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There are still many questions about the double murder that occurred this past weekend near Fort Worth, Texas. Among them: Is a shooting range a safe place for a disturbed war veteran? The vet turned his gun on two men, including Chris Kyle, a former Navy SEAL. Kyle wrote a best-selling book, called "American Sniper," that helped to fund his charity work with other veterans. As NPR's Quil Lawrence reports, the crime has raised concerns about treatments for post-traumatic stress disorder.
QUIL LAWRENCE, BYLINE: Eddie Ray Routh, a 25-year-old Marine reservist, had been checked into a hospital twice in recent months. Former SEAL Chris Kyle, and his friend Chad Littlefield, had taken Routh to a shooting range, possibly as a form of therapy. Hours later, Routh's sister called 911.
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LAWRENCE: Routh's sister then put her husband on the line.
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LAWRENCE: Police later apprehended Routh driving Chris Kyle's pickup truck. Kyle's death has inspired tributes and eulogies, but also questions about whether a firing range is a good place for a disturbed veteran.
TODD VANCE: Yes, that seems perfectly normal to me.
LAWRENCE: Todd Vance is also an Iraq war vet. He coaches a mixed martial arts group for veterans in San Diego. He says many veterans see hiking, hunting or shooting as a way to re-create their military experience but without the danger. Vance, who's getting a degree in social work, himself got treated for PTSD. Now, he says fighting in the gym helps him.
VANCE: Everybody deals with it differently. You know, somebody could look at me and say, well, you get punched in the face seven days a week. That seems like pretty risky behavior as well. But in reality, it's keeping me out of trouble. And who knows, you could be used as human exposure therapy.
LAWRENCE: Exposure therapy - that's one of the cognitive therapies proven to help with PTSD. The idea is to help a patient remember traumatic events without re-experiencing the trauma. It's not clear that's what Chris Kyle was trying to do by taking a fellow veteran to the shooting range. And anyhow, it's meant to be done with a doctor's supervision.
Some cognitive therapies, and a limited number of drugs, are the only treatments for PTSD backed up by empirical study. But with hundreds of thousands of veterans suffering, there are lots of experimental methods out there.
DR. FARRIS TUMA: The big challenges here, overall - is that what we know that works, doesn't work for everyone.
LAWRENCE: Dr. Farris Tuma is with the National Institutes for Health.
TUMA: And there's limited availability of the things that we know do work.
LAWRENCE: Treatments include everything from virtual reality to yoga; spending time with dogs or horses. Doctors sometimes try other drugs, from anti-psychotics to the recreational drug ecstasy. Dr. Tuma just wishes he had the evidence to say what helps, and what hurts.
TUMA: It's not that people are by choice flying by the seat of their pants. They're essentially using, you know, their own experience and maybe something they've read about. But the bottom line is, we don't have good guidance for them.
LAWRENCE: The Pentagon has financed a major study - due out next year - to assess all these treatments. Sandro Galea, head of epidemiology at Columbia University, leads the effort. He says it's an auspicious time with new funding, new understanding of PTSD, and new research on how the brain works.
DR. SANDRO GALEA: So there is a lot going on, and it is that depth of activity that makes me say I'm optimistic. There's a lot of effort being invested by practitioners of all stripes, to deliver effective PTSD care to those who need it.
LAWRENCE: Galea says he hopes the public will soon see PTSD as an injury, like a broken arm that can be treated. Quil Lawrence, NPR News.
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