This application is submitted jointly but separately by Dr. Rachel Yehuda of Mount Sinai Medical School and Dr. Edna Foa of the University of Pennsylvania in response to Program Announcement PA-98-017 inviting collaborative research efforts on Collaborative R0-1 for Clinical Studies in Mental Health. Previously this grant was submitted as an R0-1 with Dr. Foa and PI and Dr. Yehuda as subcontractor. Following review, in consultation with the Chief of the Adult Psychopathology and Prevention Research Branch, we have changed the funding mechanism. Thus, this grant represents the first submission for Dr. Yehuda and a resubmission of R01 MH62003 for Dr. Foa. The grant proposes to employ a longitudinal design to examine alterations in the biology of PTSD in individuals whose symptoms are expected to improve following prolonged exposure therapy (PE). Because a great majority of trauma victims who receive PE show significant improvement in clinical symptoms, examining biological parameters before, during, and after this manipulation provides an opportunity to explore the relationships among biological alterations, changes in PTSD symptom severity, and cognitions related to the disorder. Thus, this study is interested in the relationship between biological alterations and psychological factors (including dysfunctional cognitions about the danger of the world and self-incompetence) that have been implicated in chronic PTSD, particularly as they may change with reduction in PTSD symptoms. Furthermore, the study will assess whether biological alterations associated with chronic PTSD predict, or are altered in relation to, therapeutic outcome. The longitudinal design with multiple measurements will allow us to obtain data that address the temporal relationship between changes in symptom severity with biological and cognitive variables. If biological alterations are principally related to symptom severity and/or cognitive factors that maintain PTSD, then successfully treating the symptoms should alter biological findings in the direction of normality. However, it is possible that changes in symptom severity may occur in the absence of significant shifts in neuroendocrine profile, suggesting a pattern related to underlying risk rather than to symptomatic expression in this disorder. The resolution of these questions has important implications for understanding the pathophysiology of PTSD, and may provide insight into the mechanisms associated with successful psychological treatment for this disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH064104-05
Application #
6946938
Study Section
Special Emphasis Panel (ZRG1-BBBP-6 (02))
Program Officer
Tuma, Farris K
Project Start
2001-09-01
Project End
2007-07-31
Budget Start
2005-08-01
Budget End
2007-07-31
Support Year
5
Fiscal Year
2005
Total Cost
$163,500
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Psychiatry
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
Yehuda, Rachel (2009) Status of glucocorticoid alterations in post-traumatic stress disorder. Ann N Y Acad Sci 1179:56-69
Yehuda, Rachel; Bierer, Linda M; Sarapas, Casey et al. (2009) Cortisol metabolic predictors of response to psychotherapy for symptoms of PTSD in survivors of the World Trade Center attacks on September 11, 2001. Psychoneuroendocrinology 34:1304-13
Yehuda, Rachel; LeDoux, Joseph (2007) Response variation following trauma: a translational neuroscience approach to understanding PTSD. Neuron 56:19-32
Yehuda, Rachel; Flory, Janine D (2007) Differentiating biological correlates of risk, PTSD, and resilience following trauma exposure. J Trauma Stress 20:435-47
Yehuda, Rachel (2004) Risk and resilience in posttraumatic stress disorder. J Clin Psychiatry 65 Suppl 1:29-36
Yehuda, Rachel; Halligan, Sarah L; Yang, Ren Kui et al. (2003) Relationship between 24-hour urinary-free cortisol excretion and salivary cortisol levels sampled from awakening to bedtime in healthy subjects. Life Sci 73:349-58