Traumatic stress has caused a host of devastating effects for many military service members, including mental illness, substance abuse, post-traumatic stress disorder, family violence, and suicide. Since Sept. 11, 2001, more than 30,000 active duty members and veterans have taken their own lives — a tragic toll that represents four times the number of those killed in post-911 military operations.1 Developing effective approaches to prevent suicide is a top priority within the Department of Defense.
DARPA’s STRENGTHEN program, short for Strengthening Resilient Emotions and Nimble Cognition Through Engineering Neuroplasticity, aims to build on recent advances in neuroscience and clinical practice to increase well-being and prevent or mitigate the effects of traumatic stress leading to behavioral health disorders and suicidality. The program endeavors to accomplish this through enhancing cognitive flexibility (CF) and emotional regulation (ER), key behavioral health mechanisms that act as protective buffers against traumatic stress. CF refers to the mental ability to switch between thinking about two different concepts according to the context of a situation. ER is a conscious or nonconscious strategy to start, stop, or otherwise modulate the trajectory of an emotion. STRENGTHEN will attempt to identify, modulate, and ultimately optimize the brain circuits responsible for CF and ER.
“Trauma and stress change brain networks’ function resulting in the cognitive rigidity and emotional dysregulation associated with mental illness, substance abuse, and suicidality,” said Dr. Greg Witkop, a former Army surgeon, who manages the STRENGTHEN program in DARPA’s Defense Sciences Office. “Current mental health intervention approaches rely on diagnostic categories based on descriptive symptoms rather than a mechanistic understanding of brain network dysfunction causing those symptoms. By identifying and optimizing the brain networks associated with cognitive flexibility and emotional regulation, STRENGTHEN seeks to heal — and prevent — changes in the brain networks caused by traumatic stress.”
STRENGTHEN will strive to enhance the mental protective mechanisms of CF and ER through two goals: (1) Development of individualized brain network models of CF and ER and (2) design of hybrid interventions to induce neuroplastic change in the functional connectivity and/or structure of CF and ER brain networks to optimize an individual’s CF and ER.
The STRENGTHEN program is collaborating with the Department of Defense’s Center for the Study of Traumatic Stress (CSTS) at the Uniformed Services University in Bethesda, Maryland. The DARPA-CSTS partnership will harness the substantial literature and scientific expertise in the field of ER and CF to promote the nascent effort to link them in neurocognitive models. The joint effort uses the National Institute of Mental Health’s Research Domain Criteria research framework and will attempt to develop the first suite of interventions to both prevent and treat the psychological impact of traumatic stress — often referred to as Invisible Wounds of War — and promote psychological health.