The current investigation uses a brain-based technique, transcranial magnetic stimulation (TMS), which has helped to treat depression, to try to stimulate those brain regions understood to be essential to emotional experience and impaired in PTSD. In summary, the aim is to enhance emotion engagement and regulation and possibly uncover new brain-based interventions that could help ready the brain so an individual with PTSD could then fully engage and thus optimize emotion-focused psychotherapy.

We recently published results from a NIDA-funded study of a brief behavioral treatment that was designed to reduce the troublesome cravings that smokers encounter when they attempt to quit smoking. This intervention was based on a growing body of neuroscience studies showing that memories for prior learning can be retrieved by the presentation of cues involved in that learning. Once retrieved, the memories enter into a brief period of vulnerability, during which they can be modified, but after which they are reconsolidated (restabilized) back into long-term storage. The treatment potential of this phenomenon was initially demonstrated in a Science report in which inpatient heroin addicts were briefly exposed to cues associated with heroin use in order to prompt the heroin use memories into a vulnerable state. Once the memories were in this state, the heroin addicts received extinction training consisting of protracted exposure to heroin associated cues. It was argued that extinction would change the memories such that the cues would no longer be associated with heroin administration and reward. Remarkably, after just two sessions of retrieval-extinction training (RET), the investigators found that craving in response to heroin cues was substantially reduced for up to 6-months post-treatment. This effect was observed relative to a control group that received retrieval involving non-heroin cues, followed by extinction. These impressive initial findings led us to replicate and extend the study in cigarette smokers. In our study, one group of smokers received two sessions of RET with smoking cues whereas a control group received the same training except that retrieval consisted of brief exposure to neutral, smoking-unrelated cues. Craving and other reactions to familiar and novel smoking cues were assessed in test sessions performed 24-hrs, 2-weeks and 1-month after intervention; smoking behavior was also assessed over 1-month follow-up. Remarkably, at 1-month follow-up, craving to both familiar and novel smoking cues was significantly lower in the group receiving R-E training vs. control. Even more striking was the 25% reduction in the number of cigarettes smoked per day in the RET group vs. control. [Also of significance was suggestive evidence that, relative to control participants, more participants in the RET group achieved a 60% reduction in smoking (from pretreatment levels)]. The proposed project will replicate and extend these findings by 1) increasing the dose of intervention so as to bolster the observed treatment effects, 2) employing brain imaging methods to identify patterns of brain activity uniquely associated with the intervention and potentially predictive of treatment outcome, 3) adding a control group that will enhance understanding of the effects of RET, and 4) extending follow-up period to more completely document the long-term effects of RET. Positive findings from this study could lead to the development of a brief, effective behavioral intervention to reduce the burden levied against society by smoking. Importantly, this intervention could be easily adapted to treat other forms of addiction and co-occurring anxiety disorders, such as PTSD.

Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition that affects our nation's Veterans at staggering rates. The purpose of this study is to examine the ability of a medication (oxytocin) to enhance Prolonged Exposure (PE) therapy for Veterans with Posttraumatic Stress Disorder (PTSD). PE is a widely used cognitive behavioral intervention (talk therapy) for Posttraumatic Stress Disorder (PTSD). In order to accomplish this goal, we are recruiting participants for a clinical trial. Participants enrolled in this trial will complete 10 weeks of a treatment phase, that includes weekly doses of either the investigational study medication or an inactive placebo. In addition, all participants will receive 10 weekly sessions of PE talk therapy. Once per week before each therapy session, participants will take a dose of medication intranasally. This study has the potential to improve patient care practices, advance the science in this area, and decrease public health costs.

The purpose(s) of the research is to test a new medication in combination with a talk therapy for Veterans experiencing posttraumatic stress disorder (PTSD) and who may have alcohol use disorder (AUD). The study consists of 12 weekly therapy sessions. Once per week before each therapy session, an intranasal dose of investigational medication will be administered. The study also involves 3 and 6-month follow-up appointments and the administration of questionnaires at each visit.

The purpose of this study is to explore the use of a new treatment program to improve medication adherence for people with HIV and PTSD for patients at local HIV care clinics. Participants will be assigned to one of two groups. Participants in Group A will be asked to attend 12 clinic sessions (twice a week for 6 weeks, 90-minute sessions) via telehealth or in person at a HIV care clinic. Participants in Group B will receive a one session adherence intervention (60 minutes) and get the same standard treatment that someone with a trauma history and co-occurring HIV and PTSD symptoms would receive at a local HIV care clinic. The study is provided at no-cost, and participants may learn useful information and coping skills while being in the study. It is hoped the information that we get from this study will help researchers and clinicians better design treatment programs for people living with HIV and PTSD. Participants will receive study compensation for their time.

The need to advance knowledge and increase access to treatment for co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is a priority for service members and Veterans. PTSD and SUD often co-occur and are two of the most common and debilitating mental health disorders among service members and Veterans. However, few providers are trained in this approach and therefore are not prepared to deliver best practice care to Veterans who need integrated PTSD/SUD treatment.
This project will directly address this critical gap in provider training to improve the care of Veterans with comorbid PTSD/SUD, by providing development and testing of a web-based provider training course for concurrent treatment of PTSD and SUD Using prolonged exposure (COPE).

A large proportion of individuals with alcohol use disorder (AUD) also meet criteria
for posttraumatic stress disorder (PTSD). Trauma-focused, cognitive-behavioral therapy delivered alongside interventions for substance use disorders are most effective. Cognitive Processing Therapy (CPT) for PTSD and Relapse Prevention (RP) for AUD are two of the most widely used and effective treatments for these
conditions. The purpose of this study is to examine the CPT-RP, as compared to RP alone, in reducing (1) alcohol use frequency and quantity and (2) PTSD symptom severity among individuals with current AUD/PTSD.

Researchers recently developed two new, computer-administered, brief questionnaire assessments of posttraumatic stress disorder (PTSD). The purpose of this study is to determine if these new assessments are accurate by comparing them with existing assessments for PTSD. To do this, we plan to administer the new questionnaires, existing questionnaires, and interview questions to 350 veterans with and without PTSD.

Veterans will be recruited from the Ralph H. Johnson VA Health Care System and Savannah CBOC.

The purpose of this study is to compare the effectiveness of two psychological treatments for the reduction of suicide attempts among U.S. military personnel and veterans, and to identify the reasons why and how these treatments work.

Specifically, this study is looking at the efficacy of two interventions. The first intervention is Present Centered Therapy (PCT). This treatment has been shown to reduce depression, PTSD symptoms, and suicidal thoughts. The second intervention is Brief Cognitive Behavioral Therapy (BCBT). This treatment has also been shown to reduce depression, PTSD symptoms, and suicidal thoughts.

Both treatments involve a total of 12-16 sessions scheduled once or twice each week. Patients who have received either treatment have reported significant reductions in suicidal thoughts and psychological symptoms. These two treatments differ from each other with respect to the specific procedures and techniques used. The purpose of this study is to determine if one treatment works better than the other, or if they are equal to each other with respect to outcomes.

This study is only open to Veterans at the Ralph H. Johnson VA Health Care System and CBOCs or active duty military personnel in the Charleston, SC and Savannah, GA areas.

Intimate partner violence (IPV) is a serious public health problem that results in significant health and economic burdens including mortality, morbidity, and poor treatment outcomes. A well-developed field of research suggests that alcohol misuse and posttraumatic stress disorder (PTSD) can lead to IPV. Individuals with PTSD and/or problematic drinking behaviors are at risk for IPV because of several factors that are common symptoms of PTSD. Because individuals with PTSD often drink alcohol to "self-medicate" or cope with distressing PTSD symptoms, PTSD co-occurs with alcohol misuse and alcohol use disorder at extraordinarily high rates. However, few studies have examined the combined effects of alcohol misuse and PTSD on any form of violence.

This study will examine the effects of alcohol misuse and posttraumatic stress disorder (PTSD) on alcohol-related intimate partner violence (IPV). We will examine these associations among couples (N=70) in a controlled laboratory setting using validated, standardized methods in a 'real-world' settings using 28 days of ecological momentary assessment (EMA). EMA includes very short surveys (5 minutes or less) that participants respond to on a smartphone application. Participants will be asked to respond to these surveys in the morning and three additional times throughout the day.