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

在9/11之后的伊拉克和阿富汗战争中，美国军方看到了军人使用精神药物的前所未有的显著转变。2006年，美国国防部首次制定了在“战区”使用经fda批准的精神药物的官方标准，即在军事行动的物理和战术空间，包括积极的战斗中使用。据保守估计，六分之一的军人正在服用至少一种精神科药物。美国军方使用精神药物引起了公众的注意，并准备影响美国人对当兵和战争本质的看法。关于这个话题的研究仍然主要是理论性的，并且集中在军事精神药物使用的伦理上。该项目旨在了解这些药物是如何在实践中开处方和使用的，以及军人如何理解药物对平叛工作的影响。本研究的结果将对公共知识和政策，以及针对退伍军人退役后过渡的退伍军人倡导者和临床实践具有重要意义。该项目促进在军事和与退伍军人相关的学术研究中纳入代表性不足的退伍军人学生，并支持社会和行为科学的多样性。它将通过1)指导学生退伍军人，2)将研究人员和退伍军人聚集在一起，在研讨会上讨论合作研究的前进方向，以及3)就这一重要主题出版合编的卷。北卡罗来纳大学教堂山分校的乔斯林·蔡博士将探讨精神科药物是如何被同化到9/11后的反叛乱行动、基础设施和规范中去的，士兵们是如何理解和体验这些药物的，以及这些药物对美国士兵的文化景观产生了什么影响。鉴于陆军的处方趋势以及与其他军事部门相比，在地面作战行动中的突出作用，该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度访谈、焦点小组和人种学观察来了解精神科药物处方、获取、使用和共享的正式和非正式方式。研究小组还将评估士兵在部署中使用精神药物的经历，以及他们对这些药物对平叛士兵的适当性的评估。PI还将进行档案研究，在美国军队行为和心理健康实践的近代史中，将当前的军事精神药物使用情况置于背景下。研究将在北卡罗来纳州和华盛顿特区进行。北卡罗来纳州拥有四个军事基地，其中包括布拉格堡陆军基地，目前在美国所有州中，现役和预备役人数排名第三。华盛顿特区的国家档案馆和马里兰州的国家医学图书馆分别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是如何在部署中使用的，以及士兵自己对药物使用的描述，以确定理论关注和公众辩论与士兵自己的经历和关注的一致程度。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识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.