Research
Finding the best ways to prevent and treat psychological health problems in military service members, veterans, and first responders

Pilot Study of Brain Stimulation Combined with Writing Therapy for PTSD

Casey Straud, PsyD
The University of Texas Health Science Center at San Antonio
Evaluate the safety, feasibility, and psychological and physiological treatment benefits of transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, when delivered in combination with Written Exposure Therapy for posttraumatic stress disorder.
Expecting to start enrollment in summer 2022

Project MARCH: Multisite Advancement of Research on Chronic Posttraumatic Headache

Donald McGeary, PhD
South Texas Veterans Health Care System (STVHCS), San Antonio, TX , VA Palo Alto Health Care System, Palo Alto, CA , Minneapolis VA Health Care System, Minneapolis, MN , U.S. Army Health Clinic, Schofield Barracks, Honolulu, HI , Carl R. Darnall Army Medical Center (CRDAMC), Fort Hood, TX , Brooke Army Medical Center (BAMC), Joint Base San Antonio-Fort Sam Houston, TX , Walter Reed National Military Medical Center (WRNMMC), Bethesda, MD
Compare the effectiveness of two forms of a manualized behavioral health intervention for posttraumatic headache (PTH) to usual care in a sample of U.S. military personnel and veterans with chronic PTH.
Enrollment pending

Decreasing Suicide Risk among Service Members with Posttraumatic Stress Using Written Exposure Therapy

Brian P. Marx, PhD
Carl R. Darnall Army Medical Center, Fort Hood, Texas
Determine whether Written Exposure Therapy for Suicide reduces suicidal thoughts and behaviors and posttraumatic stress symptoms (PTSS); determine whether reductions in PTSS severity lead to fewer suicidal thoughts and behaviors.
Enrollment complete

Two-Armed Pilot Randomized Controlled Trial of Massed Prolonged Exposure Plus Cannabidiol or Placebo for Posttraumatic Stress Disorder

Casey Straud, PsyD
The University of Texas Health Science Center at San Antonio
Examine the safety, feasibility, and symptom reductions associated with cannabidiol (CBD) in military veterans receiving 2 weeks of daily treatment with Prolonged Exposure, a leading therapy for posttraumatic stress disorder (PTSD). Evaluate potential biochemical and physiological changes associated with CBD vs. placebo and the relationship of those changes with the physiological stress response and PTSD symptom reduction.
Currently enrolling study participants

Targeting Chronic Pain in Military Primary Care Settings Using Internal Behavioral Health Consultants

Donald McGeary, PhD, & CAPT Jeffrey Goodie, PhD
Primary care clinics at Fort Hood, TX, Joint Base San Antonio - Lackland, and Joint Base San Antonio - Fort Sam Houston
Enhance delivery of chronic pain care in U.S. military primary care clinics by developing a manual and training program for providers in a drug-free pain management therapy that helps to reduce the use of opioid medications; evaluate the program in a pragmatic clinical trial involving patients with chronic pain.
Enrollment in Phase II began in 2021.

Multi-Couple Group Intervention for PTSD

Steffany Fredman, PhD
Carl R. Darnall Army Medical Center, Fort Hood, Texas
Obtain preliminary data on the feasibility and efficacy of delivering couple-based treatment for PTSD within a multiple-couple group setting during a weekend retreat; evaluate the therapy’s impact on the severity of service members’ and veterans’ PTSD symptoms and co-occurring conditions, partners’ psychological well-being, and each partner’s relationship satisfaction.
Enrollment closed. Investigators analyzing data and publishing study findings.

A Pilot Randomized Controlled Trial of Treatment for Trauma-Related Nightmares in Active Duty Military Personnel

Kristi Pruiksma, PhD
Sleep Disorders Clinic, Carl R. Darnall Army Medical Center, Fort Hood, TX
Working with active duty military personnel who suffer from trauma-related nightmares, obtain preliminary data on the efficacy of a form of cognitive-behavioral therapy designed for treating nightmares.
Enrollment closed. Investigators analyzing data and publishing study findings.

Network Dysregulation Among Individuals with Comorbid Tinnitus and PTSD

John Moring, PhD
University of Texas Health Science Center at San Antonio
In military veterans with co-occurring PTSD and tinnitus, examine whether a leading psychotherapy for PTSD also leads to reductions in tinnitus-related distress when PTSD is treated successfully. Concurrently, evaluate brain activity before, during, and after PTSD treatment to better understand the brain network disruptions that cause and maintain PTSD and tinnitus and how those brain networks are impacted by successful PTSD treatment.
Enrollment closed. Investigators analyzing data and publishing study findings.

An Open Trial of Web-Prolonged Exposure (Web-PE) for PTSD among Active-Duty Military Personnel and Veterans

Carmen McLean, PhD
Online nationwide
Improve access to PTSD treatment by evaluating whether 10 sessions of Prolonged Exposure therapy delivered via the Internet over eight weeks (Web-PE) is effective in reducing PTSD symptoms.
Enrollment closed. Investigators analyzing data and publishing study findings.

Project Remission: Maximizing Outcomes with Intensive Treatments for Combat-Related PTSD

Alan L. Peterson, PhD, ABPP (Lt Col, US Air Force, Ret.)
Carl R. Darnall Army Medical Center (CRDAMC), Fort Hood, TX, Central Texas Veterans Health Care System (CTVHCS), Waco, TX, University of Texas Health Science Center at San Antonio (UT Health San Antonio), Brooke Army Medical Center (BAMC), South Texas Veterans Health Care System (STVHCS), San Antonio, TX
Evaluate two intensive outpatient formats of Prolonged Exposure therapy for active duty service members and veterans with combat-related PTSD.
Enrollment closed. Investigators analyzing data and publishing study findings.

Image-guided Robotically Delivered Transcranial Magnetic Stimulation for Combat-Related PTSD: a Double-Blind, Randomized, Placebo-Controlled Clinical Trial

Peter Fox, MD
Laurel Ridge Treatment Center, San Antonio, Texas
Test active duty military personnel and veterans for PTSD symptom improvements resulting from electromagnetic stimulation to the brain; test for changes in brain network functionality induced by electromagnetic stimulation.
Enrollment closed. Investigators analyzing data and publishing study findings.

The Efficacy of 90-Minute vs. 60-Minute Sessions of Prolonged Exposure for PTSD: A Randomized Controlled Trial in Active Duty Military Personnel

Edna Foa, PhD
The University of Texas Health Science Center at San Antonio, Medical University of South Carolina
Determine whether therapy sessions for a proven PTSD treatment, Prolonged Exposure (PE), can be shortened to 60 minutes from the standard 90 minutes without compromising PE's high success rate. Improve understanding of how PE helps patients recover and how to enhance its benefits by observing what factors are related to PTSD symptom reduction during therapy, utilizing patient and provider reports as well as measurable physiological markers of stress.
Enrollment closed. Investigators analyzing data and publishing study findings.

Doxazosin in the Treatment of Co-Occurring PTSD and Alcohol Use Disorder (PATRIOT Study)

Sudie Back, PhD, & Julianne Flanagan, PhD
Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, Savannah VA Outpatient Clinic, Savannah, GA
Determine the efficacy of the medication doxazosin in reducing the severity of posttraumatic stress disorder and alcohol/substance use in veterans with both PTSD and alcohol/substance use disorder; establish guidelines for measuring progress during clinical trials involving veterans with those disorders.
Enrollment closed. Investigators analyzing data and publishing study findings.

Ketamine for Antidepressant-Resistant PTSD

John Krystal, MD
Clinical Neurosciences Division of the U.S. Department of Veterans Affairs' National Center for PTSD, West Haven, Conn., Minneapolis VA Health Care System, Minneapolis, Minn., Brooke Army Medical Center (BAMC)
Evaluate the safety and efficacy of the drug ketamine in treating posttraumatic stress disorder and depression in active duty military personnel and veterans with PTSD who do not respond to treatment with antidepressant medications.
Enrollment closed. Investigators analyzing data and publishing study findings.

Establishing Efficacy of a Functional-restoration-based Pain Management Program

Donald McGeary, PhD
South Texas Veterans Health Care System (STVHCS), Polytrauma Rehabilitation Center, San Antonio, TX
Evaluate the effectiveness of a Complementary and Integrative Health pain management program for veterans with chronic, polymorbid pain and compare that against the current standard treatment methods. The goal is to develop a blueprint for a drug-free alternative for pain management that decreases use of opioid pain medications in veterans who suffer from pain and trauma symptoms.
Enrollment closed. Investigators analyzing data and publishing study findings.

Conjoint Therapy for Pain Management: A Pilot Study

Cindy McGeary, PhD, & Tabatha Blount, PhD
University of Texas Health Science Center at San Antonio
Working with couples in which a partner suffers from chronic musculoskeletal pain, determine the feasibility of Conjoint Therapy for Pain Management. Assess how well the therapy helps to improve pain-related functioning. Measure the therapy’s contribution to couples’ psychological wellbeing, relationship satisfaction, and communication with each other.
Enrollment closed. Investigators analyzing data and publishing study findings.

Clinical Effectiveness Trial of In-Home Cognitive Processing Therapy for Combat-Related PTSD

Alan L. Peterson, PhD, ABPP (Lt Col, US Air Force, Ret.)
The University of Texas Health Science Center at San Antonio
Working with service members and veterans with posttraumatic stress disorder (PTSD), evaluate the feasibility and effectiveness of Cognitive Processing Therapy (CPT) delivered in the standard, face-to-face, in-office format as compared to CPT delivered in a patient's home, either in-person or via video teleconference (similar to Skype). Determine whether in-home therapy enhances treatment and improves patient outcomes, and whether it can be delivered to special populations, such as homebound patients and those in rural areas.
Enrollment closed. Investigators analyzing data and publishing study findings.

Brief Treatment for PTSD: Enhancing Treatment Engagement and Retention

Denise Sloan, PhD
University of Texas Health Science Center at San Antonio (UT Health San Antonio), Killeen, Texas, near Fort Hood
Examine whether a form of narrative therapy in which patients write about their trauma is as effective in treating PTSD as a gold-standard form of talk therapy. Examine whether the narrative therapy, with a shorter course of treatment and fewer time demands, leads to increased patient retention and overall treatment satisfaction.
Enrollment closed. Investigators analyzing data and publishing study findings.

Randomized Clinical Trial of Cognitive-Behavioral Therapy for Posttraumatic Headache

Donald McGeary, PhD
South Texas Veterans Health Care System (STVHCS), Polytrauma Rehabilitation Center, San Antonio, University of Texas Health Science Center at San Antonio (UT Health San Antonio)
Evaluate the effectiveness of a manualized behavioral health intervention for posttraumatic headache in Iraq and Afghanistan war veterans with co-occurring symptoms of posttraumatic stress.
Enrollment closed. Investigators analyzing data and publishing study findings.

Using Emotion Regulation to Decrease Aggression in Veterans with PTSD

Shannon Miles, PhD
James A. Haley Veterans' Hospital, Tampa, Florida
Evaluate emotion regulation training designed to decrease aggression in combat veterans who suffer from PTSD and impulsive aggression. Examine if the training prepares veterans for initiating PTSD treatment.
Enrollment complete. Investigators analyzing data and publishing study findings.

Treatment of Comorbid Sleep Disorders and PTSD

Daniel Taylor, PhD
Carl R. Darnall Army Medical Center, Fort Hood, Texas
Examine whether and how to incorporate a cognitive-behavioral intervention for insomnia and nightmares with PTSD treatment to achieve the greatest treatment benefits in patients suffering from PTSD and sleep problems.
Enrollment closed. Investigators analyzing data and publishing study findings.

Variable-Length Cognitive Processing Therapy for Combat-Related PTSD

Patricia Resick, PhD
Carl R. Darnall Army Medical Center, Fort Hood, TX
Evaluate the effectiveness of Cognitive Processing Therapy-cognitive only version (CPT-C) for combat-related PTSD when treatment length is adjusted to fit the individual needs of service members. Identify factors that can help predict how quickly an individual will respond to treatment. Determine how well CPT improves related problems (e.g., depression, difficulties in social and family functioning).
Enrollment closed. Investigators analyzing data and publishing study findings.

Comparing Internet and In-Person Brief Cognitive Behavioral Therapy of Insomnia

Daniel Taylor, PhD
Carl R. Darnall Army Medical Center, Fort Hood, Texas
Evaluate in-person and Internet-based forms of cognitive behavioral therapy for insomnia with a military population. Determine the benefits of these interventions on improvement in sleep as well as on common co-morbid conditions such as depression, substance abuse, and PTSD symptoms.
Enrollment complete. Investigators analyzing results and publishing research findings.

A Study of Dog Adoption in Veterans with Posttraumatic Stress Disorder

Stephen Stern, MD
South Texas Veterans Health Care System: Audie L. Murphy VA Hospital, San Antonio
Evaluate whether adopting a pet dog from the San Antonio Humane Society as a supplement to usual care can reduce psychological distress and improve quality of life for Veterans with PTSD.
Enrollment closed. Investigators analyzing data and reporting study findings.

The Role of Exercise in the Treatment of PTSD Symptoms

Stacey Young-McCaughan, RN, PhD (COL, US Army, Ret.)
Carl R. Darnall Army Medical Center, Ft. Hood, TX
Explore the role of exercise in the treatment of symptoms of PTSD to see if treatment can be improved with exercise.
Enrollment closed. Investigators analyzing data and publishing study findings.

SSRI Treatment of Dual Diagnosis PTSD and Alcohol Dependence: A Test of the Serotonergic Hypothesis

John Roache, PhD
South Texas Veterans Health Care System (STVHCS), San Antonio, Texas
Examine how alcohol use disorder impacts the effectiveness of selective serotonin reuptake inhibitor (SSRI) antidepressants used as the only FDA-approved medication for the treatment of PTSD. Specifically, identify patient characteristics predicting the response to SSRI treatment, which would give clinicians a valuable tool to assess who would or would not benefit from such treatment.
Enrollment closed.

Brief Cognitive Behavioral Treatment of Deployment-Related PTSD in Primary Care Settings: A Randomized Controlled Trial

Jeffrey Cigrang, PhD (Lt Col, US Air Force, Ret.)
Wilford Hall Ambulatory Surgical Center (WHASC), Brooke Army Medical Center (BAMC), Joint Base San Antonio-Randolph
Evaluate a condensed cognitive behavioral therapy (CBT) for PTSD that can be implemented by mental health providers working in an integrated primary care setting. Determine whether this treatment delivery method is well received by military personnel; its efficacy in reducing PTSD symptoms; and the level of PTSD severity that is appropriate for this form of treatment.
Enrollment closed. Investigators analyzing data and publishing study findings.

Brief Cognitive-Behavioral Intervention for Managing Suicidal Behaviors in Military Settings

M. David Rudd, PhD, ABPP
Fort Carson, CO
Evaluate the efficacy of a brief cognitive-behavioral intervention for managing suicidal behaviors in military mental health patients, with the ultimate goal of decreasing suicide and self-harm behaviors among service members.
Enrollment closed. Investigators analyzing data and reporting study findings.

Individual PE vs. Couples' Cognitive-Behavioral Therapy for Combat-Related PTSD

Candice Monson, PhD
Wilford Hall Ambulatory Surgical Center (WHASC), Brooke Army Medical Center (BAMC), University of Texas Health Science Center at San Antonio (UT Health San Antonio), Carl R. Darnall Army Medical Center, Fort Hood, TX (CRDAMC)
Compare the efficacy of traditional Prolonged Exposure therapy, an evidence-based therapy that involves only the individual service member, to Cognitive-Behavioral Couples Therapy, which involves the service member and spouse and incorporates behavioral communication skills with traditional aspects of Cognitive Processing Therapy to address both individual and couple-level distress.
Enrollment closed. Investigators analyzing data and publishing study findings.

Outcomes of Prolonged Exposure and Cognitive Processing Therapy used in the Treatment of Combat Operational Stress Reactions in Deployed Settings

Alan L. Peterson, PhD, ABPP (Lt Col, US Air Force, Ret.)
Designated U.S. military sites in Iraq and Afghanistan
Conduct a pilot investigation to evaluate the treatment outcomes of deployed service members who show symptoms of combat operational stress reactions, including PTSD and acute stress disorder, and who receive CPT or PE therapy from military mental health providers in Iraq and Afghanistan. Follow treatment gains over time to provide much-needed insight on the efficacy of the leading non-pharmacologic treatments for stress-related disorders when delivered “in theater” and to guide the development of a larger, randomized clinical trial.
Enrollment closed. Investigators analyzing data and reporting study findings.

Treatment of Chronic Stress Reaction and Chronic Pain after Traumatic Orthopedic Injury

Robert Gatchel, PhD
Wilford Hall Ambulatory Surgical Center (WHASC), Brooke Army Medical Center (BAMC), South Texas Veterans Health Care System (STVHCS), San Antonio, Texas
Identify the comorbidity of orthopedic trauma and traumatic stress in an active-duty military population and evaluate a preventive behavioral health treatment strategy aimed at helping to retard or halt the development of PTSD and chronic pain.
Enrollment closed. Investigators analyzing data and reporting study findings.

Cognitive Processing Therapy for Combat-Related PTSD

Patricia Resick, PhD
Carl R. Darnall Army Medical Center, Fort Hood, Texas
Evaluate the efficacy of CPT for combat-related PTSD in an active-duty military population and determine whether the more efficient delivery of group CPT is as effective as individual CPT.
Enrollment closed. Investigators analyzing results and publishing study findings.

Prolonged Exposure for PTSD among OIF/OEF/OND Personnel: Massed vs. Spaced Trials

Edna Foa, PhD
Carl R. Darnall Army Medical Center, Fort Hood, Texas
Evaluate the efficacy of PE therapy for combat-related PTSD in an active-duty military population and determine whether a condensed delivery method maintains efficacy while improving efficiency.
Enrollment closed. Investigators analyzing data and publishing study findings.