Please select the eligibility criteria that correspond to the clinical trial below.
Title: Addressing the Health Concerns of VA Women With Sexual Trauma
Brief Summary: Lifetime sexual trauma (ST) (i.e., behaviors that range from unwanted sexual touching to attempted or completed rape) is a significant social and public health problem among women Veterans. For women Veterans, lifetime ST can occur prior to, during or after military service. ST is associated with multiple difficulties and risks, including posttraumatic stress disorder (PTSD), intimate partner violence (IPV), and alcohol misuse. Providing an effective, integrated, and low-cost intervention that targets ST-related risks for women Veterans with lifetime ST would advance clinical care for these vulnerable women.

This research will develop and assess a computer-delivered intervention (Safety and Health Experiences Program; SHE) that will provide a screening and brief behavior intervention for women Veterans with any lifetime ST. More specifically, the intervention, SHE, will address interrelated health concerns for women Veterans with ST (i.e. alcohol misuse, IPV, and PTSD). SHE will be designed to provide individualized assessment, feedback, and referrals for women Veterans with any lifetime ST. SHE will take place within a primary care setting. Primary care visits are frequent points of health care contact for women Veterans making the visit itself the ideal, and possibly only, opportunity to provide behavioral interventions.

This study will lay the groundwork for a larger clinical trial of the SHE program in multiple VA primary care settings. If effective, the intervention, SHE, represents an innovative and low cost service for early identification and intervention that could be implemented nationwide with ease and speed to address the needs of women Veterans with lifetime ST. The long-term goal of the project is to make a significant impact on advancing health services research by introducing and testing a novel and potentially powerful service tool that may improve service delivery to address the co-occurring health concerns for women Veterans with any lifetime ST.


Options:
A: Inclusion Criteria:

* Veteran (female or male) from any era with a current diagnosis of PTSD due to MST
* Experienced MST no less than 3 months prior to entering the trial
* Identify that MST is the trauma that is causing the worst current distress (if other traumas also experienced)
* Have at least one clear memory of the trauma (sufficient to write impact statement)
* Consent to be randomized into treatment
* Not receive other psychotherapy during the 6 weeks of active treatment
* (if on psychoactive medications) if new antidepressant, be on stable medication regimen for a minimum of 6 weeks prior to entering the trial (if recent changes to antidepressant dosage or additions or changes of antipsychotic or anti-anxiety medication, eligible immediately)

Exclusion Criteria:

* Current substance dependence
* Prior substance dependence that has not been in remission for at least 3 months
* Any current psychotic symptoms
* Current mania or unstable Bipolar Disorder
* Prominent current suicidal or homicidal features
* Any severe cognitive impairment or history of Organic Mental Disorder
* Current involvement in a violent relationship
B: Inclusion Criteria:

Female Veterans

* Lifetime history of ST with at least one risk factor: heavy drinking within the past 3 months, screen positive for current PTSD or for IPV within last 12 months
* Age 18-65
* Seeking treatment through the Women's Primary Care Clinics at the Central Texas VA Healthcare System.
* Ability to understand study procedures in English
* Not actively in suicidal or homicidal crisis warranting imminent hospitalization
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:

* 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.

Answer: B