ARRA Investments in Post-Traumatic Stress Disorder
Public Health Burden
Post-traumatic stress disorder (PTSD) is a medical disorder that can develop after exposure to a terrifying event in which serious physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural disasters, accidents, or military combat. The increased rate of PTSD among combat veterans has further intensified the need for research on this disorder. The main features of PTSD are intrusive thoughts including flashbacks, avoidance of situations that recall the trauma, and hyperarousal (sleeplessness, restlessness, irritability), which impair a person’s daily functioning.
Risk Factors and Underlying Mechanisms
Researchers are studying the importance of various risk and protective factors that play a role in whether a person will develop PTSD. The aim of this research is to determine the underlying mechanisms of this disorder in order to identify those at highest risk, and to advance novel treatment and prevention strategies. ARRA-supported research in this area includes:
One ARRA grant will expand a large mental health epidemiological study of military personnel to examine neurobiological and psychosocial predictors of mental health outcomes in the U.S. Army. Study investigators aim to move quickly to identify risk and protective factors for suicide among soldiers and provide a science base for effective and practical interventions to reduce suicide rates and address associated mental health problems.
In pursuit of potential biomarkers, another project will determine if individuals with and without PTSD have different epigenetic profiles—chemical modifications to their DNA that influence gene expression. The identification of these variants will advance our understanding of the underlying causes of PTSD, and facilitate the search for new and more effective psychosocial and drug interventions.
A project will examine potential brain biomarkers, through neuroimaging and other assessment measures, that could identify patients more at risk for developing PTSD following a trauma and who may be better suited to certain treatments.
One grant will examine whether reduction of a protein called GAP-43 affects fear-associated learning and memory. This research could further elucidate the brain mechanisms underlying PTSD.
Another grant will explore the role of BDNF, a protein involved in emotion regulation, in the expression and extinction of fearful and reward-related memories. Recent studies have shown that fear extinction is an active learning process, not a passive process of forgetting, which provides an important knowledge base for the development of new treatments for PTSD.
An ARRA project will increase knowledge of how chronic social stress affects development of emotional regulation and long-term outcomes for mental health and behavior.
Another grant will investigate whether stress-induced changes in immune function in the brain could underlie the anxiety, depression, and alcohol consumption seen in individuals with PTSD.
Maternal PTSD has been identified as a risk factor for PTSD in offspring. One project will look for potential biomarkers for PTSD in the offspring of Holocaust survivors.
Another ARRA project will examine the relationship between major stress during pregnancy (in this case the 2008 Midwest floods) and its impact on maternal and child well-being.
Intervention research on PTSD is conducted in a range of community settings to ensure the development and accessibility of personalized prevention and treatment approaches for all those in need. Examples of ARRA-funded research in this area include:
One ARRA grant will evaluate the dissemination and implementation of two evidence-based psychotherapies for PTSD administered by the VA, addressing an urgent public health need as more and more soldiers return from Iraq and Afghanistan with this disorder. The researchers will assess the implementation of these two therapies within the VA residential PTSD treatment programs.
Another grant will test the effectiveness of cognitive-behavioral therapy plus D-cycloserine, an antibiotic, in treating children with PTSD in an effort to speed remission and identify possible biomarkers.
Another grant will increase participant recruitment for a study to test a modified cognitive-behavioral therapy for PTSD and substance use disorders among people with serious mental illness.
A project will pilot test an evidence-based behavioral intervention for trauma to assess the feasibility of and identify key strategies for improving implementation of school-based mental health treatments.
Another project will accelerate health services research for PTSD and other post-traumatic behavioral health care needs, including economic aspects of clinical practice and service delivery that have strong implications for administration and policy at the federal and state levels.
Another grant will enhance research training and career development of a researcher studying trauma, primary care mental health services, and the needs of low-income ethnic minorities.
-- Modifiable Risk and Protective Factors for Suicidal Behavioral in the U.S. Army -- Ursano, Robert (MD)
-- Candidate Epigenetic Biomarkers for PTSD: Insights From Detroit -- Galea, Sandro (MI)
-- Abnormality of Emotional Circuitry as a Biomarker in PTSD -- Sheline, Yvette (MO)
-- Synaptic Dialogue: Plasticity Leading to Memory Storage -- Routtenberg, Aryeh (IL)
-- Prefrontal Cortex BDNF and Amygdala-Dependent Emotional Learning -- Ressler, Kerry (GA)
-- Emotion Processing: Risk for Psychopathology -- Pollak, Seth (WI)
-- Neuroimmune Factors and Co-Morbid Fear, Depression and Alcohol Consumption -- Fanselow, Michael (CA)
-- Identification of an Epigenetic Risk Marker for PTSD -- Yehuda, Rachel (NY)
-- The Iowa Flood Study: Perinatal Effects of a Natural Disasater -- O’Hara, Michael (IA)
-- Theory-Driven Mixed-Methods Evaluation of PTSD Treatment Implementation in VA Residential Settings -- Cook, Joan (CT)
-- Effect of D-Cycloserine on Treatment of PTSD in Youth -- Scheeringa, Michael (LA)
-- PTSD and Dual Disorders at the Interface of the MH and CJ Systems -- Cusack, Karen (NC)
-- Implementation Strategy for Delivering a School-based Mental Health Program -- Kataoka, Sheryl (CA)
-- Mentoring/Career Development in PTSD Services Research -- Frueh, Christopher (HI)
-- Improving Communication Between Primary Care Providers and Their Trauma Patients -- Green, Bonnie (DC)
Page Last Updated on June 30, 2018
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