Prospective Cohort Study of Accelerated Resolution Therapy (ART) for Treatment of Military Psychological Trauma

This study entitled "Prospective Cohort Study of Accelerated Resolution Therapy (ART) for
Treatment of Military Psychological Trauma" is a prospective cohort treatment intervention
study (n=200) whereby U.S. service members and veterans with symptoms of PTSD will undergo
2-5 sessions of ART delivered by Florida licensed mental health professionals trained in
ART. Clinical assessments will be conducted pre-treatment, post-treatment (approximately 2
weeks after study entry), and at 6-month follow-up (self-report questionnaires). The study
aligns with the USF College of Nursing POWER initiative by seeking to expand the science
base of effective treatment of service members and veterans with impaired psychological
status. The study rationale is to: (i) demonstrate that ART is a brief, effective, and safe
treatment for military-related PTSD including military sexual trauma (MST) and among service
members with PTSD refractory to previous psychotherapy; (ii) provide evidence of the
sustainability of clinical response 6-months after treatment completion; (iii) provide
evidence that ART is a cost effective treatment for PTSD compared to current therapies
formally endorsed by the VA and DoD; and (iv) develop the infrastructure for expansion of
the ART protocol and science base, including national and international treatment settings,
expanded patient populations, expanded clinical services, and mechanistic studies of ART.
The target population (n=200) will consist of U.S. service members and veterans who have
symptoms indicative of a current diagnosis of PTSD. Oversampling will occur for participants
with a history of MST (minimum n=60) and/or PTSD refractory to prior psychotherapy (minimum
n=60). No age limit or duration of symptoms of PTSD will be imposed for study eligibility,
and it is anticipated that most, if not all, of eligible and enrolled participants will have
had prior deployments to conflicts dating back to the 1970s, including the Vietnam War,
Persian Gulf War, and the more recent wars in Iraq and Afghanistan. Demographic and medical
history data will be collected along with details of prior military service including
service branch, deployment location(s) and type of trauma(s). Participants will complete the
7-item Combat Exposure Scale and 3-item Brief Traumatic Brain Injury Screen. To evaluate
treatment response, measures completed at entry, post-treatment, and 6 months will include:
17-item PCL-M (PTSD Checklist), 125-item Psychiatric Diagnostic Screening Questionnaire,
18-item Brief Symptom Inventory (BSI), 34-item Clinical Outcomes in Routine Evaluation
(CORE-OM) scale, Medical Outcome Study Short Form-36, 20-item Center for Epidemiological
Studies Depression Scale (CES-D), 21-item State-Trait Inventory for Cognitive and Somatic
Anxiety (STICSA), 22-item Trauma-Related Guilt Inventory (TRGI), and use of medications. The
study will be conducted over a 24-month period.

Inclusion Criteria:

- U.S. service member or veteran with prior deployment(s) to a major conflict
zone(s)(e.g. Vietnam War, Persian Gulf conflict, and wars in Iraq and Afghanistan).

- Symptoms indicative of current PTSD. This includes: (i) score of >40 on the PCL-M
Checklist; (ii) endorsement of PCL-M symptoms rated as "Moderately" or above as
follows: at least 1 B item (questions 1-5), 3 C items (questions 6-12), and at least
2 D items (questions 13-17); and (iii) scoring positive on the PTSD subscale of the
Psychiatric Diagnostic Screening Questionnaire.

- Ability to read and speak English to complete survey questions.

- Denial of suicidal ideation or intent, including homicidal ideation or intent, and no
evidence of psychotic behavior or being in psychological crisis.

Exclusion Criteria:

- Brain injury prohibiting speech, writing, and purposeful actions.

- Currently engaged in another PTSD psychotherapy treatment intervention. Screening
therapist will determine eligibility based on the type of psychotherapy and
medications the participant is receiving.

- Major psychiatric disorder (e.g. bipolar disorder) concomitant to symptoms of
psychological trauma and deemed likely to interfere with treatment delivery.

- Currently undergoing substance abuse treatment (alcohol and/or drug).

- Any medical condition that, in the judgment of the Principal Investigator and/or ART
clinician, may place the individual at high risk due to a potential heightened
emotional reaction (e.g. previous heart attack, seizure disorder).