Raising an Emotionally Healthy Child When a Parent is Sick (Muriel 

and Rauch), 517, 560

Raising Our Children to Be Resilient (Goldman), 560

Ramstein Air Base, Germany, contingency aeromedical staging 

facility, 201

RAND Corporation, Center for Military Health Policy Research 

study of the prevalence of mental health problems among U.S. 

Navy servicemen, 122

Rando, Terese A., How to Go on Living When Someone You Love Dies,

561

Rapid-deployment operations, description and reentry/reintegration responsibilities, 277–278

Ratner, Maj. R., account of his Vietnam War experience, 28–29

Rauch, Paula K., Raising an Emotionally Healthy Child When a Parent Is Sick, 517, 560

RCS. See Vet Centers

Readjustment Counseling Service. See Vet Centers

Ready, D.J., posttraumatic stress disorder program evaluation, 310

Reagan, Pres. Ronald, Executive Order 12564 mandating federal 

drug testing, 477

Recovery, definition, 330

Recruitment and retention issues

criminal history of recruits, 728
lx

Combat and Operational Behavioral Health 

ethical issues, 728–729

graduate medical education faculty, 673–675, 688–689

lowering of ASVAB scores, 728

posttraumatic stress disorder and, 743

“probational” track for special populations, 728–729

racist or gang membership of recruits, 728

recruiting and retaining medical personnel, 185

Redeployment. See Resetting the force

Reentry. See Resetting the force

Regehr, C., provider fatigue and, 381–382

Relaxation techniques

premenstrual dysphoric disorder and, 708

sleep disturbances and, 250

traumatic injury patients and, 252–253

Religious and spiritual issues. See also Chaplains

combat stress, 66, 70

provider fatigue, 381, 386–387

Remeron

depressive disorder treatment, 158–159

insomnia treatment, 158–159

Renner, Lt. Cdr. J.A., Jr., rise of psychiatric disorders during the 

Vietnam War, 21

Reserve Affairs--Mobilization and Demobilization, Web site, 501

Reserve units. See U.S. Army Reserves

Resetting the force

background, 276–278

Battlemind program (exhibit), 283

case studies, 280, 283

the characteristics of major wars, limited wars, and rapid 

deployment operations overlap in Operation Iraqi Freedom 

and Operation Enduring Freedom (figure), 277

demobilization and, 277, 280

Deployment Cycle Support Program, 276

description, 276

families and, 276, 277, 280–281, 284

health assessments after redeployment and, 279

Health Risk Appraisal questionnaires, 281

health services for returning service members, 280

identification of at-risk soldiers, 279

key components in decompression and reintegration (figure), 

279

limited wars and, 277

major wars and, 277

National Guard and Army Reserve members and, 279–280

post-deployment health assessment form (exhibit), 288–290

pre-deployment health assessment form (exhibit), 286–287

rapid-deployment operations and, 277–278

redeployment programs, 281–284

reentry challenges by population, 278–281

regular Army soldiers and family members and, 278–279

Soldier Wellness Assessment Pilot Program, 281

Soldier Wellness Assessment Pilot Program (exhibit), 282–283

stigma of behavioral health problems and, 276

stressors in, 276

Resilience. See also Provider Resiliency Training

Battlemind deployment support program and, 52

brain regions involved in, 47

collective efficacy characteristic, 46

coping self-efficacy characteristic, 45–46, 53

definitions, 45, 47–48, 219, 330, 377

dynamics of faith in soldier resilience and recovery, 167–168

evaluating resilience as an outcome, 48

factors in, 45–47

family support and, 52

future research ideas, 52–53

hardiness characteristic, 45

interventions for building resilience and preparedness, 49–52, 

53

Landstuhl Regional Medical Center’s Combat and Operational 

Stress/Staff Resiliency program, 219–222

measurement of resilience factors in the military, 48–49

mechanisms of, 49

neurobiological factors, 46–47

postwar factors, 49

prewar factors, 48–49

provider fatigue and, 385–386

reinforcing skills through military training, 51–52

“resilient trajectories,” 47–48

self-confronting and, 385, 386

self-help programs and, 50

self-soothing and, 385–386

social support and, 46, 53, 564

Survival, Evasion, Resistance, and Escape schools and, 51–52

survival skills strategies and, 50–51

toughening responses to stress, 50, 52–53

training programs for building strengths, 50

unit cohesiveness and, 51–52

war-zone factors, 49

Resources for Recovery--The Combat Injured Family: Guidelines for 

Care, 517

Response to Stressful Experiences Scale, description, 49

Return to duty

combat and operational stress continuum model and, 117

combat and operational stress control and, 60, 66, 67, 69

mild traumatic brain injury and, 235

Operation Iraqi Freedom/Operation Enduring Freedom total 

evacuations compared to return to duty by year until February 2007 (figure), 214

Rich Clarkson and Associates, For Children of Valor: Arlington 

National Cemetery gift book, 554

Risperidone, bipolar disorder treatment, 158

Ritalin. See Methylphenidate

Ritchie, Col. Elspeth C.

disaster psychiatry research, 581

guidelines for becoming a division psychiatrist, 92

humanitarian assistance missions, 610, 611, 612, 613

Joint Conference on Postdeployment Mental Health and, 330

use of psychotropic medications during Operation Restore 

Hope in Somalia, 153

Rivers, William H., military psychologist role, 658

Robins, L.N., Vietnam veterans’ drug use, 27

Rock, Col. Nicholas L.

suicide research, 404

War Psychiatry, 92

Roffman, R.A., survey of illegal drug use in the Vietnam War, 11, 

17, 20, 24

Roque, H., gender-based violence, 626

Rosen, L.N.

children’s responses to deployment, 494

impact of deployment on service members and family wellbeing, 493

Rosenheck, R., workplace and work performance issues for patients with PTSD, 308

Rothberg, Dr. Joseph, suicide research, 404

Rudd, M.D., suicide research, 395

Rundell, J.R., aeromedical evacuation of psychiatric patients, 203

Rwanda, complex humanitarian emergency example, 625, 626

S

Saddam Hussein

invasion of Kuwait, 659

surrender of, 138

SAFAC. See Soldier and Family Assistance Center
Index

lxi

Saint, Gen. Crosby, Battlemind program and, 72

Salmon, Dr. Thomas, forward treatment of combat stress during 

World War I and, 5, 90, 658

Salvation Army, September 11, 2001, terrorist attack response, 583

SAMHSA. See Substance Abuse and Mental Health Services 

Administration

Sanity boards

criminal responsibility issue, 695

on detainees, 695–696

membership of, 695

privacy issues, 695

Sapol, E., survey of illegal drug use in the Vietnam War, 11, 17, 20, 

24

Sareen, J., posttraumatic stress disorder link with suicide, 305

Sarin attack on the Tokyo subway system. See Aum Shinrikyo 

cult’s sarin attack on the Tokyo subway system

SARS. See Severe acute respiratory syndrome

Savage, P.L., incidence of soldiers attacking their superiors (“fragging”), 25

Savoca, E., workplace and work performance issues for patients 

with PTSD, 308

Savola, O., relationship of alcohol use to trauma, 233

SAVs. See Staff assistance visits

Schaefer, Dan, How Do We Tell Children: Helping Children Understand and Cope When Someone Dies, 561

Schizophrenia

age of onset, 442, 707

disabling nature of, 443

fitness for duty and, 180

pharmacologic treatment, 443, 707

women and, 707

Schizophreniform disorder

description and symptoms, 442–443

progression to schizophrenia, 443

Schlechte, J., eating disorder research, 454

Schneider, B.J., rationale for using a formulary for military operations, 153–154

Schneidman, Edwin S., key concepts in suicide, 404, 405

Schnurr, P.P., posttraumatic stress disorder treatment, 309

Schobitz, Capt. Richard, Soldier and Family Assistance Center 

and, 568

Schofield Barracks, HI. See also Integrated behavioral health services at Schofield Barracks, HI

Health Clinic, 565, 566

high cost of living and, 565

number of active duty soldiers, civilian employees, and contract employees, 565

School-age children

books recommended for dealing with trauma and grief, 

556–559

effects of deployment on, 494

grief responses, 547

response to a combat-injured parent, 514–515

Schoomaker, Lt. Gen. Eric, ProQOL Scale and, 383

Schreiber, S., uncontrolled pain as a stressor, 246, 249

Scott, Col. Brian, Battlemind program and, 73

Seasonal affective disorder, gender factors, 707

SEATO. See Southeast Asia Treaty Organization, U.S. involvement 

and

Seki, K., overview of problems in civil-military cooperation, 623

Selective serotonin reuptake inhibitors. See also specific drugs

anorexia nervosa treatment, 460

anxiety treatment, 253

bulimia nervosa treatment, 462

depressive disorder treatment, 158–159

full therapeutic response time, 303

generalized anxiety disorder treatment, 303

indications for use of, 153

introduction of, 152

panic disorder treatment, 253, 303

posttraumatic stress disorder treatment, 253, 303, 304

premenstrual dysphoric disorder treatment, 708

safety of use during pregnancy, 709

side effects, 303

social phobia treatment, 253

trauma patients and, 249, 253

Self-hypnosis

anxiety and, 253

trauma treatment, 246, 249

Seligman, Martin E.P.

Authentic Happiness: Using the New Positive Psychology to Realize 

Your Potential for Lasting Fulfillment, 560

training to build strengths, 50

Sense of achievement

definition, 378

provider fatigue and, 378, 379

September 11, 2001, terrorist attacks

Americans’ spiritual response to, 167–168

effects on civilians following, 580–581

family assistance center establishment, 583

lack of military administrative support and, 584–585

mental health impact of, 77

need for a joint doctrine of disaster response and, 584

Operation Solace and, 77, 679–680

principles of forward treatment of casualties and, 6

Project Liberty and, 582

Psychiatry Consultation Liaison Service role following, 244

psychiatry residents and, 584

rescue and recovery response, 583–585

“therapeutic debriefing” and, 583, 584

weaknesses in the response to, 584–585

Seroquel, insomnia treatment, 250

Serotonin, eating disorders and, 452

Serotonin-norepinephrine reuptake inhibitors, trauma patients 

and, 249

Sertraline

bulimia nervosa treatment, 462

posttraumatic stress disorder treatment, 303

SeRV-MH. See Services for Returning Veterans-Mental Health

Service-dog training, description, 361

Services for Returning Veterans-Mental Health

goals, 332

role of, 332–333

teams for, 333

training and, 333

Sesame Workshop Talk, Listen, Connect: Deployments, Homecomings, Changes, 517

706 boards. See Sanity boards

Severe acute respiratory syndrome

description, 594

psychosocial effects, 598

survey findings, 596

Severe psychiatric illness in the military. See also specific disorders

air evacuation and, 445–446

descriptions and symptoms, 442–445

remote site treatment considerations, 445

Sexual assault and abuse

DoD policy, 141

eating disorders and, 453–454

posttraumatic stress disorder and, 298

traumatic brain injury and, 711

Sexual Assault Prevention and Response Program, description, 

141

SGT Mom’s, interactive Web site for military spouses, 501
lxii

Combat and Operational Behavioral Health 

Shay, Jonathan, Achilles in Vietnam, 130

Sherman, DeAnne, Finding My Way: A Teen’s Guide to Living With a 

Parent Who Has Experienced Trauma, 560

Sherman, Michelle D., Finding My Way: A Teen’s Guide to Living 

With a Parent Who Has Experienced Trauma, 560

Sibutramine, obesity treatment, 462

SIT. See Stress inoculation training

Sleep disorders

alcohol use and abuse and, 475

anxiety and, 252

image reversal therapy and, 252

treatment, 250, 309

Smith, Doris Buchanan, A Taste of Blackberries, 558

Smith, Harold, What Does That Mean? A Dictionary of Death, Dying 

and Grief Terms for Grieving Children and Those Who Love Them,

558

Smokeless tobacco. See Tobacco use

Smoking. See Tobacco use

Snyder, W.M., “communities of practice” concept, 565

Social anxiety disorder, posttraumatic stress disorder and, 305, 

307

Social factors, eating disorders, 453

Social phobia

treatment, 253

women and, 709

Social support

mental well-being and, 564

resilience and, 46, 53

Social workers. See Division psychiatrists and brigade behavioral 

health officers

Society of Medical Consultants to the Armed Forces, military 

graduate education, 681

Soldier and Family Assistance Center

Adult Family Member Assistance Center and, 567, 568, 569

advertising campaign for, 568

algorithms for calculating provider numbers (exhibit), 567

Child and Adolescent Assistant Center and, 567, 568, 569

concept development, 566

current activities, 569

estimating the number of providers needed in each specialty, 

566

five areas of care (exhibit), 567

funding for, 567

Marriage and Family Assistance Center and, 567, 569

monthly patient or client visits in the three Soldier and Family 

Assistance Center clinics, January 2005 to November 2006 

(figure), 569

outcomes, 569

outreach activities, 569

principles for development, 566

projected demand for providers based on population (table), 

568

purpose of, 566

recruitment of staff for, 568

Soldier Assistance Center and, 567, 568, 569

Soldier Readiness Program and, 568

staffing level issues, 575

Triage Assistance Center and, 567, 568

Soldier Wellness Assessment Pilot Program

description, 281

exhibit detailing, 282–283

Soldiers Rehabilitation Act, 369

Solomon Wellness Educational Program

ages and gender of children evaluated at Solomon Elementary 

School in the Solomon Wellness Educational Program, from 

August 2001 to February 2007 (figure), 571

Child and Adolescent Psychiatry Service and, 569

early history, 570

future directions for, 571

goals of, 570

Primary School Adjustment Program, 571

program evaluation, 570–571

school enrollment, 569

special education students and, 569–570

Strengths and Difficulties Questionnaire and, 571

student demographics, 569, 570–571

tenets of, 570

vision for, 570

Somalia, Operation Restore Hope and, 76, 153

Southeast Asia Treaty Organization, U.S. involvement and, 12

Soviet Union, biological warfare program, 594

Special Psychiatric Rapid Intervention Teams

combat and operational stress first aid and, 125

composition and mission, 124–125

critical incident stress management and, 125

history of, 124

intervention strategies, 125

training for, 125

unit leader responsibilities, 124–125

Specimen Custody Document: Drug Testing (DD Form 2624), 

479–480

Spector, Ronald

casualty rates of the Vietnam War compared with World War 

II, 13

demoralization of troops fighting in Vietnam, 20

illegal drug use by troops fighting in Vietnam, 28

Spiegel, H.X., unit cohesiveness and resilience, 51–52

Spiritual issues. See Religious and spiritual issues

Spouse maltreatment. See Family maltreatment

Spouses. See Deployment impact on military families and children; Families

SPRINTs. See Special Psychiatric Rapid Intervention Teams

Sri Lanka. See Indian Ocean tsunami

SRMSO. See Suicide Risk Management and Surveillance Office

SSRIs. See Selective serotonin reuptake inhibitors

Staff assistance visits, Operation Iraqi Freedom 05-07 and, 145–146

Staff issues

contingency aeromedical staging facilities and, 200

Landstuhl Regional Medical Center and, 210, 212–214, 218–219

Operation Iraqi Freedom 05-07 and, 145–146

Operational Stress Control and Readiness program, 127

supportive counseling for medical staff who care for medically 

injured trauma victims, 255–256

Stamm, B.H., provider fatigue and, 384

Standard Form 513, Medical Record Consultation Sheet, 478

Standardized Assessment of Concussion, description, 233

Stanton, M.D., illegal drug use by troops during the Vietnam War, 

20–21, 24, 27, 28

State and community partnerships. See also specific states

Area Health Education Centers, 335

chaplains and religious leaders and, 336

DoD and VA partnerings, 334–336

joint training efforts, 335

key elements, 335–336

National Association of State Directors of Veterans Affairs, 334

outreach efforts, 335

summit meetings and, 334–335

States. See also specific states

psychiatrist liability for violent actions of their patients and, 

437

suicide prevention program managers, 408

Staudenmeier, J.J., use of psychotropic medications during the 

Persian Gulf War, 153

Steen, Joanne M., Military Widow: A Survival Guide, 551, 560

Sterba, J.P., attitudes of soldiers fighting in Vietnam, 20

Sternberg, Robert, “wisdom, intelligence, and creativity, synthe-
Index

lxiii

sized” model and, 636

Stetz, M.C., aeromedical evacuation of psychiatric patients, 203

Stimulants. See also Amphetamines; specific drugs

pain management and, 246

potential for abuse of, 158

Stress. See also Combat and operational stress continuum model; 

Combat and operational stress control; Oral health effects of 

combat stress

adaptive stress reactions, 63

brain regions involved in, 47

deployment-related stressor link to subsequent health problems, 60

drinking alcohol as a coping mechanism, 260

eating as a coping mechanism, 260

factors in, 44

family maltreatment and, 536–540

“leaky bucket” metaphor for stress (figure), 114

malingering and, 697

mental stressors, 61

mitigating stressors, 113–114

model of stress and its potential soldier and family outcomes 

(figure), 63

neurobiological factors, 46–47

operations involving death and the dead and, 719–722

physical and behavioral effects of, 61–62

physical stressors, 61

psychosocial stressors for women in military service, 704–707

Response to Stressful Experiences Scale, 49

smoking cigarettes as a coping mechanism, 260

sources of, 61, 123

theoretical models, 44, 66

toughening responses to, 50, 52–53

Stress inoculation training, posttraumatic stress disorder and, 302, 

308

Substance Abuse and Mental health Services Administration, 

Hurricane Katrina disaster response and, 587

Substance use and abuse. See also Alcohol use and abuse; Tobacco 

use; specific substances

alcohol and drug control officer role, 479

Army substance abuse program, 480–482

bulimia nervosa and, 453

combat and operational stress continuum model red zone and, 

112

DD Form 2624, Specimen Custody Document: Drug Testing 

(figure), 479–480

Drug and Alcohol Management Information System and, 480

drugs of abuse, 476–477

installation biochemical testing coordinator role, 479

medical review officer role, 477–480

mild traumatic brain injury and, 233

pain management and, 347, 349

posttraumatic stress disorder and, 298, 305

Standard Form 513, Medical Record Consultation Sheet (figure), 478

substance-induced psychosis, 443

suicide and, 425, 426

withdrawal and, 443

Sudan, gender-based violence and, 626

Suicide

access to lethal methods and, 411

anorexia nervosa and, 455

Army Suicide Event Reports, 145, 397–400, 404

Army suicide surveillance, 394–400

during basic or preliminary combat training, 729–730

behavioral changes and, 410

career loss as a cause of, 410, 411

causal factors (figure), 414

chaplains and, 169

Deployment Cycle Support program and, 169

depression and, 410

ethical issues, 729–730

grieving process for families members, 551

incidence of, 4

increase in rate of, 404

managing suicide and homicide risk during deployment 

(table), 435

managing suicide and homicide risk in garrison (table), 427

media reports on and increase in rates of, 147, 777

“military-specific suicidal ideation” and, 425

Operation Iraqi Freedom 05-07 and, 145, 147, 777

posttraumatic stress disorder and, 305

prison environments and, 436

protective factors, 412

relationship loss as a cause of, 410, 411, 426

risk factors, 411, 426

spectrum of suicide behaviors, 404

stigma associated with seeking behavioral healthcare (exhibit), 

411

suicidal or homicidal thoughts association with diagnosable 

mental illness, 424

suicide factors to consider (figure), 414

U.S. Army Center for Health Promotion and Preventive Medicine suicide awareness program, 169

WRAIR epidemiological consultations of suicide clusters, 77

Suicide prediction

case-controlled studies, 397

cohort studies, 397

definition of, 394

epidemiological surveillance studies, 396–397

importance of, 395–396

randomized controlled trials, 397

“reasonably foreseeable” definition, 394

research challenges, 394–395

risk factors and, 394–395

Suicide Risk Management and Surveillance Office, 397–400

Suicide prevention

active duty suicides in the U.S. Army January 1, 2001, through 

June 15, 2009 (figure), 405

history of efforts, 404–405

Los Angeles Suicide Prevention Center, 404

Operation Iraqi Freedom and suicide prevention (exhibit), 410

primary prevention description, 405

“psychological autopsies” and, 404, 698–699

secondary prevention description, 405

tertiary prevention description, 405

unit watch concept, 424–438

Suicide Prevention: A Resource Manual for the United States Army,

405

Suicide Prevention and Psychological Autopsy (PAM 600-24), 405, 406

Suicide Prevention Conference, description, 404

Suicide Risk Management and Surveillance Office

Army Suicide Event Reports and, 397–400

future directions, 399–400

history of, 397

improving accessibility of ASER data, 399

reports of findings, 399

“Summary of Theater Suicides” and, 410–412

user-friendly data reporting options, 399–400

Sullivan, Harry Stack, development of screening interviews, 172

Supportive therapy, psychiatry residency programs and competency in, 677

Survey of Health-Related Behaviors, obesity in the military population, 452

Survival, Evasion, Resistance, and Escape schools, description, 

51–52

Survival skills, resilience and, 50–51
lxiv

Combat and Operational Behavioral Health 

SWAPP. See Soldier Wellness Assessment Pilot Program

SWEP. See Solomon Wellness Educational Program

T

TAI. See Traumatic axonal injury

Takatch, Robert, Annie Loses Her Leg But Finds Her Way, 558

TAMC. See Tripler Army Medical Center

TAPS. See Tragedy Assistance Program for Survivors

Task Force Medical 115, behavioral healthcare for detainees and, 

646–656

Task Force Medical 344, behavioral healthcare for detainees and, 

646–656

Task Force on Mental Health

barriers blocking access of bereaved military family members 

to care, 551

recommendations, 126, 127

Task Force 30th Medical Brigade

funding for humanitarian needs, 610

mandate for, 610

Medical Civil-Military Operations, 610–617

Operation Iraqi Freedom 05-07 and, 610–617

A Taste of Blackberries (Smith), 558

Taylor, S.E., support for medical staff, 255

TBI. See Traumatic brain injury

TCAs. See Tricyclic antidepressants

Teenagers. See Adolescents

TEM. See Traumatic event management

Temporomandibular dysfunction

causes, 268

gender and age factors, 268

oral contraceptives and, 268–269

prevention, 269

stress and, 268

treatment, 269

Terrorism. See Chemical, biological, radiological, nuclear and 

explosive weapons; specific attacks and locations

Tet offensives of the Vietnam War, 18, 20, 34

TF30. See Task Force 30th Medical Brigade

Thailand. See Indian Ocean tsunami

That’s My Hope: Featuring a Gallery of Multigenerational Artwork

(Ingram), 517

Therapeutic debriefing

September 11, 2001, terrorist attacks and, 583, 584

treatment goals of (exhibit), 584

Therapeutic Intervention for the Prevention of Psychiatric Stress 

model

components, 248

countertransferance and, 248, 376

description, 247

empathic supportive exposure therapy and, 249, 252

group therapy and, 249

hypnotherapy and, 249

individual therapeutic components, 249–250

insomnia and, 250

pharmacological interventions and, 249

support for medical staff, 255–256

therapeutic alliance and, 248

transference and, 248

trauma patient’s family and, 254–255

treatment issues, 250–255

Therapeutic riding programs, description, 361

35 Ways to Help a Grieving Child, 561

30th Medical Brigade, Operation Iraqi Freedom 05-07 and, 

139–148

Thomas, Pat, I Miss You--A First Look at Death, 557–558

Thompson, Tommy G., importance of healthcare in medical civilmilitary operations, 611

Thorazine, use of during the Vietnam War, 152

Thought disorders. See specific disorders

Three Mile Island, PA, nuclear accident, 599, 601

Tiagabine, posttraumatic stress disorder treatment and, 304

TIPPS. See Therapeutic Intervention for the Prevention of Psychiatric Stress model

TMD. See Temporomandibular dysfunction

TMI. See Three Mile Island, PA

Tobacco use

bupropion for smoking cessation, 303

coping with stress and, 260

posttraumatic stress disorder and, 305, 476

smoking cessation programs, 281

Toddlers

effects of deployment on, 493

grief responses, 547

response to a combat-injured parent, 513–514

Topical lidocaine, pain management and, 344

Topiramate

bulimia nervosa treatment, 462

posttraumatic stress disorder treatment and, 304

TRAC2ES. See U.S. Transportation Command Regulating and 

Command and Control Evacuation System

Tragedy Assistance Program for Survivors

description of services, 501, 550, 555

Web site, 555

Traisman, Enid Samuel, Fire in My Heart, Ice in My Veins--A Journal 

for Teenagers Experiencing Loss, 559

Tramadol, pain management and, 344

Trammel v. U.S., Supreme Court case on confidentiality, 166

Transition from buildup to drawdown of the Vietnam War, 1968-

1969

atrocities and, 20

demoralization of troops and, 20, 34

illegal drug use and, 20

psychiatric overview, 20–21

psychiatrist reports, 21

racial incidents and, 20

Tet offensives and, 18, 20

Translators

behavioral health terminology and, 650

detained individuals and, 649–650

rotating among sites, 649

use of detainees as, 650

Trauma

behavior changes after exposure to, 381–382

intergenerational transmission of the effects of war and combat trauma, 495–497

Trauma Risk Management program, description, 662–663

Traumatic axonal injury

description, 229–230

neuroimaging findings, 230

Traumatic brain injury. See also Mild traumatic brain injury

alteration of consciousness and, 227, 233

burden on family members, 711

causes of, 694, 710

CDC estimates of prevalence and mortality, 226

cognitive sequelae, 231–235, 253

combat-related, 230–231

contusions occur when the brain moves within the skull 

enough to impact bone, causing bruising (figure), 229

cost of, 226

Defense and Veterans Brain Injury Center and, 226–227, 233, 

253

definition of, 226–227, 710

due to domestic violence, 711

effect on children and families of service members, 504–505

ethical issues, 743
Index

lxv

evolution of, 229–230

family and vocational issues for women, 711–712

forces that can cause the injury, 228

Glascow Coma Scale and, 227, 231

hormone treatment, 710

initial management of concussion in a deployed setting (figure), 234–235

loss of consciousness and, 227, 233

mortality rate, 710

neuroimaging findings, 230

outcome and, 710

penetrating or closed types, 226

the physical forces exerted on the brain during most of the 

events that can cause traumatic brain injury are reasonably 

well understood (figure), 228

polytrauma and, 253

posttraumatic amnesia and, 227, 230

posttraumatic stress disorder and, 711

Preventive Medical Psychiatry role, 253

psychological sequelae in women, 711

retrograde amnesia and, 227

return to active duty and, 712

risk of to military service members, 226

screening for, 694

sexual function and, 711–712

traumatic axonal injury and, 229–230

traumatic axonal injury (TAI) results when shearing, stretching, or angular forces pull on axons and small vessels 

(figure), 229

traumatic brain injury description (table), 227

traumatic subdural hemorrhage occurs when the brain moves 

within the skull enough to tear the vessels that bridge from 

the brain surface to the dural venous sinus (figure), 228

underreporting of, 226

vulnerable areas, 228–229

women and, 710–712

Traumatic event management

debriefings, 175

description, 68, 175

effectiveness of, 175

goal of, 68

leadership requests for assessments, 68–69

potentially traumatic events examples, 68

responses included, 69

Traumatic grief

children and, 550

posttraumatic stress disorder and, 550

symptoms of, 550

traumatic death compared with anticipated death, 549

Traumatic injuries. See also Potentially traumatic events

adaptive functioning and, 247

body part affected and, 246

case studies, 247, 251, 253–254

cognitive symptoms and, 245–246

conversion disorder and, 253–254

early psychiatric intervention importance, 246, 252, 256

effect of, 245

emotional trauma and, 245

families and, 247, 253–255

grieving over losses, 246, 250

hospitalization and the meaning of injury, 246–247

medical treatment and, 245

normalization of feelings and, 250

overwhelming emotion following, 244

pain issues, 245, 246

personality structures and, 247

phantom limb pain and, 246

posttraumatic stress disorder and, 44–45, 48

psychiatric illness development risk and, 246

psychological history of the patient and, 245

psychological responses, 245–246

regressive behavior and, 247

role of psychiatry following, 247

self-hypnosis treatment, 246, 249, 253

stress of injuries following, 244–247

survivor guilt and, 251

theoretical models of trauma, 44–45, 53

Traumatic recollections

definition, 378

provider fatigue and, 378, 379–380

Trazodone

insomnia treatment, 159

posttraumatic stress disorder treatment, 303

Treating Trauma and Traumatic Grief in Children and Adolescents

(Cohen), 562

TRICARE

description and services, 335, 336, 554

mental health treatment, 551

Web site, 554

Tricyclic antidepressants. See also Antidepressants; specific drugs

anorexia nervosa treatment, 460

bulimia nervosa treatment, 461–462

in-theater treatment and, 159

pain management and, 344

posttraumatic stress disorder treatment, 303

safety of use during pregnancy, 709

use of by Israeli forces, 153

Vietnam War use, 11–12

TRiM. See Trauma Risk Management program

Tripler Army Medical Center

behavioral health liaison project, 571–575

child and adolescent psychiatry fellowship programs, 680

Child and Adolescent Psychiatry Service, 565, 569, 570

clinical clerkship rotations for psychiatric residents, 677

location of, 565

Turner, M.A., aeromedical evacuation of psychiatric patients, 203

TWA Flight 800 disaster, Special Psychiatric Rapid Intervention 

Teams role, 125

24-hour watch

in deployed settings, 434

in garrison, 431–433

25 Things to Do: Activities to Help Children Suffering Loss or Change

(Kanyer), 561

25th ID. See 25th Infantry Division Light

25th Infantry Division Light

behavioral health liaison project and, 572, 574

deployment to Afghanistan, 565

funding for the Soldier and Family Assistance Center, 567

integrated behavioral health services at Schofield Barracks, HI 

and, 565–566, 572

Soldier and Family Assistance Center and, 566, 567–568

Tropic Lighting University reunion program and, 574

U

UCMJ. See Uniform Code of Military Justice

UH-60 Black Hawk helicopters, aeromedical evacuations and, 194

UNHCR. See United Nations High Commissioner for Refugees

Uniform Code of Military Justice

description, 694

expert witnesses and consultants and, 696

levels of courts-martial, 694–695

sanity boards and, 695

Uniformed Services University of the Health Sciences

Center for the Study of Traumatic Stress, 513, 521–532, 555

clinical clerkship rotations for psychiatric residents, 677
lxvi

Combat and Operational Behavioral Health 

concepts of team learning, practice, and interpersonal communication and, 677

Disaster Psychiatry Fellowship, 680

“Principles of Caring for Combat-Injured Families and Their 

Children,” 517, 533–534

survey instrument assessing the mental health effects of employees after the September 11, 2001, terrorist attacks, 77

Workgroup on Intervention With Combat-Injured Families, 

517

Unit Behavioral Health Needs Assessment, description, 175

Unit cohesion

combat and operational stress reaction and, 65

“80% solution” concept, 65

resilience and, 51–52

Unit watch

access to lethal means and, 424, 425, 435, 437

alcohol and substance use and, 425

basic precaution elements, 434

basic precautions (exhibit), 434

buddy watch and, 428–431, 432

buddy watch memorandum (exhibit), 428

case studies, 434–435

caveats concerning, 426

command team and, 425

deployed settings and, 425–426, 434–436

documentation requirements, 426–427, 436

in garrison, 425–426, 427–433

incorporation into behavioral health training programs, 

437–438

inexperience of the soldier performing the watch and, 436

information paper for commanders (exhibit), 430–431

interventions involved, 424

lack of research on, 426

lack of suicide risk factors and, 426–427

legal issues, 436–437

management of suicidal or homicidal patients in the military 

compared with civilian settings, 424

managing suicide and homicide risk during deployment 

(table), 435

managing suicide and homicide risk in garrison (table), 427

medical issues, 436–437

memorandum format and, 427–428

military duty avoidance and, 425

“military-specific homicidal ideation” and, 425

“military-specific suicidal ideation” and, 425

misperceptions about the soldier’s condition and, 424

as part of a multifaceted treatment plan, 426

“patient holds” and, 434

PIES principles and, 424

psychiatric hospitalization and, 424

rationale for, 424–426

recommendations for procedures, 427–436

standard operating procedures for buddy watch and 24-hour 

watch (exhibit), 432

stigma and, 425

suicidal or homicidal thoughts association with diagnosable 

mental illness, 424

suicide risk assessment and, 426–427

24-hour watch, 431–433, 434

24-hour watch memorandum (exhibit), 429

unit watch discontinuation memorandum (exhibit), 433

United Kingdom armed forces behavioral health

Academic Centre for Defence Mental Health, 664

chain of command and, 660

contemporary services, 660–663

current research and future directions, 663–664

defense mental health services and, 658, 660

Department of Community Mental Health and, 658, 660

during deployment, 661

field mental health teams, 658, 660, 661

historical background, 658–660

impact of military service on family life, 663

King’s Centre for Military Health Research, 663

“lack of moral fiber” diagnosis and, 658–659

levels of mental healthcare provision, 660

Operation Banner and, 658

Operation Granby, 659

Operation Telic, 660

operational mental health referral flowchart (figure), 662

operational organization, 660–661

postdeployment, 661

posttraumatic stress disorder legal case, 661–662

predeployment, 661

Trauma Risk Management program, 662–663

United Kingdom Department for International Development, 

complex humanitarian emergencies and, 621

United Nations

Guidelines on the Use of Military and Civil Defence Assets in 

Disaster Relief, 622

Office for Coordination of Humanitarian Affairs, 625

program for the reintegration of former child combatants, 626

United Nations Children’s Fund

complex humanitarian emergencies and, 621

Indian Ocean tsunami relief efforts and, 637–638

United Nations Development Program, complex humanitarian 

emergencies and, 621

United Nations High Commissioner for Refugees, complex humanitarian emergencies and, 621

United Nations Inter-Agency Standing Committee

Civil-Military Relationship in Complex Emergencies, 620

psychic environment of complex humanitarian emergencies, 

624–625

United States v. Toledo, expert witnesses and, 696

University of Minnesota, combat driving behavior modification 

brochures, 372

Ursano, R.J., disaster psychiatry research, 581

U.S. Agency for International Development, complex humanitarian emergencies and, 621

U.S. Air Force

aeromedical evacuations and, 195

eating, drinking alcohol, and smoking as a means of coping 

with stress and, 260

eating disorders and, 456, 458

Operation Iraqi Freedom 05-07 and, 140, 142, 143

September 11, 2001, terrorist attack response, 583

U.S. Army

Army Forensic Drug Testing Program, 141–142

Army Physical Disability Evaluation System, 328

Casualty and Mortuary Affairs operation center, 545

Comprehensive Behavioral Health System of Care, 749–750

Comprehensive Soldier Fitness Office, 74

current number of behavioral health providers, 750

Deployment Cycle Support Program and, 278–279

eating, drinking alcohol, and smoking as a means of coping 

with stress and, 260

eating disorders and, 456

Families First Casualty Call Center, 545

Family Advocacy Program, 536–537, 538, 539, 540

A Guide for the Survivors of Deceased Army Members, 544

Guide to the Prevention of Suicide and Self-Destructive Behavior,

405

Just the Facts...Dealing With the Stress of Recovering Human Dead 

Bodies, 52

Manpower and Reserve Affairs, 328

Medical Specialist Corps, 359

military care team for children and families of fallen service 
Index

lxvii

members, 545–546

Office of Strategic Services, 172

Proponency Office for Rehabilitation and Reintegration, 369

“Protecting the Force,” 749

provider hiring difficulties, 750

response to family stress and deployment, 539–540

September 11, 2001, terrorist attack response, 583

substance abuse program, 480–482

Suicide Prevention and Psychological Autopsy (PAM 600-24), 405

suicide prevention programs, 404–419, 424–438

Suicide Prevention Task Force, 749

suicide rate increase, 404

Suicide Risk Management and Surveillance Office, 397–400

Survival, Evasion, Resistance, and Escape schools, 51–52

Women’s Medical Specialist Corps, 359

Wounded Warrior program and, 328

U.S. Army Center for Health Promotion and Preventive Medicine. 

See also Public Health Command (Provisional) 

ACE acronym development, 407, 408

“ACE” card developed by CHPPM (figure), 407

Army Knowledge Online Web site, 407

Behavioral and Social Health Outcomes Program, 749

EPICON mission and, 413

Health Information Operations Web site, 407

new parent educational materials, 539

posters for suicide awareness, 407

renaming of as Public Health Command (Provisional), 406

suicide awareness program, 169

suicide awareness training kits for chaplains, 406–407

survey assessing the mental health effects of employees after 

the September 11, 2001, terrorist attacks, 77

training courses, 595

Web site, 595

U.S. Army Chaplain Corps. See also Chaplains

advanced civilian schooling program for midcareer chaplains, 

165

chaplains as partners in operational psychology, 168–169

chaplains as religious strength facilitators, 167

combat and operational stress control and, 66

combat stress control teams and, 168–169

confidentiality issues, 165–166

dynamics of faith in soldier resilience and recovery, 167–168

familiarity with home situations of soldiers and, 168

Family Life Centers and, 165

historical background, 164, 165

pastoral care and, 165

pastoral counselor role, 164–168

pastoral education programs, 165

primary role of, 168

resource for mental health providers, 169

training in care and counseling, 165

unit ministry team membership, 165

U.S. Army Family and Morale, Welfare, and Recreation Command, Family Advocacy Program, 536–537, 538, 539, 540

U.S. Army National Guard

benefits available to service members, 409

Deployment Cycle Support Program and, 279–280

divorce rate relationship to deployment, 538–539

Hurricane Katrina response and, 586

mobilization of the Hawaii National Guard for Operation 

Enduring Freedom, 565

“One Army” concept and, 279

Operations Desert Shield/Storm deployment, 488

partnerships with DoD and VA for care, 334

suicide awareness posters, 407

Suicide Prevention Program, 408–409

Vietnam War and, 12, 16

U.S. Army Reserves

Deployment Cycle Support Program and, 279–280

divorce rate relationship to deployment, 538–539

“One Army” concept and, 279

Operations Desert Shield/Storm deployment, 488

suicide awareness posters, 407

suicide prevention efforts, 409

Vietnam War and, 12, 16

U.S. Congress. See also specific legislation

Handoff or Fumble? Do DoD and VA Provide Seamless Health Care 

Coverage to Transitioning Veterans?, 326

U.S. Department of Defense

behavioral health issues for detained individuals and, 646, 647

civil-military operations centers description, 623–624

Clinical Practice Guidelines for Management of Post-Traumatic Stress, 116, 300–301, 310, 311, 326

combat and operational stress control implementation and, 

108–109

department-wide psychological screening, 79

Health Affairs policy letter, 698

illegal drug use during the Vietnam War, 27

Integrated Mental Health Strategy, 750

Joint Conference on Postdeployment Mental Health and, 330

Joint VA/DoD Federal Recovery Coordination Program, 328, 

332

military and family life consultants, 539

Military Assistance Program, 500

National Center on Shaken Baby Syndrome partnership, 539

policy changes for Operation Iraqi Freedom 05-07, 141–142

Policy Guidance for Deployment-Limiting Psychiatric Conditions 

and Medications, 156

Post-Deployment Health Assessment, 77, 174, 288–290, 327

Post-Deployment Health Reassessment, 79, 174, 327, 331–332, 

335–336

posttraumatic stress disorder treatment guidelines, 116

prevalence of mental health problems among soldiers returning from OEF, 333

Preventive Medicine (PAM 40-11), 415

“radiation response syndrome” and, 600

September 11, 2001, terrorist attack response, 583

Sexual Assault Prevention and Response Program, 141

Suicide Event Reports, 406, 407

Survey of Health-Related Behaviors, 452

Task Force on Mental Health, 126, 127, 551

Technology and Telehealth Initiative, 280

U.S. Department of Defense Base Realignment and Closure Act, 

provisions, 671

U.S. Department of Defense Directive 3000.05: Military Support for 

Stability, Security, Transition, and Reconstruction Operations, 586, 

613

U.S. Department of Defense Directive 6025.13, medical malpractice and, 436–437

U.S. Department of Defense Directive 6400.1, Family Advocacy 

Program and, 536

U.S. Department of Defense Directive 6490.1, division psychiatrists and brigade behavioral health officers and, 99–100, 102

U.S. Department of Defense Instructions 6490.4, command-directed mental health evaluations, 99–100

U.S. Department of Defense Patient Movement System

aeromedical evacuation patient classification codes (table), 198

Global Patient Movement Requirements Center and, 195

Joint Patient Movement Requirement Centers and, 195

mission of, 195

patient classification codes, 197–198

patient movement precedence, 195, 197

patient movement records and, 198, 200

patient movement requests and, 195

sample patient movement request (exhibit), 199

U.S. Transportation Command Regulating and Command and 
lxviii

Combat and Operational Behavioral Health 

Control Evacuation System and, 195

U.S. Department of Defense Survey of Health-Related Behaviors 

Among Active-Duty Military Personnel, oral health findings, 

260

U.S. Department of Defense Survey of Health-Related Behaviors 

in the Reserve Component, oral health findings, 260

U.S. Department of Education, “outcomes” movement, 676

U.S. Department of Health and Human Services, PsySTART 

program, 636, 640

U.S. Department of State, medical civil-military operations in Iraq 

and, 610, 613, 616

U.S. Department of the Army. See U.S. Army

U.S. Department of Veterans Affairs. See also Vet Centers; Veterans 

Health Administration

annual spending, 326

Care Management and Social Work Service, 328

chaplains, 336

Clinical Practice Guidelines for Management of Post-Traumatic Stress, 116, 300–301, 310, 311, 326

88th Regional Readiness Command COSC program and, 365

Environmental Epidemiology Service, 329

“Evolving Paradigms: Providing Health Care to Transitioning 

Combat Veterans” conference, 328

graduate medical education, 326

Integrated Mental Health Strategy, 750

Joint Conference on Postdeployment Mental Health and, 330

Joint VA/DoD Federal Recovery Coordination Program, 328, 

332

Mental Illness Research, Education, and Clinic Centers, 333

National Center for Posttraumatic Stress Disorder, 49, 116, 501, 

568, 628

overview, 326–328

partnership with the National Guard Bureau, 328

percentage of former soldiers who seek care through, 4

polytrauma call center, 328

posttraumatic stress disorder treatment guidelines, 116

program managers and, 328

Seamless Transition Office, 327–328

Services for Returning Veterans-Mental Health, 332–333

sites, 326

Suicide Prevention Conference participation, 404

transition of care for soldiers from active duty to the VA, 6

transition patient advocates, 328

Web site, 501

work internships and, 371

U.S. Food and Drug Administration, categories and labeling 

requirements for drug use during pregnancy (exhibit), 708

U.S. Marine Corps

combat and operational stress continuum model, 108–117

eating, drinking alcohol, and smoking as a means of coping 

with stress and, 260

eating disorders and, 456

family intervention program for service members, 52

Land Combat Study and, 78

Operation Iraqi Freedom 05-07 and, 141, 142, 143, 148

Operational Stress Control and Readiness program, 102, 116, 

126–128

September 11, 2001, terrorist attack response, 583

Vietnam War role, 13, 18, 21, 26

Warrior Transition Program, 332, 336

U.S. Navy

caregiver support, 131–133

carrier psychology program, 125–126, 133

casualty assistance call officers’ role in death notification, 544

combat and operational stress continuum model, 108–117, 

122–133

combat and operational stress control elements, 124–128

disaster drills, 52

diversity of operations, 122

eating, drinking alcohol, and smoking as a means of coping 

with stress and, 260

eating disorders and, 456, 458

emerging challenges for operational Navy Medicine, 128–133

expeditionary medical facilities, 124

expeditionary medical platforms, 123–124, 133

family intervention program for service members, 52

global war on terror and, 122

hospital ships, 123

individual augmentation issues, 128–131, 133

Land Combat Study and, 78

Operation Iraqi Freedom 05-07 and, 141, 142

Operational Stress Control and Readiness, 126–128, 133

operational stress control assessment and response communication (exhibit), 132

prevalence of mental health problems, 122

September 11, 2001, terrorist attack response, 583

Special Psychiatric Rapid Intervention Teams, 124–125, 133

Vietnam War role, 13

Warrior Transition Program, 129–130

U.S. Navy Medicine Support Command, combat and operational 

stress continuum model and, 122–133

U.S. Public Health Service

Commissioned Corps, 634

Disaster Response Teams, 636

Mercy model of population-based disaster relief and, 634–644

protective factors, 412

suicide risk factors, 411

U.S. Transportation Command Regulating and Command and 

Control Evacuation System

description and uses, 202

patient movement requests and, 195

US Army Vietnam Medical Journal, articles on psychiatric issues, 11

USAID. See U.S. Agency for International Development

USAR. See U.S. Army Reserves

USNS Comfort

description, 123

as first echelon of care in deployed locations, 195

Hurricane Katrina response and, 587

USNS Mercy

description, 123

as first echelon of care in deployed locations, 195

Mercy model of population-based disaster relief and, 634–644

Operation Unified Assistance and, 585–586

USS Belknap, collision with the USS John F. Kennedy, 124

USS Carl Vinson, number of medevacs for psychological problems, 

126

USS Cole

military burial for victims, 52

Special Psychiatric Rapid Intervention Teams role, 124–125

USS Enterprise, number of medevacs for psychological problems, 

126

USS John F. Kennedy

collision with the USS Belknap, 124

number of medevacs for psychological problems, 126

USUHS. See Uniformed Services University of the Health Sciences

V

VA. See U.S. Department of Veterans Affairs

Valium, use of during the Vietnam War, 152

Valproate

posttraumatic stress disorder treatment and, 304

safety of use during pregnancy, 709

Vanderwagen, Rear Admiral William C., support for Mercy model 

of population-based disaster relief, 636–637

VBA. See Veterans Benefits Administration
Index

lxix

Venlafaxine

anxiety disorder treatment, 159, 253

depressive disorder treatment, 158

pain management and, 344

posttraumatic stress disorder treatment, 303

Vet Centers

description, 33, 327, 331

early intervention efforts, 327

establishment of, 327

locations, 326

number of, 326

number of soldiers served by, 327

outreach workers for, 327

public health principles, 331

readjustment counseling role, 327

services included, 327

stigma issues and, 327

Veterans Administration, establishment of, 326

Veterans Benefits Administration

description of services, 326

phone number, 501

VA benefits counselors and, 327

Veterans Health Administration

description of services, 326

Directive 2002-049 on hospital care, medical services, and 

nursing home care, 328

number of people served by, 326

phone number, 501

VHA. See Veterans Health Administration

Vietnam Veterans Against the War, 24

Vietnam War

Agent Orange exposure and, 600

air war, 13

American troop strength, 12, 21–22

Americans killed in action, 12, 13, 14, 18

Americans wounded in action, 12, 13, 14, 20

antiwar protests, 10, 22–23, 33

Army psychiatric component, 33

black pride movement and, 23

buildup phase, 1965-1967, 13–18

civil rights movement and, 22, 23

combat psychiatry “doctrine” of brief, simple, mostly field 

treatments and, 11, 14–15, 17, 35

combat stress reactions and, 5, 16

communication issues, 536

cost of, 10

“counterculture” youth movement and, 10, 22–23, 34

counterinsurgency/guerrilla conflict, 10

cultural polarization of Americans and, 12, 22–24

demoralization of soldiers and, 10, 20, 25–26, 34

“domino theory” and, 12

draft issues, 12–13, 16–17, 22–23

drawdown phase, 21–29

effects on soldiers who served in Vietnam, 32–33

effects on the Army as a whole, 32

family notification of combat deaths, 544

“generation gap” and, 22, 23

ground war and, 10, 12

helicopters used for aeromedical evacuations, 193

high ratio of combat support and service support troops, 16

history of Army psychiatry in, 11–12

hostility toward returning soldiers, 277

illegal drug use and, 11, 17, 20–21, 24, 25, 27–28, 32, 34, 152

lack of psychiatric data, 11

lack of psychiatric documentation and, 10

lack of support for returning veterans, 496

language issues, 13

lingering questions and considerations, 32–34

as “low-intensity” combat, 13, 35

new pharmacologic agent use, 11–12, 34

number of psychiatrists serving during, 11

one-year duty tours and, 16–17, 25

posttraumatic stress disorder and, 29–30, 33, 298, 306, 309

postwar features, 29–32

psychiatric casualty rate, 11, 20, 277

psychosis rate, 27

racial tensions and, 20, 23

rationale and provocation of, 12

readjustment problems of troops after, 29–30, 33

relationship of U.S. troops to South Vietnamese citizens, 13–14

role of psychiatry in providing preventive care, 172

scope of American involvement, 12–13, 34

selected publications by buildup-phase Army psychiatrists 

(including research reports) (exhibit), 19

selected publications by drawdown-phase Army psychiatrists 

(including research reports) (exhibit), 29

selected publications by transition-phase Army psychiatrists 

(including research reports) (exhibit), 21

“short-timer’s syndrome” and, 18, 32

social and political upheaval in the United States and, 10, 34

social stress and “disease” model and, 33

soldier resistance and, 23–24

soldiers attacking their superiors (“fragging”), 25, 26, 34

survey of veteran Army psychiatrists who served in Vietnam, 

31–32

survival rates of those injured in, 226

terrain and weather issues, 13

Tet offensives, 18, 20, 34

transition from buildup to drawdown, 18–21

types of wounds sustained, 13

unit cohesiveness and, 51

U.S. Army Vietnam rates per 1,000 for battle deaths, psychiatric hospitalization, and psychosis (figure), 27

U.S. combat strategy, 14, 16

use of psychotropic medications, 152

Vistaril, use of during the Vietnam War, 152

Vitamin E, Alzheimer’s disease and, 396

Vomiting, oral health effects, 263, 264

W

Wain, H., “therapeutic debriefing” concept, 584

The Wall (Bunting), 557

Walter Reed Army Institute of Research

Army Medical Department general officers behavioral health 

summit, 81

Battlemind program and, 72–74, 80–81

deployment mental health screening research, 79

EPICON mission and, 413

EPICON surveys and, 417

epidemiological consultations of suicide and homicide clusters, 77

funding for posttraumatic stress disorder research, 81

future directions for research, 82

Health Risk Appraisal questionnaires, 281

impact of September 11, 2001, terrorist attacks, 77

Land Combat Study, 73, 77–78

Land Combat Study and, 81

leadership and unit factor research, 79–80

lme4 software, 81

ltm software, 81

mental health advisory teams, 73, 78–79

Military Life: The Psychology of Serving in Peace and Combat, 81

Operation Enduring Freedom and, 76–82

Operation Iraqi Freedom and, 76–82

pre-September 11, 2001, research on the impact of mental 
lxx

Combat and Operational Behavioral Health 

disorders, 77

psychological autopsies and, 698

soldiers diagnosed with PTSD and, 329

statistical software development, 81

study of physiological, psychological, and social correlates of 

stress, 11

suicide prevention and, 404

survey of veteran Army psychiatrists who served in Vietnam, 

12, 31–32, 34

Walter Reed Army Medical Center

child and adolescent psychiatry fellowship programs, 680

Child and Adolescent Psychiatry Service, 511, 512–513

evacuation of patients to, 201, 244

family assistance center, 254

forensic psychiatry fellowship program, 680, 697

geriatric psychiatry fellowship program, 680

Girls Time Out program, 510

National Capital Area Consortium and, 672

Parent Guidance Assessment--Combat Injury instrument and, 

513, 521–532

Preventive Medical Psychiatry, 246–256, 509–510

proposed closure of, 672

Psychiatry Consultation Liaison Service, 244–246, 583, 584, 585

September 11, 2001, terrorist attack response, 583, 584

VA Seamless Transition Office and, 327

War Psychiatry (Jones), 6, 108

War Psychiatry (Kirkland), 276–277

War Psychiatry (Rock), 92

Warner, C.H.

abnormal eating in military populations, 458

articles on the roles and responsibilities of division mental 

health units, 92

review of psychiatric service use during Operation Iraqi Freedom in 2005, 153

Warrior Training and Rehabilitation Program, peak performance 

training and, 368, 369

Warrior Transition Program

description, 129–130

goal of, 130

length of, 130

Warrior transition units

active rehabilitation and, 370

comprehensive transition plans and, 370

goal of, 369

occupational therapy and, 361, 363, 369–372

Warrior Toolkits and, 370

work reintegration and, 369–370

Washington, Gen. George, U.S. Army Chaplain Corps establishment and, 165

Washington state, memorandum of agreement with federal agencies to shore up local reintegration and reentry of returning 

service members, 280

Watchlist Project, gender-based violence and, 626

Watson, P.J., disaster psychiatry research, 581

Watson, T., eating disorder research, 454

Webb, Maj. Gen. Joseph, Jr., Suicide Risk Management and Surveillance Office and, 397

Wegner, E., “communities of practice” concept, 565, 574–575

Weight control programs, physical fitness assessments and, 704

Westmoreland, Gen. William

characterization of troops fighting in Vietnam, 17

replacement of by Gen. Creighton Abrams, 18

What Does That Mean? A Dictionary of Death, Dying and Grief Terms 

for Grieving Children and Those Who Love Them (Johnson and 

Smith), 558

What We Do When Someone Dies (Arnold), 559

Whealin, Julia, PhD, instruction of primary care providers at 

Schofield Barracks and, 568

When a Friend Dies: A Book for Teens about Grieving and Healing

(Gootman), 559

When Dinosaurs Die: A Guide to Understanding Death (Brown and 

Krasney), 557

White, R., guidelines for becoming a division psychiatrist, 92

WHO. See World Health Organization

Wilford Hall Air Force Medical Center

clinical clerkship rotations for psychiatric residents, 677

merger with Brooke Army Medical Center, 672

Winkenwerder, Assistant Secretary of Defense for Health Affairs 

Dr. William Jr., goal of the U.S. Government in world health 

concerns, 613

Wise, Col. (Ret.) Michael G., graduate medical education and, 

670–671

Wolfelt, Alan, The Healing Your Grieving Heart Journal for Teens, 559

Wolfelt, Megan, The Healing Your Grieving Heart Journal for Teens,

559

Women. See also Gender factors; Men

age of onset for schizophrenia, 442, 707

assignment locations and, 705

binge drinking definition, 475

deployments and, 705–706

drinking alcohol as a way to cope with stress, 260

eating as a way to cope with stress, 260

eating disorders and, 450, 453–454, 455–456, 459, 462–463

field conditions and, 705–706

gender-based violence in complex humanitarian emergencies, 

626

heavy drinking amount for, 475

job assignments and, 705

light drinking amount for, 475

mental health disorders in, 707–710

moderate drinking amount for, 475

noncombat role, 704

number of psychiatric patients compared with men, 203

percentage of women in the military, 704

periodontal disease prevalence (figure), 266

periodontitis and, 267–268

physical fitness issues, 704–705

posttraumatic stress disorder and, 298, 309, 709

pregnancy issues, 706–707

provider fatigue and, 376

psychosocial stressors for, 704–707

smoking as a way to cope with stress, 260

social conflicts with unit mates and, 706

social support issues, 705

temporomandibular dysfunction and, 268–269

traumatic brain injury and, 226, 710–712

Women’s Medical Specialist Corps and, 359

Woodruff, L. and B., In an Instant: A Family’s Journey of Love and 

Healing, 517

Work reintegration programs

data collection and, 372

definition, 369

objectives of, 370–371

occupational therapy focus for, 371–372

work internships, 371

World Bank, nongovernmental organization definition, 622

World Food Program, complex humanitarian emergencies and, 

621

World Health Organization

complex humanitarian emergencies and, 621

Department of Mental Health and Substance Dependence, 627

traumatic brain injury outcome research, 231–232

World War I

Army Alpha and Beta testing, 172

gas attacks, 597, 600

motorized ambulances and, 192
Index

lxxi

noncombatant casualties, 625

number of psychiatrists in the Army, 671

occupational therapy and, 358, 373

psychological casualties, 5

United Kingdom armed forces behavioral health and, 658

use of psychotropic medications, 152

World War II

aeromedical evacuations and, 192

Americans’ response to the invasion of Normandy, 167

battle fatigue casualties, 594, 597

casualty rates of the Vietnam War compared with, 13, 14

communication issues, 536

community mental healthcare in the military and, 564

family notification of combat deaths, 544

humanitarian assistance missions, 611

“lack of moral fiber” diagnosis and, 658–659

noncombatant casualties, 625

occupational therapy and, 358–359

Office of Strategic Services and, 172

psychiatric casualties, 5, 11, 26

psychological screening and, 172

survival rates of those injured in, 226

unit cohesiveness and, 51

United Kingdom armed forces behavioral health and, 658–659

use of psychiatrists in a preventive fashion, 172

use of psychotropic medications, 152

Wounded Warrior Clothing Support Program, establishment of, 

361

Wounded Warrior program, description, 328

WRAIR. See Walter Reed Army Institute of Research

WRAMC. See Walter Reed Army Medical Center

WTP. See Warrior Transition Program

WTRP. See Warrior Training and Rehabilitation Program

WTUs. See Warrior transition units Y

Yeltsin, Pres. Boris (Russia), biological warfare program, 594

Yosick, Maj. Todd, Battlemind program and, 73

You Are Not Alone: Teens Talk About Life After the Loss of a Parent

(Hughes), 559–560

Yugoslavia, complex humanitarian emergency example, 625 Z

Zero to Three, Coming Together Around Military Families pro-

gram, description and Web site, 550, 555

Zinberg, Norman, M.D., survey of illegal drug use in the Vietnam 

War, 11, 28

Zinc deficiency, anorexia nervosa and, 460

Ziprasidone, bipolar disorder treatment, 158

Zoloft, depressive disorder treatment, 158

“Zoloft with a Rifle” article, 147

Zolpidem, insomnia treatment, 159

Zonisamide, obesity treatment, 462

Zyprexa, psychotic disorder treatment, 159
lxxii

Combat and Operational Behavioral Health