Research Programs

Faculty at the Center for the Treatment and Study of Anxiety (CTSA) under the direction of Edna B. Foa, Ph.D. have continued to actively pursue research endeavors during the last year. At the present time, the CTSA faculty have several federally funded (NIMH, NIAAA) research programs.

Research Programs Post-traumatic Stress Disorder Obsessive-Compulsive Disorder Recently completed studies

The current research at the CTSA focuses on the development and testing of treatments for various anxiety disorders including posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), and generalized social phobia (GSP). In addition, we are expanding these efforts to examine treatments for trichotillomania (TTM) and other impulse control and tic disorders in children and adolescents. Descriptions of the projects that have been active during the calendar year 2006 are provided below. These descriptions include the names of CTSA faculty who serve as PI or project coordinator for each project. In addition to the faculty named in the descriptions, all CTSA faculty members are involved in one or more of the projects as therapists, supervisors of therapy, or evaluators.

Studies of Post-traumatic Stress Disorder

> Treatment of PTSD

Naltrexone and CBT in the Treatment of Alcoholism and PTSD

This study is its sixth year of funding from the National Institute of Alcoholism and Alcohol Abuse. The PI’s of the study are Edna B. Foa, Ph.D. and Joseph Volpocelli, MD, Ph.D. and the study coordinator is David Yusko, Psy.D. PTSD and alcoholism are frequently found to co-occur in persons exposed to traumatic events. This study examines the utility of established treatments for each disorder when used to treat persons who have both PTSD and alcohol problems. Naltrexone has been found
effective in combination with psychosocial interventions at reducing alcohol problems; prolonged exposure has been found effective in the treatment of PTSD. Men and women who experience both PTSD and alcohol problems are eligible to participate in this study. For further information about this study contact Dr. David Yusko at the Center for the Treatment and Study of Anxiety.

Effectiveness of Treatment for PTSD in Community Agencies

This 5-year study, a continuation of our 16-year program of research on treatment of PTSD resulting from rape and nonsexual assault, was awarded funding in October, 2001. Elizabeth A. Hembree, Ph.D., is the PI on this project with Edna B. Foa as Co-PI and Paul Ctrits-Christoph, Ph.D., as Co-I. This investigation aims to establish the external validity of treatments for PTSD by proposing two studies to evaluate the effectiveness of an empirically validated treatment for posttraumatic stress disorder (PTSD), Prolonged Exposure (PE) a brief cognitive behavioral therapy, in each of two community-based agencies. We recently completed a study in which we demonstrated that PE can be successfully implemented by counselors of a community-based agency dedicated to providing services for sexual assault victims, Women Organized Against Rape (WOAR). The present study aims to examine whether counselors at WOAR can maintain their success with PE with reduced CTSA expert involvement. In addition, we will replicate the training procedures utilized at WOAR with counselors at Joseph J. Peters Institute (JJPI), another community based agency that provides services for sexual assault victims to examine the generalizability of our training procedures. Contact Dr. Hembree at the Center for the Treatment and Study of Anxiety for additional information on this study.

Studies of Obsessive Compulsive Disorder

> Treatment of OCD

OCD Augmentation Study

This study, funded by the National Institute of Mental Health, is a collaboration between Dr. Edna Foa from the University of Pennsylvania and Dr. Blair Simpson from Columbia University-New York State Psychiatric Institute. The purpose of the study is to compare two different, but effective augmentation treatments in order to examine how to maximally improve symptoms of OCD for those who are already taking SSRIs but still have OCD symptoms. Those who participate in the study will continue to take their SSRI and will be randomly assigned to receive one of three different add-on conditions: Cognitive Behavioral Therapy (CBT), Risperdal (RIS), or placebo (PBO). Initial treatment will last for 8.5 weeks. Individuals who benefit from the add-on treatment will be invited to continue with the same treatment for 6 additional months. Individuals who do not benefit from the initial add on treatment (CBT, RIS, or PBO) will be offered 8.5 weeks of treatment with one of the alternative active treatments (RIS or CBT). The add-on treatments will be provided at no cost. Men and women ages 18-70 with OCD who are currently taking SSRI medication are eligible to participate in this study. For further information about this study, contact Jamie York at 215-746-3327 at the Center for the Treatment and Study of Anxiety, or see our online flyer.

Family-Based Treatment for Early Childhood OCD

The goal of this study, funded by the NIMH, is to test a family-based CBT treatment program for young children with OCD. Dr. Martin Franklin is the PI on this project. Participants receive family-based CBT targeting children's OCD symptoms or family-based Relaxation Training aimed at general anxiety reduction and stress management.  Children aged 5 through 8 who have symptoms of OCD may be eligible to participate in this study. Further information can be obtained from Dr. Martin Franklin at the Center for the Treatment and Study of Anxiety.


Pediatric OCD Treatment Study II

The goal of this study, funded by the NIMH, is to compare several treatments for children and adolescents with OCD. Dr. Martin Franklin is the PI on this project.  Participants receive medication management alone or in combination with therapist-administered CBT or with psychiatrist-administered instructional CBT.  Children aged 7 through 17 who have symptoms of OCD for which they are currently taking medication may be eligible to participate in this study. Further information can be obtained from Dr. Martin Franklin at the Center for the Treatment and Study of Anxiety. Click here to download our flyer (pdf). Please contact Sophia Talbott at: talbott@mail.med.upenn.edu for questions or to schedule an intake evaluation.

Studies of Chronic Tic Disorder

Behavioral Treatment of Tics Study

The goal of this study, funded by the Tourette Syndrome Association, is to develop and test a CBT treatment program for adolescents and young adults who suffer from chronic tic disorders.  Dr. Martin Franklin is the PI on this project. Participants receive Habit Reversal Training alone or in combination with Acceptance and Commitment Therapy.  Adolescents and young adults ages 15 through 25 who exhibit chronic tics may be eligible to participate in this study.  Further information can be obtained from Dr. Martin Franklin at the Center for the Treatment and Study of Anxiety.

Recently completed Studies

The following studies have recently been completed my researchers at the Center for the Treatment and Study of Anxiety.

Biological and Psychological Correlates of PTSD

This study, funded by the National Institute of Mental Health, is a collaboration between Dr. Foa from the University of Pennsylvania and Rachel Yehuda, Ph.D., of the Mt. Sinai School of Medicine, New York City. Dr. Cahill is a co-investigator on this grant and serves as the study coordinator for the University of Pennsylvania site. The University of Pennsylvania site is expert in the psychological treatment of PTSD and Dr. Yehuda is an expert in the biological correlates of PTSD (e.g., changes in circulating levels of cortisol and catecholamines, changes in negative feedback inhibition of cortisol release). The goal of this study is to evaluate changes in salivary and urinary cortisol and catecholamines before, during, and after treatment with treatment for chronic (at least one-year post-trauma) PTSD. We intend to determine whether these biological variables associated with PTSD represent "trait-like" variables that do not change with symptom resolution, and therefore may reflect a biological vulnerability to developing PTSD. Alternatively, these biological variables may reflect "state" variables that change with symptom resolution. Participants in this study were all women with symptoms of PTSD lasting at least one year. For further information about this study contact Dr. Shawn Cahill at the Center for the Treatment and Study of Anxiety.

Cognitive Behavior Therapy Augmentation of Serotonin Reuptake Inhibitors (SRI) for OCD 

Recruitment for this NIMH-funded study recently ended.  The study was designed to examine the potential benefits of augmenting SRI treatment for obsessive-compulsive disorder with cognitive behavior therapy (CBT). The study was conducted at the University of Pennsylvania (PI: Edna Foa, Ph.D.) and at the New York State Psychiatric Institute (PI: Michael Liebowitz, MD).  Although SRI treatment leads to some improvement in symptoms among patients with OCD, many are left with residual symptoms that are still in need of help. Therefore, this study examined the immediate and long-term value of adding CBT to continuing SRI treatment for reducing these residual symptoms and increasing general functioning and quality of life.  The data are currently being processed and analyzed for this study.

Sertraline and Prolonged Exposure in the Treatment of PTSD

This was a three-center study that included the University of Pennsylvania (Edna B. Foa, Ph.D., PI), Duke University (Jonathan Davidson, M.D., PI), and Emory University (Barbara Rothbaum, Ph.D., PI) and was funded by Pfizer, Inc.  The study coordinator for the University of Pennsylvania site was Shawn P. Cahill, Ph.D. The goal of this study iwas to determine whether adding prolonged exposure to medication improved treatment outcome. Further information on this project is available from Dr. Shawn Cahill at the Center for the Treatment and Study of Anxiety.

A Brief Program for Preventing PTSD

This study, funded by NIMH, examined the efficacy of a brief cognitive-behavioral intervention program designed to prevent the development of chronic PTSD among recent female sexual assault victims. The brief prevention program was compared with supportive counseling and assessment only control groups. The PI of this project was Edna B. Foa, Ph.D., and the study coordinator was Elizabeth A. Hembree, Ph.D.   Further information about this study is available from Dr. Elizabeth Hembree who served as project coordinator. The main results of this study is currently “in press” at the Journal of Traumatic Stress (Foa,). 

Treatment of Chronic PTSD

This NIMH funded research project examined the ability for clinicians from the Center for the Treatment and Study of Anxiety to train clinicians from other agencies to effectively use prolonged exposure to treat chronic PTSD among women assault survivors. This study was a collaboration between CTSA faculty and the community organization Women Organized Against Rape (WOAR) with treatment administered at both sites. The goal of the cross-site comparison was to determine whether prolonged exposure, which has been used successfully in academic settings such as the CTSA, can be effectively disseminated to non-academic settings.  Dr. Edna B. Foa was the PI for this project and Dr. Elizabeth Hembree was the study coordinator.  The main results of this study were recently published in the Journal of Consulting and Clinical Psychology (Foa, Hembree, Cahill, Rauch, Riggs, Feeny, & Yadin, 2005). 

A Randomized Clinical Trial of CBT for PTSD in Women

This 4-year Cooperative Studies Program, funded by the Department of Veterans Affairs, evaluated the efficacy of cognitive-behavioral therapy (CBT) in treating PTSD and associated problems in female veterans and active duty military personnel. The study compared a cognitive behavioral therapy developed and extensively studies in the CTSA, Prolonged Exposure (PE), with a therapy that focuses on current problems, Present-Centered Therapy (PCT). Edna B. Foa, Ph.D., was the "master therapist" for prolonged exposure (PE) and was responsible for the training and supervision of all therapists conducting PE in this study. Elizabeth A. Hembree, Ph.D., was the coordinator of the study. The role of CTSA faculty in this study was to train and continuously supervise the 24 therapists who worked in the 12 VA and DoD clinics that were study sites. The data are currently being processed and analyzed for this study.

Treatment of Generalized Social Phobia

We recently completed this NIMH-funded multi-center study evaluating the immediate and long-term efficacy of group comprehensive cognitive-behavioral therapy (CCBT), fluoxetine (FLU), and their combination for adults with social phobia. The study was conducted at the University of Pennsylvania (Edna B. Foa, Ph.D., PI) and at Duke University (Jonathan Davidson, M.D., PI). Additional information about this study is available from Dr. Jonathan Huppert, the study coordinator at the Center for the Treatment and Study of Anxiety.

CBT for Pediatric Trichotillomania (compulsive hair pulling)

The goal of this study, funded by NIMH, is to develop and test a CBT treatment program for children who compulsively pull their hair. Dr. Martin Franklin is the PI on this project. Participants received CBT aimed at habit reversal and stress management. Children and adolescents aged 7 to 17 inclusive who compulsively pulled their hair were eligible to participate in this study. Further information can be obtained from Dr. Martin Franklin at the Center for the Treatment and Study of Anxiety.