By: Dr. Michael J. Perrotti, Ph.D.
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The United States is seeing more and more young men returning from Afghanistan and Iraq with horrendous results in terms of family integration, societal integration, and domestic violence. Some of these individuals, according to Cernak, are found on the battlefield dead with no marks whatsoever on them. These individuals have been the victims of blast or shock neurotrauma. This examiner has, in fact, seen individuals who were in buildings that were blown up and walked away from these situations. Cernak writes how, with blast neurotrauma, there can be a shockwave going up the spinal cord to the brainstem and damage being caused at the DNA level. There is a great need to conduct correct imaging studies and to evaluate these individuals for blast-induced neurotrauma. There is the unwieldy difficult situation of many young men coming back with symptoms of posttraumatic stress disorder (i .e., hypervigilance, alteration of structures in the brain regulating anger). Individuals who are angry and depressed prior to PTSD become exponentially more depressed after PTSD. Only a proper comprehensive neuropsychological assessment as well as comprehensive brain imaging studies would highlight the problems in these young men returning home.
There then also is the problem of medications (i .e., frequently only purely psychiatric medications are used for returning veterans, such as antidepressants). However, many of these individuals need neuroleptics, which is a class of medicines that treat neurological disorders. Indeed, this is an area that needs to be evaluated by psychology, neurology, and psychiatry. Ideally, a multidisciplinary team approach would be useful. Ideally, these disciplines involved in the triage of these individuals coming home would hopefully result in treating the problems before they reach the crisis stage that they do with the young men returning home with these problems untreated and having to integrate themselves into society and their homes.
Brain chemistry and brain neurophysiology is the next frontier in psychology in terms of our understanding of the relation between brain pathology and brain injury and problems in an individual. Yudofsky (2011) writes in a textbook on traumatic brain injury that personality change and changes in an individual (i .e. , anger and agitation) can be present up to 12-15 years later in an individual. Moreover, a base rate of 10-15% of individuals with closed-head injuries has been shown in the research to show syndromes of brain injury 10-15 years later.
This frontier of neurological problems and issues certainly is deserving of emphasis and study in the behavioral sciences.
Dr. Perrotti received his PhD in Clinical Psychology from Alliant University in San Diego, CA. He is a licensed psychologist in California and Pennsylvania. Dr. Perrotti is a member of the National Register of Health Service Provider in psychology and the National Academy of Neuropsychology. He was an Assistant Professor of Psychiatry and Behavioral Sciences at the Keck School of Medicine, USC from 2005-2006. Dr. Perrotti is the author of numerous publications in forensic psychology and assessment, traumatic brain injury in college, professional sports and military populations, and child trauma and complex PTSD.
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