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Objective: To replicate and extend findings from a previous controlled trial of Cognitive Trauma Therapy for Battered Women (CTT-BW; Kubany et al., 2004), the current study presents data on the treatment of 8 women with PTSD related to intimate partner violence (IPV). Method: CTT-BW was administered weekly, using the manual provided by Kubany and a multiple baseline across participants design. Participants were assessed for PTSD and depression, as well as secondary outcomes. Results: Significant decreases from pre-to posttreatment were noted in PTSD (Hedges g ϭ 1.90) and depression (Hedges g ϭ 1.52), the primary outcomes. Obtained effect sizes for PTSD and depression can be classified as large. Anxiety, self-esteem, and quality of life improved significantly during the pre-to posttreatment interval. Conclusions: Results are discussed in light of treatment needs for women with PTSD related to IPV and the potential for CTT-BW to be used in diverse settings.

Within the current theoretical frameworks used in grief and bereavement research, it remains unclear which individual factors confer risk for specific bereavement-related mental health problems, such as posttraumatic stress disorder (PTSD) and prolonged grief disorder. The present study investigated individual differences in motivational sensitivity and self-regulatory processes in a sample of 326 bereaved individuals who experienced sudden and/or unexpected death losses. We (1) examined associations between behavioral activation system (i.e., orientation to rewarding stimuli) and behavioral inhibition system (orientation to aversive stimuli) sensitivity and bereavement-related mental health problems (i.e., PTSD and prolonged grief symptoms), and (2) explored whether experiential avoidance (i.e., effortful avoidance of internal stimuli) would moderate such associations. Results revealed PTSD was more strongly associated with behavioral inhibition system sensitivity, while prolonged grief symptoms more strongly associated with behavioral activation system sensitivity. In particular, drive sensitivity -a dimension of the behavioral activation system -appeared uniquely associated with prolonged grief symptoms, especially in those who endorsed high experiential avoidance. Findings support a theoretical reconceptualization of prolonged grief as a reward system disorder. This reconceptualization may aid in further understanding mechanisms of bereavement-related mental health problems and related risk factors.

Objective Combat veterans are at risk for several adverse outcomes such as posttraumatic stress disorder (PTSD), depression, hazardous alcohol use, and most critically, suicidal behaviors. The high rate of suicide in veterans has been understood as a correlate of PTSD and depression, but it is possible that certain specific types of combat experiences may lead to suicidal behaviors. Acts committed by the veteran in the context of war such as killing may evoke a “moral injury,” which leads to thoughts of ending one’s life. Method The present exploratory research examined relationships between combat experiences and suicidal ideation (SI) and PTSD in a sample of 68 OEF/OIF veterans (91% male, mean age = 32.31 years) who had screened positive for alcohol misuse. We examined firing a weapon/killing in combat (Firing/Killing) and killing in combat (Killing) alone as predictors of (SI) and PTSD severity in both the full sample, and in analyses that examined men only. Results Firing/Killing were associated with SI for the full sample and men only, and Killing showed a trend towards significance in predicting SI. Hierarchical regression analyses suggested that Firing/Killing did not predict PTSD for the full sample or men only, but Killing was predictive of PTSD for both samples. Conclusions These results indicate that there may be differences in Firing/Killing and Killing alone in OEF/OIF veterans who screened positive for alcohol misuse. Thorough screening of combat experiences and addressing moral injury in returning combat veterans may help reduce high rates of suicide and PTSD.

Posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD) are two of the most common mental health disorders affecting civilians as well as military populations. If left untreated, individuals with co-occurring PTSD/AUD are at increased risk for developing other mental health problems (e.g., depression, anxiety), physical health problems, reduced resiliency and military readiness, and vocational and social impairment. Substantial gaps in the treatment of co-occurring PTSD/AUD exist and there is a critical need to develop more effective pharmacological treatments. The current study addresses this gap in the literature by testing the efficacy and safety of doxazosin, a long-acting and selective alpha-1 adrenergic antagonist, as compared to placebo in reducing PTSD and AUD severity among U.S. military veterans. Noradrenergic dysregulation has been implicated in the development and maintenance of PTSD and AUD, and pilot studies examining doxazosin in PTSD-only or AUD-only samples have shown promise. This is the first study, however, to evaluate doxazosin in a comorbid PTSD/AUD sample. This paper describes the rationale, design and methodology of a randomized, double-blind, placebo-controlled trial of doxazosin (16 mg/day) delivered over 12 weeks among military veterans with current PTSD and AUD. In addition, functional magnetic resonance imaging (fMRI) is applied at pre- and post-treatment to investigate the underlying pathophysiology of comorbid PTSD/AUD and identify prognostic indicators of treatment outcome. This study is designed to accelerate research on co-occurring PTSD/AUD and provide empirical evidence to inform clinical practice.