Our Soldiers’ physical health and psychological well-being is an Army priority. Unfortunately, whereas physical ailments are often visible, the more insidious injuries are those that are less obvious injuries affecting Soldiers’ psychological well-being.

Injuries resulting from blast incidents are the basis for most casualties today and will continue to be in the foreseeable future. A significant number of Soldiers returning from the battlefield potentially suffer from post-traumatic stress disorder (PTSD) or other mental health issues and 15 to 20 percent could have suffered mild traumatic brain injury (TBI) and concussion. Ongoing science and technology (S&T) efforts show exceptional promise in developing novel approaches to diagnosing and treating both PTSD and TBI. Research into developing novel drugs to treat brain injuries, developing intervention models, and identifying “protein biomarkers” as clinical indicators of brain injuries are just some of the approaches being taken to mitigate and treat these injuries.

The first step is to fully understand the nature of the condition. PTSD is a psychological injury in response to a single or multiple traumatic events. Many PTSD symptoms are emotional in nature; however, there are a variety of cognitive problems associated with the disorder as well. Symptoms, such as forgetfulness, a sense of being overwhelmed with simple tasks, and clouded thinking, are associated with PTSD. These same symptoms are also seen in Soldiers who experienced a mild to moderate concussive event.

TBI is head trauma that can cause physical injury, disrupting normal brain function of memory, attention, mental organization, and logical thinking. Survivors of TBI frequently exhibit persistent physical functional impairment and cognitive function, memory, mood, and other personality disorder problems that are very similar to PTSD symptoms. The Walter Reed Army Institute of Research (WRAIR) is looking at candidate neuroprotective drugs for acute treatment of TBI that will aid in the management of returning a Soldier’s brain back to optimal function.

A major challenge facing military health care providers is the ability to differentiate between PTSD and mild TBI in returning Soldiers. Both can have similar symptoms that make distinguishing between the two very difficult, especially without sufficient observation. There are innovative technological developments to specifically help the health care provider in diagnosis. The WRAIR is developing a clinically validated diagnostic system that is based on the measurement of biomarkers released from the injured brain to objectively diagnose the presence and severity of injury in TBI casualties. The TBI diagnostic system looks for the presence of protein biomarkers released after brain injury and other physiological data integrated into a fieldable, hand-held device. This device will also incorporate a software-based decision algorithm to aid health care providers in identifying TBI and monitoring casualty recovery.

The Army has committed significant S&T investments and set research priorities to reduce and treat combat-related psychological problems. The unit-level training program Advanced Battlemind is geared to post-deployment resetting with the goal of facilitating faster recovery from combat, building individual and unit resilience in preparation for subsequent deployment, and reducing the incidence of debilitating symptomatic problems and risk-taking behavior of our warfighters. Advanced Battlemind training involves six in-depth sessions that integrate state-of-the-art cognitive behavior approaches to traumatic stress, while maintaining the focus on Soldier strengths, unit cohesion, leadership skills, and individual cognitive skill building. The program also incorporates cognitive education strategies shown to be effective in reducing TBI symptoms that often overlap with PTSD.

In FY07 Congress provided $300 million in supplemental funding for PTSD and TBI research through the Congressionally Directed Medical Research Program (CDMRP). The U.S. Army Medical Research and Materiel Command (USAMRMC) manages the CDMRP and will award 201 grants for PTSD/TBI research that will develop improved tools to get a better understanding at basic neurological, cognitive, and performance levels of the real impact of PTSD and TBI, as well as improved treatment modalities.

Additionally, in consultation with a group of the Nation’s top researchers and leading experts in PTSD and TBI fields, USAMRMC formed a research consortium with CDMRP funding. The Army contracted with the University of California, San Diego to lead this consortium that includes military medical centers, academic medical centers, and U.S. Department of Veterans Affairs hospitals. The consortium will analyze patient data to identify causes and potential treatments for PTSD and TBI.

MG George W. Weightman, USAMRMC Commanding General, emphasized the consortium’s importance. “The Army medical research community is doing everything it can to improve the lives of our Nation’s wounded warriors,” he said. “The PTSD/TBI research consortium is a collaborative effort that demonstrates the Army’s commitment to care for our Soldiers’ psychological and physical health.”

The Army is committed to developing better tools for earlier identification of PTSD and TBI, improving interventions, and taking innovative approaches to sustain our fighting forces, ensuring that they are recipients of preventive measures and cutting-edge treatments. Through enhanced techniques for earlier identification of PTSD and TBI, Soldiers diagnosed with PTSD/TBI are likely to have better outcomes. Through innovation and responsive S&T investments, the welfare of our warfighters will continue to be sustained.