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Robert E. Mitchell Center for RPOW Studies

The Robert E. Mitchell Center for Prisoner of War Studies is a special program* of the Naval Aerospace Medical Institute (NAMI). As such the RE Mitchell Center provides follow up evaluations of repatriated prisoners of war (RPW) from Vietnam, Desert Storm, and Operation Iraqi Freedom, to study the mental and physical effects of captivity and to address the findings' applicability to current military operations. A unique institution, it singularly holds the longitudinal database of the long term effects of repatriated RPWs and its Comparison Group.




*USC Title 10, Section 1501-1513
DoDI 3002.03 (Jul 2013/Apr 2016): DoD Personnel Recovery-Reintegration of Recovered Personnel
Joint Publication 3-50(Aug 2023): Personnel Recovery
OPNAVINST 1000.24D (Jan 2019): Personnel Recovery
NAVPERSCOMINST 1000.24 (Nov 2022): NAVPERSCON Personnel Recovery Phase III Reintegration Program

 

Mission/Vision

Honoring and keeping the faith to a grateful Nation’s warriors, the RE Mitchell Center’s mission has remained steady and true ever since Operation Homecoming (1973). The course is guided by:

Salute
  

Vision: An American team of physically healthy and psychologically strong warriors, families, and civilians whose resilience and physical fitness enables them to survive/perform and thrive in both the military and civilian sectors and to meet a wide range of operational demands.

Mission: Provide evidence-based, captivity-related, medical lessons learned in order to equip and train medical and line/fleet forces for real world operations.

Goal: Determine the long term physical and psychological effects related to POW internment.

Objectives:

  • Provide study results to the Department of Defense for integration into training future warriors
  • Develop, propose, and conduct retrospective and prospective studies
  • Build captivity-related longitudinal medical and psychological database
  • Provide results to repatriated prisoner of war, enabling routine health maintenance and disability documentation
  • Conduct medical and psychological evaluations on repatriated prisoners of war, the control group, and germane eligible beneficiaries

The RE Mitchell Center subject matter expertise is recognized. The Executive Director serves as an advisor to the Congressionally mandated VA Advisory Committee on Former Prisoners of War and works closely with the VA on POW related matters including identifying medical and psychological conditions related to captivity.

The Mitchell Center’s recent work on bone density resulted in the VA’s adapting a new POW-specific service-connected presumptive diagnosis of osteoporosis for disability compensation.

The Mitchell Center provided the Navy and Air Force medical and psychological information for adjudicating applications for Combat-Related Special Compensation. It also helped design the Emotional Fitness Training module of the Army’s Comprehensive Soldier & Family Fitness Program.

In 2018, the REMC augmented its course with a new operational orientation, one which directly supports Commanders and the warfighter. REMC has integrated deeper into the broader Personnel Recovery and Reintegration community, serving as an Agency and/or Activity medical subject matter expert and research capability.  It contributed to the new DoD repatriation instructions and the Joint Personnel Recovery Agency’s plans for repatriation of future American POWs.  As such, the REMC’s expanded vision finds near perfect alignment with the US Navy Surgeon General’s first-ever Campaign Order.

Our Team

John P. Albano, MD, MPH—Program Director
John P. Albano received his medical degree from the University of South Dakota School of Medicine, master’s in public health from the University of Texas School of Public Health at San Antonio, and Aerospace Medicine training at Brooks AFB.  Dr Albano has 25 years of combined clinical, research, academic, and executive medicine experience in US Army aerospace medicine and 11 years working with the RPWs aboard NAS-Pensacola, FL.  Dr Albano is board certified in Aerospace Medicine, certified as a Level III Science and Technology Manager, trained as Contracting Officer Representative,  and received Human Research Subject Use training.  He is a Fellow of the Aerospace Medical Association and received honors from the Army Medical Department Regiment, Society of US Army Flight Surgeons, Army Aviation Association of America, and Army Space Professionals Association.  Dr Albano military certifications include Master Flight Surgeon, Level 2 Space Professional, Code of Conduct, Fundamentals of Personnel Recovery, Introduction to Reintegration, and Survival, Evasion, Resists, and Escape (SERE) Level-C.
 
LT Jacob R. Westerberg, MSC, USN – Research Lead
Lieutenant Jacob Westerberg earned his Ph.D. and M.A. in Organizational Psychology from the California School of Professional Psychology at Alliant International University, San Diego. He also holds an M.A. in International Psychology (with Distinction) from The Chicago School of Professional Psychology and a B.A. in Political Science (with Honors) from the University of California, Riverside. In September of 2021, Lieutenant Westerberg received his direct commission to the Medical Service Corps as a Research Psychologist and reported to his first duty station at Naval Aerospace Medical Institute in Pensacola, Florida. Lieutenant Westerberg serves as Associate Director of Research for the Robert E. Mitchell Center for Repatriated Prisoners of War Studies. He also serves as Vice Chair for Navy Medicine Operational Training Command’s Scientific and Ethical Review Committee and as a Core Faculty member in the ACGME Residency in Aerospace Medicine program. His additional military training includes completion of the Division Officer Leadership Course and Survival, Evasion, Resists, and Escape (SERE) Level-C.

POW Background

During the Vietnam conflict, POWs suffered malnutrition, general abuse, and various types of torture.  In the North, the torture appeared to have been “standardized” and designed to provide the maximum of pain and discomfort with the minimum of obvious physical traces.  Very restrictive restraints and unusually extreme (ie; against the joint) posture would be used on a daily basis.

Despite this adversity and isolation, the POWs maintained a code of conduct.  They also developed various forms of communication; the TAP Code was the cornerstone.  Through command, control, and communication, the POWs demonstrated remarkable preservation and resilience.

Former POWs have been successful in later years counting among their numbers Members of Congress, Members of State Government, Officials in the Veterans Administration, the first Ambassador to Hanoi and various successful businessmen.
 

Ropes and over-extended limbs torture.

Rope marks on biceps and forearms
from ropes torture and resulting wrist drop.


"Manacles" originally designed for much smaller wrists


"Tap Code"

Illustrations are courtesy of Captain Mike McGrath, USN (Ret)

 

Timeline

The Mitchell Center has its roots in the 1000 Aviator Study. The 1940 Program gave the Navy its first comprehensive look at personal attributes of successful student aviators. From it, better aviation selection standards were created.

With the anticipated end of hostilities in Vietnam, planning for a Center for Prisoner of War Studies (CPWS) at Point Loma, California began in 1971. During Operation Homecoming, 660 United States Military POWs were repatriated from South East Asia prisons between January and May 1973. The Department of Defense mandated a five-year  five-year program for all the services to evaluate the effect of captivity among the repatriated POWs (RPWs).

The Navy and Marine Corps personnel were seen at the Naval Aerospace Medical Research Laboratory. In 1978, the CPWS Charter ended and the Navy and Marine Corps records were archived. The evaluations, however, were transferred to and continued at the Naval Aerospace Medical Institute (NAMI). NAMI later became subordinate to the Naval Operational Medicine Institute, which later became the Navy Medicine Operational Training Center.

Captain Robert E Mitchell was the cornerstone of the program. He was integral to the 1000 Aviator Study, involved in the planning of the CPWS, and performed the RPW evaluations until 1990, when he finally retired. As a result of CAPT Mitchell’s vision and singular effort, the Mitchell Center expertise was recognized, Army and Air Force Vietnam, Operation Desert Storm and Operation Iraqi Freedom RPWs, Somalia and Bosnia hostages/detainees, and program funding were added.

Timeline:

  • 1940 1000 Aviator Study begins
  • 1970 1000 Aviator Study concludes
  • 1973 Original DoD 5-year Charter for Prisoner of War (POW) Studies
  • 1976 A Navy matched Comparison Group was added
  • 1978 The Air Force and Army end their part of the Original POW Studies, the Navy (ie CAPT Mitchell) continues
  • 1991 Operation Desert Storm Repatriates added, 21 all services
  • 1992 VA $100,000 Grant to document and publish long term health effects on Naval aviators
  • 1993 Air Force authorized their former Vietnam repatriated POWs
  • 1996 Congress appropriates $1,000,000 to establish a Center for Prisoner of War Studies.
  • 1997 Army authorized their former Vietnam repatriated POWs
  • 1998 Congress appropriates a second $1,000,000 to continue support of research for the RPOW program
  • 1998 Dedication of Bldg 3933 as the REM Center for POW Studies
  • 2003 Operation Iraqi Freedom Repatriates added, 8 Army
  • 2004 Department of Navy-Robert E Mitchell Foundation, Inc MOU allows gifting of money, IAW SECNAVINST 4001.2G, to the Robert E Mitchell Center for POW Studies
  • 2010 Hostages/Detainees from Somalia & Bosnia are also eligible for participation
  • 2023 50 years of Freedom (Anniversary of Operation Homecoming)
     

Robert E. Mitchell Bio

CAPT Robert E. Mitchell

CAPT Robert E. Mitchell graduated from the University of California at Berkeley in 1942, and received his medical degree from the McGill University Faculty of Medicine in Montreal, Canada in 1947. Performing his internship and residency at the U.S. Naval Hospitals in San Diego and Oakland, he attended the Army Medical Service Graduate School at Walter Reed Army Medical Center before being designated a Naval Flight Surgeon at Naval Air Station Pensacola in 1955. His career included service ashore and afloat, including duty as Senior Medical Officer on the carrier Shangri-La (CVA 38), Staff Medical Officer for the First Marine Aircraft Wing in Vietnam, and Senior Medical Officer and Commanding Officer of the U.S. Naval Hospital at NS Rota, Spain. He accumulated 2,000 flight hours, including many under combat conditions.

Furthermore, he spent fifteen years in various posts at the U.S. Naval School of Aviation Medicine, and Naval Aerospace Medical Research Laboratory, culminating with command of the latter. During this time, he played the leading role in the "Thousand Aviator Study", and a program of medical evaluation of repatriated Vietnam prisoners of war, both landmark studies that have contributed immeasurably to the medical field.

After 44 years of selfless dedicated service, CAPT Mitchell retired. "Doc" Mitchell is well respected by the RPWs and is known for his classic house calls to area RPWs and telephone consultations to those geographically distant. He is a Fellow of the Aerospace Medical Association and Royal Society of Medicine. "Doc" Mitchell was made an Honorary Naval Aviator June 1990.

Coin Challenge

"REMC Commemorative Challenge Coin"



Background
The Robert E Mitchell Center (REMC) for Prisoner of War (POW) Studies Logo was created as a special program insignia to commemorate both the hardships endured by POWs and the REMC’s unwavering medical support to those selfless yet distinguished Repatriated Prisoners of War (RPWs).  The challenge coin was created to memorialize the individual, CAPT Robert E Mitchell, whose singular vision and sheer audacity enabled an unbroken (since 1973) dedicated service to those who suffered as a POW.

 

Description
On a 1 ½ inches diameter 2-sided circular brass device, the obverse shows a bas-relief image of CAPT Robert E Mitchell encircled by a rope-design border depicting his association with the Navy.  The reverse is an enameled colored logo encircled by the inscription Robert E Mitchell Center POW Studies.

 

Symbolism
The logo is highly symbolic in that the background is adopted from the ribbon of the POW Medal.  The unchained bald eagle, an embodiment of the American POW spirit, stands with pride and dignity. 

 

Below the bald eagle is a yellow ribbon inscribed with Never Forgotten.  A bold proclamation that not only did REMC desire for a speedy and safe return of those interned, but upon repatriatization, acted in fulfilling a grateful Nation’s promise to care for him who have borne the battle and endured harsh captivity.

 

Overlaying the yellow ribbon is a serpent entwined staff, the rod of Aesculapius, which is a symbol of medicine administered by a physician, in this case, a flight surgeon.  The two together resemble a Caduceus, a winged staff with two entwined serpents, which is recognized to be a larger military health care system. 

 

In this larger setting, the single serpent indicates the multidiscipline REMC’s singular commitment and dedication to supporting the RPWs and providing lessons learned for future military training and operations.

Products/Annual Medical Evaluation

The ongoing retrospective longitudinal study is based on the annual medical and neuropsychological evaluation parameters of the Original POW Studies Charter.  The medical and psychological information are provided to the repatriated POWs to aid in their routine health maintenance and disability documentation.
 


The extensive age-depended evaluation includes:
 
  • Comprehensive routine lab screening testing
  • 12-Lead Electrocardiogram and 10 sec Rhythm Strip
  • Pulmonary function testing
  • Chest X-ray
  • Bone density scan
  • Extended History and Physical evaluation
  • Neuropsychological evaluation
  • Ophthalmology evaluation
  • Otolaryngology evaluation
  • Neurological consultation
  • Orthopedic consultation
  • Dermatological consultation 
Depending on a particular study design, other parameters were added for that study.  They included:
 
  • MRI
  • Graded Exercise Test
  • Echocardiograms
  • Carotid and abdominal ultrasounds
  • 12-hour urine tests
  • Specific serum indicators
  • Telomeres
  • Insulin levels
The benefit in the longitudinal study goes far beyond taking care of the immediate needs of these national heroes.
 
  • Lessons learned used extensively today in SERE. (i.e., Survival, Evasion, Resistance, & Escape) training
  • Information developed used by the Department of Veterans Affairs (VA) for presumptive diagnoses and adjudicating compensable disabilities
  • Stress Research may be used to guide selection and training of personnel for high stress environments
  • Provide insights into basic disease processes
  • Collaborative research good for the Command, Navy Medicine, Navy, and Department of Defense
  • Training for medical department personnel of all Services assigned to operational billets who might be involved in the repatriation process

Product/Collaborators

Findings of Collaborative Study

 
       
                                          


 
Robert E. Mitchell Center for Repatriated Prisoner of War Studies, Pensacola, Florida
Products/Findings of Various Collaborative Studies

                            

 

RPOW Publications in Professional Journals or Texts
 
Sleep and Resilience: A Longitudinal 37-year Follow Up Study of Vietnam Repatriated Prisoners of War, 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
 
42-year Morbidity and Mortality Report of Vietnam era former POWs.  NMOTC-REMC-019 (DTIC AD1044458), 2017 December.
The purpose of this article is to report on, for the first time ever, not only the survival/mortality of the USN (USMC) RPWs, but also on the USAF RPWs, USA RPWs, and USN CGs from the Vietnam conflict. Another purpose is to report and analyze the morbidity at the 42-year milestone for each of these groups. Unlike the Nice et.al (1996) study with a “controlled” sample size, we’ll look at the entire REMC cohort. Based on our previous results regarding ICD diagnoses at the time of repatriation and the predictors of long-term resilience/health, as well the morbidity/mortal findings from WWII and Korea, we propose several hypotheses.
 
Injuries and Illnesses of Vietnam War POWs Revisited: IMEF Combined Risk Factors.  NMOTC-REMC-018 (DTIC AD1042577), 2017 March.
As a part of O/H (Thirteenth Air Force, 1973), medical and psychological conditions of all repatriates were documented in the Initial Medical Evaluation Form (IMEF), a 400 page, 29 section, standard protocol.  In this final report on IMEF diagnoses among Vietnam repatriates, we will report the prevalence of categorically-defined diagnoses for the combined group, as well as group summary descriptive statistics for each of the risk factors. Since these data have never been previously combined, we will analyze group differences on both risk factors and the outcome measure (number of physician- made diagnoses at the time of O/H).  
 
Injuries and Illnesses of Vietnam War POWs Revisited: IV Air Force Risk Factors.  NMOTC-REMC-017 (DTIC AD1031529), 2017 March.
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 (1977a,b and c) described the findings of the medical teams that examined Navy, Marine Corps, and Army RPWs at Clark Air Force Base (Republic of the Philippines) and at eleven stateside military medical treatment facilities.  There was no such similar report from the Air Force, aside from a detailed account of Air Force IMEF psychiatric findings (Ursano, et. al, 1981). Berg and Richlin (1977a) found that psychiatric illness was not in the top ten most common diagnoses among Navy repatriates.  The purpose of this present study is to look, for the first time ever, at the Air Force IMEF diagnoses and explore the relationship between the number of diagnosis at repatriation and the various risk factors.
 
Are Optimistic Repatriates More Hardy and Resilient?  NMOTC-REMC-016 (DTIC AD631863), 2016 January.
Previous research conducted by the RE Mitchell Center for Prisoner of War Studies (REMC) has concluded that optimism proved to be the strongest predictor of health and resilience in a group of Vietnam era Repatriated Prisoners of War (RPWs). Optimism is associated with increased positive psychological health in those afflicted by extreme trauma or illness (Segovia et. al, 2012). In the follow-up study (Segovia et. al, 2015), optimism measured at repatriation was again an excellent predictor of a composite measure of psychological (9 component measures) and physical (9 component measures) health. Further studies measured psychological resilience and individual components of hardiness as a mediating factor, but did not study the relationship of optimism or pessimism on resilience and hardiness. The aim of this study is to exploit whether optimists are more hardy and resilient as compared to a pessimist.
 
Injuries and Illnesses of Vietnam War POWs Revisited: III. Marine Corps Risk Factors, NMOTC-REMC-015 (DTIC AD626659)   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 (DTIC AD626687)   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 (DTIC AD626171)   05 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   (DTIC AD624844) 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.
 
The Robert E Mitchell Center for POW Studies: The Product of One Flight Surgeon’s Promise to Honor a Grateful Nation’s Warriors.  NMOTC-REMC-005 (DTIC AD606093), 2014 July.
This historical note outlines the development of the Robert E. Mitchell Center (REMC) for Prisoner of War (POW) 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.  CAPT Mitchell's dedication is the reason that today the REMC for POW studies stands as the only program which continued its care of U.S. repatriated prisoners of war (RPWs) well beyond the expiration of the original 1973-1978 charter.
 
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.
 

Research Areas of Interest

Summary of aging aviator routine labs (1973-2013/2018-2023)
Cognitive impairment concerns in the aging aviator
Cognitive norms in the aging aviator
Psychological Resilience and Posttraumatic Growth
Hardiness and psychological resilience as predictors of neurobiological resilience
Factors that mediate how well subjective health rating predicts objective health rating
Predictors of good vs poor outcomes during and after a captivity event
Best practices to support cognitive, emotional, psychological functioning and regulation in captivity situations

Links

POW/MIA Websites


Defense POW/MIA Accounting Agency (DPAA)
https://www.dpaa.mil/
Joint Personnel Recovery Agency (JPRA)
https://www.jpra.mil/
Library of Congress POW Database
http://lcweb2.loc.gov/pow/powhome.html
Veterans Affairs, Advisory Committee on Former Prisoners of War
https://www.va.gov/ADVISORY/FormerPrisonersofWar.asp
 

Laws of War 18th to 21 Century (and the Treatment of POWs)

 

Yale University Avalon Project “Laws of War”
http://avalon.law.yale.edu/subject_menus/lawwar.asp
 

Memorials and Museums

 

National Park Service Andersonville
http://www.nps.gov/ande/index.htm  
National Prisoners of War Museum
http://www.andersonvillegeorgia.com  
Arlington National Cemetery
http://www.arlingtoncemetery.org/
Vietnam Veterans Memorial
http://www.nps.gov/vive/
Korean War Veterans Memorial
http://www.nps.gov/kwvm/
World War II Veterans Memorial
http://www.nps.gov/wwii/

 

Other Links

 

US Department of Veterans Affairs
http://www.va.gov/
Defense Finance & Accounting Service
http://www.dfas.mil
Defense Technical Information Center (DTIC)
https://discover.dtic.mil/technical-reports/
US Army Comprehensive Soldier & Family Fitness Program
https://www.army.mil/e2/downloads/rv7/r2/policydocs/r350_53.pdf

 

 

 


 

Contact Us

Position Phone Number Email


Program Director           


850-452-2770                   


john.p.albano.civ@health.mil


Office Manager


850-452-3140


travis.v.meyer.civ@health.mil


Research Lead


850-452-3158


jacob.r.westerberg.mil@health.mil


LPO


850-452-3149


cherish.a.hamiltondemus.mil@health.mil                                             


Fax


850-452-2690

 


REMC RPOW Studies:

340 Hulse Road (Bldg 3933)
Pensacola, FL 32508

 



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