Psychopharmaceuticals and Medicated Soldiering in America's post-9/11 Military

在9·11事件后的伊拉克和阿富汗战争中，美国军方看到了服役人员使用精神药物的史无前例的显著转变。2006年，美国国防部首次制定了官方标准，用于在包括主动作战在内的军事行动的物理和战术空间中“在战区”使用FDA批准的精神药物。保守的估计表明，现在每6名服役人员中就有1人正在服用至少一种精神药物。美军使用精神药物引起了公众的关注，并有望影响美国人对当兵和战争性质的看法。关于这一主题的研究在很大程度上仍然是理论上的，并集中在军事精神药物使用的伦理问题上。该项目旨在了解这些药物在实践中是如何开出和使用的，以及军人如何了解药物对反叛乱工作的影响。这项研究的结果将对公众知识和政策以及退伍军人倡导者和旨在退伍军人服务后过渡的临床实践具有重要影响。该项目促进将未被充分代表的退伍军人学生纳入军队和退伍军人相关的学术研究，并支持社会和行为科学的多样性。它将通过以下方式做到这一点：1)指导退伍军人学生；2)将研究人员和退伍军人聚集在一起，讨论合作研究的前进方向；3)出版一本关于这一重要主题的共同编辑的卷。北卡罗来纳大学教堂山分校的Jocelyn Chua博士将探索精神药物如何被吸收到9/11后反叛乱的行动、基础设施和规范中，士兵如何理解和体验这些药物，以及这些药物对美国士兵的文化格局产生了什么影响。考虑到陆军的处方趋势和与其他军事部门相比在地面作战中的突出作用，这项研究将集中在美国陆军、陆军预备役和陆军国民警卫队。PI和研究团队将使用深入访谈、焦点小组和人种学观察，以了解精神药物的正式和非正式方式被开出、获取、使用和分享。研究小组还将评估应征士兵在部署中使用精神药物的经验，以及他们对这些药物对反叛乱士兵的适当性的评价。PI还将进行档案研究，将当前军事精神药物的使用与美国军事行为和精神健康实践的近期历史联系起来。研究将设在北卡罗来纳州和华盛顿特区。北卡罗来纳州拥有包括布拉格堡陆军基地在内的四个军事基地，目前拥有美国各州第三多的现役和预备役人员。分别位于华盛顿特区和马里兰州的国家档案馆和国家医学图书馆为档案研究提供了大量的军事资源。这项研究的结果将阐明精神科药物在部署中是如何使用的，以及士兵自己对其使用的描述，以确定理论上的关切和公众辩论在多大程度上符合士兵本身的经历和关切。这一奖项反映了NSF的法定使命，并通过使用基金会的智力价值和更广泛的影响审查标准进行评估，被认为值得支持。

The United States military has seen an unprecedented and marked turn to the use of psychiatric medications by service personnel in the post-9/11 wars in Iraq and Afghanistan. In 2006, the US Department of Defense developed for the first time official criteria for the use of FDA-approved psychiatric medications "in theater", in the physical and tactical spaces of military operations including active combat. Conservative estimates suggest that 1 in 6 service members is now taking at least one psychiatric medication. The use of psychiatric medications by the US military has attracted public attention, and is poised to influence the ways that Americans think about soldiering and the nature of war. Studies on the topic remain largely theoretical and center on the ethics of military psychiatric medication use. This project aims to understand how these medications are prescribed and used in practice, as well as how military service members understand medication effects on the work of counterinsurgency. The results from this study will have important implications for public knowledge and policy, as well as for veteran advocates and clinical practice aimed at the post-service transition of veterans. The project fosters the inclusion of underrepresented student veterans in military and veteran-related academic research and to support diversity in social and behavioral science. It will do so by 1) mentoring student veterans, 2) bringing together researchers and veterans in a symposium to address ways forward for collaborative research, and 3) publishing a co-edited volume on this important topic. Dr. Jocelyn Chua of the University of North Carolina at Chapel Hill will explore how psychiatric medications have been assimilated into the operations, infrastructures and norms of post-9/11 counterinsurgency, how these medications are understood and experienced by soldiers, and what impact these medications have had on the cultural landscape of soldiering in the U.S. Given the Army's prescription trends and prominent role in ground combat operations compared with other military branches, the research will focus on the US Army, Army Reserve, and Army National Guard. The PI and research team will use in-depth interviews, focus groups, and ethnographic observation to understand the formal and informal ways that psychiatric medications are being prescribed, accessed, used, and shared. The research team will also assess enlisted soldiers' experiences of psychiatric medication use in deployment and their evaluations of the propriety of these medications to counterinsurgency soldiering. The PI will also conduct archival research to contextualize current military psychiatric medication use within the recent history of the practice of US military behavioral and mental health. Research will be based in North Carolina and Washington, DC. Home to four military bases, including Fort Bragg Army base, North Carolina currently has the third highest number of active duty and reserve members of all US states. The National Archives and the National Library of Medicine in Washington, DC and Maryland, respectively, house extensive military resources for the archival research. Findings from this research will illuminate how psychiatric medications are used in deployment and soldiers' own accounts of their use in order to determine the extent to which theoretical concerns and public debate align with the experiences and concerns of soldiers themselves.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.