Researchers from UF Health Jacksonville and the University of Florida College of Medicine – Jacksonville are taking part in a first-of-its-kind national initiative to improve the understanding, prevention and recovery of soldiers and civilians who have experienced a traumatic event.The study is being funded by the National Institute of Mental Health and, along with UF Health, includes research teams from the University of North Carolina and Harvard University.
The project, referred to as the AURORA study, will enroll 5,000 patients who come to emergency rooms after they have experienced trauma such as a car accident, fall or other event that involves actual or threatened serious injury, sexual violence or death exposure. UF Health Jacksonville’s emergency department and trauma center is the second of 12 sites to begin the study.
“There is so much we don’t know about post-traumatic stress-related symptoms and disorders. This study will lead to breakthroughs in identifying and treating patients in the early aftermath of trauma,” said Phyllis Hendry, MD, a professor of emergency medicine at the UF College of Medicine – Jacksonville. “This really is a groundbreaking study and could change how we treat everyone from soldiers to people who come through the doors of our trauma center.”
Hendry, also an assistant chair of research, says the latest technology will be used to gather data from study participants after discharge from the emergency room. Those who participate will have blood drawn to collect biological data and will be monitored for several months using mobile devices such as a study wristwatch and smartphone to track various factors, including activity, sleep and mood. Some participants will also have in-depth exams, brain imaging and psychological tests as part of the data collection.
After a traumatic event — be it an assault, car crash or combat experience — people commonly report a range of symptoms, including hypervigilance, intrusive upsetting thoughts, flashbacks, and changes in sleep, work and mood. These often co-occur with chronic pain, as well as other enduring effects from body or brain injuries. Most individuals gradually get better, but a substantial number develop persistent problems. There is no reliable way to predict who will recover without treatment and who will develop lasting problems after trauma. Even when post-traumatic stress, anxiety and depression are diagnosed, symptoms differ from person to person, as does response to treatment.
Samuel McLean, MD, MPH, of the University of North Carolina, is leading the study in collaboration with Ronald Kessler, PhD, of Harvard Medical School; Karestan Koenen, PhD, of the Harvard School of Public Health; and Kerry Ressler, MD, PhD, of McLean Hospital in Belmont, Massachusetts.
“Trauma-related disorders affect millions of Americans and are a central concern for the health and security of the nation,” said Farris Tuma, ScD, chief of NIMH’s Traumatic Stress Research Program. “Because of the lack of understanding of what contributes to these disorders, predicting outcomes for individuals and treating them effectively remain major scientific and public health challenges. While treatments are effective for many patients, not all benefit equally, and we lack effective prevention strategies. We are frustrated but not surprised that people respond differently to the best available treatments and must learn how to tailor existing and new interventions to specific patient needs.”
NIMH is providing $21 million in funding over five years for the study in addition to funding by private foundations.
“This study reflects the need for our research investments to address short- and medium-term clinical goals, as well as long-term basic research,” said NIMH Director Joshua A. Gordon, MD, PhD. “In the relatively short term, this project is expected to deliver tools for clinicians to make informed decisions about risk and follow-up care soon after trauma. In addition, the research resource to be created will fuel a new generation of analyses on the underlying causes of disorders; identify new intervention targets; and in turn, give rise to mechanism-informed treatments based on individual needs.”