Background: Recent studies have found that about one of every six veterans returning from deployments in support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) have symptoms of post-traumatic stress disorder (PTSD). This corresponds to an estimated 100,000 to 300,000 combat veterans who 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." However, no randomized clinical trial has ever evaluated the treatment of combat-related PTSD in active-duty military personnel. The South Texas Research Organizational Network Guiding Studies on Trauma And Resilience (STRONG STAR) Multidisciplinary PTSD Research Consortium will conduct scientific studies 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 veterans.

Research Strategy: STRONG STAR includes approximately 20 of the nation's leading research institutions and 100 military and civilian researchers and clinicians. Our consortium research includes treatment-outcome studies, research cores, animal studies, and exploratory studies. The University of Texas Health Science Center (UTHSC) at San Antonio is the coordinating institution for the consortium and provides the majority of the research staff and infrastructure to support the STRONG STAR research projects and cores. Alan Peterson at UTHSC is the overall Consortium Director and also leads the Administrative Core in collaboration with John Roache (Deputy Consortium Director) and Stacey Young-McCaughan (Consortium Coordinator). James Mintz directs the Data and Biostatistics Core. UTHSC also hosts two of our military Partnering Principal Investigators (PIs): COL Kathryn Gaylord and Lt Col Jeffrey Cigrang. Dr. Gaylord's study will evaluate enhanced prolonged exposure therapy for PTSD in burns patients, and Dr. Cigrang will evaluate the use of an exposure therapy protocol modified for use in primary care settings. Smaller exploratory studies will evaluate the use of exposure therapies for the treatment of military patients while deployed to Iraq (PI: Alan Peterson), changes in comorbid insomnia and pain in patients treated for PTSD (PI: Stacey Young-McCaughan), and risk for the development of fibromyalgia in patients with PTSD and their family members (PI: Jay Higgs).

Research Vision: The vision of STRONG STAR is to establish itself as the nation's leading research consortium for the development and evaluation of prevention and treatment approaches for combat-related PTSD. This vision will be accomplished by the close collaboration of leading research institutions and investigators including military, civilian, and Department of Veterans Affairs partnerships. Strategically located in South Texas, STRONG STAR includes the nation's largest concentration of active duty and recently discharged Operation Iraqi Freedom/Operation Enduring Freedom veterans and will include three of the military's largest military medical centers. STRONG STAR will conduct scientific studies to develop and evaluate evidence-based interventions, provide military health care professionals with valuable training to treat combat veterans at home and in the field, and provide early interventions for PTSD to significantly reduce the risk of chronic PTSD. We anticipate that our initial consumer outcomes will become available before the end of 2009.