Please select the eligibility criteria that correspond to the clinical trial below.
Title: Online Early Resilience Intervention for Combat-Related PTSD in Military Primary Healthcare Settings: A Randomized Trial of "DESTRESS-PC"
Brief Summary: This study will compare a cognitive-behavioral online self-management intervention designed for primary care treatment of war-related PTSD to a control intervention, "optimized usual primary care PTSD treatment". Patients with PTSD will be trained to use the online PTSD treatment website and asked to do so three times per week for six weeks. They will have phone and email access to a nurse trained to assist them in their treatment program. Three scheduled phone check-ins during the six week treatment period will provide ongoing contact with patients during treatment. The investigators will assess PTSD symptoms, depression, anxiety and somatic symptoms, physical health status and occupational functioning on three occasions: before the intervention, at the end of the treatment period, and six weeks after the end of treatment.


Options:
A: Inclusion Criteria:

* Aged 70 years or over
* At least some concerns about falling
* At least some associated avoidance of activity
* Fair or poor perceived general health
* Living independently in the community
* Written informed consent

Exclusion Criteria:

* Cognitive impairment (a score of less than 4 on the Abbreviated Mental Test 4)
* Language or hearing problems that impede completing an interview by telephone
* Sight problems that impede completing the intervention
* Confinement to bed
* Waiting for nursing home admission
* Permanent use of a wheelchair
B: Inclusion Criteria:

1. Age 65 years old or older.
2. Severe fear as measured by a brief FES-I score \> or = 13.
3. Low to moderate actual risk of falls as set out in Lamb et al. (2008).
4. Distress or functional impairment due to fear of falling.
5. Approval from the patient's primary health care provider.

Exclusion Criteria:

1. Medical condition that would interfere with the safe conduct of the intervention or compromise study participation.
2. Bedbound, wheelchair-dependent, paralyzed in the lower extremities, or requiring the assistance of another person to transfer, walk, or perform intervention exercises within the home.
3. Dementia or cognitive impairment as measured by a score above 10 on the Blessed Orientation Memory Test.
4. Corrected visual acuity \< 20/60.
5. Current participation in psychotherapy or professional rehabilitation services (PT, OT) or in the process of being referred or evaluated for such services. Patients who develop a need for such services during their participation will complete an assessment prior to commencing the outside therapy but will be allowed to continue in the study.
6. Active suicidal ideation
7. Lifetime diagnosis of bipolar I or II disorder or any psychotic disorder.
8. Alcohol or other substance abuse or dependence within six months.
9. Psychosocial factors that would compromise study participation (e.g. homelessness, no telephone).
10. History of osteoporotic fracture.
11. Experiencing 3 or more falls in the past year.
12. Body Mass Index of 17.0 or under.
13. Significant orthostasis, defined as a 20 point or greater difference between seated and standing blood pressure, either systolic or diastolic.
C: Inclusion Criteria:

* Referred by a primary care providers in a participating primary care clinic.
* Deployed to either Operation Iraqi Freedom or Enduring Freedom.
* War-related trauma while deployed (may include military sexual trauma).
* Current PTSD as addressed by the CAPS interview.
* Reports routine access to computer, internet, and email.
* Successfully uses Internet to coordinate baseline assessment appointment.
* Provides research informed consent using local IRB-approved form.
* Plans continued care at the enrolling primary care clinic for at least 4 months.

Exclusion Criteria:

* Actively engaged in specialty mental health care in the previous two months.
* Failed specialty mental health treatment for PTSD or associated condition.
* Acute psychosis, psychotic episode, or psychotic disorder diagnosis within the past two years.
* Active substance dependence disorder in the past year.
* Active suicidal or violent ideation within the past two months.
* Currently on an antipsychotic or mood-stabilizing agent.
* Unstable administration schedule or dosing of any antidepressant, anxiolytic, or sedative-hypnotic (i.e., will exclude for any related medication changes in the two-months prior to randomization).
* Acute or unstable physical illness.
D: Inclusion Criteria:

* age 18 or older
* female
* Veteran of the US military
* current PTSD
* reports routine access to computer and Internet
* willing to provide at least one collateral contact
* willing to allow investigators to leave phone messages pertaining to the study
* willing to be audio-taped during assessments and study coach calls

Exclusion Criteria:

* actively engaged in individual therapy in the past two months, or receiving couple's or group therapy in the past two months that focuses on PTSD
* scheduled to receive a future individual therapy appointment or future couples' or group therapy appointment focused on PTSD at a frequency of once per month or more
* active suicidal or violent ideation within the past two months or on the VA "high risk" list for imminent danger to self or others
* moderate or extreme substance use disorder in the past year
* acute psychosis, psychotic episode, or psychotic disorder diagnosis within the past year
* unstable administration schedule or dosing of any antidepressant, anxiolytic, or sedative-hypnotic

Answer: C