Laurel L. Hourani, Ph.D.; RTI International; PTSD Concept Award

This was actually the first time that a real skills-based prevention program for PTSD is being developed. Soldiers are coming back suffering emotional problems that may be preventable. So this research is intended to be the first that would design a research program that would help prevent-mitigate PTSD and other stress-related disorders prior to their exposure to traumatic events. So, this program is a predeployment program that is designed to instill some skills, some basic easy-to-learn coping mechanisms, coping skills that they could take with them before they are exposed to traumatic event or a stressful time in their deployment. So what we do is to teach them a couple of basic breathing exercises that will hopefully lower their physiological arousal. This program is called the "Predeployment Stress Inoculation Training." Stress inoculation has 3 components, basic education, training-skills acquisition, and then practicing in a simulated environment. And we think that this is really going to be the best type of prototype predeployment or preventive training program that will help us, that's very practical, we can do it in a group setting, we can teach the trainer kind of situation very easily, we can teach other people how to do the training. So it's practical in that sense and it's cost effective for the military. This has just been newly funded and it's in the development stage. But we have some preliminary data; so far we have designed the breathing exercise and the protocol for that. We have also designed what we call a multimedia stressor environment. This is a video that we've designed that's a stressful video and it is designed so the soldiers have to respond quickly-as quickly as they can to the stressors to the triggers. And so we also have physiologic monitoring, we monitor their heart rate variability and their reaction time. So we want to make sure the idea is to lower their physiologic arousal because we know from the literature that if you lower anxiety within 72 hours of a traumatic exposure you're less likely to have PTSD symptoms. So this whole breathing exercise, which we call battle breathing, is designed to reduce the physiological arousal. So we can actually monitor that arousal level with biofeedback and they can look at themselves. So during the training they can see with the computer set-up that if they are actually lowering their heart rate or increasing their heart rate variability which would see them relax. So they can actually get the biofeedback from that. And it's very quickly and easily learned by the way; we can do the training in an hour. So we think it's very effective and the next step is to actually do some randomized trials. Hopefully we will be able to mitigate some of the stress injuries and PTSD symptoms.