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Rocky Mountain MIRECC for Suicide Prevention

Updated: 17 March 2015

Featured Research Project

Exploring the use of acupressure, a free (once learned) treatment that Veterans may supply for themselves, to potentially help relieve some symptoms created by TBI and/or PTSD.

Simply click on the plus (+) symbol to expand each section to learn more about our acupressure research.

Principal Investigators

Theresa D. Hernández, PhD
Professor, University of Colorado at Boulder
Principal Investigator
Theresa.Hernandez@va.gov

Lisa A. Brenner, PhD, ABPP, Rp
Director, VA Rocky Mountain MIRECC
Co-Principal Investigator
lisa.brenner@va.gov

Study Team

Tyler Jorgensen, Study coordinator
Emily Wingeier, acupressure practitioner
Christine Palafox, acupressure practitioner

Funding

Background

Acupressure treatments originated in China, along with the related practice of acupuncture. Traditional use targets both physical symptoms as well as emotional well-being, integrating a mind-body approach. Recently, Western practitioners have gained interest in different forms of Complementary and Alternative Medicine (CAM) and the use of Integrative Medicine, or combining alternative practices with mainstream approaches for the best overall results.

Research to explore the effectiveness of acupressure and acupuncture, along with other types of CAM treatments is currently gaining momentum as these types of treatments increase in the U.S. In addition to scientific research being conducted with civilians, the VA is also exploring use of CAM to help improve medical as well as mental health symptoms. Stress management appears to be a primary benefit resulting from use of CAM in VA. Formal Complementary and Alternative Medicine research is also being conducted nationally with civilians, through the National Center for Complementary and Alternative Medicine (NCCAM) as well as other sources.

Researchers at the Rocky Mountain MIRECC are also interested in how alternative practices can help Veterans and others facing mental health and physical challenges. Dr. Theresa D. Hernández studied the use of acupressure with adult civilians who had experienced a Traumatic Brain Injury (TBI), and found that treatment significantly improved performance on tests of cognitive functioning. It also positively impacted physiological markers of relaxation and stress reactivity, reducing amounts of perceived stress following treatments.1 Studies by other MIRECC researchers test the acceptability as well as effectiveness of CAM use with Veterans, including the use of yoga, physical activity and acupressure.

How Could Acupressure Benefit Veterans With PTSD And TBI?

It is well-established that significant numbers of current, as well as past era Veterans face challenges posed by both Traumatic Brain Injury and Posttraumatic Stress Disorder. A recent report from the Defense and Veterans Brain Injury Center (DVBIC) states that, since 2,000, 12,083 members of U.S. Armed forces worldwide have sustained a brain injury. Large numbers of recently returning Vets are also being assessed and treated for PTSD, according to Office of Public Health Veterans Health Administration. A September, 2014 report cites that 337,285 Veterans (from 2002 – 2014) are receiving treatment for PTSD. These numbers do not reflect pre-911 era Veterans, Veterans treated outside VA care, or those who seek no help.

Coping with either TBI or PTSD separately can pose challenges, cognitively and emotionally that can make day-to-day living difficult. Some research exploring the combined effects of these two conditions suggests that these challenges together are even more significant. A study by Dr. Brenner and other researchers found that members of a Brigade Combat Team who were diagnosed with both mild TBI and PTSD experienced more symptoms than soldiers who had only one diagnosis (just PTSD or just mild TBI).2 The study also suggests that individuals with a history of TBI may face greater risk of developing PTSD. A review of scientific literature on PTSD and TBI by MIRECC clinicians revealed that one diagnosis may make the other worse.3 For instance, PTSD may worsen some TBI symptoms related to memory and attention. Or a TBI may make it harder to cope with the stressful effects of PTSD.

The visual below shows how PTSD and TBI share some overlapping symptoms like staying focused, depression, irritability, and anxiety. There are some distinct symptom that could be worse when both conditions are present.

Potentially the most serious consequence of combined TBI/PTSD may be an increased overall risk for suicidal thoughts and behaviors. Another study by Brenner and colleagues found that the risk of a suicide attempt from individuals with both TBI and PTSD was 3 times greater than for those with just a TBI.4

From this and other scientific evidence, Drs. Brenner and Hernández sought to find a treatment that could potentially help reduce symptoms and enhance well-being for Veterans facing both conditions. Studies with military, Veterans, and civilians provides evidence that treatments such as acupressure may offer a valuable alternative for Veterans with PTSD and TBI. Accumulating evidence has demonstrated that acupressure may have a significant positive effect on thinking, stress management and relaxation. These benefits target important coping mechanisms that have the potential to assist symptoms from both conditions.

Finally, acupressure is an independent practice. That is, a Veteran can learn their own acupressure points. They can then practice almost anywhere. Acupressure is inexpensive (free once the technique is learned) and does not involve medication. These qualities may enhance appeal among Veterans looking for non-pharmaceutical alternatives.

Rocky Mountain MIRECC Acupressure Study

Drs. Brenner and Hernández’s study was designed to evaluate the effectiveness of acupressure in a Veteran population, for individuals with both posttraumatic stress disorder (PTSD) and mild Traumatic Brain Injury (mTBI). In order to assess this, participating Veterans were randomly placed into one of two groups: an active acupressure treatment group, or a placebo group. Both groups agreed to receive the eight sessions of acupressure treatments. The difference being that only the active group was treated using active/therapeutic acupressure points during the initial sessions. (The placebo group was given the option to learn the actual acupressure points following completion of the eight treatment sessions.) Unlike acupuncture, acupressure does not involve the use of needles, only the use of finger pressure to key points on the body.

The aim of this study was to compare the effects of between the treatment and placebo groups. Specifically, the study was designed to determine if acupressure affects day-to-day functions such as memory, sleep, mood, psychiatric health and stress resilience. The information from this study will be used to help identify potential treatment strategies to improve quality of life and overall function for Veterans. The information may also benefit family and caregivers, as well as civilians living with both PTSD and TBI.

Results of the study will be measured by self-reports that measure aspects of targeted symptoms, as well as some objective biological measures. These include tests of heart rate and potential indicators of stress conducted by skin, etc.

Currently, recruitment and enrollment for this study is closed.

Analysis of collected data has begun. As results become available, they will be reported here, so please check back for more information. You can email us at joe.huggins@va.gov if you would like to receive an email when the results are posted.

Sources

  1. McFadden, K. L., Healy, K. M., Dettmann, M. L., Kaye, J. T., Ito, T. A., & Hernández, T. D. (2011). Acupressure as a non-pharmacological intervention for Traumatic Brain Injury (TBI). Journal of Neurotrauma, 28, 21 – 34.
  2. Brenner, L. A., Ivins, B. J., Schwab, K., Warden, D., Nelson, L. A., Jaffee, M., & Terrio, H. (2010). Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq. Journal of Head Trauma Rehabilitation, 25(5), 307 – 312.
  3. Betthauser, L. M., Bahraini, N., Krengel, M. H., & Brenner, L. A. (2012). Self-report measures to identify post traumatic stress disorder and/or mild traumatic brain injury and associated symptoms in military Veterans of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF). Neuropsychology Review, 22, 35 – 53.
  4. Brenner, L. A., Betthauser, L. M., Homaifar, B. Y., Villarreal, E., Harwood, J. E., Staves, P. J., & Huggins, J. A. (2011). Posttraumatic stress disorder, traumatic brain injury, and suicide attempt history among Veterans receiving mental health services. Suicide and Life-Threatening Behavior, 41(4), 416 – 421.

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