Doctoral Dissertation Research: Understanding how neuroscience is changing the relationship between the state and US veterans with war disabilities

轻度创伤性脑损伤（mTBI）和创伤后应激障碍（PTSD）是最近美国在伊拉克和阿富汗战争中的标志性伤害。这种伤害给退伍军人及其家属过渡到平民生活带来了困难和长期挑战。患有战争致残的退伍军人需要立即和长期的社会、职业和医疗支持。了解退伍军人如何理解和使用生物医学和神经科学研究可以加强科学家、临床医生和退伍军人之间的交流，也可以提高mTBI和PTSD的科学和健康素养。该项目还旨在记录退伍军人未满足的需求，同时在退伍军人护理的关键利益相关者之间协作确定解决方案。最后，本研究希望有助于临床和社会对个体的理解，以及在基础科学研究和临床实践之间移动的诊断类别所附带的深刻的个人意义。这项研究的结果将与军事和医疗保健专业人员以及对战争创伤、神经科学、退伍军人健康和残疾研究感兴趣的人类学家和其他社会科学家分享。该项目还将提供一名人类学博士研究生的培训。由于需要更好地照顾退伍军人，美国政府、临床医生、科学家和士兵越来越多地转向神经科学，以提供对这些战争获得性残疾的见解。在伊利诺伊大学厄巴纳-香槟分校的简·德斯蒙德博士的指导下，詹妮弗·鲍德温将探索神经科学研究产生的新意义，以及这些新知识对退伍军人、临床医生和退伍军人事务部（VA）医院的研究人员如何理解退伍军人所遭受的不同类型创伤的影响。本项目采用参与者观察、访谈和社区健康方法来评估：a)不断发展的神经科学知识和技术在改变临床医生、神经科学研究人员和退伍军人对创伤后应激障碍和mTBI的理解方面发挥了什么作用？b)神经科学的研究进展是否改变了被诊断患有这些疾病的退伍军人如何描述自己、他们的病情和他们的生活目标？如果有，是怎么做到的？c)关于战争获得性脑/精神创伤的神经科学解释允许和否认老兵自己对他们在战争中的经历和回家后的理解？d) VA临床和研究空间对神经科学知识和技术的使用如何影响这些退伍军人与国家之间的关系？本研究通过分析最近关于创伤后应激障碍和mTBI的神经科学研究如何改变国家对退伍军人的照顾方式，以及临床、社会和退伍军人对暴力、创伤和战争影响的看法，有助于医学和文化人类学的研究。因此，这项研究有助于更广泛地了解医疗权威、国家权力和在VA临床空间中出现和谈判的新形式的公民之间的关系。

Mild Traumatic Brain Injury (mTBI) and Post Traumatic Stress Disorder (PTSD) are the signature injuries of the recent US wars in Iraq and Afghanistan. Such injuries pose difficulties in transitioning to civilian life and long-term challenges for veterans and their families. Veterans with war-acquired disabilities constitute a population needing immediate and long-term social, vocational, and medical support. Knowledge of how veterans understand and use biomedical and neuroscientific research can enhance communication between scientists, clinicians, and veterans, and also promote improved scientific and health literacy on mTBI and PTSD. This project also aims to document veterans' unmet needs, while collaboratively identifying solutions among key stakeholders in veteran care. Finally, this study hopes to aid clinical and social understandings of the individual and deeply personal meanings attached to a diagnostic category as it moves between the bench of basic science research and the bedside of clinical practice. The results of this research will be shared with military and healthcare professionals, and among anthropologists and other social scientists interested in studies of war trauma, neuroscience, veteran health, and disability. The project also will provide for the training of an MD-PhD graduate student in anthropology.Mobilized by the need to better care for returning veterans, the US Government, clinicians, scientists, and soldiers have increasingly turned to the neurosciences to provide insights into these war-acquired disabilities. Jennifer Baldwin, under the supervision of Dr. Jane Desmond of the University of Illinois at Urbana-Champaign, will explore the emergent meanings produced by neurscientific research, and the effect of this new knowledge on how veterans, clinicians, and researchers at Veteran Affairs (VA) hospitals understand the different types of traumas with which veterans are suffering. This project employs participant-observation, interview, and community health methodologies to evaluate: a) What role do evolving neuroscientific knowledge and technologies play in transforming understandings of PTSD and mTBI for clinicians, neuroscience researchers, and veterans? b) Are research developments in the neurosciences changing how veterans diagnosed with these conditions characterize themselves, their conditions, and their life goals? And if so, how? c) What do neuroscientific explanations of war-acquired brain/mind traumas allow and disavow with regards to veterans' own understandings of their experiences at war and upon homecoming? and d) How does the use of neuroscientific knowledge and techniques by VA clinical and research spaces influence the relationship between these veterans and the state? This research contributes to the study of medical and cultural anthropology by analyzing how recent neuroscientific research on PTSD and mTBI is transforming how the state cares for returning veterans, as well as clinical, social, and veterans' perspectives about the effects of violence, trauma, and war. This study thus contributes broader insight into the relationship between medical authority, state power, and new forms of citizenship that emerge and are negotiated in VA clinical spaces.