Center for the
Study ofTraumatic
Stress

2014 Annual Report

The reach and impact of our Center’s research, education, and intervention
activities are broad — extending from bench to bedside to community. We
work to support people and institutions in our local communities,
at the national level, as well as globally.

CONTENTS
From the Director of CSTS...................................................................................1
A Successful Collaboration to Create the First Brain Bank Dedicated to PTSD.......3
Achieving Our Mission.........................................................................................4
Research.............................................................................................................5
Education and Training......................................................................................12
Development and Dissemination of Educational Resources.................................14
Consultation......................................................................................................15
Interview with Senior Program Manager, Paul E. Hurwitz, MPH..........................17
CSTS Publications in 2014................................................................................19
CSTS Presentations, Briefings, and Interviews in 2014.......................................22
CSTS Directors, Scientists, and Scientific Advisory Board...................................25
2014 Funded Grants..........................................................................................31
CSTS Partnerships.............................................................................................32

From the Director
Dear Center Colleagues and Friends,
The Center for the Study of Traumatic Stress(CSTS) was established in 1987, and has been providing service to our nationfor 27 years. Our mission
is to advance scientificand academic knowledge,
interventions, educational
resources and outreachto mitigate the impact of
trauma from exposure towar, disasters, terrorism,
community violence andpublic health threats. Our Center continues to serve
an essential mission for the Department of Defense
and the nation.
The Center has built and trained a highly-collaborative, multi-disciplinary team of scientists, educators and clinicians who function in a unified manner.
The team promotes clarity of message and uses
scholarly and research-oriented problem-solving toaddress the mental and behavioral health problemsof those exposed to war, disaster and other traumatic
events. This unity of effort by a multi disciplinary
team is what makes the Center unique.
The reach and impact of our Center’s research,education, and intervention activities are broad —extending from bench to bedside to community. We
work to support people and institutions in our local
communities, at the national level, as well as globally.
Many of the Center’s unique contributions are
the result of the integration of two separate yetinterrelated fields — military and disaster psychiatry— that our Center has helped define and advance.
Another unique aspect of the Center is our dedication to research in neuroscience and the neurobiology of stress and trauma. We identify effective
interventions for a number of health issues of special
interest to the military including posttraumaticstress disorder (PTSD), mild traumatic brain injury (mTBI), and suicide. The Center’s findings help

inform our nation’s policies regarding the impact of
traumatic exposure.
In 2014, after more than a decade of collaborative
effort by the Center and the Department of Veteran’s Affairs National Center for PTSD (NCPTSD),
Senator Patrick Leahy (D-VT) and the Veterans
Administration (VA) announced the establishmentof The Leahy-Friedman National PTSD Brain Bank.
Since 2003, the Center, the NCPTSD, and other academic and research institutions, have collaborated
in an effort to establish a national PTSD brain bank.
This is the first brain tissue repository dedicated to

Our mission is to advance scientific and academic
knowledge, interventions, educational resources andoutreach to mitigate the impact of trauma from exposure
to war, disasters, terrorism, community violence andpublic health threats.
researching the physical impact of stress, trauma and
PTSD on brain tissue, thereby advancing the scientific knowledge of PTSD and other stress-relateddisorders.
The Center is also engaged in groundbreaking
epidemiologic and neurobiologic and translational
studies whose findings inform the Department of
Defense. Some of the Center’s research activities
include:■■ The CSTS neuroscience laboratories shed lighton associations between brain-derived neurotrophic factor (BDNF) and PTSD, and telomere
length and PTSD.
■■ The child and family research program includes
the National Military Family Bereavement Study
which is one of the largest studies of grief andbereavement, and the first large, rigorous, scientific study of the impact of a U.S. Service member’s death on surviving family members.
■■ Our epidemiology and Service member research
program includes the Army Study to Assess2014 ANNUAL REPORT | 1

Risk and Resilience in Servicemembers (ArmySTARRS) which is the largest study of suicide,and mental health risk and resilience, ever conducted among military personnel.
The Center was actively involved in a wide rangeof activities in 2014. Some of the highlights of theCenter’s activities include:■■ In response to the international Ebola outbreak,the Center rapidly developed fact sheets for patients, providers and leaders, and distributed themacross the nation and overseas where they were
utilized by many organizations and individuals.
■■ The Center provided consultation and knowledge support to the Washington State Department of Mental Health for distribution to
National Guard medical personnel and mental
health counselors who were on-site responding
to the landslides in Washington State.
■■ The Center was the key contributor to the curriculum recommendations for disaster healthprofessionals developed by the National Center
for Disaster Medicine and Public Health.
■■ The Center worked with the International Atomic Energy Agency of the United Nations(Vienna,
Austria) to develop recommendations for science and technology education and research to
mitigate the effects of natural disasters effecting
nuclear reactors.
■■ The Center co-chaired a working group at theInternational Symposium on Disaster Medical
and Public Health Management to review the
Hyogo framework for action to develop policy
recommendations for the United Nations on
mental health disaster risk reduction.
■■ The Center presented Military Cultural Competency at the National Association of State Mental Health Program Directors annual conference
which enhanced our ongoing collaboration withthe most senior state leaders in mental healthcare throughout the U.S.

2 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU■■

The Center participated in the Mental Healthand Suicide Prevention briefing at the WhiteHouse with White House and President Obama’s
Administration officials.

The year 2014 was a year of change for theCenter. The U.S. involvement in wars in the Middle East has greatly reduced, one of our largest andhighest-impact research projects (Army STARRS)
neared completion and began a transition to the next
five-year phase, and the Center made additions tothe scientific staff and changes to our administrative
structure.
Looking ahead, the Center continues to engage in
the important task of transmitting its unique knowledge and experience in trauma research, education,
consultation and training to our local community,
throughout the nation, and across the globe. In particular, we continue to mentor the next generation of
dedicated scientists, who will continue to fulfill our
mission.
In the pages ahead, we share with you someof the many contributions that we are making toenhance psychological health, recovery and prevention of the consequences of trauma on an individual,family, community and national level in both our
military and civilian populations. We are proud of
our Center scientists and our work that has assisted
the Department of Defense in leading the nation in
trauma-informed care.
To our many colleagues and friends who havecollaborated with us, and who have supported ourwork throughout the year, we would like to express
our sincere and heartfelt gratitude.

— Robert J. Ursano, MD
Professor of Psychiatry and Neuroscience
Chair, Department of Psychiatry
Director, Center for the Study of Traumatic 		
Stress
Uniformed Services University

A Successful Collaboration to Create the First
Brain Bank Dedicated to PTSD
In 2014, after more than a decade of collaborative effort, the Veterans Administration(VA) announced the establishment of The Leahy-Friedman National PTSD Brain Bank.
The National
PTSD Brain Bank was
co-founded by Dr. Matthew Friedman (Dartmouth/VA) and Dr. Robert Ursano (USU/DoD).
The mission to improve
the lives of veterans with
PTSD has been strongly
supported by Senator
Patrick Leahy (D-VT),and he played a majorrole in leading the effort
to obtain Congressional
funding for this project.
There are more than
50 brain banks around the nation that investigate a variety of neurological disorders, however, there has never been a brain bank for PTSD
until now. This is the first brain tissue repository
dedicated to researching the physical impact
of stress, trauma and PTSD on brain tissue. It
will advance the scientific knowledge of PTSD,
particularly PTSD biomarkers.

A great deal has been learned about how thebrain functions, and about structural brain abnormalities, through brain imaging techniques
and other research. However, looking at neurons at the cellular andcircuit levels will allow
a greater and moredetailed understandingof brain activities in
PTSD.
This brain bank isa critical step toward
identifying potential
biomarkers of susceptibility and developing
new treatments thattarget PTSD at the cellular level. The National
PTSD Brain Bank will
help pave the way for
new approaches to the diagnosis and treatment
of individuals with PTSD. Dr. Robert Ursano
and Dr. David Benedek serve as members of the
Scientific Advisory Board of the Brain Bank.
The Leahy-Friedman National PTSD Brain
Bank is expected to become operational in 2015
and is a national resource that will support andenhance academic research.

This is the first brain tissue repository dedicated to researching
the physical impact of stress, trauma and PTSD on brain tissue.
It will advance the scientific knowledge of PTSD,
particularly PTSD biomarkers.

2014 ANNUAL REPORT | 3

Achieving Our Mission
In 2014, the Center was actively involved in fulfilling its mission:

1. RESEARCH: The Center has taken the leadand been deeply committed to translational
research ranging from basic neuroscience toepidemiology and neurobiology of the medical,
behavioral, and mental health consequences oftrauma and stress. The goal of the research is
to better understand the origins of traumaticstress, inform treatment, and impact policies
for traumatic stress disorders.
2. EDUCATION AND TRAINING: The Center trains
and educates Uniformed Services University(USU) medical students committed to service in our nation’s Army, Air Force, Navy andPublic Health Service. The Center educates
individuals, leaders, and health care providers
at public and private agencies. The Center hassponsored conferences, seminars, and symposiathat advanced knowledge and education. We
continue to provide opportunities for post-doctoral training for medical scientists to conduct
research into, and respond to, the health consequences of trauma, disasters and terrorism.

4 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

3. DEVELOPMENT AND DISSEMINATION OF
EDUCATIONAL RESOURCES: The Center maintains a large archive of medical literature on
the health consequences of traumatic events,
disasters, and terrorism for individuals, families, organizations and communities. The
Center develops and disseminates materials to
address timely issues regarding military healthand mental health to educate physicians, andother military and civilian healthcare providers
engaged in military and trauma-informed care.
4. CONSULTATION: The Center provides real time
consultation and collaboration with leadershipin the Department of Defense (DoD) and othergovernment agencies, academia, and industry
to foster knowledge, develop and make available educational and clinical resources, provide
solutions for optimizing and sustaining military
health and influence military health policy.

Research
SERVICE MEMBERS
Army Study to Assess Risk and Resilience inServicemembers (Army STARRS)
In 2014, Army STARRS entered into its sixth
year. Due to the great success of the project, theCenter received funding
from the DoD to continue
the Army STARRS platforms, systems, and data
for another five years. This will allow the researchteam to conduct follow-up studies with the cohort ofArmy STARRS participants to collect additional information for further analysis. This will enhance theArmy STARRS research, and provide further benefit
for the Army, the DoD, and the nation.
The project, which is the largest research studyof mental health risk and resilience ever conductedamong military personnel, is under the scientificdirection and leadership of the two Co-Principal
Investigators, Center Director Dr. Robert Ursano,and Dr. Murray Stein at University of California, San
Diego. The management of this complex project ishandled by Center Associate Director, Dr. Robert
Gifford, Army STARRS Senior Project Director,
Center Senior Program Manager, Paul Hurwitz,
MPH, and Center Senior Financial Program Manager, Susan Moss, CPA. More than twenty other CSTS
scientists and staff supported Army STARRS.
Army STARRS is a collaborative effort between
USU, the University of California San Diego, Harvard University, the University of Michigan, theArmy STARRS was designed to examine the mental
health and resilience of active duty U.S. Army soldiers
to increase our knowledge of the risks and protective
factors that underlie vulnerability and resilience inthe face of traumatic exposure for Service members
who have served and will serve our nation for years tocome.

National Institute of Mental Health and the U.S.
Army. Army STARRS was designed to examine
the mental health and resilience of active duty U.S.
Army Soldiers to increase our knowledge of the risks
and protective factors that underlie vulnerability
and resilience in the face of traumatic exposure forService members who have served and will serve
our nation for years to come. The seven separate but
integrated epidemiologic and neurobiologic studies
that comprise Army STARRS were designed to be
a comprehensive approach to the research questions. The project involves large and representative
samples of Army Soldiers, including Regular Army,
Army National Guard, and activated Army Reserve.
The project includes longitudinal, cross-sectional,
historical, and prospective studies. Army STARRS
involves the collection, integration and analysis
of very large volumes of data. The research teamobtained, organized, and prepared to analyze a data
file of more than a billion data points from existing
Army and DoD administrative records representing
more than 1.6 million active duty Soldiers from 2004
to 2009; collected data from nearly 200,000 questionnaires administered to more than 100,000 active
duty Soldiers from 2011 to 2014 throughout the2014 ANNUAL REPORT | 5

United States and at ten locations overseas; administered questionnaires to Soldiers in Kuwait as theytransitioned into and out of combat zones for R&R;
obtained data from approximately 400,000 neurocognitive tests administered to active duty Soldiers;
collected approximately 77,000 tubes of blood fromapproximately 52,000 active duty Soldiers; used theblood samples to perform a wide-range of different
types of state-of-the-art biomarker assays (genetic,
metabolomic, proteomic, inflammatory, and neurodegenerative) from DNA, RNA and plasma derived
from the blood; conducted multiple, highly technicaland complicated neurobiological analyses of the biomarker assay data; linked the above data to extensive
Army and DoD administrative data records; andperformed sophisticated and highly-complex data
analyses using the huge volume of data.
To date, sixteen Army STARRS papers have been
published, three papers are in press, seven papers areunder review for publication, and thirty-three additional papers are in various stages of development.
As findings have become available, the researchers have reported results directly to senior Armyleadership at in-person briefings at the Pentagon
that include the Secretary of the Army, the Army
Chief of Staff, the Army Vice Chief of Staff, theDeputy Under Secretary of the Army, Office of theSurgeon General staff, and other senior Army officials. In this way, the Army has the ability to apply
the findings to ongoing health-promotion, risk-reduction, and suicide-prevention efforts. The benefit
from this extraordinary, groundbreaking, complex,
and successful undertaking is beginning to emerge
and will increase substantially over time as Army
STARRS researchers continue to analyze the large
amount of data.

Psychological Stress and Resilience in Army
Mortuary Affairs
Army Mortuary Affairs (MA) Soldiers care forthe dead of all military services on the battlefield andupon returning home. The Center has worked withthis population of Soldiers and civilians for morethan 25 years to better understand the stresses andthe rewards of this work. Our research with MA
Soldiers has implications for intervention with MA
6 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Soldiers as well as other military and civilian populations.
During 2014, we conducted pre- and post-deployment surveys with 209 Soldiers of the 111th
and 54th Quartermaster (MA) companies at Fort
Lee, VA as part of our ongoing longitudinal study
to better understand risk and resilience factors of
deployment to Afghanistan. Dr. James McCarroll
conducted specialty qualification courses for officers
on the psychological stresses of Mortuary Affairs
operations at the Joint Mortuary Affairs Center andSchool in Fort Lee, VA.
The Troop Education for Army Morale (TEAM)
study is a stress management and resilience-building
early intervention designed to improve post-deployment readjustment in MA Soldiers. In 2014, after six
years of recruitment, the enrollment and intervention phase of the study concluded. TEAM is basedon the five evidence informed principles of Psychological First Aid: safety (physical and psychological),calming, connectedness, self-efficacy, and hope/
optimism. These concepts are delivered throughfour group workshops, informational handouts, a
dedicated website, and are supported through concierge phone and email services. In order to test theeffectiveness of TEAM, participants were initiallyrandomized into intervention or non-intervention
groups. In 2014, preliminary data analyses of 125
participants indicated that MA Soldiers have a highnumber of exposures to potentially traumatic events
during deployment and high rates of probable PTSD
and depression, similar to that of combat troops. The
TEAM intervention was well accepted by the Soldiers and the majority reported that overall, TEAM
was helpful. We continue to analyze data collectedfrom the Soldiers in order to better understandpost-deployment readjustment in areas such as qual-

ity of life, personal functioning, social interactions,stress management, unit and personal morale, as
well as examination of posttraumatic symptoms anddisorders including PTSD and depression. Some ofthese data have been presented as posters at researchmeetings, and are being prepared for publication.

Reserve Component of the U.S. Armed Forces
The Center is strongly committed to supporting
the Reserve Component (RC) of the United States
Armed Forces. The citizen Soldiers who are members of the RC experience unique stressors when activated, due to having to transition from civilian life
to full-time military, and then, following completionof their activation, having to re-integrate back into
their civilian communities. Historically, the effectsof these special burdens have not been adequately
understood, with RC members often studied only
as a subset of the Active Component (AC) using thesame research instruments.
The Center conducts research to address thisimbalance by adapting research to the specificexperiences of members of Reserve and National
Guard forces. The Center conducted studies of Army
National Guard units before and after deployment
to Afghanistan, and a study of National Guard units
responding to a natural disaster. Our study of anationally representative sample of RC members is
conducted in collaboration with Dr. Sandro Galea,
Dean, School of Public Health of Boston University.
Findings from the early waves of data collection havebeen published and more publications are in development. Plans are underway for a fifth wave of datacollection so we can examine the health and well-being of this unique cohort over time.
Army STARRS also provides an unprecedented
opportunity to examine the physical and mental
health of RC members. The New Soldier Study, a
study within Army STARRS, includes surveys ofapproximately 23,000 RC Soldiers during their firstweek of basic training. Many of these Soldiers provided blood samples for genetic and other biomarker
analyses. This collection of data at the beginning ofmilitary service provides a unique opportunity to
study Soldiers through the course of their military
careers and beyond. In addition, Army STARRS

included RC members in the All Army Study andin the in-theater study of Soldiers serving in Afghanistan, again yielding data that can be used inlong-term studies while providing a snapshot of theircurrent health and mental health, and creating theopportunity for assessment of concentrations of riskin order to develop future interventions to promoteand sustain military health.
As part of its research on RC members, the Center has examined Army National Guard members
who were likely to deploy as individual augmentees
in support of a unit other than their regular unit
compared to active duty personnel. Since high social
support is associated with better mental health outcomes following deployment, reservists who deploy
without their regular unit may experience less social
support and consequently may be at greater risk ofmental health problems. However, empirical data on
the mental health consequences of deploying without one’s regular unit are scant.
These RC research efforts are being conductedin keeping with the CSTS philosophy of examining
stress at multiple levels, from the cellular to thecommunity. Because they include genetic assays,
individual health and mental health data, and examination of unit issues, the research is able to consider
interactions among factors at the biological, psychological, and community levels and to develop not
only predictors of vulnerability and resilience, butalso interventions for individuals, small groups, units
and the communities in which they are embedded.

CHILD AND FAMILY PROGRAM (CFP)Over a decade of war in Iraq and Afghanistan
has taken a toll on thousands of Service members,families and children. Nearly 45% of the more than
two million Service members who have deployedin the past ten years have children. While mostmilitary families are resilient and have had positive
experiences, some military and veteran families will
require health and mental health care and services
for years to come.
The Center’s Child and Family Program (CFP)
has been a national leader in advancing scientificand clinical knowledge, as well as providing educational resources that address the needs of children
2014 ANNUAL REPORT | 7website or its Facebook page. NMFBS, a national
study, has representation from every state.
The Child and Family Program continues to berecognized as a leading authority on military families
and children. It is essential to bridge science to inform quality care and interventions that support andsustain populations at risk. The Center has expanded
its knowledge and commitment to improve the livesof our military families and children, and to mitigate
the impact of trauma on all our nation’s children andfamilies.

National Military Family Bereavement Studyand families affected by trauma, especially our
nation’s military families and children. Dr. Stephen J.
Cozza, CSTS Associate Director, underscores boththe strength of these children and families, as wellas their vulnerability resulting from the impact ofthese experiences. Military and veteran families canbenefit from developing skills and strategies to better
manage the challenges that they face.
The Child and Family Program addresses thesecomplex issues through pioneering research, byeducating professional audiences including militaryand government stakeholders at presentations andconferences, through scholarly publications andthrough consultation to DoD leadership and national media outlets.
CFP projects continue to shed light on military
bereavement, the combat injured family, and childmaltreatment and neglect in military communities.
Both the National Military Family Bereavement
Study (NMFBS) and the Combat Injury Studies haveeffectively used the web and social media to engage
eligible study participants. These vehicles promote
understanding of the study, generate interest in participating, and provide updates through the study’s
8 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

The National Military Family Bereavement
Study (NMFBS), the first rigorous scientific study
to examine the impact of a U.S. Service member
death on surviving family members, aims to describe
the population of Service members who have diedsince 9/11 and to identify experiences of the Service
member’s bereaved family members — how psychological, physical and/or behavioral outcomes of thegrieving process are influenced by military-uniquecontributions, as well as family members’ pre-existing psychological and physical health, support, andgenetic factors. An optional part of the study examines saliva samples for biomarkers associated withoutcomes. The year 2014 saw continued data collection culminating in more than 2,000 completed adultparticipant Phase 1 questionnaires and more than

The website home page and portal to the National
Military Family Bereavement Study 		
(www. militarysurvivorstudy.org).

800 adults and nearly 120 children participating in
the longitudinal portion of the study, where data arecollected annually for three years. Expert consultantsfrom Columbia University, UCLA and the Universityof Michigan are also involved and collaborating on
study analyses.

Deployment Family Stress: Child Neglect and
Maltreatment in U.S. Army Families
The Deployment Family Stress: Child Neglect
and Maltreatment in U.S. Army Families study seeks
to describe the characteristics of substantiated childneglect cases in the Army, and to identify factors
within the family, the military community and thecivilian community that contribute to family healthor child maltreatment. Findings from this study will
help to develop strategies for effective prevention
with this population and to foster child and family
health in the community. In 2014, activity included the acceptance of three manuscripts using thedatasets collected from 1,088 questionnaires representing 26 Army installations in the United States,
as well as data collected from the records of 400
substantiated child neglect cases around the country.
These findings help us better understand the varying
types, subtypes and severity of neglect occurring
within families, highlighting the importance of multiple public health strategies to minimize risk.

Impact of Combat Injury on Military Service
Families and Children
The Impact of Combat Injury on Military Service
Families and Children study has involved the collection of important data from: (1) families participating in the National Military Family Association
Operation Purple Healing Adventures Camps;(2) through a longitudinal study comparing combat injured and similarly deployed but non-injured
families from Walter Reed National Military Medical Center, San Antonio Military Medical Centerand Fort Stewart, GA, and; (3) FOCUS-CI (Families
OverComing Under Stress: Combat Injury), a pilot
randomized controlled trial that tests the effectiveness of a newly developed family-centered, strengthbased intervention to be used with severely combat
injured Service members and their families. The

study will better help us understand the experienceof combat injury, its impact on children and families,
and will inform programmatic intervention that canbetter address their needs.

Family Violence and Trauma Project (FVTP)
The Family Violence and Trauma Project (FVTP),a part of the Center’s Child and Family Program, wasinitiated in 1995 based on joint interests of the Centerand the U.S. Army. The project: (1) reviews scientificprotocols and manuscripts on family violence research submitted to the Community and Family Support Center (CFSC); (2) monitors ongoing research
for further research needs and policy development,
and establishes liaisons with other federal agencies
in family violence research; (3) maintains an active
scientific data base of family violence literature toassist with the establishment of Centers of Excellence
as model Army programs for furthering educationand training in family violence; (4) supports the Army
Family Advocacy Program (FAP) by providing consultation, briefings, papers, and research studies to answer questions involving spouse and child abuse; and(5) assists investigators in the field with their research.
In addition, members of the program consult within
the Army, and within the broader federal community,
to support Army and civilian investigators in family
maltreatment research, and publish the highly praised
newsletter Joining Forces/Joining Families. During
2014, Dr. McCarroll reviewed the scientific literature
on family maltreatment fatalities for the Army Installation Management Command, and produced a paper
for the Army on maltreatment fatalities. The paper
addressed maltreatment fatalities to educate social
services, health care providers, and forensic and law
enforcement personnel. This project approaches theprevention of maltreatment fatalities through a publichealth model that promotes strategies at individual, family, community, and societal levels to address
practices, policies, and public attitudes and beliefs
about maltreatment.

CLINICAL NEUROSCIENCE AND
NEUROBIOLOGYThe Center advanced its work in neuroscienceand the neurobiology of stress through its continued
2014 ANNUAL REPORT | 9oversight and leadership of the National Capital
Area Integrated Clinical Study Site. Center Associate Director, COL David Benedek, MD, directs
this established network of clinician-researchersat Walter Reed National Military Medical Center(WRNMMC), the DC Veterans Administration
Hospital and the Armed Forces Retirement Home.
The site is one of 10 study sites across the nation thatparticipates in the INTRuST Consortium for Psychological Health and TBI. In 2014, the Consortium
completed data collection for several clinical trials ofnovel medication and psychotherapy treatment for
PTSD and other combat-related disorders. Resultsof the Consortium’s trial of high-dose transcranial
magnetic stimulation (TMS) for suicidal ideation
and behavior in veterans, conducted at WRNMMC
and the Charleston, SC Veterans Administration
Hospital, were published in Brain Stimulation. The
study demonstrated that the delivery of high doses of
TMS to the left prefrontal cortex over three days was
safe, and that the trend toward more rapid reduction
in suicidal ideation noted over control inpatientsshould be studied in larger patient samples. The
Consortium’s study of Acceptance and Commitment
Therapy (ACT) for patients with deployment-related
psychiatric disorders including depression, PTSD,
and TBI and a separate study of Ganaxolone — asynthetic neurosteroid — for PTSD both completed enrollment in 2014. Data analysis for ACT wascompleted and study results are pending publication
at this time. Analysis for the Ganaxolone study will
be completed in the near future.
Independent of
its affiliation with the
INTRuST Consortium, the Center also
conducts clinicalintervention trials
and social and epidemiologic studies to
identify modifiablerisk and resilience
factors in Service
Recruiting for Riluzole Study members and theirfamilies. COL
at Walter Reed.
Benedek initiated
10 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

collaboration with the Syracuse VA Medical Centerin a two-site clinical trial of Riluzole (a glutamatergic modulator used to treat Lou Gherig’s Disease) inveterans of recent conflicts with combat-related PTSD
who have not experienced relief of their symptoms
from current evidence-based treatments. Currently
recommended medications for combat-related PTSD
increase the availability of serotonin (SSRIs) or serotonin and norepinephrine (SNRIs) in the brain, but do
not adequately relieve symptoms for many patients.
Therefore, there is an urgent need to investigate othertypes of medications that may be more effective. Riluzole is a medication that reduces glutamate activity
in, and may help reverse damage to, areas of the brain(amygdala, anterior cingulate cortex, and hippocampus) where an excess of glutamate is believed tocontribute to PTSD symptoms. This is a randomized
controlled, double-blind trial. PTSD, depression,and anxiety symptoms are assessed once a week, andmagnetic resonance spectroscopy (1H MRS) is done
pre- and post-treatment. The study hypothesizedthat participants who receive Riluzole will experiencegreater PTSD symptom improvement and experiencegreater improvement in depression and anxiety symptoms and overall functioning compared to placebo;and pre- to post-treatment spectroscopy changes in
amygdala, anterior cingulate cortex, and hippocampus
will associate positively with treatment with Riluzole
compared to placebo. This multiyear study continued
recruitment and enrollment at both sites throughout
2014 and so far has met 20% of total recruitment targets in its first year.

Brain Indices Study
The Brain Indices Study is conducted in the Brain
Assessment Research Laboratory directed by Dr.
Connie C. Duncan. The study is funded by the DoD
Congressionally Directed Medical Research Programs(CDMRP) and the Center for Neuroscience and Regenerative Medicine (CNRM). The goal of this longitudinal study is to identify measures of brain structure and function that predict later PTSD in Service
members with mild TBI, and to identify associations
between type of brain injury and outcome.
The past year was one of the busiest years in theseven year history of the Brain Indices Study. Enroll-ment was completed and a major effort was madeto follow-up with participants to complete theirthree-month and six-month evaluations, as well
as recruiting participants for a new study group:
Healthy Service Members (HSM). The HSM has
proven to be of great significance because analyses
of baseline data revealed similar findings between
Service members with mild TBI and those who are
injured but screen negative for TBI. The healthy
Service members, who have significant extra-cranial injuries but apparently no signs of TBI, show
similar and highly significant effects on measures ofcognitive function as indexed by brain potentials.
It is hypothesized that exposure to blast, similar
for both groups, may be at the root of the similarity of results. Consequently, efforts have been
directed to enroll a group of unexposed, uninjured“healthy” Service members. This has turned out tobe an elusive group, especially in active duty Service
members. However, we have had some success inrecruitment efforts.
The most notable findings to date based on
baseline evaluations, which are done within a few
months of injury, are: (a) mild TBI delays cognitive
processing involved in working memory (an effectpreviously identified in severe TBI); (b) Service
members injured by blast explosions who were rated
negative for TBI on standard DoD screening measures showed similar processing delays to Service
members with mild TBI. These findings, based on
measures of brain electrical activity (ERPs), raise
the question of whether current screening measures
for TBI lack the sensitivity to detect blast effects on
brain function in wounded warriors; (c) mild TBI
caused by impact and blast is associated with similardelays in cognitive processing; and (d) processingof novel stimuli appears to be impaired in Service
members with impact but not in those with blast-induced TBI. The results suggest that “brain indices”
could inform the diagnosis, treatment and recovery
from TBI. Enrollment in the new study group of
healthy Service members (who had no history of TBI
or significant blast exposure) is underway to serve as
a comparison group for the injured Service membersin the Brain Indices Study.
Some of these data have been presented as post-ers at national and international research meetings,
and are being prepared for publication. This study is
producing exciting findings that will ultimately improve the diagnosis and treatment of TBI.

Daily Diary Study
The Daily Diary Study (“Ecological Momentary
Assessment of Posttraumatic Stress Symptoms in Service Members Undergoing Rehabilitation”) uses cutting edge ecological momentary assessment methodology to assess daily variability in posttraumatic stresssymptoms in Service members with moderate tohigh symptoms. Soldiers complete four assessments
per day over a 15-day period in order to assess daily
variability in symptoms associated with psychiatricdisorders such as PTSD and depression. Psychiatricdisorders, stress symptoms and health risk behaviors
such as smoking and alcohol use are assessed at baseline and at one and three months. In Phase I of thestudy, Service members completed daily assessments
using paper questionnaires. In 2014, with enrollmentof the 50th participant, we began Phase II of the study.
In the second phase, Service members complete daily
assessments on an electronic tablet. Electronic assessment has considerable advantages including electronic time stamping that provides an accurate record ofwhen symptoms occur. In addition, participants canbe followed in “real time” throughout the day as they
complete assessments. Data transfer is also facilitated by the use of electronic assessment. Currently, 16participants have enrolled in Phase II. Soldiers have
had a positive response using the electronic tablets
because they are
more interactive
and efficient. Plans
are underway tocollect biogenetic
samples (blood andsaliva) in order to
identify potential
genetic biomarkers
for PTSD, depression and otherpsychiatric disRecruiting for Daily Diaryorders in Service
Study at Walter Reed.
members.
2014 ANNUAL REPORT | 11

Education and Training
The Center scientists educate and train USU
medical students committed to service in our
nation’s Army, Air Force, Navy and Public HealthService. The Center also educates leaders and healthcare providers in public and private agencies. In
addition, the Center sponsors conferences, seminars,
and symposia that have educational and training
objectives.
The Center has advanced the field of military anddisaster psychiatry through presentations, outreach,training, and participation in conferences, international workshops and collaborations, as well as
domestic collaborations. The Center’s knowledge
base has expanded through public health efforts andinterventions during and after disasters.

EDUCATIONAL CONFERENCES
The Center sponsored two conferences in 2014,
the Amygdala, Stress and PTSD Conference and theArtiss Symposium.

Amygdala, Stress and PTSD Conference: Benchto Bedside
The Center held the 9th Annual Amygdala, Stressand PTSD Conference at the Uniformed Services
University. With more than 400 individuals registered, the Amygdala conference was a robust meeting that brought together scientists, clinicians andpolicy makers working toward solving the biological basis of stress, fear, and PTSD. The conference
speakers represented prestigious universities andresearch institutions across the country and internationally. For the first time the conference was simulcast to our colleagues at the Naval Medical Center
San Diego.

Artiss Symposium: Psychiatry and PainManagement
The Center was a sponsoring partner of the Artiss
Symposium along with the Department of Psychiatry, Walter Reed National Military Medical Center(WRNMMC), and the National Intrepid Center of
12 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Excellence (NICoE) for the annual Artiss Symposium.
Kenneth L. Artiss, MD (1913–2001), the namesakeof the symposium, was an Army officer, a research
psychiatrist and instructor at Walter Reed Army
Medical Center who inspired generations of military
psychiatry residents to conduct high quality research.
This year’s symposium, “Psychiatry and Pain Management,” brought together several renowned speakers to discuss pain from a biopsychosocial approach.
The biopsychosocial approach systematically considers biological, psychological, and social factors in thecomplex interaction in understanding health, illness
and the healthcare delivery system. The Artiss Conference Report is widely distributed and is a reference
resource that can be found on the Center’s website(www.CSTSonline.org).

NEUROSCIENCE MODULE FOR PRECLERKSHIP USU MEDICAL STUDENTS
The neuroscience module prepares pre-clerkship
medical students for their clerkship period, as well as
providing a foundation of knowledge that will informtheir long-term education. The neuroscience module
covers a breadth of information from basic neuroanatomy to clinical skills in neurology and psychiatry.
The Class of 2017 chose the Neuroscience Module
Directors as the Best Module Directors of the year:
LTC Gary Wynn, MD, USU, Department of Psychiatry and CSTS scientist and Dr. David Mears, USU,
Department of Anatomy, Physiology and Genetics.

HOMELAND SECURITY
The Department of Homeland Security (DHS)
and the Center are collaboratively developing and pilot testing a cutting-edge resilience training programthat incorporates findings from an initial assessmentof existing DHS programs and includes elements of
Psychological First Aid, Decision Making in HighStress Environments, and individual and teamresilience. The Center conducted the assessment ofexistent resiliency programs for DHS employees andmade recommendations based on that assessment.
The Center is currently developing the pilot calibration training curriculum, and will provide ongoing
consultation, specifically related to program evaluation, data collection and the Institutional Review

Board process, as DHS potentially expands its Responder Resiliency and Decision Making program.

FIREARM SAFETY
The Center partnered with the Yellow Ribbon
Reintegration Program (YRRP) and the Defense
Suicide Prevention Office (DSPO) to develop a seriesof multi-modal educational materials
on personal firearm
safety. This program isa targeted effort thatstrategically supports
the DoD suicide
prevention efforts byimplementing education and assessment componentsof personal firearm safety. This training program,
implemented in conjunction with pre-and post-deployment events, promotes evidence-based gun safety
practices to enhance the safety of Service members
and their families.

TEXTBOOK OF DISASTER PSYCHIATRY(Second Edition)
Since the publication of the first edition of the
Textbook of Disaster Psychiatry in 2007, there has
been a proliferation of disasters worldwide, including
natural and human-made disasters, terrorist events,
and an escalation of the war in the Middle East. The
second edition of the Textbook of Disaster Psychiatry
advances the goals of the first edition by bringing together a distinguished group of international experts
providing an updated, comprehensive review of thepsychological, biological, and social processes of response to, and intervention for, disaster mental healthneeds. The second edition represents a decade ofadvances in disaster psychiatry: the epidemiology ofdisaster response, the neurobiology of disaster exposure, socio-cultural issues, interventions, actionable
research, and advances in public health responses todisaster. The second edition has a Scientific Advisory
Board, Section Editors and Associate Editors comprised of distinguished scientists, scholars, practitioners and researchers who are leaders on the cuttingedge of the field of disaster psychiatry. The second
edition has an expected publication date of 2016.
2014 ANNUAL REPORT | 13

Development and Dissemination of
Educational Resources
The Department of Defense featured a piece on
the Center and its expert role in disaster psychiatry
in a web-based article titled, “Disaster Psychiatry
Emerges as DoD Field of Study.” CDR Joshua Morganstein and COL Benedek provided an overview of
the rapid response process and the Center’s role indisaster response, consultation and education.
COL Benedek presented a webinar titled “Promoting Resilience in Disaster First Responders” forthe National Center for Disaster Medicine andPublic Health which had attendees from across thecountry.
The Center published an article in PsychiatricTimes that was disseminated to 40,000 mental healthprofessionals that provided education and guidanceon caring for individuals affected by the Ebola virus.
Center educational resources on Ebola were used
at Johns Hopkins University Hospital in Baltimore,
MD to educate distressed hospital employees after
the hospital was designated as one to receive Ebola
patients.
In partnership with the National Center for Disaster Medicine and Public Health, Center scientists

co-authored the first Curriculum Recommendations
for Disaster Behavioral Health Professionals. This
comprehensive document provides the framework
and resources needed to create customized training and education curriculum that can be used toeducate healthcare professionals, first responders,leaders, policy makers and others on nearly all
facets of disaster behavioral health world-wide. The
Curriculum Recommendations can be found on the
NCDMPH website and were presented at the annual
Learning in Disaster Health conference.

CSTS ONLINE
In 2014, the Center developed a new website(www.CSTSonline.org) focused on information
dissemination in support of our mission to advancescientific and academic knowledge, interventions,educational resources and outreach to mitigate theimpact of trauma from exposure to war, disasters,
terrorism, community violence and public healththreats. Over the past 27 years, the Center has
developed and published an extensive collection of
resources for citizens, academia, leaders, healthcare
personnel and government agencies. These resources include books and book chapters, journal articles,
conference summaries, presentations and reports
and educational fact sheets. The website is a portal
to this rich collection of knowledge and provides users with advanced features to access this information
through extensive search capabilities and optimized
viewing on mobile devices.

ENTERING THE REALM OF SOCIAL MEDIAIn 2014, the Center also ventured into the worldof social media for dissemination of information via
both Facebook and Twitter. The use of social media
allows the Center to broaden its audience and ensurethat valuable information reaches those who may
not regularly visit the website. “Like” the Center on
Facebook. Follow us on Twitter.
Facebook: www.facebook.com/USU.CSTS
Twitter: www.twitter.com/CSTS_USU
14 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Consultation
The Center provided consultation in response
to national disasters and public health threats that
occurred in 2014.
The Center also provided informal consultation
to the Centers for Disease Control and Prevention(CDC) in directing their public response to the Ebola
virus incidents that occurred within the United States.
The Center adapted and customized fact sheets
in response to the mudslides in Washington State.
The fact sheets were posted on the CSTS website
and rapidly disseminated to several thousand stakeholders supporting the response and management of
the mudslides including:■■ The National Association of State Mental Health
Program Directors (NASMHPD)■■ The Mental Health Commissioner in Washington State■■ The U.S. Surgeon General’s office■■ The American Psychiatric Association■■ The National Guard medical personnel■■ Local mental health counselors
The Missouri Department of Mental Healthcontacted the Center to provide informal consultation following the shootings in Ferguson, MO. They
were primarily interested in reviewing current crisis
behavioral health issues and interventions, and planning more long-term efforts. The Center provided
several relevant fact sheets.
Center Associate Director, Dr. Brian Flynn, wasappointed to the SAMHSA Disaster Distress Helpline (DDH) advisory committee. This new advisorycommittee works to establish, monitor and maintainevidence-informed standards and best practices in
the areas of outreach, communications and training
for the Disaster Distress Helpline, ensuring that the
project provides the most effective services possible.

GLOBAL HEALTH IMPACT
The Center plays an important role in the national and global response to war, disasters, terrorism
and public health threats. The Center partners withnational and international organizations in response

Center scientists provided subject-matter expertiseon the mental health effects of extreme weather
in support of a federal multi-agency report on thecurrent status of climate change.
to global health care needs.
The Curriculum Recommendations for DisasterBehavioral Health Professionals that Center scientists co-authored in partnership with the National
Center for Disaster Medicine and Public Health were
distributed internationally to a wide range of global stakeholders involved in the education, training
and delivery of disaster behavioral health planning,
preparation, response and recovery.
Center scientists provided subject-matter expertise on the mental health effects of extreme weather
in support of a federal multi-agency report on thecurrent status of climate change being prepared forCongress and the President of the United States.
This report, to be released in 2015, represents extensive collaboration between federal agencies and theprivate sector to provide contemporary and evidence-based information to our government’s mostsenior leaders for the purposes of informing nationaland global policy.
Dr. Ursano co-chaired the working group on
psychosocial/mental health concerns and community resilience at the International Symposium on
Disaster Medical and Public Health Management:2014 ANNUAL REPORT | 15

Review of the Hyogo Framework for Action (HFA).
Dr. Ursano, along with Dr. Hiroaki Tomita (International Research Institute of Disaster Science at
Tohoku University in Japan), led a team of international subject-matter experts, including other Centerscientists, in the development of policy recommendations to be disseminated globally to United
Nations member countries that assist with reducing
the risk of adverse psychosocial and mental healthimpacts of disasters. Dr. Ursano co-authored the first
Psychosocial and Mental Health Guidelines as partof the United National General Assembly’s 20152025 global Hyogo Framework for Action, which
provides the international community with guidanceon Disaster Risk Reduction.
Center scientists participated in the Defense
Centers of Excellence Psychological Health andTraumatic Brain Injury’s Psychological Health andResilience Summit held at the Defense Health Agency Headquarters. The Summit included onsite andvirtual formats that facilitated interaction with morethan 800 behavioral health and primary care professionals and program leaders within the DoD and VA
locally and worldwide.
The Center provided consultation and educational materials in support of the response to the South
Korea ferry disaster.

David H. Marlowe, PhD
In 2014, the Center lost a friend and an
important source of research guidance andwisdom: David H. Marlowe PhD, former Chiefof the Department of Military
Psychiatry at Walter Reed Army
Institute of Research (WRAIR)
and senior lecturer in the Department of Psychiatry at USU as
well as a senior consultant to theleadership of the Center for the
Study of Traumatic Stress. Dr. Marlowe died at
the age of 83 after a prolonged illness.
A lifetime of study of the effect of social
structure and belief upon responses to humanconflict, war, and natural disasters made him an
extremely valuable colleague to the Center. The
occasion of his death brings to mind his substantial contributions and the challenges that hehas bequeathed us.
As a social anthropologist, he conceptualized culture and ideology as resulting from anddefined by relationships to others. Throughout
his career Dr. Marlowe was concerned with how
people organize their relationships with otherpeople — close relatives, loved ones, coworkers,
neighbors, members of the congregation, commanders, subordinates, peers, strangers, co-religious, those with shared culture
or nationality, and those fromother cultures. He pursued theseinterests and applied his insights
within the context of military
populations and groups, demonstrating how these relationships
had a profound effect on both performance andhealth.
He was also committed to the concept that
one learns about Soldiers by going to them intheir operational environments and where theylive. His research took him and the researchteams he led to combat zones in Vietnam, Panama, the Persian Gulf, and Somalia. He was asmuch at home in tents with junior Soldiers as
he was in the offices of the senior generals who
sought his advice. He was willing to share hardship and risk with Soldiers to acquire the knowledge necessary to understand them and ultimately to make their lives better.

Releasing lanterns into the sky is a Thai tradition. Dr. Marlowe spent considerable time doing research in
Thailand and developed a deep appreciation for Thai traditions.
16 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Interview with Senior Program Manager,
Paul E. Hurwitz, MPH
Paul Hurwitz joined the Center in 2010 as the
Senior Program Manager for the Army Study toAssess Risk and Resilience in Servicemembers(Army STARRS), which is the largest study of mental
health risk and resilience ever conducted among military personnel, and heassumed an expanded role in the Centerin 2014. He is also an Instructor in the
Department of Psychiatry of the Uniformed Services University. Mr. Hurwitz
received his MPH from the Universityof Michigan with a dual major in Epidemiology and Health Administration. He
has more than 30 years of experience inthe administration and management oflarge and complicated health research
projects. This interview with Mr. Hurwitz reflects
the perspective of a member of the Center who is
not a scientist.
You have been with the Center since 2010. Can you
share your perspective about working at the Center?
I accepted the position at the Center for two
main reasons: the project I would be working on,
and the people I would be working with. I was
intrigued by my first project assignment, managing
Army STARRS. Army STARRS is a large and complicated project involving several concurrent epidemiologic studies that include scientists from several
different institutions, working together toward thesame goal. The project involved tackling the difficult
but important issue of suicide in the military. I was
impressed by the team of people working on the
project, and the dedication of people at the Center.
The intellectual caliber and the international reputations of the personnel I have had the honor to workwith at the Center, and the outstanding work they
were involved in, made it an enticing opportunitythat I could not refuse. Since joining the team at
the Center, I have had the privilege of working withbright, dedicated, and hard-working people whohave inspired me and my work.

Can you tell me more about what made you
excited about your first project assignment?
Army STARRS sounded like a management
challenge, because of the size, complexity, the manydifferent personnel involved, and thelarge number of moving parts that had
to be managed, but that was part of
the appeal. When I joined the projectin the early, formative phase of theresearch, I thought Army STARRS
could benefit from some additionalorganization, management, structureand documentation. The scientists andstatisticians were incredibly busy working on so many aspects of the projectsuch as designing the multiple studies,developing and testing the many different questionnaires, determining how to select large and representative samples of Soldiers to recruit, and writing
consent forms and study protocols for submission to
IRBs. As a result, the scientists had little to no time
available to devote to managing, tracking, and documenting these processes. The team was composedof many scientists who possessed more than enoughscientific know-how, but the project was very large
and complicated, and needed someone who could
step back and look at the big picture to help makesure all the many parts fit together, to keep everything moving in the same direction and according
to schedule, and to help avoid having any pieces fall
through the cracks. There were what seemed likemany hundreds of detailed steps that needed to be
defined, monitored, and moved forward harmoniously. It was a long and difficult process to get where
we are now, but looking back at what the team has
accomplished in the past five years, I am extremely
proud of what I see.
Can you tell me more about your view of the workat the Center aside from Army STARRS?
The work at the Center is primarily geared
toward psychiatry and psychology, and it clearly pro2014 ANNUAL REPORT | 17

vides tremendous research, educational and otherbenefits to professionals working in those two fields.
But the work also benefits many other people. I havepersonally had the opportunity to help people in mycommunity by sharing with them materials developed by Center scientists.
Can you give me an example?
When major disasters, or other traumatic eventstake place, Center scientists spring into action. They
often travel to the disaster site to offer direct help
and consultation, and they provide educational
materials regardless of whether they visit the site.
Some of these materials are what they refer to as fact
sheets, and the Center provides them to those who
deal with the aftermath of these events. Separate fact
sheets are produced for, and distributed to, different
groups of people such as community leaders, first
responders, health care providers, parents, teachersand other workers. We have had a series of mass
shooting incidents in schools and workplaces overthe past several years. I had friends and neighbors
who as school teachers, or as parents, were struggling with how to discuss, or how to avoid discussing, these incidents with their students or theirchildren. I have posted fact sheets on my Facebook
page, and emailed them to friends and neighbors, after some of these traumatic events. I was amazed by
the number of people who thanked me and told me

how much the information helped them discuss theevents with children. It helped them know what tosay and how to say it. This is a good example of how
the Center responds to traumatic events and offers
real and immediate help.
What else do you want to tell me about your view ofworking at the Center?
The Center makes a difference in the lives ofpeople, the University, the local community, distantcommunities, the nation, and even the world. Making
a difference is important to me. There is a Hebrew
expression, “tikkun olam,” that my parents repeatedoften and engrained in me growing up. In English itmeans “repairing the world” or “healing the world.”
My folks said everyone has this responsibility. It refers to humanity’s shared responsibility to heal, repair
and transform the world. In my 30 years of conducting and managing epidemiologic research before
coming to the Center, there have only been a couple
of instances I can recall when my research directly
made a tangible difference. Clearly, research results
add to general scientific knowledge, but so many
research results just sit on a shelf. At the Center, I feelthat pretty much all of our research and education
efforts actually make a difference, improve people’s
lives, and contribute to the concept of “tikkun olam.”
I am honored to have had the opportunity to work at
the Center over the past five years.

The Center makes a difference in the lives of people, the University, the local
community, distant communities, the nation, and even the world. Making a
difference is important to me. — Paul E. Hurwitz

18 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

CSTS Publications in 2014
(Names in bold text are CSTS staff )Journal Articles
Balakathiresan, N.S., Chandran, R., Bhomia,
M., Jia, M., Li, H., Maheshwari, R.K. (2014).
Serum and amygdala microRNA signatures of
posttraumatic stress: fear correlation and biomarker potential. Journal of Psychiatric Research,
57: 65–73.
Cozza, S.J. (2014). Supporting America’s militarychildren and families. Applied Developmental
Science, 18(1): 1–4.
Engel, C.C., Cordova, E.H., Benedek, D.M., Liu, X.,
Gore, K.L, Goertz, C., Freed, M.C., Crawford, C.,
Jonas, W.B., Ursano, R.J. (2014). Randomized effectiveness trial of a brief course of acupuncture
for Posttraumatic Stress Disorder. Medical Care,52(12 suppl. 5): S57–S64.
Flynn, B.W. (2014). Sometimes a gun is not justa gun. [Review of the book Glock: The Rise of
America’s Gun, by P. M. Barrett]. Psychiatry,77(2): 209–214.
Flynn, B.W., McCarroll J.E., Biggs, Q.M. (2014).
Stress and resilience in military mortuary workers: Care of the dead from battlefield to home.
Death Studies, [Epub ahead of print].
Flynn, B.W., Speier, A.H. (2014). Disaster behavioral
health: Legal and ethical considerations in a rapidly changing field. Current Psychiatry Reports,
16(8), 457.
Gadermann, A.M., Heeringa, S.G., Stein, M.B., Ursano, R.J., Colpe, L.J., Fullerton, C.S., Gilman, S.E.,
Gruber, M.J., Nock, M.K., Rosellini, A.J., Sampson, N.A., Schoenbaum, M., Zaslavsky, A.M.,
Kessler, R.C., on behalf of the Army STARRS collaborators. (2014). Classifying U.S. Army militaryoccupational specialties using the occupational
information network. Military Medicine, 179(7):752–761.
George, M.S., Raman, R., Benedek, D.M., Pelic,C.G., Grammer, G.G., Stokes, K.T., Schmidt, M.,
Spiegel, C., DeAlmeida, N., Beaver, K.L., Borckardt, J.J., Sun, X., Jain, S., Stein, M.B. (2014). A
two-site pilot randomized 3 day trial of high doseleft prefrontal repetitive transcranial magnetic
stimulation (rTMS) for suicidal inpatients. Brain
Stimulation, 7(3): 421–431.
Gilman, S.E., Bromet, E.J., Cox, K.L., Colpe, L.J., Fullerton, C.S., Gruber, M.J., Heeringa, S.G., Lewandowski-Romps, L., Millikan-Bell, A.M., Naifeh,
J.A., Nock, M.K., Petukhova,M.V., Sampson, N.A.,
Schoenbaum, M., Stein, M.B., Ursano, R.J., Wessely, S., Zaslavsky, A.M., Kessler R.C., on behalf of
the Army STARRS Collaborators. (2014). Sociodemographic and career history predictors of suicidemortality in the United States Army 2004–2009.
Psychological Medicine, 44: 2579–2592.
Jia, M., Smerin, S.E., Zhang, L., Xing, G., Li, X.,
Benedek, D.M., Ursano, R.J., Li, H. (2014).
Coricosterone mitigates the stress response inan animal model of PTSD. Journal of PsychiatricResearch, 1–11.
Kessler, R.C., Heeringa, S.G., Stein, M.B., Colpe, L.J.,
Fullerton, C.S., Hwang, I., Naifeh, J.A., Nock,
M.K., Petukhova, M., Sampson, N.A., Shoenbaum,
M., Zaslavsky, A.M., Ursano, R.J. (2014). Thirty-day prevalence of DSM-IV mental disorders
among nondeployed soldiers in the U.S. Army:
Results from the Army Study to Assess Risk andResilience in Servicemembers (Army STARRS).
JAMA Psychiatry, 71(5): 504–513.
Lamontagne, M., Flynn, B.W. (2014). Communications in the aftermath of a major earthquake:
Bringing science to citizens to promote recovery.
Seismological Research Letters, 85: 561–565.
Le, T., Xia, M., Jia, M., Sarkar, N., Chen, J., Li, H.,
Wynn, G.H., Ursano, R.J., Choi, K.H. (2014).
Association between initial morphine intake
and body weight change, acoustic startle reflex
and drug seeking in rats. Psychopharmacology, 231(23): 4569–4577.
Lewandowski-Romps, L., Peterson, C., Berglund,P.A., Collins, S., Cox, K., Hauret, K., Jones, B.,
Kessler, R.C., Mitchell, C., Park, N., Schoenbaum,
M., Stein, M.B., Ursano, R.J., Heeringa, S.G.
(2014). Risk factors for accident death in the U.S.
2014 ANNUAL REPORT | 19

Army, 2004–2009. American Journal of Preventive Medicine, 47(6): 745–753.
Li H., Li, X., Smerin, S., Zhang, L., Jia, M., Xing,
G., Su, Y., Wen, J., Benedek, D.M., Ursano, R.J.
(2014). Mitochondrial gene expression profiles
and metabolic pathways in the amygdala associated with exaggerated fear in an animal model of
PTSD. Frontiers in Neurology, 5: 164.
Mash, H.B. Herberman, Fullerton, C.S., Ng,
T.H.H., Ursano, R.J. (2014). Factor analysis of
the drinking motives questionnaire in a young
adult U.S. Army sample. Psychological Reports,
115(2): 339–350.
Mash, H.B. Herberman, Fullerton, C.S., Ramsawh, H.J., Ng, T.H.H., Wang, L., Kessler, R.C.,
Stein, M.B., Ursano, R.J. (2014). Risk for suicidal
behaviors associated with alcohol and energy
drink use in the U.S. Army. Social Psychiatry andPsychiatric Epidemiology, 49(9): 1379–1387.
Mash, H.B. Herberman, Fullerton, C.S., Shear,
M.K., Ursano, R.J. (2014). Complicated grief anddepression in young adults: Personality and relationship quality. Journal of Nervous and Mental
Disease, 202(7): 539–543.
McKibben, J.B.A., Fullerton, C.S., Mash, H.B., Herberman, Nock, M.K., Naifeh, J.A., Kessler, R.C.,
Stein, M.B., Ursano, R.J. (2014). Suicidal behaviors and the use of mental health services among
active duty Army soldiers. Psychiatric Services,65(3): 374–380.
Morganstein, J.C., Ursano, R.J. (2014). What psychiatrists should know about Ebola. PsychiatricTimes, 31(12): 26.
Nock, M.K., Stein, M.B., Heeringa, S.G., Ursano,R.J., Colpe, L.J., Fullerton, C.S., Hwang, I.,
Naifeh, J.A., Sampson, N.A., Schoenbaum, M.,
Zaslavsky, A.M., Kessler, R.C. (2014). Prevalence
and correlates of suicidal behavior among soldiers: Results from the Army Study to Assess
Risk and Resilience in Servicemembers (ArmySTARRS). JAMA Psychiatry, 71(5): 514–522.
Ramsawh, H.J., Fullerton, C.S., Mash, H.B. Herberman., Ng, T.H.H., Kessler, R.C., Stein, M.B.,
Ursano, R.J. (2014). Risk for suicidal behaviors
associated with PTSD, depression, and theircomorbidity in the US Army. Journal of Affective
Disorders, 161: 116–122.
20 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Russell, D.W., Cohen, G., Gifford, R.K., Fullerton,
C.S., Galea, S., Ursano, R.J. (2014). Mental healthamong a nationally representative sample of UnitedStates military reserve component personnel.
Social Psychiatry and Psychiatric Epidemiology,[Epub ahead of print].
Schoenbaum, M., Kessler, R.C., Gilman, S.E., Colpe,
L.J., Heeringa, S.G., Stein, M.B., Ursano, R.J., Cox,
K.L. (2014). Predictors of suicide and accident
death in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS): Resultsfrom the Army Study to Assess Risk and Resiliencein Servicemembers (Army STARRS). JAMA Psychiatry, 71(5): 493–503.
Shultz, J.M., Thoresen, S., Flynn, B.W., Muschert,
G.W., Shaw, J.A., Espinel, Z., Walter, F.G., Gaither, J.B., Garcia-Barcena, Y., O’Keefe, K., Cohen,
A.M. (2014). Multiple vantage points on the mental
health effects of mass shootings. Current Psychiatry Reports, 16(9): 469.
Spangler, P.T. (2014). Nightmare deconstruction andreprocessing for trauma related nightmares: An
integrative approach. Psychotherapy Bulletin, 49(1):31–35.
Street, A.E., Gilman, S.F., Rosellini, A.J., Stein, M.B.,
Bromet, E.J., Cox, K.L., Colpe, L.J., Fullerton,
C.S., Gruber, M.J., Heeringa, S.G., Lewandowski-Romps, L., Little, R.J.A., Naifeh, J.A., Nock,
M.K., Sampson, N.A., Schoenbaum, M., Ursano,R.J., Zaslavsky, A.M., Kessler, R.C. (2014). Understanding the elevated suicide risk of female soldiersduring deployments. Psychological Medicine, [Epubahead of print].
Tomita, H., Ursano, R.J. (2014). Breakout session 3summary: Psychosocial/mental health concerns andbuilding community resilience. Disaster Medicine
and Public Health Preparedness, 8(4): 363–365.
Ursano, R.J., Benedek, D.M., Wynn, G.H. (2014).
Deployment to war and mental health consequences. Commentary on: Mental health consequencesof overstretch in the UK Armed Forces, 2007–09:
A population-based cohort study. Lancet, 1(7):487–489.
Ursano, R.J., Colpe, L.J., Heeringa, S.G., Kessler, R.C.,
Schoenbaum, C., Stein, M.B. (2014). The Army
Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Psychiatry, 77(2): 107–119.

Ursano, R.J., Heeringa, S.G., Stein, M.B., Jain,
S., Raman, R., Sun, X., Chiu, W.T., Colpe, L.J.,
Fullerton, C.S., Gilman, S.E., Hwang, I., Naifeh,
J.A., Nock, M.K., Rosellini, A.J., Sampson, N.A.,
Schoenbaum, M., Zaslavsky, A.M., Kessler, R.C.
(2014). Prevalence and correlates of suicidal
behavior among new soldiers in the U.S. Army:
Results from the Army Study to Assess Risk andResilience in Servicemembers (Army STARRS).
Depression and Anxiety, 1–10.
Ursano, R.J., McKibben, J.B.A., Reissman, D.B.,
Liu, X., Wang, L., Sampson, R., Fullerton,
C.S. (2014). Posttraumatic stress disorder andcommunity collective efficacy following the2004 Florida Hurricanes. PLOS ONE, 9(2):e88467.
Worthen, M., Rathod, S.D., Cohen, G., Sampson,
L., Ursano, R.J., Gifford, R.K., Fullerton, C.S.,
Galea, S., Ahern, J. (2014). Anger problems andposttraumatic stress disorder in male and female
National Guard and Reserve service members.
Journal of Psychiatric Research. 55: 52–58.
Zhang, L., Benedek, D.M., Fullerton, C.S., Forsten, R.D., Naifeh, J.A., Li, X.X., Hu, X.Z., Li, H.,
Jia, M., Xing, G.Q., Benevides, K.N., Ursano,
R.J. (2014). PTSD risk is associated with BDNF
Val66Met and BDNF over-expression. MolecularPsychiatry, 19(1): 8–10.
Zhang, L., Hu, X.Z., Li, X., Li, H., Smerin, S., Russell, D., Ursano, R.J. (2014). Telomere length— A cellular aging marker for depression andposttraumatic stress disorder. Medical Hypotheses, 83(2): 182–185.

Books

Cozza, S.J., Cohen, J.A., Dougherty, J.G. (Eds.),
Trivedi, H.K. (Consulting Ed.). (2014). Disasterand Trauma. Child and Adolescent Psychiatric
Clinics. Elsevier (in progress).
Cozza, S.J., Goldenberg, M.N., Ursano, R.J. (Eds.).
(2014). Care of military service members, veterans, and their families. Arlington, VA: American
Psychiatric Publishing.
Benedek, D.M, Wynn, G.H. Complementary andAlternative Medicine for PTSD. Oxford University
Press (in progress).

Flynn, B., Sherman, R. (Eds.). Integrating Emergency
Management and Disaster Behavioral Health: One
Picture: Two Lenses. Elsevier (in progress).
Ursano, R.J., Dichtel, M., Fullerton, C.S., Gabbay,
F.H., McCarroll, J.E., Benevides, K.N. (Eds.).
(2014). Forum on Health and National Security:
Military Families in Transition: Stress, Resilience,and Well-Being. (DTIC: ADA607405). Bethesda,
MD: CSTS.
Ursano, R.J., Fullerton, C.S., Weisaeth, L., Raphael,
B. (Eds.). Textbook of Disaster Psychiatry: 2nd Edition (in progress).
Wain, H., Dichtel, M., Benevides, K.N., Ursano, R.J.
(Eds.) (2014). Artiss Symposium 2014: Psychiatry
and Pain Management. Bethesda, MD: CSTS.
Wain, H., Schneider, B., Dichtel, M., Ursano, R.J.
(Eds.) (2014). Artiss Symposium 2013: Psychiatry
and Sleep Disorders. Bethesda, MD: CSTS.

Book Chapters

Malone, R.D., Benedek, D.M. (2014). Personality
disorders in the military operational environment.
In J.M. Oldham, A.E. Skodol, D.S. Bender (Eds.),
Textbook of Personality Disorders, Second Edition.
Arlington, VA: American Psychiatric Publishing.
Naifeh, J.A., Cox, D.W., Goldenberg, M.N., Nock,
M.K. (2014). Suicidal thoughts and behaviors inmilitary service members and veterans. In S.J.
Cozza, M.N. Goldenberg, R.J. Ursano (Eds.), Careof military service members, veterans, and theirfamilies (pp. 183–201). Arlington, VA: American
Psychiatric Publishing.
Naifeh, J.A., Nock, M.K., Ursano, R.J. (2014). Suicidein the armed forces. In C. Nemeroff, P. Ruiz, S.H.
Koslow (Eds.), A Concise Guide to Understanding
Suicide: Epidemiology Pathophysiology and Prevention. Cambridge, UK: Cambridge University Press.
Ursano, R.J., Carr, R. (2014). Psychodynamic psychotherapy. In R.E. Hales, S.C. Yudofsky, G. Gabbard(Eds.), Textbook of Psychiatry 6th Edition. Arlington,
VA: American Psychiatric Press.
Ursano, R.J., Sonnenberg, S.M., Lazar, S.G., Carr, R.B.
(2014). The psychodynamic psychotherapy. In R.
Hales, S. Yudofsky, G. Gabbard (Eds.), The Textbookof Psychiatry 6th Edition. Arlington, VA: American
Psychiatric Press.

2014 ANNUAL REPORT | 21

CSTS Presentations, Briefings, andInterviews in 2014
Presentations
Disasters and Resilience: Behavior, Communicating
and Caring, Ursano, R.J., the International Atomic Energy Agency’s (IAEA) Technical Meeting on
Radiation, Health and Society: for a better understanding of the psycho-social consequences ofFukushima nuclear accident, IAEA headquarters,
Vienna, Austria, January 2014.
Military Response to Terrorism: A Public HealthApproach, Benedek, D.M., George Washington
University, Washington, DC, April 2014.
Complementary and Alternative Approaches to
PTSD in Advances in PTSD, Benedek, D.M.
(Co-Chair and Presenter), Annual Meeting of
the American Psychiatric Association, New York
City, NY, May 2014.
Interactive Session Update on PTSD, Benedek, D.M.,

Dr. Ursano speaking at the Italian Embassy.
22 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Annual Meeting of the American Psychiatric
Association, New York City, NY, May 2014.
Military Cultural Competence: Impact on Research,
Benedek, D.M., Annual Meeting of the American
Psychiatric Association, New York City, NY, May
2014.
Committee on Psychiatric Dimensions of Disaster,Ursano, R.J., Annual Meeting of the American
Psychiatric Association, New York, NY, May
2014.
Veterans and the Criminal Justice System, Howe,E., American Psychological Association and theAmerican Bar Association National Conference,
Confronting Family and Community Violence:
The Intersection of Law and Psychology, Washington, DC, May, 2014.
Thirty-Day Prevalence of DSM-IV Mental Disorders
among Nondeployed Soldiers in the US Army:
Results from the Army Study to Assess Risk andResilience in Servicemembers (Army STARRS),Ursano, R.J., Uniformed Services University
Research Days Conference Lecture in support ofreceiving the James Leonard Award, Bethesda,
MD, May 2014.
Gender and Position of Authority and the Risk ofDepression and Post-Traumatic Stress Disorderamong a Representative Sample of U.S. Reserve
Component Personnel, Cohen, G., Sampson,K., Fink, D., Wang, J., Russell, D., Gifford, R.K.,
Fullerton, C.S., Ursano, R.J., Galea, S. Society for
Epidemiologic Research Annual Meeting, Seattle,
WA, June, 2014.
War, Combat and Outcomes, Institute of Medicine
Annual Meeting, Ursano, R.J. (invited speaker),
Washington, DC, June 2014.
Amerithrax and Insider Threat: Challenges andOpportunities at the Military-Civilian Interface,
Benedek, D.M., Forensic Expert Behavioral Analysis Panel Briefing to American Red Cross and
US Capitol, Washington, DC, June 2014.
Military Cultural Competency, Morganstein, J., National Association of State Mental Health Pro-

gram Directors Annual Conference, Washington,
DC, July 2014.
Learning in Disaster Health, Morganstein, J., National Center for Disaster Medicine and Public
Health Annual Conference, Fort Myer, VA, September 2014.
Focusing on DSM-5, Regier, D.,World Psychiatric
Association Meeting, Madrid, Spain, September
2014.
Suicidality, TBI, and National Security, Ursano, R.J.,
United Kingdom/United States VA-DoD Joint
Task Force on Suicide and Mental Health, VA
Central Office, Washington, DC, October 2014.
PTSD and Trauma Related Disorders: PTSD, Suicide and TBI, Ursano, R.J., Clinical Neuroscience
Grand Rounds, NIND/NIMH, Bethesda, MD,
October 2014.
Effect of Relationship-to-Deceased and Military
Pride on Adaptive Grief Reactions in Parentally
Bereaved Children of U.S. Service Members,
Cozza, S.J., Fisher, J., Ortiz, C., Kaplow, J., Layne,
C., Harrington-Lamorie, J., Zhou, J., Liu, A., Grein, K., Fullerton, C.S., Ursano, R.J., presented by
Cozza, S.J., Annual Meeting of the International
Society for Traumatic Stress Studies, Miami, FL,
November 2014.
Interactive Effect of Early Childhood Adversities andMental Health Symptoms on Family Function in
Military Wives Following Combat Deployment,
La Flair, L., Holmes, A., Sullivan, J., Beech, E.,
Kansky, J., Fullerton, C.S., Ursano, R.J., Cozza,
S.J., presented by La Flair, L., Annual meeting of
the International Society for Traumatic StressStudies, Miami, FL, November 2014.
Effectiveness of Post-Deployment Early Intervention
for U.S. Army Mortuary Affairs Soldiers: Results from Four Years, Biggs, Q., Fullerton, C.S.,
McCarroll, J.E., Kansky, J., Zatzick, D., Ursano,R.J., presented by Biggs, Q., Annual Meeting of
the International Society for Traumatic StressStudies, Miami, FL, November 2014.
Effects of Prior Trauma on Grief after U.S. MilitaryService Member Death. Fisher, J., Ortiz, C., Harrington-LaMorie, J., Zhou, J., Grein, K., Liu, A.,
Fullerton, C.S., Ursano, R.J., Cozza, S.J., poster
presented by Fisher, J., Annual Meeting of the In-

ternational Society for Traumatic Stress Studies,
Miami, FL, November 2014.
Effects of chronic intravenous morphine self-administration on in vivo brain glucose utilization(18FDG-PET) and transcriptome expression(RNA Sequencing) in rats. Choi, K.H., Le, T.,
Sukumar, G., Wilson, C.M., Selwyn, R.G., Dalgard, C.L., Ursano, R.J., poster presented by Choi,
K.H., at the Society for Neuroscience Meeting,Washington, DC, November 2014.
The Army Study to Assess Risk and Resilience inServicemembers (Army STARRS): Design andearly results. Naifeh, J.A., Kessler, R.C., Nock,
M.K., Schoenbaum, M. Colpe, L.J., Fullerton,
C.S., Heeringa, S.G., Stein, M.B., Ursano, R.J.,
presented by Naifeh, J., 5th Annual Forum of
the Canadian Institute for Military and VeteranHealth Research, Toronto, Canada, November
2014.
Planning Committee for Disaster Research Response
Workshop, Ursano, R.J., IOM Forum on Medical
and Public Health Preparedness for Catastrophic
Events, New Orleans, LA, November 2014.
Military Mental Health Response to Terrorism,
Benedek, D.M., George Washington University(Northern VA campus), Alexandria, VA November 2014.
DSM-5 for Clinical Practice-RDoC for Research, Regier, D., presentation to the editorial staff of thejournal Health Affairs, Bethesda, MD, November
2014.
Association of childhood anxiety disorders andquality of life in a primary care sample, Ramsawh,
2014 ANNUAL REPORT | 23

H.J., Chavira, D.A, presented by Ramsawh, H.J.,
at the 48th Annual Convention of the Association for Behavioral and Cognitive Therapies in
Philadelphia, PA, November 2014.
Update on Posttraumatic Stress Disorder: Phenomenology and Treatment, Benedek, D.M., Grand
Rounds, Department of Psychiatry, Walter Reed
National Military Medical Center, Bethesda, MD,
December, 2014.
PTSD: The Evolution of Diagnostic Conceptualization and Approach to Management, Benedek,
D.M., George Washington University Medical
School, Departments of Pharmacology andPsychiatry Seminar on the History of Mental
Well-Being, Washington, DC, December 2014.
Fostering Resilience in First Responders: Self-Careand Peer Support, Benedek, D.M., US Drug
Enforcement Administration FAST Peer Support
Training Conference, Stafford VA, December
2014.

Briefings
Department of Homeland Security Chief of Staff and
Deputy Chief of Staff for Operations and Coordi-

24 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

nation Briefing, Benedek, D.M., Washington, DC,
February 2014.
Senior Army Leadership briefing on the latest actionable findings from the Army Study to Assess
Risk and Resilience in Servicemembers (ArmySTARRS), Ursano, R.J., Pentagon, Arlington,
VA, September 2014.
Invited Participant: Mental Health and Suicide Prevention Briefing with White House and Obama
Administration Officials. Ursano, R.J., September
2014.

Interviews
DSM-5 and the NIMH Research Domain Criteria,“BioCentury This Week,” CBS Network, interview with Dr. Thomas Insel, NIMH Director, andDr. William Carpenter, Professor of Psychiatry,
University of Maryland, Regier, D., September
2014.
New York Times interview, “Prevalence and Correlates of Suicidal Behavior among New Soldiersin the US Army: Results from the Army Study toAssess Risk and Resilience in Servicemembers(Army STARRS),” Ursano, R.J, October 2014.

CSTS Directors, Scientists, and Scientific
Advisory Board
CSTS DIRECTORS
Robert J. Ursano, MD
Chair, Professor of Psychiatry and Neuroscience
Department of Psychiatry
Director
Center for the Study of Traumatic Stress
Uniformed Services University
David M. Benedek, MD
COL, MC, USA
Deputy Chair, Professor
Department of Psychiatry
Associate Director, Consultation and Education
Center for the Study of Traumatic Stress
Uniformed Services University
Stephen J. Cozza, MD
Professor
Department of Psychiatry
Associate Director, Child and Family Program
Center for the Study of Traumatic Stress
Uniformed Services University
Brian W. Flynn, EdD
Adjunct Professor
Department of Psychiatry
Associate Director, Health Systems
Center for the Study of Traumatic Stress
Uniformed Services University

Carol S. Fullerton, PhD
Research Professor
Department of Psychiatry
Scientific Director
Center for the Study of Traumatic Stress
Uniformed Services University
Robert K. Gifford, PhD
Assistant Professor
Department of Psychiatry
Executive Officer, and Associate Director, Homeland
Security Studies
Center for the Study of Traumatic Stress
Uniformed Services University
John A. Stuart, PhD
Research Assistant Professor
Department of Psychiatry
Director, Resource Management
Center for the Study of Traumatic Stress
Uniformed Services University
Nancy T. Vineburgh, MA
Assistant Professor
Department of Psychiatry
Associate Director, Public Education andPreparedness
Center for the Study of Traumatic Stress
Uniformed Services University
CSTS SCIENTISTSDavid M. Benedek, MD
COL, MC, USA
Deputy Chair, Professor
Consultant to the U.S. Army Surgeon General for
Forensic Psychiatry
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Quinn M. Biggs, PhD, MPH
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
2014 ANNUAL REPORT | 25

Maria Braga, DDS, PhD
Associate Professor
Department of Anatomy, Physiology and Genetics
Center for the Study of Traumatic Stress
Uniformed Services University

Richard S. Epstein, MD, PA
Clinical Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Kwang Choi, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Joscelyn E. Fisher, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Stephen J. Cozza, MD
Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Brian W. Flynn, EdD
Adjunct Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Brian Crowley, MD
Adjunct Associate Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Michael C. Freed, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Catherine L. Dempsey, PhD, MPH
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Carol S. Fullerton, PhD
Research Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Connie Duncan, PhD
Research Associate Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Frances Gabbay, PhD
Research Associate Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Gary Gackstetter, DVM, PhD
Col, USAF
Associate Professor
Department of Preventive Medicine/Biometrics
Center for the Study of Traumatic Stress
Uniformed Services University
Robert K. Gifford, PhD
Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Derrick Hamaoka, MD
Lt Col, USAF, MC, FS
Assistant Professor
Department of Psychiatry

26 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Center for the Study of Traumatic Stress
Uniformed Services University
Jill Harrington-LaMorie, DSW, LCSW
Senior Field Researcher
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Harry C. Holloway, MD
Professor of Psychiatry and Neuroscience
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Marjan G. Holloway, PhD
Associate Professor
Department of Medical & Clinical Psychology
Center for the Study of Traumatic Stress
Uniformed Services University
Tomoko I. Hooper, MD
Professor
Department of Preventive Medicine & Biostatistics
Center for the Study of Traumatic Stress
Uniformed Services University
Edmund G. Howe III, MD, JD
Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Luke Johnson, PhD
Adjunct Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Tzu Cheg Kao, PhD
Professor
Department of Preventive Medicine and Biometrics
Center for the Study of Traumatic Stress
Uniformed Services University
Elie Karam, MD
Professor and Chairman
Department of Psychiatry
American University — Beirut
Beirut, Lebanon

David S. Krantz, PhD
Professor
Department of Medical and Clinical Psychology
Center for the Study of Traumatic Stress
Uniformed Services University
Lareina LaFlair, PhD, MPH
Research Psychologist
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
He Li, MD, PhD
Associate Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Xian Liu, PhD
Research Professor
Deployment Health Clinical Center
Walter Reed Army Medical Center
Holly B. Mash, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
James E. McCarroll, PhD, MPH
Research Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

2014 ANNUAL REPORT | 27

Joshua Morganstein, MD
CDR USPHS
Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
James Naifeh, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Claudio Ortiz, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Holly Ramsawh, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Darrel A. Regier, MD, MPH
Adjunct Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Dori B. Reissman, MD, MPH
CAPT, USPHS
Medical Director, World Trade Center Responder
Health Program
Senior Medical Advisor, National Institute ofOccupational Safety and Health
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Patcho Santiago, MD, MPH
CDR, MC, USN
Psychiatry Residency Program Director
Walter Reed National Military Medical Center
Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

28 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Patricia Spangler, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
John A. Stuart, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
E. Fuller Torrey, MD
Executive Director
Stanley Medical Research Institute
Robert J. Ursano, MD
Chair, Professor of Psychiatry and Neuroscience
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Jing Wang, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Maree J. Webster, PhD
Research Assistant Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Director, Laboratory of Brain Research
Stanley Medical Research InstituteLars Weisaeth, MD
Professor, Division of Disaster Psychiatry
University of Oslo
Oslo, Norway
Curt West, MD
CDR, MC, USN
Assistant Professor
Clerkship Director
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University
Anthony Woodson, DHA
Associate Administrator
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Kathleen Wright, PhD
Former Director (Retired)
Force Health Protection Program
USAMRU-E
Walter Reed Army Institute of Research

Carol S. Fullerton, PhD
Research Professor, Department of Psychiatry
Scientific Director, Center for the Study of 		Traumatic Stress
Uniformed Services University

Gary Wynn, MD
LTC, MC, USA
Associate Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

David S. Krantz, PhD
Professor, Department of Medical and Clinical 		
Psychology
Uniformed Services University

Lei Zhang, MD
Associate Professor
Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

Craig H. Llewellyn, MD
Professor, Department of Military and Emergency
Medicine
Uniformed Services University

CSTS SCIENTIFIC ADVISORY BOARD

Francis O’Conner, MD, MPH
COL, MC, USA
Chair, Professor, Department of Military andEmergency Medicine
Uniformed Services University

James E. Barrett, PhD
Chair, Professor
Department of Pharmacology and Physiology
Drexel University, College of Medicine

Robert M. Post, MD
Head, Bipolar Collaborative Network
Former Chief, Biological Psychiatry Branch
National Institute of Mental HealthCharles W. Beadling, MD
Col (Ret), MC, USAF
Director, Assistant Professor
Center for Disaster & Humanitarian Assistance 		Medicine
Department of Military and Emergency Medicine
Uniformed Services University

Gerald V. Quinnan, Jr., MD
RADM (Ret), USPHS
Chair, Professor, Preventive Medicine & Biometrics
Uniformed Services University

M. Richard Fragala, MD
Col (Ret), USAF, MC, FS
Professor, Department of Psychiatry
Uniformed Services University
Matthew J. Friedman, MD, PhD
Professor, Department of Psychiatry
Professor, Department of Pharmacology & 		
Toxicology
Dartmouth University, Geisel School of Medicine
Director, Leahy-Friedman National PTSD BrainBank
Senior Advisor, National Center for PosttraumaticStress Disorder
U.S. Department of Veterans Affairs

Arieh Y. Shalev, MD
Professor, Department of Psychiatry
New York University
Professor, Department of Psychiatry
Hadassah University School of Medicine
Jerusalem, Israel
Robert J. Ursano, MD
Chair, Professor of Psychiatry and Neuroscience,
Department of Psychiatry
Director, Center for the Study of Traumatic Stress
Uniformed Services University
Lars Weisaeth, MD
Professor, Division of Disaster Psychiatry
University of Oslo
Oslo, Norway

2014 ANNUAL REPORT | 29

Distinguished Former Scientific Advisory Board Members & Emeritus Friends of CSTS
Herbert A. Hauptman, PhD (1917–2011)1985 Nobel Laureate, Chemistry
President, Hauptman-Woodward Medical
Research InstituteResearch Professor, Department of BiophysicalSciences
Adjunct Professor, Department of Computer
Science
University of Buffalo

David H. Marlowe, PhD (1931–2014)
Senior Lecturer, Department of Psychiatry
Uniformed Services University
Former Chief, Department of Military Psychiatry
Walter Reed Army Institute of Research
Fellow, American Anthropological Association

Joshua Lederberg, PhD, ForMenRS (1925–2008)
1958 Nobel Laureate, Physiology or Medicine
Professor Emeritus, Department of Molecular
Genetics and Informatics
Rockefeller University
Founder, Department of Medical Genetics
University of Wisconsin-Madison

CSTS STAFF
Pablo Aliaga
Jean Arlt
TSgt Rondricueas Barlow
Erin Beech
K. Nikki Benevides
Natasha Benfer
Yvette Bodrick
LCDR Jennifer Bornemann
Christina Buckley
Nina Calmenson
Freda Denis-Cooper
Evelyn Cordero
Nicole Dacuyan
Amanda Devane
Alice Fladung
Katie Grein
Jessica Grom
April Harris
TSgt. Syrus Henderson
Helena Hassen

30 | CENTER FOR THE STUDY OF TRAUMATIC STRESS, USU

Michelle Herman
Karly Hrank
Paul Hurwitz
Jessica Kansky
Natalie Kodsy
David Kopp
F. Julian Lantry
Thien Le
Alex Liu
Mona Mendelson

Diana Monday
Mikelle Mooney
Susan Moss
Stanley Ng
Nichole Nicholas
Kevin Nishida
Maegan Paxton
Joseph Piemontese
Deborah Probe
Sara Pula
Heidi Shull
Stephanie Singer
Chad Spiegel
Natara Strother-WareJamie Sullivan
Tung Tu
Patti Vegella
Leming Wang
Holly Wu
Bailey Zhang
Jing Zhou

2014 Funded Grants
GRANT

FUNDING INSTITUTION

P11: a Biomarker for Memory Retrieval

USAMRMC

Resilience Building for Homeland Security A Specialized Training and Collaborative Consultation

DHS

Development of an Education Curriculum for Personally Owned Firearms Safety Enhancement Initiative

DSPO

Family Violence and Trauma Project

IMCOM

Riluzole Augmentation Treatment for Complicated PTSD

USAMRMCStress and Biomarkers in a Military Population

USAMRMC

Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)NIMHContinuation of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS 2)

DHP

Brain Indices of Risk for PTSD after Mild TBI

UCSD

Reliability and Initial Validation of the INTRuST Structured Assessment for Evaluation of TBI

UCSD

Brain Indices Structure and Function

CNRM

The Impact of Service Member Death on Military Families: A National Study of Bereavement

CDMRP

A Preventive Intervention with Children and Families of the Combat Injured
PTSD/TBI Clinical Consortium Coordinating Centers

USAMRMCUCSD

Behavioral-Based Predictors of Workplace Violence in the Army STARRSHarvardDeployment Family Stress: Child Neglect and Maltreatment in US Army Families

CDMRP

Mortuary Affairs Soldiers: Early Intervention and Altering Barriers to Care for PTSD

USAMRMC

Addressing the Needs of Children and Families of Combat

CDMRP

A Proof-of-Concept, Double-Blind, Randomized, Placebo-Controlled Study of Ganaxolone in PTSD

UCSD

PTSD, Comorbidity and Service Utilization among National Guard

USAMRMCThe Injury and Traumatic Stress (INTRuST) Consortium Biorepository

UCSD

CSTS Program Grant

DHP
2014 ANNUAL REPORT | 31

CSTS Partnerships
The Center for the Study of TraumaticStress would like to acknowledge andthank our partners and collaborators.
The Center has worked with organizations in the public and private
sector through research partnerships,
project collaborations, consultations
and trainings.
American Academy of Child andAdolescent Psychiatry
American Gold Star Mothers
American Psychiatric Association
American Psychological Association
Architect of the Capitol
Armed Forces Retirement Home
Broad Institute
The Carter Center
Catholic University of America
Center for Health Care Research
Medical University of South
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Uniformed Services University
Union Pacific Railroad
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