Exposure Therapy for Veterans With PTSD and Panic Attacks (Phase 1)

With the increasing number of Operations Iraqi Freedom and Enduring Freedom (OIF/OEF)
veterans returning from war-zone areas, many will experience anxiety disorders such as PTSD
and comorbid problems. Currently, about one in every six OIF/OEF veterans experiences PTSD
and co-occurring PD. Although effective treatments exist for treating one or the other, we
do not yet have treatments that can simultaneously target PTSD and PD. Thus, recent
attention has focused on the development of multi-component treatments that simultaneously
address PTSD and PD. This study is the first systematic investigation of a time-limited,
multi-component cognitive-behavioral treatment for veterans with specific comorbid anxiety
problems. The purpose of the first phase of the study is to evaluate the feasibility and
acceptability of the multi-component cognitive-behavioral treatment in an open trial.

Inclusion Criteria:

- being an OIF/OEF veteran, defined as having received the Global War on Terrorism
Expeditionary or Service Medal and/or being involved in combat after November 11,
1998;

- being enrolled in the Trauma Recovery Program (TRP) at the Michael E. DeBakey
Veterans Affairs Medical Center (MEDVAMC), with a current diagnosis of PTSD and PD;

- being stable on psychotropic medication for 4 weeks before study participation; and

- being at least 18 years of age.

Exclusion Criteria:

- active substance dependence, or bipolar or psychotic disorders;

- severe depression and active suicidal ideation and intent (based on Structured
Clinical Interview for DSM-IV disorders [SCID-IV] & Beck Depression Inventory-2nd
edition [BDI-II]);

- cognitive impairment as indicated by the St. Louis University Mental Status exam
(SLUMS); and

- veterans currently receiving psychosocial treatment specifically targeting PTSD or
panic symptoms.