Eileen M. Delaney

International trends in spice use: Prevalence, motivation for use, relationship to other substances, and perception of use and safety for synthetic cannabinoids

Synthetic cannabinoids (SC), commonly known as Spice, are a class of compounds that share affinity for the cannabinoid receptors. Recreational use of SCs has grown in recent years. A literature search was conducted of national and international organizations as well as peer-reviewed publications describing SC use in non-clinical populations. Our primary goal was summarizing SC use prevalence within the general population from representative surveys. Our secondary goals included describing SC use frequency, motivation for use, the relationship between SC use and use of other substances, and perception of SC use including beliefs about safety and use by peers. Nationally and regionally representative surveys describe lifetime prevalence of SC use in the general population as between 0.2% and 4%. Longitudinal data, though limited, shows decline in SC use with peak use occurring in the late teens and early twenties. Users tend to be males. The majority of SC users report using only a small number of times and use tends to not be sustained. The most common motive for SC use is curiosity. SC users generally report a history of extensive use of other substances. Perception of SC use by others tends to be significantly greater than actual SC use.

Preventing PTSD and depression and reducing health care costs in the military: a call for building resilience among service members

The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately

Psychological Impact of Deploying in Support of the U.S. Response to Ebola: A Systematic Review and Meta-Analysis of Past Outbreaks

196,

Interactive effects of stress and individual differences on alcohol use and posttraumatic stress disorder among personnel deployed to Guantanamo Bay.

288, and

Predicting firearms performance based on psychiatric symptoms and medication usage.

597 million in annual treatment costs, respectively, or approximately

State of Psychology in the US Armed Forces

1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system.

Responding to Trauma at Sea: A Case Study in Psychological First Aid, Unique Occupational Stressors, and Resiliency Self-Care

OBJECTIVE To examine the potential psychological impact of deploying in support of the U.S. response to Ebola in west Africa by systematic review and meta-analysis. METHODS Peer-reviewed articles published between January 2000 and December 2014 were identified using PubMed, PsycINFO, and Web of Science. Thirty-two studies involving 26,869 persons were included in the systematic review; 13 studies involving 7,785 persons were included in the meta-analysis. Pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. RESULTS Reflecting the sociodemographics of the military, those who are younger, single, not living with family, have fewer years of work experience, lower education, and lower income are at increased risk for psychological distress, alcohol/drug misuse, post-traumatic stress disorder (PTSD), depression, and/or anxiety as a result of their perceived risk of infection. Effect sizes for post-traumatic stress disorder, depressive, and anxiety symptoms were considered small (SMD = 0.12, 95% CI = -0.23 to 0.47), moderate (SMD = 0.40, 95% CI = 0.24-0.51), and small (SMD = 0.08, 95% CI = -0.09 to 0.25), respectively; however, only the effect size for depressive symptoms was statistically significant. CONCLUSIONS Deployed service members may return with clinically significant problems, the most notable of which is depression. Delivering resilience training and fostering altruistic acceptance may protect service members from developing mental health disorders.

Health Care Provider Burnout in a United States Military Medical Center During a Period of War.

This study examines the role of factors such as perceived stress, neuroticism, beliefs in psychotherapy stigma, resilience, and demographics in understanding posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) among deployed military personnel. Results show that personnel who screened positive for PTSD were more likely to screen positive for AUD (versus those who did not screen positive for PTSD). Perceived stress, neuroticism, and psychotherapy stigma all have direct multivariate relationships with PTSD symptoms. Moderated regression analyses show that the positive relationship between perceived stress and PTSD symptoms is significantly stronger among those scoring high on neuroticism and psychotherapy stigma. The positive relationship between perceived stress and AUD symptoms is only significant among those scoring high on psychotherapy stigma. Given the moderating role of psychotherapy stigma in the relationship between perceived stress and PTSD symptoms and the relationship between perceived stress and AUD symptoms efforts to reduce the stigma associated with mental health care in the military should be expanded. Also, the current research adds to the literature highlighting the role of neuroticism as a key variable in understanding PTSD.

A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder ☆

Health care providers may be asked to make recommendations whether individuals with a mental health history and/or are taking psychiatric medication should have access to firearms as part of their work. For example, in the military, some instructions require a waiver from a medical provider for those individuals taking a psychiatric medication to be able to continue carrying a weapon. There is currently little data or established protocols to help objectively guide such recommendations. This study examined the reliability and validity of using a video game simulation of firearms performance and examined variables that might predict such performance. Participants were asked questions about demographics, psychiatric symptoms, and usage of psychiatric medication. They then took a computerized neuropsychological battery and were observed in a video game simulation of firearms performance. Data were examined for relationships among measures of test−retest stability over 1 month, and models were constructed to predict performance. Results showed that most aspects of firearms performance were found to be a reasonably stable construct with good relationships to established neuropsychological measures. When predicting who would perform more poorly on the firearms simulations, performance on the neuropsychological battery was a significant predictor. Being on psychiatric medication had a small but significant effect on one aspect of firearms performance. This study provides a first step in providing a more objective means of guiding medical recommendations about firearms.

Screening for Complicated Grief in a Military Mental Health Clinic

Military psychology is a specialized branch of psychology that plays a critical role in national defense through the application and advancement of psychological study and practice. Military psychologists engage in a variety of services, providing direct clinical care, advising military commands, consulting, teaching, and conducting research activities. They perform their roles in a multitude of settings, providing psychological services to ten million beneficiaries, working with operational forces, consulting with military commands/leaders, and providing expertise in assessment as well as program development, implementation, and sustainment. Military psychologists can be found in both medical treatment facilities and embedded within operational communities. In addition to performing their clinical duties, having psychologists in embedded roles decreases negative stigma about seeking mental health treatment and encourages early help seeking. Written by the lead clinical psychologists in the US Army, Navy, and Air Force, this chapter describes how each military branch utilizes psychologists to enhance the performance of service members, commands, and the military as a whole.