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Int J Qual Stud Health Well-being. 2017 Dec;12(1):1267317. doi: 10.1080/17482631.2016.1267317.

Active-duty military service members' visual representations of PTSD and TBI in masks.

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a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.
b College of Nursing and Health Professions , Drexel University , Philadelphia , PA , USA.


Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery.


Post-traumatic stress disorder; active duty military; art therapy; masks; traumatic brain injury

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