Dr. Kevin Kip, a COPH professor of epidemiology and biostatistics and a distinguished USF Health professor, is a leading researcher on post-traumatic stress disorder (PTSD) in veterans. Kip, along with other past and present USF colleagues, has published three studies on PTSD and its effects on veterans and active-duty military personnel.
PTSD is a disabling condition that results from a traumatic experience(s) and elicits negative changes in mood, arousal and reactivity. It is often associated with depression, anxiety and substance abuse. It’s estimated that between 5 to 13 percent of veterans experience PTSD; the number can vary according to combat exposure. PTSD can also affect active-duty military personnel and the public at large.
PTSD and ART
Kip’s most recent study, “The emergence of accelerated resolution therapy for treatment of post traumatic stress disorder: A review and new subgroup analyses,” was published in the January 2019 edition of Counseling and Psychotherapy Research.
Accelerated Resolution Therapy (ART) is a type of therapy that consists of four main elements:
- Relaxation and orientation: The patient is asked to identify the traumatic experience.
- Imaginal exposure: The patient is asked to visualize the trauma and process distressing sensations that emerge.
- Imagery re-scripting: The patient is asked to visualize the experience and change it so it is less traumatic.
- Assessment: The practitioner goes through a series of exercises with the patient to determine whether the original experience still produces significant distress, or whether the new, revised version of the event has taken hold.
- Hand movements. During each step of ART, patients are asked to follow with their eyes the practitioner’s hand (which moves back and forth).
“Research shows that when a person moves his or her eyes from left to right, it engages both sides of the brain and elicits a relaxation response,” said Kip. “But why it produces relaxation is not really clear.”
Kip found that ART provided clinical relief of symptoms of PTSD in an average of four sessions—even among those who had mild-to-moderate traumatic brain injuries and those in special operations forces who had considerable combat histories. Brain injuries and combat experience are two factors that can make PTSD more challenging to treat.
“By reducing the symptoms of distress that emerge from thinking about a traumatic experience, and also changing the content and meaning of the original traumatic memory, many individuals can experience a strong reduction in symptoms of PTSD in just a few sessions,” reported Kip.
PTSD and Brazilian Jiu Jitsu
Earlier this year, Kip, along with USF College of Medicine Professor Alison Willing as first author, also published the study “Brazilian Jiu Jitsu Training for US Service Members and Veterans with Symptoms of PTSD” in the journal Military Medicine.
Brazilian Jiu Jitsu (BJJ) is a martial art that focuses on grappling and ground fighting. Kip notes that there’s been a lot of anecdotal evidence supporting its effectiveness in reducing PTSD, but no formal studies have been done.
Tampa Bay area veterans and active duty servicemen (the study was limited to men), attended 40 BJJ sessions over the course of five months and were periodically assessed. At the end of the five months, Kip and his colleagues found that the study subjects saw a significant drop in their PTSD symptoms. Kip theorizes that that may be due to the fact that:
- BJJ is a physical activity that teaches resiliency.
- BJJ can be used as a kind of combat exposure therapy that lets practitioners learn how to resolve uncomfortable situations.
- BJJ promotes social interaction and camaraderie.
“As of now, there is insufficient evidence to recommend BJJ as a first-line treatment for PTSD,” said Kip. First-line treatments are things like psychotherapy and cognitive processing therapy, a type of therapy that teaches you to challenge negative thoughts. “But it may be used as a complimentary therapy,” added Kip.
PTSD and hypertensive disorders in pregnant service women
Kip’s third article, published with COPH alumna Michelle Nash as first author, “Post-traumatic stress disorder and hypertensive disorders of pregnancy among military women,” was published in the journal Paediatric and Perinatal Epidemiology.
In the introduction to the study, Kip and his colleagues note that prior research—using VA data—shows that pregnant women in the military diagnosed with PTSD within a year of giving birth have a 30 percent increased risk of pre-eclampsia (a disorder of pregnancy marked by high blood pressure). It’s a leading cause of maternal death during pregnancy.
But, Kip and his colleagues point out, VA data is not always representative of active-duty personnel. Their study found no significant relationship between PTSD and hypertensive disorders of pregnancy (HDP)—except when the women were diagnosed with PTSD a year or longer prior to conceiving.
“PTSD is a chronic, disabling anxiety disorder,” explained Kip. “It’s possible that long-term symptoms of PTSD influence the autonomic nervous system [a part of the body responsible for the stress response], which could have long-term negative health effects, including those related to health outcomes.”
Story by Donna Campisano, USF College of Public Health