Post-traumatic Stress Disorder and its Dissociative Subtype in Military Personnel and Veterans

Investigators: Lanius, Ruth; McKinnon, Margaret; Admon, Roee; Foster, Jane; Frewen, Paul; Fruchter, Eyal; Gonzalez, Andrea; Jetly, Rakesh; McCabe, Randi E; Neufeld, Richard; Rhind, Shawn; Richardson, Don; Theberge, Jean

Funding: Canadian Institutes of Health Research (CIHR), $607,780 over 5 years

Lay Abstract:  Urgent calls exist within Canada to address the mounting crisis of post-traumatic stress disorder (PTSD) among serving members of the military forces and veterans.  Critically, PTSD among military members has been shown to be less responsive to treatment than PTSD stemming from other forms of trauma exposure, and is associated with greater cognitive impairment.  Work in our laboratory has focused heavily upon the identification of specific subtypes of PTSD, where we have been instrumental in adoption of the new dissociative subtype of PTSD in the recent diagnostic manual for psychiatry.  This subtype has been associated with increased disease severity and poorer functional outcomes.  Moreover, poor treatment outcomes in this subtype have been tentatively linked to the negative effect of dissociation on cognitive functioning.  It is therefore probable that the dissociative subtype of PTSD is one factor contributing the increased disease burden of PTSD in military members; yet to date no studies have addressed this issue.  Given that dissociative symptoms are further associated with poor cognitive functioning, it is likely that these symptoms impact performance in the combat theatre.  We propose a novel series of studies to assess: i) cognition; ii) brain patterns; and iii) biological markers of the dissociative subtype of PTSD among military members and veterans diagnosed with PTSD.  With a broad referral base and the full support of the Department of Defense in Canada, coupled with relevant expertise, including Col. Rakesh Jetly, Senior Psychiatric Advisor to the Surgeon General and the Head of Research of the Israeli Defense Forces, we are in a strong position to characterize the dissociative subtype among military members.  This work will be central to the development and the implementation of novel interventions that address directly the negative effect of the dissociative subtype of PTSD on treatment response and combat performance among members of the military.