The goal of this study is to document the phenomenology and longitudinal course of illness in patients with sleep panic disorder, narcolepsy (associated with fear-induced cataplexy), sleep paralysis, PTSD, nightmare disorder (not associated with PTSD), and sleep seizures disorders. Subjects will complete questionnaires, complete semi-structured interview, and be guided to complete a timeline of life events and illness episodes, etc. A second visit will ensure completion of timeline information and allow clinicians to have information to plot on a life chart to view the longitudinal course of illness.
The 'dual burden' of (a) loss of a fellow service member in the context of (b) experiencing repeated extreme life threat is unique to military combat personnel and a core characteristic of combat-related Prolonged Grief Disorder (PGD), a disorder as prevalent as Post-traumatic stress disorder and associated with functional impairment, disability, and suicidality. Effective treatments for depression and PTSD have proven less than adequate in treating PGD when each is offered in isolation; and simply combining these 12-16 week treatment regimens into a 24-36 week treatments is not a viable approach, particularly with a population predisposed to avoiding extended mental health care. The proposed project addresses the need for a Veteran/ military specific treatment of PGD, and uses technology to deliver this treatment in a format that is far more likely to be accepted by military personnel and Veterans. This study will impact clinical practice by providing the first evidence for effective treatment PGD in Veterans.
Future Direction: The current available treatments for PTSD are not fully effective for cognitive symptoms of PTSD and have high drop-out and poor engagement, two factors found to be most indicative of overall return to functioning for patients with PTSD. Successful completion of this pilot clinical trial may build a platform for future large scale double-blind, placebo-controlled studies using either atomoxetine or psycho-stimulants or other cognitive enhancing medications. The response inhibition related measurements are sensitive to psychotropic medications. Therefore it is advantageous for us to use GNG and Stop Signal approaches to investigate individual treatments response in our future research. We believe GNG and Stop signal approaches together with pharmacogenetic approach will provide valuable information to direct future individualized medicine.
Although sex differences in brain development, structure and function are well known, few studies have explored how these differences contribute to risk and resilience to mental illness. Therefore, biomedical research studies investigating sex differences in brain physiology may lead to more effective intervention and treatment strategies.
To conduct a study using N-acetylcysteine (NAC) in young adults who bite their fingernails in order to determine if this medication may assist in their quit attempts or help them to resist the urge to bite their fingernails.
The objective of the proposed study is to investigate the cortical excitability in combat related PTSD. To accomplish this objective, we will recruit combat veterans with and without PTSD. Clinical assessment will be performed to assess the severity of PTSD and combat exposure. A newly developed transcranial magnetic stimulation approach will be applied to examine the cortical excitability, then genetic analysis will be used to learn how genetic factors influence individual cortical excitability. We expect this innovative approach will enhance our knowledge about the mechnism of PTSD development.
This study will provide preliminary information regarding the use of repetitive Transcranial Magnetic Stimulation (rTMS) in a medication-free adolescent population. We will be looking at what effects (good and bad) the rTMS treatment has on adolescent depression.
TMS is FDA approved for adults but there are very little data on its use in adolescents.
This is a randomized controlled trial comparing GMI to a control treatment condition (CT) across five critical outcomes. 186 Veterans in VA housing services (93 per treatment arm) will be enrolled with a diagnosis of alcohol or drug abuse/dependence. Recruitment will take place in Charleston VAMC HUD-VASH & GPD. Participants will be randomly assigned to (1) GMI or (2) CT, each consisting of 4 sessions, and will be evaluated at 1, 3, and 6 months. Participants with a non-substance related DSM-IV-TR major Axis I disorder (e.g., MDD, PTSD) will be eligible for the study. Analyses will be conducted using generalized linear mixed models (GLMM) approach.
This research is sponsored by the National Institute on Drug Abuse Clinical Trials Network. This study is evaluating the safety and efficacy of the medication N-acetylcysteine (NAC) to help adults with marijuana dependence quit using marijuana. NAC has been approved by the Food and Drug Administration (FDA) for use in adults and children for other uses, but has not been approved by the FDA for treatment of marijuana dependence. The use of NAC is investigational for the purpose of this study, meaning that we are studying whether or not this medication is effective for marijuana cessation in adult marijuana users.
The study is being done at six sites across the country and will enroll approximately 300 participants in total. Approximately 40-60 participants will be enrolled at the Medical University of South Carolina.
Suicide is the tenth leading cause of death in the United States with approximately 30,000 civilian deaths annually. Suicide has continued to increase in the military and is particularly high among Veterans. Omega-3 Highly Unsaturated Fatty Acids (HUFAs) are essential for brain function and must be obtained from food. US food production practices over the last century have resulted in a dramatic change in the fatty acid profile of the US diet. At the same time, evidence continues to build regarding the potential importance of omega-3s on emotional state, thinking and mental health. Nearly all US military personnel have low n-3 HUFA status. The purpose of this study is to investigate whether supplementation with omega-3s will reduce the risk for suicidal behaviors, depression, and PTSD in a Veteran population. Sub-analyses will evaluate associated alcohol use disorders and the neurological impact of the omega-3 fatty acid action using functional magnetic resonance imaging. The potential outcome of this study would be information supporting the role of dietary supplements of omega-3 fatty acids contributing to reducing suicide risk and associated mental disorders.