Research

To conduct a comprehensive review of psychiatric aeromedical evacuations from Iraq and Afghanistan. Determine the long-term impact of those evacuations, identify areas of risk, provide recommendations to improve patient and aircrew safety, and yield data leading to improved care for patients, more efficient utilization of resources, and a reduction in medical discharges.

Test the hypothesis that early life stressors cause alterations in the expression of genes, specifically genes that regulate hypothalamic pituitary adrenal (HPA) axis activity, and that these genetic changes increase an individual’s susceptibility to PTSD following a traumatic event in later life. Potentially identify a molecular link between early environment, gene expression, and susceptibility to PTSD, a finding that could lead to intervention methods to reverse someone’s increased susceptibility to PTSD, perhaps with the use of medication.

Evaluate the interrelation of comorbid insomnia, pain and PTSD as seen in participants of other STRONG STAR randomized clinical trials focused on the treatment of combat-related PTSD. Perform an in-depth analysis to determine if the successful treatment of PTSD in turn reduces comorbid insomnia and pain, and whether comorbid insomnia and/or pain have a negative effect on participants’ response to PTSD therapy, providing insight to help providers tailor patients’ treatment to achieve the best possible outcomes.

Examine how alcohol use disorder impacts the effectiveness of selective serotonin reuptake inhibitor (SSRI) antidepressants used as the only FDA-approved medication for the treatment of PTSD. Specifically, identify patient characteristics predicting the response to SSRI treatment, which would give clinicians a valuable tool to assess who would or would not benefit from such treatment.

Evaluate a condensed cognitive behavioral therapy (CBT) for PTSD that can be implemented by mental health providers working in an integrated primary care setting. Determine whether this treatment delivery method is well received by military personnel; its efficacy in reducing PTSD symptoms; and the level of PTSD severity that is appropriate for this form of treatment.

Examine how evidence-based therapies for PTSD can be successfully disseminated and implemented among Army mental health providers by comparing two training models for Prolonged Exposure (PE) therapy. Determine whether extended provider training in PE increases both its use and quality of delivery by providers and its efficacy with patients.

Review and analyze data collected from military blast-injury patients in Iraq to disentangle the symptoms of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD) and acute stress disorder (ASD); use analyses to develop and then prospectively evaluate a clinical TBI/PTSD/ASD assessment battery that can be used by the military for accurate assessment of future blast-injury patients in deployed settings.

Evaluate the efficacy of a brief cognitive-behavioral intervention for managing suicidal behaviors in military mental health patients, with the ultimate goal of decreasing suicide and self-harm behaviors among service members.

Utilize the comprehensive dataset developed from all STRONG STAR trials to perform a variety of analyses aimed at providing knowledge to inform decisions about how best to prevent problems in those most at risk for PTSD and tailor treatments for maximum benefit.

In light of the significant overlap between PTSD and fibromyalgia, determine whether it is important to assess for this painful rheumatic disorder in active-duty military personnel with PTSD. Screen volunteers from other STRONG STAR treatment studies and their spouses to determine the prevalence of fibromyalgia, observe its influence on patients’ prognosis, and look for secondary familial consequences of PTSD.