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Annotated Bibliography

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This paper provides an annotated bibliography of 5 peer-reviewed articles that pertain to the issue of causes and repercussions of PTSD on deployed troops, their families, and the government. It concludes with the overview of the process of the annotated bibliography creation.  

Tuerk, P., Steenkamp, M. & Rauch, S. (2010). Combat-related PTSD: Scope of the current problem, understanding effective treatment, and barriers to care. Developments in Mental Health Law, 29(1).

The article provides an overview of the issues linked to effective treatment of combat-related PTSD in the context of contemporary public health issues. The main point of the article is that due to the extent of mental health difficulties experienced by returning troops, the scope of medical aid to the PTSD-diagnosed military has to be broadened. The authors provide a reliable overview of the secondary data, including latest reports in public health, pharmacotherapy, and government initiatives. PTSD is conceptualized on the basis of meta-analysis and synthesis of empirically based research. Along with evaluation of the progress in the sphere of combat-related PTSD treatment, barriers which prevent people from effective treatment have been identified.  Specifically, these are lack of innovative approaches to psychotherapy, low levels of veterans’ access to empirically supported strategies in PTSD therapy, poor access to public health facilities, etc. At the same time, the authors provide an overview of recent successes of policies directed at combat-related PTSD treatment initiated by VA (Veterans Administration), DOD (Department of Defense), and CDP (The Center for Deployment Psychology). Importantly, the authors attempt to predict the way the problem is going to unfold in the future. Given the likely growth of PTSD-related cases, multiple additional outreach programs will be required to address the issue fully. This article is helpful since it informs the current research about the successes and gaps in modern handling of the problem of PTSD treatment among U.S. veterans and allows gaining insight into the future.   

Shea-Porter, C. (2009). Posttraumatic stress disorder and government initiatives to relieve it. Health & Social Work, 34(3), 235-236.

The article provides a brief overview of the causes, scope, and approaches to dealing with PTSD on the government level. It cites secondary research data that allow us to clarify the causes of PTSD such as stressors of service, multiple deployments, insufficient time to recover, and specifics of war in Iraq and Afghanistan. The main point of the article is that the government initiatives to help veterans relieve their mental health problems have been quite successful and need to be extended. The value of the article is in its provision of an expert opinion – Shea-Porter, a Congresswoman  from New Hampshire, reports her experience as a member of the Armed Services Committee and the Personnel Subcommittee in relation to PTSD initiatives. She expresses confidence that the government will be able to deal with the problem of PTSD treatment effectively. However, the article lacks a critical insight into the problem, and in some cases, Shea-Porter’s statements seem to lack empirical support. In particular, she talks about what has been done by her to improve the situation but fails to identify serious gaps that need to be addressed in the future. Her claims are often general and unwarranted, although they may be helpful as a source of expert opinion. Overall, the article does not meet al criteria of a reliable scholarly source but provides an expert opinion into the issue. This will also be used as an evidence to inform our research into causes and repercussions of PTSD.    

Hoge, C., Castro, C., Messer, S., McGurk, D., Cotting, D. & Koffman, R. (2004) Combat duty in Iraq and Afghanistan, mental health problems and barriers to care.  New England Journal of Medicine, 351, 13-22.

This study provides a consistent assessment of mental health in the U.S. troops deployed to Iraq and Afghanistan. On the basis of the anonymous survey, it has been estimated that the military, who were deployed to Iraq, had greater exposure to combat than those deployed to Afghanistan. Respectively, the percentage of research participants that provided responses that indicated PTSD, major depression, or generalized anxiety was significantly higher among those deployed to Iraq. Apart from identifying the high level of risk of PTSD among these troops, the study revealed the insufficiency of mental health therapies provided to the military. On the one hand, it is associated with the concern about stigma among those who needed mental health services; on the other hand, lack of screenings for PTSD and major depression prevent soldiers and marines from getting adequate medical assistance. The study provides implications for future research and policy – the quality of mental health care to the troops deployed to Iraq and Afghanistan should be enhanced in terms of reduction of stigma and overcoming of barriers. Importantly, this study uses reliable research tools and methods, as well as an adequate sample, which allows generalizing about the overall situations in Marine Corps and Infantry. The study helps to prioritize the focus of mental health services on Iraqi and Afghani troops and identifies barriers to effective treatment.

De Burgh, T., White, C., Fear,N. & Iversen, A. (2011).The impact of deployment to Iraq or Afghanistan on partners and wives of military personnel. International Review of Psychiatry, 23, 192–200.

This article provides a qualitative assessment of a range of credible peer-reviewed secondary sources on the issue of psychological effect of military deployment on spouses. Despite the fact that the research focuses only on spouses of the male personnel and only in quantitative studies of troops deployed to Afghanistan and Iraq, it managed to create an objective picture of psychological problems in the military’s families. In particular, three major sets of problems have been identified: problems related to psychiatric disorders, stress, and marital health. It has been revealed that female spouses of the military personnel are at a higher risk of developing such mental health problems as sleep disorders, depression, anxiety disorders, adjustment disorders, and acute stress reaction. At the same time, it has been found that only a certain percentage of spouses seek mental health aid due to perceived stigma. Next, it has been found that spouses suffer from marital dissatisfaction during long deployments, which puts marital relationships at risk. At the same time, marital health has been found to suffer greatly from inability of PTSD affected military personnel to reintegrate into family life, including parenting, communication, and bonding problems. Also, stress has been revealed to be twice as high in spouses of the deployed troops than in those of the non-deployed. The biggest stressor is pregnancy. The study concludes that spouses of the deployed military are at greater risk of mental health problems. The factors that contribute to thheir mental health or lack of it are: deployment lengths, mental health of the returning military, and personal circumstances of spouses, including pregnancy. Besides, the researcher identified the interrelationship between spouses’ mental health. The research has been particularly helpful in creating the general picture of the PTSD impact on spouses’ health, its factors, and its major aspects.

Carter, S., Loew, B., Allen, E., Stanley, S., Rhoades, G. & Markman, H. (2011). Relationships between soldiers’ PTSD symptoms and spousal communication during deployment. Journal of Traumatic Stress, 24(3), 352–355.

The article focuses on the role of spousal support and communication during the troops’ deployment to Iraq, particularly on their PTSD exposure. It has been found that frequent telephone conversations, e-mails, care packages, and letters were the means of enhancing marital satisfaction in the couples who were martially satisfied. Deployed male spouses were found to have had smaller exposure to PTSD during and after combat. At the same time, males, who had low marital satisfaction, did not benefit from spousal communication, which was typically delayed and scarce; they were subject to a higher risk of PTSD. The study provides valuable primary data related to the topic of spousal interaction and PTSD. The conclusions are based on the data obtained in a result of a highly reliable method of a randomized controlled trial. The article is helpful in terms of considering ways to reduce the possible repercussions of PTSD on the troops involved in direct combat. Enhancement of family communication as a means of fortifying emotional stability will be described in the paper as a part of possible PTSD-related strategies in the future.

In conclusion, creation of the annotated bibliography helped gain insight into the problem of PTSD among the military in the context of medical services, government policy, and family problems. It enabled the author identify research of various levels of credibility, relevance, and validity. In particular, the annotated bibliography allowed distinguishing the primary data based research, which is of the highest value for the current research, as well as helped identify secondary data based research, which makes it possible to generalize about trends in PTSD treatment, policy, and effects on the family life. The articles have been selected on the basis of their thematic relevance and adequacy to the topic of our research, as well as by the criteria of being published in a peer-reviewed source. Besides, the author aimed at combining qualitative and quantitative studies within the annotated bibliography, as well as studies that employ various methods of research. The most difficult thing was to identify the gaps of the articles and their limitations in relation to the topic they discuss. At the same time, strengths identification has been useful in terms of defining articles’ reliability in informing the current research. The research has changed the author’s point of view only to a certain extent. The author was aware of the insufficiency of government aid to veterans with PTSD. The articles just supported this view and provided necessary empirical data. As for changed views, the author has realized the scope of the problem, drawbacks of psychotherapies used to treat ex-military diagnosed with PTSD, and the impact on the spouses. In particular, the task has changed my view of the repercussions of PTSD on marital health. It appears that people diagnosed with PTSD cannot normally function as parents and spouses due to bonding and communication incapability. 

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