PTSD: National Center for PTSD
Women's Health Sciences Division Research
Women's Health Sciences Division Research
The Women's Health Sciences Division specializes in women Veterans and Active Duty personnel, including research related to cognitive behavioral treatments for PTSD, psychological and physical health, and interpersonal violence including military sexual trauma. The Division has also been a leader in the development and dissemination of Cognitive Processing Therapy (CPT).
Work at the Division includes studies aimed at elucidating basic biological processes underlying PTSD, including a recently completed VA-funded study of sex hormones and derivatives associated with increased fear conditioning across the menstrual cycle in PTSD, a study of GABAergic neuroprotective steroids in men and women across the menstrual cycle, and a series of NIMH-funded studies of the gene-environment interplay in the comorbidity of PTSD and disordered eating.
Division investigators are also focused on developing and testing psychopharmacological interventions for PTSD, with several recently completed projects that include a Department of Defense (DoD)-funded double-blind, randomized, placebo-controlled trial of ganaxolone and a CIMIT/DoD-funded study investigating event-related potentials as a predictor of SSRI response in individuals with PTSD.
Several other intervention studies examine more efficient treatment formats for Cognitive Processing Therapy (CPT). With funding from DoD via the STRONG STAR consortium, investigators are completing studies that examine the relative effectiveness of CPT delivered in a group versus individual format, in office as compared to in home, and via telehealth as compared to in-person. In addition, the Division is investigating a variable-length CPT protocol to evaluate whether treatment benefits may be achieved in fewer sessions. Investigators are also examining strategies to more efficiently train clinicians in CPT and monitor fidelity in routine care settings, including an ongoing NIMH-funded study focused on improving and sustaining the delivery of CPT among previously trained clinicians who treat Veterans with PTSD. An additional VA-funded study examines the effect of tobacco use on recovery from PTSD during CPT treatment.
Other intervention studies focused on traumatized populations includes a recently completed VA-funded examination of the efficacy of contingency management supported tobacco cessation in Veterans with and without PTSD and a newly VA-funded study that will apply a physical exercise intervention to elucidate the shared neurobiology of PTSD and chronic pain. Another NIMH-funded intervention study is underway to examine the effectiveness and fit of a transdiagnostic treatment, the Unified Protocol, for trauma-exposed Veterans with co-occurring diagnoses. Additionally, an ongoing DoD-funded project examines a mindfulness-based training as a tool to assist Veterans coping with postdeployment intrusive thoughts.
The Division is continuing its research on the OEF/OIF/OND cohort, particularly in regard to the experiences of female Veterans. A large national survey of OEF/OIF Veterans that included the updated Deployment Risk and Resilience Inventory (DRRI-2) is now being used to investigate a wide range of research questions regarding the relationship between deployment experiences and postdeployment mental health.
The Division is continuing a large, national survey of male and female returning OEF/OIF Veterans (with women oversampled) designed to examine gender differences in deployment experiences and post-deployment adjustment. Recent work with this sample has included investigations of predictors of suicidal ideation and associations between deployment stressors, PTSD and nicotine use. Work with the OEF/OIF/OND cohort also includes a VA-funded examination of the effects of deployment stressors and associated mental health sequelae on female Veterans', as compared to male Veterans', occupational and family functioning over time.
Investigators are also conducting research on the associations between PTSD, treatment for PTSD, suicidal behavior, and death from suicide among VA healthcare users. For example, a cohort study funded by the American Foundation for Suicide Prevention examines differences in suicide and suicide attempts for female and male VHA patients with and without PTSD, with a particular focus on gender differences in the role of PTSD treatment as a moderator of these relationships.
Military Sexual Trauma and Partner Violence
Division staff are examining the role of sex hormones in the psychophysiological and biological correlates of PTSD in women, by assessing female subjects across their menstrual cycles. Additional projects that are underway include investigations on a twin model of eating disorders, comorbid conditions in women, and an NIMH-funded study of GABAergic neurotransmission in PTSD.
Exposure to interpersonal violence is a key issue of study at the Women's Health Sciences Division. Research related to military sexual trauma (MST) includes a recent qualitative investigation aimed at identifying unique factors associated with sexual trauma that occurs within a military context and a newly-funded investigation of Veterans' experiences with and preferences for the Veteran Health Administration's (VHA) universal MST screening program.
Intimate partner violence (IPV) among women Veterans is a growing area of focus. Research is examining best practices for IPV identification, assessment, treatment, and coordination of care within the VHA context. Focusing on interpersonal trauma more broadly, a recently initiated project will examine VHA primary care providers' experiences with and reactions to providing care to women Veterans with interpersonal trauma histories.