STRONG STAR
STRONG STAR Multidisciplinary PTSD
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L to R: Pedro L. Delgado, MD, John D. Roache, PhD, Alan Peterson, PhD, Jim Mintz, PhD, David C. Glahn, PhD |
BACKGROUND: The American public and the military community have made enormous commitments and sacrifices in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Recent studies have found that about one of every six returning OIF/OEF veterans has symptoms of Posttraumatic Stress Disorder (PTSD). PTSD is caused by exposure to traumatic stress, and one of the most common examples from OIF/OEF is exposure to grotesquely injured and mutilated people and human remains as a result of roadside bomb explosions. U.S. service members and others see things that no humans should have to see, and as a result, even some of the healthiest individuals can have traumatic memories that last a lifetime. It is currently estimated that 100,000 to 300,000 OIF/OEF veterans are at significant risk for developing chronic PTSD. Research with civilians with non-combat-related PTSD (e.g., rape or motor vehicle accidents) has shown that most can be treated successfully with a type of counseling called "exposure therapy" and their symptom reductions are large and fairly permanent. However, counseling with Vietnam veterans indicates that treating combat-related PTSD can be difficult when it is treated after discharge from active duty and after a significant amount of time has passed between when the trauma occurred and the counseling is started. There are currently about half a million Vietnam War veterans with chronic PTSD, and the Government spends over 4 billion dollars per year in disability payments for them. No study has ever evaluated the treatment of combat-related PTSD in active-duty military personnel. Studies are desperately needed to prevent a new generation of veterans with chronic PTSD.
Both of the 2007 Reports from the DoD Task Force on Mental Health and the Institute of Medicine have documented the urgent need for basic and clinical research on combated-related PTSD among OIF/OEF veterans. In an effort to address this problem, Congress has allocated funding to create a PTSD Research Consortium. Only one PTSD Research Consortium will be funded, so the focus of the research and the institutions and investigators involved are critically important. STRONG STAR, the South Texas Research Organizational Network Guiding Studies on Trauma And Resilience is a Research Consortium centered in San Antonio, Texas that is highly qualified and prepared to optimize research and accelerate a solution that will help avoid the staggering financial, emotional, and societal costs associated with PTSD.
OBJECTIVE: To develop and evaluate the most effective early-interventions possible for the detection, prevention, and treatment of combat-related PTSD in active-duty and recently discharged OIF/OEF veterans. We have organized a team of military, civilian, and VA institutions and investigators to create and implement a centralized, coordinated, health services research program to identify and solve many of the problems related to causes, diagnoses, treatment, and rehabilitation of PTSD and other trauma-related disorders.
RESEARCH STRATEGY: Our research includes treatment-outcome studies, research cores, animal studies, and exploratory studies. The treatment studies will evaluate early interventions with prolonged exposure and cognitive processing therapy (two treatment programs that were found to have sufficient empirical evidence for their efficacy with PTSD by the recent report of the Institute of Medicine) in various clinical populations, settings, and comorbid conditions. Research cores will include assessment, neuroimaging, genomics, and basic science, and animal studies will target how PTSD susceptibility is programmed by early life trauma and can be reversed with medication treatment. Exploratory studies will evaluate the use of exposure therapies for the treatment of military patients while deployed, changes in comorbid insomnia and pain in patients treated for PTSD, and risk for the development of fibromyalgia in patients with PTSD and their family members.
CENTER STRUCTURE: The Consortium is centered in South-Central Texas and is structured around research projects and cores. Texas contains the largest concentration of OIF/OEF veterans, the DoD’s largest military medical complex, state-of-the-art trauma research facilities, and established military, VA, and civilian institutional collaborations. Whereas other regions are well-resourced in researchers, proportions of OIF/OEF veterans are minimal; STRONG STAR brings the best of PTSD researchers from other regions to the highest concentration of OIF/OEF warriors and veterans in the nation. The Consortium Director and Coordinator have extensive experience in conducting research in military settings. Consortium Advisory Boards and the Executive Steering Committees will keep the research projects and cores on target. An Investigator Committee, Clinical Trials Committee, Medical Trauma Committee, and an Education, Training, and Dissemination Committee will oversee key processes to ensure the success of the Consortium. STRONG STAR has the critical mass of talent required to make major scientific advances in military PTSD research.