Posttraumatic Stress Disorder (PTSD) is a debilitating, often chronic disorder with serious psychiatric morbidity among civilians. The incidence in the U.S. is estimated at 1 % to 3%, although rates can be considerable higher in vulnerable populations. In traumatized groups such as rape and severe assault victims, the rate of PTSD can approach 50%. Little is known regarding effective pharmacologic and psychosocial treatment in civilians with PTSD, as the majority of research to date has been conducted in war veterans. This grant proposes a five year training and research program, which encompasses 3 major research domains of PTSD: pharmacologic treatment, psychosocial treatment, and biological correlates of clinical symptoms. Training would be accomplished in intensive supervision with the mentor (Michael Liebowitz, M.D.) and scientific advisors; course work; tutorials in major research centers; collaboration with established investigators; and original research projects. Five interrelated projects are proposed: 1) a double-blind, placebo-controlled, 12-week trial of paroxetine in PTSD; 2) development of a time-limited individual psychotherapy which integrates cognitive-behavioral and psychodynamic principles; 3) a systematic open trial of the integrated psychotherapy; 4) measurement of cortisol levels pre- and post-treatment in both clinical treatments; 5) assuming positive findings in #1 and #3, development of a clinical trial to assess the efficacy of paroxetine, pill- placebo, psychotherapy, and combined paroxetine and psychotherapy. It is hypothesized that both paroxetine and psychotherapy will be effective for PTSD, and that the combination might be superior to either treatment alone.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08MH001412-05
Application #
6391331
Study Section
Violence and Traumatic Stress Review Committee (VTS)
Program Officer
Light, Enid
Project Start
1997-04-01
Project End
2002-09-30
Budget Start
2001-04-01
Budget End
2002-09-30
Support Year
5
Fiscal Year
2001
Total Cost
$162,103
Indirect Cost
Name
Columbia University (N.Y.)
Department
Psychiatry
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Marshall, Randall D; Bryant, Richard A; Amsel, Lawrence et al. (2007) The psychology of ongoing threat: relative risk appraisal, the September 11 attacks, and terrorism-related fears. Am Psychol 62:304-16
Dohrenwend, Bruce P; Neria, Yuval; Turner, J Blake et al. (2004) Positive tertiary appraisals and posttraumatic stress disorder in U.S. male veterans of the war in Vietnam: the roles of positive affirmation, positive reformulation, and defensive denial. J Consult Clin Psychol 72:417-33
Marshall, Randall D; Carcamo, Jaime H; Blanco, Carlos et al. (2003) Trauma-focused psychotherapy after a trial of medication for chronic PTSD: pilot observations. Am J Psychother 57:374-83