The STRONG STAR Multidisciplinary PTSD Research Consortium

Principal Investigator: GATCHEL, ROBERT J
Institution Receiving Award: TEXAS, UNIVERSITY OF, AT ARLINGTON
Program: PH-TBI
Proposal Number: PT074199P15
Award Number: W81XWH-08-2-0113
Funding Mechanism: PTSD Multidisciplinary Research Consortium Award
Partnering Awards: PT074199, PT074199P12, PT074199P13, PT074199P14, PT074199P17, PT074199P18, PT074199P19, PT074199P20, PT074199P21
Award Amount: $1,521,564.00


With the continuation of Operation Iraqi Freedom and Operation Enduring Freedom, chronic pain associated with orthopedic trauma and combat-related post-traumatic stress disorder (PTSD) and traumatic stress are growing concerns for the U.S. military. As both pain and PTSD evolve into chronic conditions, the financial costs associated with treatment exceed hundreds of billions of dollars annually (Berkowitz et al., 1999; Feuerstein et al., 1999; Huang et al., 1998; Zouris et al., 2006; Greer et al., 2006; Arnst and Licking, 1999; Weathers et al., 1993). Unfortunately, recent research suggests that individuals suffering from comorbid chronic pain and traumatic stress may respond poorly to treatment targeting only one diagnosis, contributing to the chronicity and severity of chronic PTSD and chronic pain diagnoses (Bosse et al., 2002). This phenomenon is particularly vexing considering that evidence is beginning to mount suggesting that civilian individuals experiencing physical trauma are quite likely to experience symptoms of significant psychosocial distress as well (Zatzick et al., 2002; Starr et al., 2004). One specific study identified over half of a civilian sample of orthopedic trauma patients who met criteria for PTSD after their injury (Starr et al., 2004). To date, similar data are not available for a military population, though it is suspected that the comorbidity between orthopedic trauma and PTSD would be similar to that noted above for civilians, if not more prevalent. The purpose of the present study is to identify the comorbidity of orthopedic trauma and traumatic stress in an active duty military population and to evaluate a preventive behavioral health treatment strategy aimed at helping to retard or halt the development of PTSD and/or chronic pain syndromes. Existing data suggest that early interventions for orthopedic trauma pain and related traumatic stress can be effective in preventing chronic pain or PTSD syndromes (Feldner, Monson, and Friedman, 2007; Dahl and Nilsson, 2001). No study, to date, has examined combining preventive pain and PTSD treatments for any pain/psychosocial trauma conditions.