Complementary/Integrative Approaches to Treating "The Invisible Wounds of War:" Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI)

Friday, 26 July 2013: 8:50 AM

Cathy M. St. Pierre, PhD, APRN, FNP, FAANP
Urgent Care/Research, ENRM VA Hospital, Bedford, MA

Learning Objective 1: 1. Define Post Traumatic Stress Disorder and Traumatic brain injury and its impact on patients and their families quality of life.

Learning Objective 2: 2. Describe evidence based complementary approaches to treating PTSD and TBI.

Purpose: The purpose of this presentation is to discuss current approaches to screening, diagnosis and management of both TBI and PTSD.  Treatment including traditional and complementary evidence based approaches will be discussed.

Methods: Review of the literature and research studies, expertise in subject content.


  The recent war conflicts in Iraq and Afghanistan have created new health problems for many of the soldiers and veterans.  Traumatic brain injury (TBI) and Post traumatic stress disorder(PTSD) have become known as the “invisible wounds of war” because there are no outward signs of these diseases.  Currently, there are over 300,00 or 20% of  veterans  who served in Iraq or Afghanistan diagnosed with PTSD.  The Defense and Veterans Brain Injury Center(2012) currently estimates that approximately  230,000 military personnel have been diagnosed with TBI.  TBI is classified into three categories: Mild, Moderate and Severe.  Although veterans diagnosed with Severe TBI are often easily identified physically, the majority of the cases (77%) of  TBI are considered mild and display no visible wounds.  The long term sequelae for both of these diseases, can be devastating to both veterans and their families.  To complicate matters, some  veterans diagnosed with TBI, also have PTSD, so the impact can be a “double whammy”.   The financial burden of care related to the costs of these two diagnoses  reaches approximately $916 billion dollars per year (2008).


Emerging research is demonstrating  positive effects and improvement in quality of life factors in the utilization of various complementary modalities to treat treating PTSD and TBI.