and biofeedback skills can also improve awareness of and con- trol over physiological and cognitive processes, as these skills help regulate emotions and general distress and make it easier to adapt to situational stressors.
In 2009, WRAIR tested a one-hour post-deployment training session that focused on improving psychological resilience by harnessing service members’ inherent abilities. Specifically, the training aimed to teach Soldiers to recognize and anticipate normal reactions to stressful circumstances and to manage those reactions effectively in training, operations, combat and when transitioning from deployment to home. In three group-randomized trials, the WRAIR team demonstrated that the training improved behavioral health. Te researchers found that units completing this interactive resilience train- ing within one week of returning from deployment showed greater readiness to conduct their mission 12 months later, in comparison with units that received only education about human stress responses and ways to address those responses.
2. Developing objective tools to assist in the diagnosis of PTSD.
Current diagnostic methods for PTSD rely on patients’ own reports of symptoms. Symptoms often vary greatly from one patient to the next, and the subjective nature of self- reporting can complicate behavioral health providers’ evaluations. Additionally, other factors can influence patients’ self-reports, including concerns about PTSD carrying a stigma that could affect their career progression, potential medical discharge and longer-term disability status.
One of MOMRP’s major current efforts focuses on developing a blood-based laboratory test that behavioral health profes- sionals can use to aid in PTSD diagnosis so as not to rely solely on subjective self-reporting of symptoms. Te goal is to have an objective platform, consisting of a biomarker assay and blood analyzer that can easily identify markers of illness from blood components, such as metabolic proteins, genetic markers and common biometric data. Tis screening tool will be used in military medical treatment facilities. Later uses will be to assess the trajectory of disease, PTSD subtypes, treat- ment matching and optimization, and response to treatment.
Tese advances fit well with the White House Precision Medicine Initiative launched in 2015. Tey also aim to accel- erate biomedical discoveries and provide clinicians with new tools and therapies to select treatments, taking into account
individual differences in genes, symptoms, environments and lifestyles. Within five to 10 years, when trials validate the blood-based PTSD test and it comes into common use by DOD behavioral health providers, the test will bolster readi- ness by ensuring that those who have PTSD are identified early, receive the best treatment and return to duty with con- fidence that they are psychologically ready for their missions.
3. Improving treatment of PTSD.
Two main evidence-based psychotherapies are currently in use across the military health system. Te first is prolonged
A HEALING KINSHIP
Retired Command Sgt. Maj. Sam Rhodes, diagnosed with PTSD after serving 30 straight months deployed to Iraq, discovered that horses helped him regroup. Now he runs a nonprofit organization, Warrior Outreach Ranch, which helps veterans and their families reconnect and relax by learning to work with horses. In the search for effective treatments for PTSD in its many manifestations, MOMRP funds some studies that use complementary and alternative medicine approaches. (U.S. Army Reserve Photo by Maj. Michelle Lunato, 98th Training Division)
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SCIENCE & TECHNOLOGY
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