Native American veterans are among the most under-served of the under-served. Behavioral health research with this group is lacking, and Western treatment protocols often fail with this population. There is a particular need for effective clinical interventions for PTSD and substance abuse in this population. Both disorders are widespread among Native American people, and when combined, as is often the case in combat-related PTSD, are difficult to treat. The two existing studies of Native American veterans point to extraordinarily high rates of PTSD that, depending on the tribe studied range between 27 percent and 86 percent. However, no studies have examined the intersection of PTSD and Alcohol use disorders, measuring their impact on the Native American veteran and his family. This study, building on my previous epidemiological study of PTSD among the Hopi Vietnam veterans, proposes a comprehensive research project to assess and map the occurrence of PTSD and substance use symptoms across the life span of Zuni Vietnam veterans and took at the impact of these co-occurring disorders on the Zuni Native American family. Using similar clinical instruments as the National Vietnam Veterans Readjustment Study and the Matsunaga Project, this study will establish population-based prevalence rates of PTSD and alcohol related disorder among the Zuni Vietnam Veterans. Within the context of this research project this study will (a) determine the prevalence rates of PTSD and substance use disorders among Zuni Vietnam veterans, (b) map longitudinally, across the life span of Zuni Pueblo American Indian Vietnam veterans, the emergence of PTSD symptomatology, substance use and related disorders, and specific treatment and other change efforts to address these problems, (c) estimate the impact that these two disorders have had on spousal and familial relationships through family profile analysis and (d) study the construct of inter-generational trauma (IGT) by comparing two groups of Zuni Vietnam veterans: those whose fathers had combat experience in WWII or Korea, and those whose fathers had no military experience. This study also will develop and apply a unique, hybrid clinical approach to Zuni veteran dyads who request treatment. By combining PTSD and Substance Abuse treatment manuals from the National Center for PTSD and the Center on Alcohol, Substance Abuse and Addictions (CASAA) with the cdgnitive-behavioral teachings found in traditional medicine as practiced by the Zuni Medicine people, this study will develop a hybrid protocol for alcohol and PTSD problems. Finally, this study on Zuni, when compared to the culturally similar Hopi, will make a contribution to the theory that cultural variables moderate the expression of PTSD and alcohol disorders.
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