Please select the eligibility criteria that correspond to the clinical trial below.
Title: Efficacy of Sequential Imagery Rehearsal Therapy and Cognitive-Behavioural Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: a Randomized Control Trial
Brief Summary: Sexual assault victims (SAV) have an elevated risk of developing posttraumatic stress disorder (PTSD). Trauma-focused cognitive-behavioural therapy (CBT) is an effective first-line treatment for this pathology. However, although sleep disturbances are a common complaint in SAV with PTSD, trauma-focused CBT does not directly address this symptom. Posttraumatic nightmares are widespread among SAV. Trauma-related sleep disturbances are associated with significant impairment in general functioning and quality of life (mental and physical health), and contribute to the maintenance of PTSD symptoms. This study evaluates the efficacy of sequential nightmare therapy (imagery rehearsal therapy; IRT) and trauma-focused CBT, in comparison to CBT alone. Forty-two SAV suffering from PTSD and sleep difficulties were recruited and randomly assigned to the experimental (IRT+CBT) or control condition (waiting period followed by CBT alone). Participants were administered a clinical interview and a series of questionnaires assessing PTSD symptoms, general functioning and quality of life.


Options:
A: 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.
B: 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
C: 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
D: 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

Answer: A