Pretreatment predictors of dropout from cognitive behavioral therapy for PTSD in Iraq and Afghanistan war veterans.

Cognitive–behavioral therapies (CBTs) can be effective treatments for posttraumatic stress disorder (PTSD) but their effectiveness is limited by high rates of premature dropout. Few studies have compared pretreatment characteristics of treatment completers and dropouts, and only one has examined these factors in Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) Veterans. This study analyzed archival clinical data from 117 OEF/OIF Veterans evaluated and treated through a Veterans Affairs PTSD clinic. High numbers dropped out of treatment (68%). Treatment dropouts (n = 79) and completers (n = 38) differed significantly on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales, PTSD symptom severity, and age. Regression analyses identified one MMPI-2 scale, TRT (negative treatment indicators), and age as unique but modest predictors of dropout. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Circumventing mental health stigma by embracing the warrior culture: Lessons learned from the Defender's Edge program.

Despite considerable efforts on the part of the Department of Defense, Department of Veterans Affairs, and the wider mental health community, mental health stigma continues to be a significant barrier to seeking help by service members, highlighting the need for newer modes of thought. A significant factor contributing to this stigma is the fundamental difference between traditional mental health approaches and the warrior culture. As a mental health prevention initiative, the Defender's Edge (DEFED) program was specifically developed to fit within the United States Air Force Security Forces (SF) charged with ground combat operations while deployed to Iraq. DEFED adopted a strengths-based philosophy and integrated a psychologist into the SF culture. Evaluative feedback from 192 program participants is presented, demonstrating high programmatic acceptability and feasibility suggestive of success in circumventing mental health stigma. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

"Treating traumatized OEF/OIF veterans: How does trauma treament affect the clinician?": Correction to Voss Horrell et al. (2011).

Reports an error in "Treating traumatized OEF/OIF veterans: How does trauma treatment affect the clinician" by Sarah C. Voss Horrell, Dana R. Holohan, Lea M. Didion and G. Todd Vance (Professional Psychology: Research and Practice, 2011[Feb], Vol 42[1], 79-86). The word “While” was erroneously inserted in the first sentence of the “Clinician Factors” section. The corrected sentence is provided in the erratum. (The following abstract of the original article appeared in record 2011-04544-011.) The authors of this article describe the rewards and challenges for clinicians treating veterans who have served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Issues of vicarious trauma, secondary traumatic stress, compassion fatigue, and burnout are defined and reviewed, as are compassion satisfaction and posttraumatic growth. Patient, clinician, and organizational characteristics that are likely to affect clinicians working with this clinical population are discussed. Patient factors that may increase strain on clinicians are discussed such as age, likelihood of redeployment, comorbid conditions, attendance issues, and elevated risk for suicide and aggression. Clinician factors, such as theoretical orientation, training, supervision, military affiliation, personal trauma history, spirituality, social support, and self-care, are also discussed as possible risk and protective factors for vicarious trauma and burnout. Organizational influences, such as caseload size and diversity, clinician control and autonomy, use of evidence-based practices, availability of resources, rural isolation, and the philosophy of the clinic, are further discussed. Recommendations for ameliorating risks are discussed relative to each area and include allowing clinicians to plan their own appointments so as to balance their caseload of OEF/OIF veterans, attending to self-care practices, and having a supportive team with thorough training in evidence-based practices. Future empirical research is needed on risk and resiliency factors for clinicians working with traumatized OEF/OIF veterans given that this population is likely to grow. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Power decoupling control of a solid oxide fuel cell and micro gas turbine hybrid power system

Solid Oxide Fuel Cell (SOFC) integrated into Micro Gas Turbine (MGT) is a multivariable nonlinear and strong coupling system. To enable the SOFC and MGT hybrid power system to follow the load profile accurately, this paper proposes a self-tuning PID decoupling controller based on a modified output-input feedback (OIF) Elman neural network model to track the MGT output power and SOFC output power. During the modeling, in order to avoid getting into a local minimum, an improved particle swarm optimization (PSO) algorithm is employed to optimize the weights of the OIF Elman neural network. Using the modified OIF Elman neural network identifier, the SOFC/MGT hybrid system is identified on-line, and the parameters of the PID controller are tuned automatically. Furthermore, the corresponding decoupling control law is achieved by the conventional PID control algorithm. The validity and accuracy of the decoupling controller are tested by simulations in MATLAB environment. The simulation results verify that the proposed control strategy can achieve favorable control performance with regard to various load disturbances.     

The impact of PTSD, depression, and substance use disorders on disease burden and health care utilization among OEF/OIF veterans.

Growing evidence suggests that posttraumatic stress disorder (PTSD) is associated with poorer health status (e.g., more medical disease, physical symptoms, and sick visits to health care professionals) among veterans who served in Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq. We investigated whether PTSD, depression, and substance use disorders independently predicted health status over time among OEF/OIF veterans. Information regarding psychiatric and medical conditions and health care utilization was culled for 4,463 OEF/OIF veterans enrolled in Veterans Administration primary care for a period of 6 years. Data were analyzed using multilevel modeling and generalized estimating equations. Results suggest that PTSD, depression, and substance use disorders are independently associated with increased medical disease burden and mental health care utilization but not increased medical health care utilization. The association between PTSD and medical disease burden strengthened over time. These data suggest that OEF/OIF veterans with PTSD may be at risk for increasingly poorer physical health in terms of medical disease burden over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dynamic modeling of a SOFC/MGT hybrid power system based on modified OIF Elman neural network

Solid oxide fuel cell (SOFC) integrated into micro gas turbine (MGT) cycle is a promising power‐generation technology. This article proposes a modified output–input feedback (OIF) Elman neural network model to describe the nonlinear temperature and power dynamic properties of the SOFC/MGT hybrid system. A physics‐based mathematical model of a 220 kW SOFC/MGT hybrid power system is used to generate the data required for the training and prediction of the modified OIF Elman neural network identification model. Compared with the conventional Elman neural network, the simulation results show that the modified OIF Elman identification model can follow the temperature and power response of the SOFC/MGT hybrid system with higher prediction accuracy and faster convergent speed. Copyright © 2010 John Wiley & Sons, Ltd.     

Relationship adjustment, PTSD symptoms, and treatment utilization among coupled National Guard soldiers deployed to Iraq.

Although combat-related posttraumatic stress disorder (PTSD) is associated with considerable impairment in relationship adjustment, research has yet to investigate how PTSD symptoms and relationship distress uniquely and jointly predict utilization of a range of mental health services. The present study sought to examine these issues utilizing a longitudinal sample of National Guard soldiers surveyed 2–3 months following return from deployment to Iraq and again 12 months later (N = 223). Results indicated that PTSD symptom severity, but not relationship adjustment, uniquely predicted greater odds of utilizing individual-oriented mental health services. A significant interaction was found indicating associations between PTSD symptoms and the odds of using services were increased when soldiers reported greater relationship adjustment. For utilization of family-oriented care, greater relationship distress was significantly correlated with greater odds of using services, but associations with PTSD symptoms were nonsignificant. The association between relationship distress and utilization of family-oriented services did not vary significantly with severity of PTSD symptoms. Results suggest supportive intimate relationships facilitate mental health treatment utilization for soldiers with PTSD symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

PHI高光谱数据和高空间分辨率遥感图像融合技术研究

提出了一种新的高光谱图像融合技术———基于最佳指数准则的高光谱小波包图像融合方法,即首先利用最佳指数选择高光谱的最佳合成波段,得到低分辨率的彩色合成影像,然后采用一种基于区域多特征的小波包融合算法进行融合处理.文中利用上海地区PH I高光谱数据和高分辨率全色航空像片来验证算法的有效性,实验结果表明该方法可有效的实现高光谱数据和高空间分辨率遥感图像的融合处理.     

一种基于递归神经网络的自适应控制方法研究

本文针对快速、多变量、强非线性的复杂系统的控制问题,在强化学习方式的基础上,提出一种新的自适应控制方法。该方法在没有先验知识的条件下,基于递归神经网络并结合强化学习的自调节能力,通过自身神经网络的在线学习,有效控制不稳定的非线性系统。本文以一级倒立摆系统为实验对象,仿真实验结果表明:所提出的控制方法具有非常好的控制效果和稳定精度,抗干扰能力强。     

Concussive and psychological symptom predictors of aeromedical evacuation following possible brain injury among deployed military personnel.

Over 2.5 million U.S. military members have deployed in support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), and more than 48,000 service members have been aeromedically evacuated (A/E'ed) from both theaters for both battle and nonbattle injuries. The purpose of this study was to consider differences in clinical presentation associated with dispositional status among a sample of 157 deployed service members evaluated subsequent to a suspected brain injury and to identify which symptomatic variables are most associated with the decision to recommend A/E. Results from an in-theater hospital suggest that symptoms persisting to the point of clinical evaluation were associated more strongly with disposition than symptoms reported immediately postinjury. When considering a range of common concussive and psychological symptoms associated with brain injury, only memory problems, irritability, and hearing problems were associated with increased likelihood for A/E from a combat zone following suspected brain injury. (PsycINFO Database Record (c) 2011 APA, all rights reserved)