Findings of Collaborative Studies

 

 

RPOW Publications in Professional Journals or Texts

Optimism Predicts Positive Health in Repatriated Prisoners of War, Psychological Trauma: Theory, Research, Practice, and Policy, 2015, 7, 222-28.
 
Sleep and Resilience: A Longitudinal 37-year Follow Up Study of Vietnam Repatriated Prisoners of War, Military Medicine, 2013, Vol 178, No 2, 196-201.
Optimism Predicts Resilience in Repatriated Prisoners of War:  A 37-Year Longitudinal Study.  Journal of Traumatic Stress, 2012, 25, 330-336.
 
Potential Association of Posttraumatic Stress Disorder and Decreased Bone Mineral Density in Repatriated Prisoners of War.  Military Medicine, 2011, 176, 270-275.
 
Posttraumatic Stress Disorder and Metabolic Syndrome: Retrospective Study of Repatriated Prisoners of War. Military Medicine, 2011, 176, 369-374.
Captivity Stressors and Mental Health Consequences among Repatriated U.S. Navy, Army and Marine Vietnam-era Prisoners of War.  Psychological Trauma: Theory, Research, Practice, and Policy, 2011, 2.  
 
Long-term Effects of Coping with Extreme Stress: Longitudinal Study of Vietnam-era Repatriated Prisoners of War.  Journal of Traumatic Stress, 2011, 24, 380-690.
 
The Neuropsychological Functioning of Prisoners of War Following Repatriation.  Military Neuropsychology text, 2010, Springer Publishing Company, New York, New York.
 
Posttraumatic Growth in Former Vietnam Prisoners of War.  Psychiatry: Interpersonal and Biological Processes, 2008, 71: 359-370.
 
Cognitive Measures of Vietnam-Era Prisoners of War.  Journal of the American Medical Association, 2002; 288(5):  574-575.

Based on the results of the cognitive evaluation conducted 20 years post-repatriation, documented that RPWs generally outperformed controls on measures of intelligence, memory and general neuropsychological ability.
 

RPOW Study Reports in the Defense Technical Information Center

Injuries and Illnesses of Vietnam War POWs Revisited: III. Marine Corps Risk Factors, NMOTC-REMC-015,   12 JAN 2016
As a part of O/H, medical and psychological conditions of all repatriates were documented in the Initial Medical Evaluation Form (IMEF), a 400 page, 29 section, standard protocol.  Berg and Richlin (1977) described the procedures and findings.  Berg and Richlin emphasized documentation of the specific injury and illness diagnoses.  The purpose of this present study is to identifying risk factors that predisposed the US Marine Corps RPWs to various injuries and illnesses.
 
Injuries and Illnesses of Vietnam War POWs Revisited: II. Army Risk Factors, NMOTC-REMC-014, 12 JAN 2016
As a part of O/H, medical and psychological conditions of all repatriates were documented in the Initial Medical Evaluation Form (IMEF), a 400 page, 29 section, standard protocol.  Berg and Richlin (1977) described the procedures and findings.  Berg and Richlin emphasized documentation of the specific injury and illness diagnoses.  The purpose of this present study is to identifying risk factors that predisposed the US Army RPWs to various injuries and illnesses.
 
Injuries and Illnesses of Vietnam War POWs Revisited: I. Navy Risk Factors, NMOTC-REMC-013, 5 JAN 2016
As a part of O/H, medical and psychological conditions of all repatriates were documented in the Initial Medical Evaluation Form (IMEF), a 400 page, 29 section, standard protocol.  Berg and Richlin (1977) described the procedures and findings.  Berg and Richlin emphasized documentation of the specific injury and illness diagnoses.  The purpose of this present study is to identifying risk factors that predisposed the US Navy RPWs to various injuries and illnesses.
 
The Mediating Effects of Hardiness on Resilience in Repatriated Vietnam-Era Prisoners of War, NMOTC-REMC-012, 30 NOV 2015
Previous research documented the importance of various psychological factors in predicting psychiatric resilience and health in repatriated Vietnam-era prisoners of war. Optimism was shown to be a better predictor of long-term psychiatric health than other variables and composite measures.  These findings emphasized the need to pursue a more direct assessment of resilience using both neurobiological (allostatic load) and psychological measures. In the present study, we sought to disentangle the resilience-hardiness relationship through the use of mediation analysis.
 
Clinical Association of Leukocyte Telomere Length in a Cohort of Repatriated Prisoners of War, NMOTC-REMC-006, 1 JUL 2014
A cohort consisting of 127 American repatriated prisoners of war (RPWs) was studied in order to ascertain whether there were statistically significant correlations between Leukocyte Telomere Length (LTL) obtained from a commercially available LTL test and 47 clinical indicators of health, environmental stress and aging.
 
The Robert E Mitchell Center for Prisoner of War Studies: The Product of One Flight Surgeon’s Promise to Honor a Grateful Nation’s Warriors, NMOTC-REMC-005 1 JUL 2014
This historical note outlines the development of the Robert E. Mitchell Center for Prisoner of War Studies and summarizes the pivotal role CAPT Mitchell, MC, USN played in its establishment. His singular vision and sheer audacity enabled the center to provide an unbroken 41 years of dedicated service to those who suffered as a POW.
 
Resilience and Hardiness in Repatriated Vietnam-Era Prisoners of War, NMOTC-REMC-003, 31 JUL 2013
To date there has been no direct measurement of the resilience of Vietnam era repatriated Prisoners of War (RPWs). Previous research conducted by the RE Mitchell Center for Prisoner of War Studies (REMC) used presence or absence of post-repatriation psychiatric illness as a proxy measure of resilience, but did not administer any specific scales to directly measure this construct. The purpose of this brief study was to directly measure psychological resilience in a group of Vietnam era RPWs and identify those RPWs who self-identify as resilient.
 
Resilience and Health in Repatriated Prisoners of War, NMOTC-REMC-001, 14 DEC 2012
Background: In an earlier study, the Robert E. Mitchell Center for POW Studies identified in the 1973 medical/psychiatric database those former, Vietnam-era, repatriated prisoners of war who at the time of captivity viewed their experience as one to survive and overcome, to not ruin their entire life once freed (known as dispositional optimism), these repatriates did not suffer from any psychiatric illnesses 37 years after their POW experience. This follow-up study added new mental, physical, biological data collected in 2011 to 2012 to determine whether dispositional optimism was still linked to their overall state of health today.
 
 

RPOW Studies Presentations at Professional Conferences

Symptoms of Sleep Disorders in Older Aviators.  Aerospace Medical Association, Kansas City, Missouri, May 2005.

Established guidelines for screening older aviators, RPWs and control, for symptoms of sleep disorders. The observed pattern of item endorsement suggests the need for careful evaluation of Sleep Apnea and Periodic Limb Movements of Sleep.
 
The Evaluation of Depression in Older Aviators.  Aerospace Medical Association.  Anchorage, Alaska, May 2004.

Established guidelines for the use of a standard depression scale with older aviators (RPWs and controls). Published norms are inadequate for use with aviators as only one-half of the depressed aviators scored above the published norms.
 
The Five A’s of Aviator Personality.  Aerospace Medical Association, San Antonio, Texas, May 2003.

Based on a sample of 376 retired military aviators, RPWs and controls, personality test data identified the following components of what has previously been described as "The Right Stuff:" Adventurousness, Aggression, Affiliation, Achievement and Adaptability.
 
Post-Captivity Cortisol Levels Predict Later-Onset Osteopenia in Former Prisoners of War.  American Psychosomatic Society, Phoenix, Arizona, March, 2003.

Cortisol levels obtained five years post-repatriation were shown to predict current low bone mineral density in a group of Vietnam RPWs. Higher Cortisol levels in 1978 were predictive of lower bone mineral density in 2003.
 
The Evaluation of Divided Attention in Older Aviators Using the CogScreen-AE.  National Academy of Neuropsychology, Miami, Florida.  October, 2002.

Divided attention is a cognitive skill that is highly relevant to aviation. Although older aviators in this study (RPWs and controls) did show some age-related decline in the ability to perform two task simultaneously, many older aviators performed at a level characteristic of younger aviators, and vice versa. Any prediction that aviators beyond the age of 60 should show an excessive decline in performance during multi-tasking that would affect flight safety appears to be unwarranted.
 
WAIS Correlates of CogScreen-AE Performance for Older Aviators.  Aerospace Medical Association. Montreal, Canada.  May, 2002.
In a sample of older aviators, RPWs and controls, the relationships between performance on a computerized cognitive screening instrument and standard intelligence tests were explored. Although the observed test correlations were consistent with previous research, this study documented that computerized testing adds a unique component to the evaluation of older aviators.
 
Memory Abilities Among Healthy Older Aviators.  Aerospace Medical Association, Montreal, Canada.  May, 2002.
Memory abilities, as measured by list learning and retention, remain intact in older aviators (RPWs and controls) provided there is no evidence of psychiatric or neurological illness. The healthy older aviators in the 60-64 year old group were indistinguishable from those in the 55-59 year old group.
 
The Relationship Between Peritraumatic Dissociation and Chronic PTSD Symptoms Among Military Aviators.  International Society, for Traumatic Stress Studies, New Orleans, Louisiana.  December, 2001.
Dissociative symptoms were significantly in RPWs than controls. The level of peritraumatic dissociation was shown to be a better predictor of current PTSD symptoms than were factors associated with captivity duration or subjective torture severity.
 
Emotional Correlates of Predicted Neurological Status as Measured by CogScreen-AE.  Aerospace Medical Association. Reno, Nevada.  May, 2001.

Based on a large sample of older aviators, RPWs and controls, current psychiatric symptoms were shown to be unrelated to the results computerized cognitive assessment. Approximately one-half of the subjects reported significant amounts psychiatric symptoms on the MMPI, but these two groups performed equivalently on a test designed to detect neurological difficulties.
 
The Relationship between Age and Neurological Status as Predicted by the CogScreen-AE. Aerospace Medical Association. Reno, Nevada.  May, 2001.
Performance on a computerized measure of cognitive ability was shown to change significantly with age in a large group of older aviators (RPWs and controls), but only one-half of those over age 60 exhibited poor test performance. The largest group difference was observed when 60-64 year olds were compared to 65-73 year olds.
 
Post-Traumatic Stress Disorder Symptoms as Predictors of Osteopenia in Older Aviators. Aerospace Medical Association. Reno, Nevada.  May, 2001.

Body Mass Index and PTSD symptom severity were identified as significant predictors of lower bone mineral density in RPWs and controls. These variables were significant after accounting for the effects of age alcohol use, depression and dissociative symptoms. Chronic and/or severe stress that results in a higher cortisol level may contribute to later reductions in bone mineral density.
 
The Incidence of Osteoporosis in Repatriated Prisoners of War (RPWs) versus Controls.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
The results of this study suggest that there may be a relationship between low bone density and PTSD among RPWs.
 
The Acute long-term impact of prolonged under nutrition in adulthood on body composition, immune function and selected cardiovascular risk factors in RPWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
Weight gain was typical immediately following repatriation, however long-term weight changes were subtler over time. RPWs and controls were of similar weight during their sixth decade.
 
Onset of various disease states for RPWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
RPWs were at greater risk than controls for musculoskeletal injuries, nerve damage arthritis and joint injury. Many of these conditions were worse among RPWs with more extensive torture.
 
Gait and balance assessment in RPWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
RPWs were more impaired than controls on measures on balance and walking. When combined with nerve damage and lower bone density, such findings may indicate an increase risk of falls and fractures.
 
Remote effects of captivity stress on cardiovascular disease.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
A study that addressed the relationship between internment stress, coronary heart disease, heart rate variability, and current PTSD.
 
Predicting health adjustment among Vietnam-era RPWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
Age at the time of captivity, rank, military experience, career commitment and social support may reduce the long-term risk for psychological and negative health outcomes in RPWs.
 
Psychobiological assessment of high-intensity military training.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
Various chemicals in the body are available to reduce the impact of stress and individuals differ in the amount of these available chemicals. Low levels of these chemicals at the time of stress predict poor stress coping and memory difficulties, perhaps setting the stage for later development of PTSD.
 
Examining the 20-year psychiatric sequelae of the RPW experience: Methods and preliminary findings from Operation Homecoming Vietnam Veterans.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
RPWs are more likely than controls to receive psychiatric diagnoses. Approximately one-third of the RPWs received such diagnoses during the follow-up period and 13% were experiencing current illnesses 20 years following repatriation.
 
Changes in outlooks among Vietnam veterans and RPWs (positive outcomes).  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
Evaluates the possibility of post-traumatic growth following captivity. Positive changes in self-perception, interpersonal relationships and philosophy of life may result from captivity experiences and repatriation experiences.
 
A qualitative investigation of Families of RPWs: interviews with wives of RPWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
This study used one-on-one interviews with the wives of RPWs to document family challenges associated with separation and reunion. Family hurdles associated with uncertainty, decision-making and parental responsibilities were addressed, as were the coping strategies used by the wives to deal with this stressor.
 
Risk and resilience following repatriation – marital transitions and RPWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
When compared to controls, RPWs were at greatest risk for divorce during the first two years following repatriation. In addition, an RPW who divorced and then remarried was twice as likely as a remarried control to "re-divorce."
 
Health consequences for women RPWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
This study relied on a series of interviews and record reviews to summarize the health outcomes of military nurses held captive in the Philippines and China during WWII. Captivity-related ailments such as tuberculosis, intestinal disorders, weight loss and memory loss were common, as were liver disorders, osteoporosis, diabetes and depression later in life. Social support, identity maintenance, remaining active, faith and positive thoughts were reported as positive factors in survival.
 
Long-term health consequences and sources of health care for RPWs compared to Controls.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
Using the findings from the Health Enrollment Assessment Review, in comparison to controls, RPWs were found to be less healthy, use more resources and required more specialized care. Many RPWs rely on the Mitchell center program for annual checkups and medical diagnoses.
 
Service utilization and satisfaction among former WWII POWs.  Center for Naval Analysis: The Repatriated Prisoner of War Research Conference.  Alexandria, VA April, 2001.
Former WWII RPWs rely heavily on the VA for medical care, mental health care and disability compensation. A relatively high percentage (72%) of surveyed WWII RPWs received no medical care from non-VA sources. Survey participants were generally satisfied with care and services received from the VA.
 
Peritraumatic Dissociation, Depression, Memory Ability and Memory Complaints Among Repatriated Prisoners of War. National Academy of Neuropsychology.  Orlando, Florida.  November, 2000.
Demonstrated a complex relationship between memory self-appraisal, actual memory performance and PTSD symptoms in RPWs with and without PTSD. RPWs with PTSD performed less well, had more dissociative experiences and experienced an increased frequency of self-rated memory failures.
 
Personality Clusters Among Experienced Naval Aviators.  Aerospace Medical Association.  Seattle, Washington.  May, 1998.
Personality profiles of older aviators, RPWs and controls, do not differ from those of younger aviators. Most aviators could be described as exhibiting one of three personality types: narcissistic, compulsive or combined narcissistic-compulsive. RPW and controls did not differ with respect to aviator personality type.
 
Preliminary Psychiatric and Psychological Findings in Studies of Vietnam-Era RPWs.  The Repatriated Prisoner of War Health Study: A Conference on the Long-term Effects of Captivity and Torture Among Vietnam-Era POWs. Washington, D.C., April, 1998.
RPWs exhibit a greater prevalence of PTSD than controls, while the prevalence of other psychiatric diagnoses do not differ between the groups. Intelligence, memory and general neuropsychological abilities are well preserved in both groups.
 
The Longitudinal Neuropsychological Evaluation of Repatriated Prisoners of War. Fourth Annual Navy Neuroscience Symposium.  Portsmouth, Virginia.   June, 1994.

Documented that RPWs and controls were equivalent in the areas of intelligence, memory and general neuropsychological functioning when examined at 5 and 10 years post-repatriation.