Please select the eligibility criteria that correspond to the clinical trial below.
Title: Trauma-sensitive Yoga for Female Veterans With PTSD Who Experienced Military Sexual Trauma
Brief Summary: In this study, we are evaluating the effectiveness of a yoga intervention to treat posttraumatic stress disorder (PTSD), its associated symptoms of chronic pain and insomnia, and biological and physiological responses to trauma and PTSD in women Veterans who experienced military sexual trauma (MST). If effective, this yoga intervention could reduce PTSD symptoms and chronic pain, improve sleep quality, and decrease the body's automatic "fight or flight" stress response and the damage this stress response causes in the body, including heart disease and diabetes. This intervention could improve these women Veterans' quality of life and social functioning, for example, going to work and having satisfying relationships with family and friends. This study may support an innovative, complementary and alternative PTSD treatment for women Veterans who experienced MST. This new, evidence-based PTSD treatment could supplement current PTSD treatments. Clinical guidelines for this yoga intervention could be implemented nationally in the VA health care system.


Options:
A: Inclusion Criteria:

* Women Veterans who experienced MST
* Diagnosed with PTSD related to MST
* Insomnia
* Willing to participate in either TCTSY or CPT study intervention

Exclusion Criteria:

* Schizophrenia with significant psychotic symptoms
* Current, active suicidal intent or plan
* Current substance abuse or dependence
* Certain medical conditions that can contribute significantly to psychiatric symptoms, including:

  * poorly controlled hypo/hyperthyroidism
  * kidney or liver failure
* Dementia
* Moderate or severe traumatic brain injury (TBI) or other cognitive impairment sufficient to interfere with ability to give informed consent
* Pain due to acute injury (\<3 months), post-surgical pain (\<3 months) or pain due to malignancy; pain related to injury and surgery are excluded to reduce risk of exacerbating underlying injury
* Receiving mental health treatment outside of the VA
* Ongoing participation in mental health treatment at odds with study intervention (For Example: yoga, trauma-focused treatment)
B: Inclusion Criteria:

* over 18 years of age;
* able to understand and speak French;
* history of unwanted sexual experience;
* PTSD diagnosis according to DSM-IV-TR;
* sleep complaints, as established by Pittsburgh Sleep Quality Index score ≥ 5 and a mean of one or more NM per week for at least one month;
* if psychotropic medication was used, (antidepressant, antianxiety, antipsychotic or hypnotic medication) stable for a minimum of three months;
* available for in-person assessments and therapy sessions.

Exclusion Criteria:

* past or present psychotic episode, bipolar disorder or organic mental disorder (e.g. dementia);
* substance use disorder;
* sleep apnea diagnosis;
* use of prazosine to treat nightmares;
* presently in treatment for psychological difficulties;
* significant suicidal thoughts requiring immediate intervention.
C: Inclusion Criteria:

* informed consent
* self-identification as female
* sexual assault, defined as endorsement of unwanted, attempted or completed sexual contact in the past 10 weeks
* age \> 18
* English fluency
* smartphone and internet access at least daily for 3 weeks and at least weekly for 3 months
* consumption of \>1 alcoholic drink in the past month
* \>1 episode of high-risk drinking in past 6 months, defined as either more than 3 drinks on a given day or more than 7 drinks in a given week
* at least 3 symptom clusters endorsed on the PTSD Checklist.

Exclusion Criteria:

* active suicidality
* psychosis
D: Inclusion Criteria:

* Female; any race or ethnicity; age 18 to 65 years old.
* Sexual assault that occurred within the past 12 months.
* Subjects must be able to comprehend English.
* A score of 3 or greater on the Alcohol Use Disorders Identification Test (AUDIT-C) screen.
* A score of 31 or greater on the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (PCL-5). Subjects may also meet criteria for an alcohol use disorder, previous history of posttraumatic stress disorder, mood disorder (except bipolar affective disorder, see Exclusion Criteria) or other anxiety disorders (panic disorder, agoraphobia, social phobia, generalized anxiety disorder, or obsessive-compulsive disorder). The inclusion of subjects with affective and other anxiety disorders is essential because of the marked frequency of the co-existence of mood and other anxiety disorders among patients with AUD and PTSD (Norman et al., 2018; Zinzow et al., 2012). Subjects may meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for another substance use disorder if AUD is the primary substance of choice.
* Must consent to complete all treatment and follow-up visits.

Exclusion Criteria:

* Lack of any memory of the sexual assault
* Subjects meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a history of or current psychotic, bipolar, dissociative identify disorder, or a current eating disorder, as the study protocol may be therapeutically insufficient.
* Subjects experiencing significant withdrawal symptoms, as evidence by a score of 10 or more on the Clinical Institute Withdrawal Assessment of Alcohol (CIWA). These subjects will be referred for clinical detoxification and may be re-assessed for study eligibility after medically supervised detoxification has been completed.
* Individuals considered an immediate suicide risk, with current suicidal ideation and intent.
* Individuals who attempted suicide in the past month. These individuals will be referred directly for treatment.
* Individuals on psychotropic medications must be stabilized on it for at least two weeks prior to beginning the study.
* Any other medical or psychiatric conditions that the investigators believe may compromise the individual's ability to safely participate in the study.

Answer: A