Anticipated Impact: Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Strategies for identifying and promoting safe and cost-effective PTSD treatments in the military are urgently needed as a large and growing number of soldiers struggle with the disorder. We seek to evaluate the adjuvant therapeutic value of a promising educational music therapy intervention among Veterans with PTSD. Should the results indicate significant and clinically relevant improvement in outcomes, they will lay the foundation for a multicenter, randomized controlled evaluation. Project Background: The proposed intervention, which represents a partnership with and builds on infrastructure developed by 'Guitars for Vets'-a non-profit organization based in Milwaukee, WI-- will provide 40 Veterans diagnosed with PTSD at the Zablocki VA with a guitar, guitar pick and tuning instruments, a music book, and six individual hourly sessions of music instruction. In addition to individual sessions, group practices will be offered bi-weekly during the 6-week intervention period. Objective: To conduct a pilot study that will examine the effectiveness and cost-effectiveness of an educational music therapy intervention aimed at improving psychological health and social functioning among a high-risk population of Veterans at the Zablocki Veterans Administration (VA) Hospital. Data and Methods: The pilot evaluation will rely on a prospective, randomized, delayed entry control group, pre- and post-intervention comparison design. Data drawn from 1) patient clinical records, 2) in-person patient interviews, conducted at baseline and at fixed points (6-weeks) post-study enrollment and 3) intervention fidelity and cost information will be used to determine program uptake, adherence, and effectiveness. In addition to basic socio-demographic and economic characteristics, data collected at baseline will include duration of military service, combat exposure, and pre-intervention measures of all outcomes. Outcomes to be examined include post-traumatic stress disorder (PTSD), depressive symptoms (Beck Inventory), physical, emotional and social functioning (SF-36), social isolation (UCLA Loneliness Scale), and health-related quality of life (EuroQoL). Bivariate comparisons and, to the extent possible, multivariate regression techniques will be used to examine characteristics of Veterans who opted out of the intervention and to estimate the intervention's effect on participant's outcomes, adjusting for randomization status and pre-intervention differences in Veteran's characteristics.
Post traumatic Stress Disorder (PTSD) is a common sequellae of intense and severe emotional trauma associated with combat and military deployment. This condition, which is characterized by feelings of loneliness and isolation, intrusive memories, outbursts of anger, and feelings of helplessness, has been recognized in returning soldiers from past and current conflicts and can be more disabling and chronic than many physical wounds. Currently, people with PTSD may be treated with psychotherapy, medications, or a combination of the two. Despite a variety of treatments, returning veterans are often hesitant to engage in psychotherapy and some medications may actually cause more harm than good, due to side effects. The need is great, therefore, to identify safe, low cost, long-term strategies for self-management of PTSD. In this pilot project, we propose to develop and test an educational music therapy intervention-Guitars for Vets-as an alternate method for emotional expression that may decrease symptoms in veterans with PTSD.
