Individuals with posttraumatic stress disorder (PTSD) commonly experience sleep disturbance. Such disturbances can have a birdrectional effect in those with PTSD –interrupted sleep due to hypervigilance and nightmares are common symptoms of PTSD, and poor sleep is associated with a worse course of PTSD. Sleep disturbance can potentially be a prognostic factor in overall outcome in those seeking treatment for PTSD.
Our proposed project will explore the effect of sleep quality on PTSD outcomes and assess the
effect of treatment of PTSD on patient-reported sleep quality.
Posttraumatic stress disorder (PTSD) is linked to altered physiologic functioning, including increased blood pressure and heart rate, especially in response to stressors. Increased cardiovascular reactivity to trauma-related stressors may link PTSD to poorer cardiovascular health and thus an increased risk of cardiovascular disease. Prior work by our lab suggests that these effects of trauma may be due to persistent changes in the central and peripheral nervous systems’ stress-response system. While there is an urgent need to address these effects, limitations in our ability to effectively measure these changes have led to a paucity of data regarding the impact of current PTSD treatments on these important endpoints.
We propose to develop a novel emotional Stroop task that will quantify physiologic reactivity to interpersonal and affective cues, and quantify the impact of affective and physiologic reactivity on cognitive control. In a Veteran sample, we will characterize how performance on this task relates to PTSD symptom burden and physiologic reactivity to tilt-table testing, and gather pilot data assessing its response to pharmacologic treatment.
Trauma and posttraumatic stress disorder (PTSD) are common in veteran and civilian populations. Meanwhile, observationally estimated half of people cared for at UW autonomic nervous system (ANS) disorder clinic have a history of trauma. Increasingly, research explains this observation through an evolving understanding of the complex interplay of peripheral and central catecholamine signaling that appear to underlie much of the persistent impact of trauma. An improved understanding of ANS changes in trauma and their relationship to the complex symptoms people experience is an important research frontiers to improve a) our understanding of PTSD, b) our ability to predict effective treatment for a given person, and c) the development of new treatments for PTSD. We propose implementing a novel analysis method for non-invasive autonomic testing in context of several clinical studies at VA Puget Sound. The proposed research aims to 1) make use of ANS testing results already available to provide quantitative data for adrenergic signaling, 2) test associations of extracted biomarkers with symptoms of PTSD, and 3) collect prospective data to test the relationship of peripheral autonomic signaling to quantitative measures of central nervous system (CNS) catecholamine signaling measured by event-related potential (ERP).
Post-traumatic stress disorder (PTSD) and substance use often go hand in hand, with many people using substances like cannabis to manage their symptoms. This concept, known as the self-medication hypothesis, suggests that people might use cannabis differently depending on the nature of their symptoms. Symptoms are classically split into domains – hyperarousal, emotional numbing, re-experiencing, and avoidance. However, it remains unclear whether different patterns of cannabis use might correspond to specific symptom domains, which could reveal distinct clinical phenotypes of PTSD.
By analyzing data from the PREDICT clinical trial, this study will apply advanced statistical methods to identify unobservable (“latent”) factors that characterize cannabis use in individuals with PTSD and examine their relationship with symptom presentation. In statistics and psychometrics, latent refers to a variable that cannot be directly observed—such as internal motivations, behavioral tendencies, or physiological dependence—but which can be inferred from patterns in observed data (e.g., questionnaire responses). These patterns could offer insights into subgroups of people with PTSD who experience different symptom profiles, also known as phenotypes, and may respond to treatments in unique ways. Ultimately, this research could contribute to more personalized, targeted interventions for individuals living with PTSD.
This research project focused on existential distress (death anxiety, existential isolation, true-self incongruence, inauthenticity, low self-concept clarity, and limited future time perspective) among individuals with chronic pain, PTSD, and co-occurring chronic pain and PTSD.
The COVID-19 pandemic facilitated simultaneous paradigm shifts in healthcare delivery: virtual care (telehealth and videoconferencing) and the need for “Whole Person” healthcare that targets mind, body, and spirit, per recent US Surgeon General1 and National Academy of Medicine2 calls-to-action. The pandemic also highlighted treatment delivery inequities involving rural Veterans. The current proposal will address these trends, assessing virtual VA Whole Health care use in Primary Care-Mental Health Integration (PC-MHI) for rural and non-rural Veterans with chronic pain and co-occurring posttraumatic stress disorder (PTSD).
The aim of the project is to conduct a pragmatic pilot trial of a CIH-based stepped care approach v. treatment as usual in two primary care settings (one rural and one urban). The pilot trial will focus on feasibility, acceptability, and appropriateness for providers and patients (e.g., randomization, retention, and treatment satisfaction) of the stepped care approach versus usual care (n=30 per site, N=60 total). Primary clinical outcomes are pain interference and PTSD symptoms at 6-months.
This PTSD-focused methods-development EEG project aims to develop new tools for a) predicting PTSD treatment response, b) understanding the underlying biological process, and c) supporting the development of new treatments for PSTD. We are using an event-related potential (ERP) paradigm to develop non-invasive, easily implemented in clinic biomarker to provide useful information about the neurobiology of PTSD. The specific goals are to 1) collect ERP data within a veteran population before and after treatment with methylphenidate, 2) design data analysis methods that maximize available data, and 3) add to ongoing effort of translating technological advancements for PTSD research.
The goal of this study is to understand the impact of stigma on mental health and recovery from trauma in different parts of the country.
The proposed research will determine whether primary care clinics should offer medications or talk therapy first to treat posttraumatic stress. In addition, for patients who do not respond to the first treatment, the STEPS trial will determine what treatment should be offered next. More information on our info sheet.
