"Inside the Brain: Unraveling the Mystery of Alzheimer's Disease"

"Inside the Brain: Unraveling the Mystery of Alzheimer's Disease," by Stacy Jannis and her team at Jannis Productions, Silver Spring, Md.

In a brain riddled with Alzheimer's disease, protein tangles grow and connections between nerve cells shrivel. This video animates this microscopic damage to explain how the disease starts. The team from Jannis Productions produced the movie for the National Institute on Aging to depict scientists' most current understanding of what happens inside cells during the disease.

This is one of two images that won Honorable Mention in the Non-Interactive Media (Screen Shots) category of the 2009 International Science & Engineering Visualization Challenge (SciVis) competition, sponsored by the National Science Foundation and the journal Science. The competition is held each year to celebrate the grand tradition of science visualization and to encourage its continued growth. The spirit of the competition is to communicate science, engineering and technology for education and journalistic purposes.

(Date of Images: September 2008)

Credit: Stacy Jannis, William Dempsey and Rebekah Fredenburg; Jannis Productions

Deliver Psychological First Aid with the Help of New Mobile App

By DCoE Strategic Communications

The new mobile app “Psychological First Aid” or “PFA Mobile,” supports providers and other response workers who provide psychological care to adults, families and children affected by natural or man-made disasters and emergencies. Developed through a collaborative effort among the Department of Veterans Affairs National Center for PTSD, National Child Traumatic Stress Network and National Center for Telehealth and Technology (T2), the app was designed to meet the challenges faced by first responders by making information and resources associated with response efforts readily accessible to them.

Materials in this application are adapted from the Psychological First Aid Field Operations Guide (2nd Edition), which has been used for successful disaster response around the world for the past six years.

Features of the app include:

■Summaries of psychological first aid fundamentals

■Intervention strategies for specific concerns and needs of survivors

■Mentor tips for applying psychological first aid in the field

■A self-assessment tool

■Easy forms for collecting data and making referrals

“PFA Mobile,” is free and currently only available for Apple users (iPhone, iPad and iPod touch). It will be available for Android devices in 2013. To learn more, read this article written by Dr. Julie Kinn, a clinical and research psychologist with T2 who leads the center’s mobile health application development.

T2 is a Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury center and serves as the primary Department of Defense office for cutting-edge approaches in applying technology to psychological health. Information about other mobile apps available for health professionals and the military community is at t2health.org.

Psychological First Aid? There’s An App For That

Written by Dr. Julie Kinn

I’m not alone in saying my heart goes out to those impacted by Hurricane Isaac. As a clinical psychologist, I have treated many children and adults who carry trauma symptoms long after danger has passed from natural or man-made disasters. We health care providers are keenly aware that disasters happen many times a year, and that those treating the survivors rarely have a surplus of resources.

To help support providers on the frontlines of care in emergencies, the VA’s National Center for PTSD and the DoD’s National Center for Telehealth & Technology (T2) have released PFA Mobile . This free mobile application assists providers in putting Psychological First Aid (PFA) into practice in the field. The app includes a brief refresher on the main components of PFA, assists with mentorship of other providers, and allows providers to self-assess and develop insight into readiness to provide PFA.

Some primary features that make the app so appropriate for disaster situations include:

 ■Easy forms for collecting data in difficult circumstances

 ■Intervention strategies tailored to unique conditions

 ■No requirement for internet or phone connectivity to run

PFA Mobile is currently available for iOS (Apple) devices and will deploy for Android devices in 2013. If you are a first responder or frontline care provider, I suggest you take it for a test drive and become familiar with this excellent resource.

Dr. Julie Kinn is a clinical and research psychologist. She leads mobile health application development for the DoD’s National Center for Telehealth & Technology (T2).

PE COACH Mobile App Supports Prolonged Exposure Therapy

By Robyn Mincher

DCOE Strategic Communications

The Departments of Defense and Veterans Affairs (DoD/VA) have released “PE Coach,” a smartphone mobile application for use with posttraumatic stress disorder (PTSD) treatment.

PE Coach is a form of “prolonged exposure” therapy available to all past and present service members — including the more than 10,000 Wisconsin Soldiers and Airmen who have deployed since 9/11 — as a way to help diagnos and treat symptoms of PTSD.

“As technology grows – our ability to find new ways to get information out to our service members and their families needs to grow as well. This new technology is another great tool for our service members and their families to use while transitioning back into their normal routines following a mobilization.” said Vicki Cushman Edgren, director of the Wisconsin National Guard Badger Yellow Ribbon program.

“In addition to our three phases of reintegration, PE Coach can be a valuable tool for our Soldiers and Airmen to use when returning from deployment and beyond. It especially speaks to the younger generation who already utilize phone apps in many other areas of their lives,” she continued.

Both the DoD and DVA use prolonged exposure (PE) therapy as an effective treatment for PTSD.

Psychologists at the Defense Department’s National Center for Telehealth and Technology, known as T2, and VA National Center for PTSD, developed the mobile app to specifically help patients with their therapy.

“‘PE Coach’ is a helpful tool that assists our service members and veterans who are between visits and in treatment for posttraumatic stress disorder,” said Dr. Jonathon Woodson, assistant secretary of defense for health affairs. “We have shared this app with our military health care providers as well, and hope that many individuals who are receiving PE therapy will find it useful.”

Prolonged exposure therapy helps a patient process a trauma memory to reduce the distress and avoidance caused by the trauma. The patient revisits the memory with a therapist and as the memory is emotionally processed, anxiety decreases. The therapy also helps the patient confront avoided situations that trigger memories of the trauma.

“We worked with a broad and diverse group of psychologists in the DoD and VA who are treating PTSD patients with prolonged exposure therapy,” said Dr. Greg Reger, clinical psychologist with the T2 Innovative Technology Applications division. “We wanted to help our patients in the therapy and make it easier for providers to deliver this treatment. PE Coach does both.”

Many psychologists who provide prolonged exposure therapy acknowledge it could be more effective if patients could better adhere to their assignments between sessions.

The patient installs “PE Coach” on their smartphone and can record the therapy session for playback between sessions. The app also provides an explanation of exposure therapy, assignments, explanations of PTSD and its symptoms, and a convenient way to write notes about typically avoided locations, situations and events for later discussions with their therapist.

Reger said that writing in a notebook in public places may make people feel uncomfortable. However, tapping a note on a smartphone is much easier and a more personal way to capture those in-the-moment feelings.

“PE Coach” will help users successfully adhere to PE treatment, which could improve the quality of treatment. Reger said it was not designed to be used as a self-help tool and should not replace professional counseling.

The Defense Department and VA released a similar mobile app last year; “PTSD Coach” is a reference tool for education, tracking symptoms, self-assessments and connections to support individuals with PTSD.

“PE Coach” is available for Apple and Android mobile devices. Find more information about the app at t2health.org/apps/pe-coach.

The National Center for Telehealth and Technology, located at Joint Base Lewis-McChord, Wash., serves as the primary Department of Defense office for cutting-edge approaches in applying technology to psychological health. More information about T2 is at t2health.org.

T2, a Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury center, designs, tests and evaluates available and emerging technologies in support of psychological health and traumatic brain injury recovery for service members, veterans and their families. To learn more, read “About T2.”

DCoE Seeks Feedback on Mild TBI Pocket Guide

By Corina Notyce, DCoE Strategic Communications

We want to hear from you! Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) encourages health care professionals to share their thoughts on the Mild Traumatic Brain Injury Pocket Guide and corresponding mobile app. Your feedback will help us make improvements to the pocket guide and other traumatic brain injury-related products.

How often do you refer to the pocket guide? What aspect of it do you find most useful? Based on your experience with the pocket guide, tell us everything from advantages and disadvantages to recommendations and suggestions for future traumatic brain injury (TBI) clinical resources and tools.

The pocket guide, developed by DCoE, is an all-encompassing, quick reference clinical guidance tool to help primary care providers assess and treat service members and veterans who have sustained a concussion. It includes a summary of the clinical practice guidelines and recommendations from the Defense Department and Department of Veterans Affairs on the management of mild TBI and provides information on treating common mild TBI symptoms; coding guidance; clinical recommendations for cognitive rehabilitation and driving following TBI; patient education materials; and additional clinical tools and resources related to TBI prevention and care.

You can also access the pocket guide from your smartphone with the free mobile app developed by National Center for Telehealth and Technology, a DCoE center. The mobile app was created to help providers conveniently access the latest evidence-based clinical guidelines for concussion care and enhance provider-patient interactions.

Hard copies of the pocket guide are available from Defense and Veterans Brain Injury Center. Call 800-870-9244 or email for details. To download an electronic version and other TBI clinical resources, visit the Health Professionals section of the DCoE website.

Take the online survey today — it only takes a few minutes. Participation is voluntary and responses will remain anonymous.

Social Media and Suicide Prevention

What would you do if a Facebook friend updated that they were depressed and thinking of ending their life?

What would you do if you observed a group of individuals bullying another person on a social media site? Would your actions be the same if the person was a friend or a complete stranger?

Your answers to these questions may have important implications for how these scenarios turn out. Fortunately, there are resources in social media to help you reduce the risk for suicidal behavior and to get help.

Suicide is a serious but preventable public health problem.  According to the World Health Organization , more than one million suicides occur in the world every year.

Social media, such as chat rooms, blogs, video sites like YouTube, and social networking sites such as Facebook, Twitter, and Google+, have become important ways that many people communicate and share information about a variety of topics, including suicide.

Two colleagues and I recently discussed the role of social media in suicidal behavior in an article published in the American Journal of Public Health  called “Social Media and Suicide: A Public Health Perspective.” In the article, we examined the evidence for how social media can have both negative as well as preventative influences on suicidal behavior.

There are several ways social media is used that can negatively influence suicidal behavior, some examples are:

 ■Pro-suicide forums offering “how-to” information or encouraging suicide pacts.

 ■Cyberbullying and cyber-harassment directed through social networking sites

 ■The “media contagion effect” where reports of things like a celebrity suicide influence suicidal behavior.

It is important to be aware of how your friends and family may interact with or be exposed to these types of social media. Your understanding of these risks and your knowledge of where to go for help may prevent a suicide.

Social media can also be used to increase awareness and provide information on suicide prevention programs, crisis help lines, and other educational resources. Check out the Facebook and Twitter accounts of the Substance Abuse and Mental Health Services Administration (SAMHSA)  or the National Suicide Prevention Lifeline  to find information and share personal stories about suicide prevention and coping. You might also want to watch the suicide survivor stories on the National Suicide Prevention Lifeline’s www.lifeline-gallery.org  website.

There are hundreds of support and prevention groups on Twitter, as well video-based public service announcements geared toward suicide prevention on popular social media sites such as YouTube. Several social networking sites such as Facebook, and Bebo even provide a “panic button” feature to report cyberbullying.

Facebook also works with the Samaritans charity to provide a suicide-alert reporting system for Facebook users to report individuals they believe are expressing suicidal thoughts or intent.

The Department of Defense  is also using social media to address the problem of suicide. For example, the Afterdeployment.org  Facebook and Twitter accounts provide education and prevention information tailored for the military community. Other suicide prevention sites for the military and veteran community include suicideoutreach.org , Realwarriors.net , and the Wingman Project .

There are ways that social media can influence suicide behavior, both positively and negatively. I hope that by reading this blog you have become more aware of the issue and have learned what to look out for as well as what options there are for finding support, learning more, and helping others.

If you or someone you know is in an emotional distress or suicidal crisis, please seek help immediately. If an emergency, contact 911.

Some available resources:

National Suicide Prevention Lifeline  is there to help 24/7, or give them a call at 1-800-273-TALK (8255) or check out their Facebook page.

Want to talk in 140 characters or less?  Check out their Twitter feed.

Suicide.org has an international listing of hotline numbers that could help you or someone you know.

The Substance Abuse and Mental Health Services Administration (SAMHSA)  has some great resources available; Take a look at the AfterDeployment.org  website.

Dr. David Luxton is a Research Psychologist and Program Manager at the National Center for Telehealth and Technology (T2).