Complementary and Alternative Interventions for Veterans With Posttraumatic Stress Disorder

• Change in Clinician-Administered PTSD Scale (CAPS) scores [ Time Frame: Baseline, 1 month post-intervention (approx. 6 weeks) ] [ Designated as safety issue: No ]
  
• Change in PTSD Checklist-Military (PCL-M) scores [ Time Frame: Baseline, Post-Intervention (approx. 10-14 days), 1 month post-intervention (approx. 6 weeks) ] [ Designated as safety issue: No ]
  
• Change in fMRI brain blood oxygen level-dependent (BOLD) responses [ Time Frame: Baseline, post-intervention (approx 10-14 days) ] [ Designated as safety issue: No ]
  Brain activation during anticipation of, response to, and recovery from aversive stimuli will be measured at baseline, and the intervention groups will be compared to the wait-list controls following the intervention to assess changes based on the interventions.
  
  

• Quality of sleep [ Time Frame: Baseline through one month post-intervention (approx. 6 weeks) ] [ Designated as safety issue: No ]
  Sleep quality will be assessed using actigraphy
  
  
• Changes in self-reported mood, anxiety, and sleep symptoms [ Time Frame: Baseline, post-intervention (approx. 10-14 days), one month post-intervention (approx. 6 weeks) ] [ Designated as safety issue: No ]
  
• Changes in peripheral psychophysiological arousal [ Time Frame: Baseline and post-intervention (approx. 10-14 days) ] [ Designated as safety issue: No ]
  Assessed using multiple measures, including heart rate, heart rate variability, corrugator EMG, and skin conductance.
  
  
• Changes in neuropsychological functioning [ Time Frame: Baseline, post-intervention (approx. 10-14 days) ] [ Designated as safety issue: No ]
  Memory, attention, and rapid perceptual processing will be measured using neuropsychological tasks by Cambridge Cognition and/or the NIH toolbox
  
  

The overarching purpose of this study is to assess the impact of CA interventions on posttraumatic stress symptoms in veterans with PTSD. Twenty percent of the approximately 2 million veterans returning from Iraq and Afghanistan ("Operation Iraqi Freedom" or OIF and "Operation Enduring Freedom" or OEF) suffer from the symptoms of Post-traumatic Stress Disorder. PTSD may be the reason behind alarming increases in suicidal behavior among returning veterans in Wisconsin and nation-wide. In addition to traditional treatments, Veterans Administration (VA) Hospitals and other community institutions for veterans now offer CA programs to their patients. Past research from our laboratory and others suggests that CA programs may provide effective relief from anxiety while increasing psychological well-being. However, little research exists on the effects of CA programs for combat veterans with PTSD. The proposed study aims to address this important gap by assessing CA programs such as Sudarshan Kriya Yoga (SKY) and Mindfulness-Based Stress Reduction (MBSR). 150 veterans with PTSD will be randomly assigned to either SKY, MBSR, or the wait-list control (WLC) group. We will assess participants' PTSD symptoms pre-intervention, post-intervention (approximately 10-14 days after initial visit), and 1 month post-treatment (approximately 6 weeks after initial visit). In order to evaluate the programs' effects as comprehensively as possible, we propose a multi-method approach: baseline psychophysiology, autonomic reactivity and recovery, neuropsychological (cognitive) assessments, self-report questionnaires, and functional brain imaging (fMRI). Baseline measures will be collected from a group of 50 combat-exposed veterans without PTSD to assess group differences on these measures prior to treatment.