CAP: Neurobiological Predictors and Mechanisms in Exposure Therapy for PTSD

Principal Investigator: Sheila A.M. Rauch, PhD
Aim: Identify changes in levels of certain hormones, steroids, and other biological substances to “track” improvements in patients’ PTSD symptoms over the course of treatment; determine the specific changes associated with two different forms of psychotherapy.
Prolonged Exposure, or PE, is one of the most effective treatments for posttraumatic stress disorder. The therapy has helped many PTSD patients face thoughts, feelings and situations that they have avoided due to distress. Even with this effective therapy, however, many patients continue to suffer with PTSD symptoms following treatment.

In this study for the Consortium to Alleviate PTSD, a research team led by Sheila A.M. Rauch, PhD, of the Emory University School of Medicine and Atlanta VA Medical Center, will use neuroscience methods in an effort to learn how effective therapy for PTSD works on a biological level in order to learn how to make it work even better.

Neurobiological studies have found links between PTSD severity and the levels of certain compounds produced by the body. Dr. Rauch and her fellow CAP investigators want to know if changes in the levels of those substances can serve as biomarkers of response to therapy and whether different therapies result in different biological changes.

To help answer such questions, this study will work with active duty post-9/11 war veterans receiving PTSD treatment through a separate clinical trial affiliated with the STRONG STAR Consortium. That study, led by Carmen McLean, PhD, of the University of Pennsylvania, compares Prolonged Exposure therapy delivered via the Internet with a supportive type of PTSD treatment called Present Centered Therapy, or PCT.

For the CAP study, Dr. Rauch and her colleagues will measure various neuroendocrine and neurosteroid substances before, during, and after the patients’ eight-week treatment period to see how those substances change in response to therapy, potentially shedding light on components of PE and PCT that are most effective. Substances to be measured include cortisol, allopregnanolone and related metabolites, and dehydroepiandrosterone.

Potential benefits
The ability to measure neurobiological processes in response to PTSD treatment will provide a guide for making improvements to treatment so that more patients will benefit. This study will inform our understanding of how therapy works (or does not work) and how we might improve treatments based on these biological responses.

Version: 11/12/2015

PI: SheilaRauch, PhD
Emory University School of Medicine and Atlanta VA Medical Center

Study Site:
Carl R. Darnall Army Medical Center, Fort Hood, Texas

On-Site Principal Investigator:
COL Jeffrey S. Yarvis, PhD, LCSW, BCD

Funding Source:
U.S. Departments of Defense and Veterans Affairs, Consortium to Alleviate PTSD award

Status of Study:
Currently enrolling study participants

Active duty military and veterans who have had a post-9/11 military deployment, who have PTSD symptoms and who also are enrolled in the STRONG STAR Consortium-affiliated study Web-PE: Internet-Delivered Prolonged Exposure Therapy for PTSD

Media Contact:
(210) 562-6700

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