Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center
Girija Kaimal, Melissa S Walker, Joanna Herres, Louis M French and Thomas J DeGraba
Published, Version of Record (VoR)CC BY-NC V4.0, Open
Abstract
anxiety post traumatic stress military depression visual imagery Traumatic Brain Injury
The study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures.
Observational study of correlations between clinical symptoms of post-traumatic stress, depression and anxiety and visual themes in mask imagery.
The National Intrepid Center of Excellence at the Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Active-duty military SMs (n=370) with a history of traumatic brain injury, post-traumatic stress symptoms and related PH conditions.
The masks used for analysis were created by the SMs during art therapy sessions in week 1 of a 4-week integrative treatment programme.
Associations between scores on the PTSD Checklist-Military, Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale on visual themes in depictions of aspects of individual identity (psychological injury, military symbols, military identity and visual metaphors).
Visual and clinical data comparisons indicate that SMs who depicted psychological injury had higher scores for post-traumatic stress and depression. The depiction of military unit identity, nature metaphors, sociocultural metaphors, and cultural and historical characters was associated with lower post-traumatic stress, depression and anxiety scores. Colour-related symbolism and fragmented military symbols were associated with higher anxiety, depression and post-traumatic stress scores.
Emergent patterns of resilience and risk embedded in the use of images created by the participants could provide valuable information for patients, clinicians and caregivers.
Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center
Creators
Girija Kaimal - Drexel University
Melissa S Walker - Walter Reed National Military Medical Center
Joanna Herres - College of New Jersey
Louis M French - Uniformed Services University of the Health Sciences
Thomas J DeGraba - Walter Reed National Military Medical Center
Publication Details
BMJ open, v 8(6), e021448
Publisher
British Medical Journal (BMJ)
Number of pages
9
Resource Type
Journal article
Language
English
Academic Unit
Creative Arts Therapies
Web of Science ID
WOS:000435567900086
Scopus ID
2-s2.0-85053016900
Other Identifier
991019168430604721
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