International Journal of Emergency Mental Health and Human Resilience
Open Access

Abstract

Statement of the Problem: Community reintegration (CR) describes the process of an individual’s adjustment and return to participation in their major social roles at home, work and in the community. Estimates suggest of the 2.3 million Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) US service members deployed, over 300,000 have mild TBI and at least 300,000 have PTSD. Negative consequences for CR in Veterans associated with mild TBI have included increased rates of apathy, depression, anger and disinhibition and increased risk of being victims of violence and abuse. The negative consequences for CR associated with PTSD have included decreased quality of life, increased self-reported medical and physical symptoms, increased substance use and suicide. PTSD also has negative economic and interpersonal consequences for Veterans including decreased work performance, increased homelessness and impaired family relationships.

Methodology & Theoretical Orientation: This talk will be based on a synthesis of the presenter’s work completed over the past five years and will highlight associations and points of clinical relevance among TBI, PTSD and CR. Findings: Mild TBI and PTSD are indirectly associated with CR ratings through increases of depression symptoms. These associations are moderated by an individual’s genetics and Ventral Striatum integrity. Conclusion & Significance: Clinical providers struggle with assisting Veterans in their attempts to successfully reintegrate into their civilian lives. Recommendations will be made how to use the information to better assist Veterans with CR efforts.

Biography

David P Graham is a native Houstonian who received a BS in Biology from Notre Dame, an MS in Zoology from Texas A&M (having studied the feeding behaviors of American Alligators as part of my field herpetology degree), before returning to Baylor College of Medicine to attend medical school. He completed his residency in Psychiatry at the University of New Mexico and a Health Services research fellowship at the MEDVAMC as part of the MIRECC program. He worked in the Mental Health Care Line as a staff psychiatrist. He is an avid researcher and his focus being on the overlap of traumatic brain injury and PTSD on community reintegration. As an Associate Professor at Baylor College of Medicine, he taught several courses to the 1st and 2nd year Psychiatry residents and mentor 3rd and 4th-year residents both in research and clinical services.

E-mail: david.graham@va.gov