The PI's long-term career goal is to become an independent clinical scientist conducting translational research aimed at establishing risk and resilience processes associated with mental illness following trauma and developing preventive interventions that target these mechanisms. Risk and resilience to traumatic stress involves a complex interplay of psychological, biological, and behavioral processes;thus, the candidate aims to integrate neurobiology and behavioral science in the pursuit of this research program. This proposal outlines a training and research plan to achieve this goal, culminating in a successful R01 proposal. This plan takes full advantage of the candidate's strong institutional support and environment at Rush University Medical Center as well as a team of mentors, collaborators, and consultants with expertise in each of the critical training areas. The candidate's early focus has been in vulnerability mechanisms associated with anxiety. She also has experience with clinical trials research, biological markers of acute stress, and delivering evidence-based treatments for PTSD. The candidate seeks to build upon this skill set by pursuing training goals aimed at developing 1) expertise in risk and resilience to traumatic stress, 2) proficiency in conducting clinical trials, 3) a sophisticated understanding of the neurobiology of conditioned fear and responses to traumatic stress, and 4) mastery in conducing translational research that integrates biological and behavioral science. By synthesizing these training goals, the candidate will develop a unique patient-oriented career aimed at reducing the burden of trauma-related psychopathology through the development of translational preventive interventions. The research plan uses Stress Inoculation Training (SIT), a well-established cognitive behavioral stress management intervention, to probe risk and resilience mechanisms linked to post-trauma psychopathology. Ninety participants with a history of interpersonal trauma during childhood or adolescence and mild to moderate distress will be randomized to SIT or a health education control condition. The primary aims of this proposal are to examine whether individuals who receive SIT demonstrate increases in psychological resilience, biological resilience, and extinction learning compared to those in the control group. This proposal will also explore associations between these psychobiobehavioral risk and resilience factors.
The specific aims of the proposal match well with the strategic goals of NIMH in that this study aims to explore dimensional processes of risk and resilience that cut across psychological disorders. By establishing the malleability of these risk and resilience candidates, the results of this study could have clinical utility in refining prevention strategies and will prepare the candidate to submit an R01 proposal examining the extent to which modification of underlying psychobiobehavioral risk and resilience mechanisms prevents psychopathology following future trauma exposure.

Public Health Relevance

Trauma exposure is widespread and can lead to a variety of mental health problems. Understanding the underlying risk and resilience mechanisms that contribute to psychopathology following trauma and the malleability of these factors will improve our ability to develop effective translational prevention programs. The proposed work uses Stress Inoculation Training, a cognitive-behavioral stress management intervention, to probe these psychological, biological, and behavioral risk and resilience mechanisms among vulnerable individuals at risk for future trauma.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZMH1-ERB-I (06))
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Chavez, Mark
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Rush University Medical Center
Other Clinical Sciences
Schools of Medicine
United States
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Zalta, Alyson K; Held, Philip; Smith, Dale L et al. (2018) Evaluating patterns and predictors of symptom change during a three-week intensive outpatient treatment for veterans with PTSD. BMC Psychiatry 18:242
Held, Philip; Klassen, Brian J; Brennan, Michael B et al. (2018) Using Prolonged Exposure and Cognitive Processing Therapy to Treat Veterans with Moral Injury-Based PTSD: Two Case Examples. Cogn Behav Pract 25:377-390
Held, Philip; Boley, Randy A; Karnik, Niranjan S et al. (2018) Characteristics of veterans and military service members who endorse causing harm, injury, or death to others in the military. Psychol Trauma 10:352-359
Ng, Ada; Reddy, Madhu; Zalta, Alyson K et al. (2018) Veterans' Perspectives on Fitbit Use in Treatment for Post-Traumatic Stress Disorder: An Interview Study. JMIR Ment Health 5:e10415
Carroll, Kathryn K; Lofgreen, Ashton M; Weaver, Darian C et al. (2018) Negative posttraumatic cognitions among military sexual trauma survivors. J Affect Disord 238:88-93
Horwitz, Adam G; Held, Philip; Klassen, Brian J et al. (2018) Posttraumatic Cognitions and Suicidal Ideation among Veterans receiving PTSD Treatment. Cognit Ther Res 42:711-719
Held, Philip; Klassen, Brian J; Hall, Joanne M et al. (2018) ""I knew it was wrong the moment I got the order"": A narrative thematic analysis of moral injury in combat veterans. Psychol Trauma :
Zalta, Alyson K; Bui, Eric; Karnik, Niranjan S et al. (2018) Examining the Relationship Between Parent and Child Psychopathology in Treatment-Seeking Veterans. Child Psychiatry Hum Dev 49:209-216
Zalta, Alyson K; Gerhart, James; Hall, Brian J et al. (2017) Self-reported posttraumatic growth predicts greater subsequent posttraumatic stress amidst war and terrorism. Anxiety Stress Coping 30:176-187
Held, Philip; Klassen, Brian J; Zou, Denise S et al. (2017) Negative Posttrauma Cognitions Mediate the Association Between Morally Injurious Events and Trauma-Related Psychopathology in Treatment-Seeking Veterans. J Trauma Stress 30:698-703

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