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.

This study will examine the efficacy of intranasal oxytocin versus placebo in combination with Alcohol Behavioral Couples Therapy (ABCT) to reduce alcohol use disorder severity. We will also use observational coding and neuroimaging to examine behavioral and neural mechanisms underlying treatment outcomes.

Alcohol use disorders (AUD) and intimate partner aggression (IPA) frequently co-occur. There are significant health and economic burdens associated with AUD and co-occurring IPA, and little empirical data to guide treatment efforts. The neuropeptide oxytocin may help mitigate both AUD and IPA. However, clinical data examining oxytocin's effects on human aggression is scant. The proposed study is designed to address these gaps in the literature by utilizing a human laboratory paradigm to test the effects of oxytocin on craving and aggression among couples with AUD and co-occurring IPA.