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  • PTSD, Violent Behavior: What You Need to Know

    Service memeber running
    U.S. Marine Corps photo by Cpl. Matthew Callahan

    Capt. Janet Hawkins is a violence prevention subject matter expert at the Deployment Health Clinical Center. She specializes in posttraumatic stress disorder and interpersonal violence prevention in military populations.

    In support of PTSD Awareness Month in June, I was invited to speak at the 2013 Family Advocacy Training Course in Quantico, Va., on the relationship between posttraumatic stress disorder (PTSD) and interpersonal violence. I shared findings from the July 2012 Institute of Medicine report, “Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment,” which examined PTSD treatment programs and services at the Defense Department and Department of Veterans Affairs, and served as a basis for discussing the relationship between the clinical disorder and interpersonal violence. More than 40 Marine Corps leaders attended the annual violence prevention training, including installation sergeant majors, behavioral health managers and family advocacy managers.

  • New DSM-5 Revisions Add More Options to Diagnosis Criteria for PTSD

    Chaplain counseling a service member
    Chaplain (Capt.) Troy Parson encourages service members, family members and civilian employees who are battling depression to seek help. (U.S. Army photo by Ms. Jennifer Clampet)

    When the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) was released May 2013, it marked the end of more than a decade’s journey in revising criteria to diagnose and classify mental disorders.

    During last month’s Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) webinar, participants heard about revisions to diagnosis criteria for posttraumatic stress disorder (PTSD) that take into account information learned from scientific research and clinical experience.

    Removing criterion A2 and splitting ‘avoidance’ into its own category were among the major changes to the diagnosis of PTSD in the DSM-5. Criterion A2 requires that the person’s reaction to a traumatic event involve fear, helplessness or horror. It was removed because research suggests it doesn’t improve diagnostic accuracy, according to DSM-5 literature.

  • How to Answer Security Clearance Question 21 on Psychological Health

    Update: As one of the most read DCoE blogs, we've recently published an update, “Worried about Security Question 21? These Tips Can Help.”

    Get this picture on

    U.S. Marine Corps photo by Cpl. Casey Jones

    Many jobs in the military and government require a security clearance. Maybe you, or someone you know or someone they know has a clearance — confidential, secret or top secret — or will apply for a national security position in the future, requiring answers to Standard Form 86 “Questionnaire for National Security Positions.” The U.S. government uses the information from this form to conduct background checks and evaluations of those individuals under consideration for a national security position and for those requiring access to classified information. As you complete the form, you’ll need to answer questions about your personal life, including whether you’ve had psychological counseling — Question 21.

    Seeking psychological health counseling or treatment alone won’t automatically impact your ability to obtain or maintain a security clearance, however, Question 21 still discourages some people from applying for certain jobs or from seeking help. The Real Warriors Campaign recently published an article, “Security Clearances and Psychological Health Care,” to help you answer questions about your psychological and emotional health history and to debunk myths surrounding Question 21 of the security clearance form. Here are some things to consider before you fill out the form.

  • Are You Stuck? Learn Coping Skills to Help You Move Forward

    Service member jumping out of a plane
    U.S. Marine Corps photo by Kowshon Ye

    A new website gives members of the military community access to an educational and life coaching program online. Developed by National Center for Telehealth and Technology (T2) and Department of Veterans Affairs (VA) as part of the Defense Department and VA initiative to provide collaborative and integrated mental health services to veterans and service members, “Moving Forward” helps individuals better understand their own problem-solving abilities and teaches new skills to overcome obstacles in life, both big and small.

    Below, Dr. Pam Murphy, a licensed psychologist and project lead at T2 for “Moving Forward,” describes the training through a series of questions we thought a service member or veteran might ask if given the chance to speak with her.

    Q: What is “Moving Forward” and where can I find it?

    A: “Moving Forward,” at, is a self-help online training course that teaches problem-solving skills to help individuals overcome life’s challenges. It’s based on a highly effective cognitive behavioral treatment program used successfully with veterans across the country for the past several years. Although many veteran centers continue to offer the program in-person, we hope this online version expands the reach of this resource to individuals who may not have easy access to VA centers and our active-duty service members.

  • The Shame of Embarrassment

    U.S. Air Force photo by Airman 1st Class Monet Villacorte

    As a caregiver for a husband with traumatic brain injury (TBI), Rosemary Rawlins shares insights garnered from her own experiences along with insights from other caregivers and family members in her blog, “Learning by Accident,” on BrainLine. Caregiving can trigger a host of emotions. In this blog post, Rosemary shares advice on coping with a particularly awkward and often shameful feeling that sometimes surfaces when caring for a loved one with TBI — embarrassment.

    The wife of a brain injured man with behavioral issues recently asked me if I ever felt embarrassed of Hugh and how I handled it. When she asked me this question, I could sense the pain in her voice along with a shameful sadness weighing her whole body down. I answered honestly and said I felt that way a few times in the past, and we agreed it’s an uncomfortable and difficult emotion to cope with.

  • Taking Total Charge of Your Health

    Service members marching
    U.S. Marine Corps photo by Lance Cpl. Cuong Le

    Fitness may mean different things to different people. Your idea of fitness and what it takes to maintain it may be different from others. One approach is to look at it holistically — mind, body and spirit. The Defense Department uses a holistic approach and framework called Total Force Fitness to support warriors’ health and wellness. Achieving total fitness is a state in which you, your family and your unit or organization can sustain optimal well-being and performance even under difficult conditions.

    Within this framework, we’ve highlighted information and resources geared toward service members that discuss the importance of a fit mind, body and spirit for overall health and resilience. The concept of Total Force Fitness encompasses eight domains:


    • Psychological: Building mental, emotional and behavioral abilities to strengthen resilience
    • Behavioral: Controlling actions to the benefit of your health
    • Spiritual: Maintaining a relationship with certain religious practices or in non-religious practices such as through a family focus or nature
    • Social: Building and maintaining healthy relationships with others