Targeted Condition: PTSD

Communication and Recovery Enhancement (CARE) clinical trial

This study aims to refine and test a brief intervention (CARE) that aims to promote recovery in recent sexual assault survivors. CARE is delivered to supporters of sexual assault survivors (e.g., friends, family members, romantic partners), with or without the survivor present. It aims to encourage conversations about the assault and decrease negative reactions by the supporter. In stage 1 of this study, we will conduct feedback sessions with 8-10 dyads of survivors and their supporters to finalize the intervention materials. In stage 2, we will conduct a pilot clinical trial of CARE with 60 dyads, who will be randomized to dyadic intervention, supporter-only intervention, or waitlist control.

Project THRIVE pilot

This study involved developing and preliminarily testing a new app to prevent PTSD and alcohol misuse following recent sexual assault.

Understanding mental health problems and health risk behaviors among LGBT Veterans

LGBT Veterans have faced a long history of stigma, discrimination, and exclusionary policies that were intended to exclude them from military service. Despite recent shifts in policy and increased staff trainings, existing evidence suggests that this group is at high risk for health disparities, particularly with respect to mental health and health risk behaviors. While informative, the research to date has been limited in several respects: cross-sectional designs, collapsing LGBT subgroups, severe lack of data on some subgroups, problems with identifying a comparison group, and lack of data on risk and protective factors and care experiences. This prospective cohort study will fill these gaps, recruiting and conducting surveys online with 1,600 Veterans to identify health disparities, test a conceptual model of prospective risk and protective factors, and assess VA utilization, barriers to care, and treatment preferences. Data from this study will inform future intervention efforts to achieve health equity for LGBT Veterans.

MOVE!+UP: Testing a tailored weight management program for Veterans with PTSD

This Hybrid Type 1 Trial will test the effectiveness of MOVE!+UP, a behavioral weight management intervention tailored to address PTSD-based weight loss barriers. The trial will compare MOVE!+UP to VA’s standard weight loss program on weight and PTSD symptom changes. The study also will identify implementation barriers and facilitators to help understand effectiveness findings and inform future implementation.

Development of F-18-Labeled Radiotracers for PET Imaging of Brain Alpha1A Adrenoceptor: A Tool for Precision Medicine in PTSD

Prazosin, a drug that prevents the neurotransmitter norepinephrine from binding to its alpha1 receptor (alpha1-AR) subtype has shown efficacy in reducing PTSD symptoms in most, but not all, studies of trauma-exposed Service Members, Veterans, and civilians. However, it is not effective in all patients and its use is complicated by variability in effective doses, a short duration of action, and frequent orthostatic hypotension at dose initiation.

We propose to develop a fluorine-18-labeled radiotracer for PET imaging of brain alpha1A-ARs (implicated in the pathophysiology of PTSD) in human subjects so as to create a PET-based method to identify alpha1A-AR blocking drugs that are more broadly effective and lack the shortcomings of prazosin. Displacement of radiotracer binding by drug candidates will allow assessment of their actions at brain alpha1A-ARs and facilitate the development of novel PTSD therapeutics.

Validating a non-invasive imaging method to measure astroglial water transport in brain health and disease

We aim to determine the accuracy and specificity of Arterial spin labeling (ASL) — a non‐invasive perfusion technique used in MRI to track cerebral blood flow — in measuring vascular and glial‐dependent water transfer to establish whether it is a valuable clinical tool in Alzheimer’s disease. This simple and safe technique, already approved for use in a clinical setting, has potential to circumvent current invasive approaches in human subjects at risk for AD‐related dementias.

Does the microbiome play a role in adverse outcomes following mTBI and PTSD?

The proposed research will be a preliminary investigation into the potential association between microbiota abundance, hormone levels, peripheral inflammation and current symptoms (psychiatric and cognitive) in Veterans with and without a history of mild traumatic brain injury (mTBI). This work has the potential to form a new line of research that could ultimately provide new treatment options for individuals who have persisting symptoms following mTBI.

Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment

Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.