Abstract: Studies have shown that about half of U.S. veterans who served in Iraq or Afghanistan report significant postcombat stress symptoms, and the prevalence of posttraumatic stress disorder (PTSD) averages 12%–13% in infantry personnel. Unfortunately, utilization of mental health services by combat veterans is relatively low. While evidence-based treatments exist, treatment dropout significantly reduces efficacy. Even among veterans who complete treatment, significant PTSD symptoms often remain, and there are high rates of comorbidity and chronicity. We hypothesize that the phenomenon of “combat attachment” represents a hidden, underrecognized variable in treatment outcomes. We define combat attachment as a pattern of habitually engaging in combat-related experiences for considerable amounts of time, accompanied by feelings of excitement or euphoria and physiological hyperarousal, with impairment in social or occupational functioning.
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The participant will explain the concept of “combat attachment” and its potential importance in the treatment of combat-related posttraumatic stress disorder.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Estimated Time to Complete
Duration: 1 hour
Begin Date: December 1, 2016
End Date: November 30, 2018
How to Earn Credit
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
Title: Postdeployment PTSD and Addictive Combat Attachment Behaviors in U.S. Military Service Members
Authors: Marjorie S. Campbell, Ph.D., Margaret Ryan, M.D., Daniel Wright, Ph.D., Maria D. Devore, M.S., Charles W. Hoge, M.D.
Affiliations: From the Directorate of Mental Health and the Clinical Investigation Program, Naval Hospital Camp Pendleton, Camp Pendleton, Calif. (M.S.C., M.R., D.W., M.D.D.); and the Center for Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Md. (C.W.H.).
Disclosures: The authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP) ; Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
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