Please select the eligibility criteria that correspond to the clinical trial below.
Title: Manualized Treatment for Veterans With Military Sexual Trauma
Brief Summary: The purpose of this study is to evaluate the effectiveness of Cognitive Processing Therapy (CPT) versus Present-Centered Therapy (PCT) in treating current post-traumatic stress symptoms associated with sexual assault that occurred while veterans were serving in the military.


Options:
A: Inclusion Criteria:

* Veteran
* A positive screen for MST
* A positive PTSD screen defined as PC-PTSD cut-off of \> 3

Exclusion Criteria:

* Substance abuse not in remission for at least 3 months
* Current psychotic symptoms

  * unmedicated mania or bipolar disorder
  * prominent current suicidal or homicidal ideation
* Cognitive impairment indicated by chart diagnoses or observable cognitive difficulties
* Current involvement in a violent relationship defined as more than casual contact

  * e.g., dating or living with an abusive partner
B: Inclusion Criteria:

1. Identifies as female.
2. Between the age of 18 and 65.
3. Reports a sexual assault in the last 4 weeks to 1 year.
4. Current PTSD severity of 23+ on the PSS-I-5.
5. Current heavy alcohol use (2+ heavy episodic drinking occasions \[4+ drinks on one occasion\] in past month).
6. Access to the internet and a device with a webcam.

Exclusion Criteria:

1. Current diagnosis of schizophrenia, delusional disorder, or organic mental disorder as defined by the DSM-5.
2. Current diagnosis of bipolar disorder, depression with psychotic features, or depression severe enough to require immediate psychiatric treatment (i.e., serious suicide risk with intent and plan).
3. Unwilling or unable to discontinue current trauma-focused psychotherapy or current substance use psychotherapy.
4. Unstable dose of psychotropic medications in the prior 3 months.
5. Ongoing intimate relationship with the perpetrator of most recent assault.
6. Current diagnosis of a severe substance use disorder according to DSM-5, other than alcohol in the last month.
7. No clear trauma memory.
8. Current higher dose use of benzodiazepines (greater than the equivalent of 4 mg of lorazepam, 2 mg alprazolam, 1.5 mg clonazepam, or 20 mg of diazepam).
C: Inclusion Criteria:

* Participants will be at least three months post-crime at the time of their participation and will have been diagnosed with PTSD. Participants will score at least a "3" on the CAPS symptom of sleep impairment. This score is indicative of clinically significant symptomatology on any PTSD symptom. There is no upper limit on time since the trauma for participation.

Exclusion Criteria:

* Exclusion criteria for participants include psychosis, mental retardation, active suicidality, parasuicidality, or current addiction to drugs or alcohol. In the case of apparent illiteracy, we will try to accommodate the individual as much as possible to maximize success in the program. In addition, participants cannot be in a currently abusive relationship or being stalked. For marital rape or domestic violence, the participant must have been out of the relationship for at least three months. Participants can have received any therapy in the past with the exception of CPT. They may be receiving concurrent therapy as long as it is not trauma-focused. Allowing subjects to continue with concurrent therapy offers them the option to continue with established supports and more closely mimics clinical practice and the generalizability of the results. Participants will be asked to monitor and adhere to several behaviors that significantly impact sleep and may introduce error into the study aims. Inability or unwillingness to comply the the following will constitute exclusion criteria: Participants will be asked not to increase sleep medications, but to continue usual practice. This usage will be monitored on a daily basis on the sleep diaries. Daytime sleeping or naps will be monitored on the daily diaries and used as an outcome measure as naps are utilized less and less frequently across time in a number of insomnia treatment studies. Participants will also be asked to keep alcohol consumption to no more than 14 servings per week with no more than 5 servings on any given day. We will also ask participants to consume no more than 500 mg of caffeine on a daily basis and to refrain from caffeine consumption after 6 pm. We will further ask participants to maintain their bedtime and rise time during the work week and to not vary these times by more than one hour on days off. Participants will record bedtime and rise time on their daily diaries. Participants will be asked to maintain these sleep-related behaviors for the duration of therapy - approximately 8-10 weeks.
D: 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

Answer: D