The Executive Division directs strategic planning and policy across the Center's seven divisions. Research of Division staff is focused on clinical trials and disaster mental health but also includes other topics.
Data collection was completed and data analyses are underway on several clinical trials. These include RESPECT-PTSD, a multi-site randomized clinical trial of integrated care for Veterans with PTSD treated in primary care, and a trial evaluating use of a decision aid that is intended to help Veterans with PTSD make choices about the treatments they receive. In addition, staff is analyzing data from CSP 494, which examines how functioning relates to PTSD symptoms and symptom change.
A number of clinical trials are being launched. These include studies of the medications galantamine and ganaxalone for treating mTBI and a randomized controlled trial to see if adding Cognitive Behavioral Therapy for PTSD to intensive outpatient substance use care-as-usual is effective in addressing PTSD in Veterans with co-morbid PTSD and substance use. In addition, recently underway are two studies on Acceptance and Commitment Therapy; one a four-site randomized clinical trial of Acceptance and Commitment Therapy (ACT) for PTSD and the other a manual development pilot of ACT for co-morbid PTSD and substance use disorders.
Executive Division researchers continue work on several disaster related studies. The NIMH-funded National Center for Disaster Mental Health Research (NCDMHR) also includes investigators from the the National Center for PTSD's Clinical Neurosciences Division. During the past year, NCDMHR completed data collection for the Galveston Bay Recovery Study, a longitudinal epidemiologic study following Hurricane Ike. Participants who continued to report disaster-related symptoms early in 2009 were invited to participate in a clinical trial testing the efficacy of Cognitive Behavioral Therapy for Postdisaster Distress, a treatment that was developed by researchers at the National Center after the September 11th terrorist attacks.
The first wave of data was collected on an NIMH-funded study of prolonged grief and PTSD following the day care center fire that took the lives of 49 children in Hermosillo, Mexico. Other disaster work continues with the National Consortium for the Study of Terrorism and Responses to Terrorism (led by the University of Maryland) funded by the Department of Homeland Security. The Division continued to collaborate with the Substance Abuse and Mental Health Services Administration's Center for Mental Health Services to conduct cross-site program evaluation of federally funded crisis intervention programs, and began work with the Federal Emergency Management Agency to help them develop an evaluation strategy for their new disaster case management program.
Data collection is complete for a study evaluating the effectiveness of a collaborative community-based network in increasing awareness in the community about the needs of returning service members from Afghanistan and Iraq and their families. The overarching goal is to help prevent chronic PTSD by encouraging early intervention. This study is testing a model that was developed by National Center staff and a variety of service providers in Vermont who work with National Guard members and their families.
In an upcoming project, staff will study VA administrative data in order to examine the benzodiazepine prescribing variability in VA and to explore if other medications are being prescribed as alternative strategies. The project will also involve qualitative interviews with prescribers to learn of their perceptions about barriers/facilitators to Clinical Practice Guideline recommendations regarding benzodiazepines in PTSD patients. Based on the resultant data, a consensus group will make recommendations for an intervention in VA to decrease the prescribing of benzodiazepines in PTSD patients.