Recently Completed Studies
The following studies have recently been completed by researchers at the Center for the Treatment and Study of Anxiety.
Treating Troops with PTSD
This study, which recently concluded recruitment, is funded by the US Department of Defense. The study objective is to determine the most effective means of helping military personnel regain full functioning after having been diagnosed with posttraumatic stress disorder (PTSD) after returning from deployments in Afghanistan and Iraq. The PI of the study is Edna B. Foa, Ph.D. Prolonged exposure (PE) is an efficacious treatment for PTSD, typically administered in once- or twice-weekly sessions. This project will evaluate whether massing 10 PE sessions in 2 weeks is as effective as providing 10 PE sessions delivered over 8 weeks.
Varenicline and CBT in the Treatment of Smoking and PTSD
This 5-year research study was funded by the National Institute on Drug Abuse under the direction of principal investigator Edna Foa, PhD. The purpose of the study was to test the efficacy of an integrated treatment for smoking cessation among smokers with PTSD. This group of smokers has been found to have a particularly hard time quitting; they tend to be heavy smokers, more nicotine dependent, and to have more severe nicotine withdrawal when they try to stop smoking. Varenicline is a new medication that has shown greater effectiveness for smoking cessation than previously available drugs. Individuals who participated in this study were randomly assigned to receive either varenicline alone or varenicline plus prolonged exposure for PTSD. Treatment lasted for 13 weeks, and study participants were monitored for an additional 3 months after the end of treatment. Individuals who received varenicline alone had the option to receive prolonged exposure at the end of this follow-up period. Men and women ages 18-75 with PTSD who wanted to quit smoking were recruited to participate in this study. The data for this study are currently being processed and analyzed.
Treatment for Teens Traumatized by Sexual Abuse
This project was a joint effort between The Center for the Treatment and Study of Anxiety (CTSA) at the University of Pennsylvania and Women Organized Against Rape (WOAR). Its purpose was to examine the effectiveness of a treatment developed for post-traumatic stress disorder (PTSD) in female adolescents exposed to child sexual abuse (CSA) and sexual assault. Adolescents who choose to participate in the study were randomized to one of two types of therapy, Prolonged Exposure (PE) or Client-Centered Therapy (CCT). Both types of therapy consisted of once weekly, individual counseling sessions that last for approximately 1 1/2 hours each. PE focused more on processing the teens' trauma, whereas CCT focuses more on problem solving and current life stressors. In past literature CCT has been shown to be extremely effective for treating PTSD symptoms in adolescents, and two pilot projects utilizing PE for adolescents also show excellent results. Treatment in this study included up to three preparation sessions and 14 sessions of active treatment. A CTSA clinician conducted evaluations at mid and post-treatment. In addition, follow up evaluations were held 3, 6, and 12 months after treatment ended. Information from this study directly benefited clients by guiding appropriate treatment planning. Clients in the treatment study also benefited from receiving a comprehensive evaluation by study staff and well-delivered treatment for PTSD.
OCD Augmentation Study
This study, funded by the National Institute of Mental Health, was 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 was to compare two different, but effective augmentation treatments in order to examine how to maximally improve symptoms of OCD for those who were already taking SSRIs but still experienced OCD symptoms. Those who participated in the study continued to take their SSRI and were randomly assigned to receive one of three different add-on conditions: Cognitive Behavioral Therapy (CBT), Risperdal (RIS), or placebo (PBO). Initial treatment lasted for 8.5 weeks. Individuals who benefited from the add-on treatment were invited to continue with the same treatment for 6 additional months. Individuals who did not benefit from the initial add-on treatment (CBT, RIS, or PBO) were offered 8.5 weeks of treatment with one of the alternative active treatments (RIS or CBT). The add-on treatments were provided at no cost. Men and women ages 18-70 with OCD who were taking SSRI medication were recruited to participate in this study.
Naltrexone and CBT in the Treatment of Alcoholism and PTSD
This study was funded by the National Institute of Alcoholism and Alcohol Abuse. The PI’s of the study were Edna B. Foa, PhD and Joseph Volpicelli, MD, PhD and the study coordinator was David Yusko, PsyD. The literature has found that PTSD and alcoholism are frequently found to co-occur in persons exposed to traumatic events. This study examined the utility of established treatments for each disorder when used to treat persons who had 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 experienced both PTSD and alcohol problems were eligible to participate in this study.
Effectiveness of Treatment for PTSD in Community Agencies
This 5-year study, a continuation of a 16-year program of research on treatment of PTSD resulting from rape and nonsexual assault, was awarded funding in October, 2001. Elizabeth A. Hembree, PhD, was the PI on this project with Edna B. Foa as Co-PI and Paul Ctrits-Christoph, PhD, as Co-I. This investigation aimed 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. This project followed on the heels of a study which demonstrated that PE could be successfully implemented by counselors of a community-based agency dedicated to providing services for sexual assault victims, Women Organized Against Rape (WOAR). This study aimed to examine whether counselors at WOAR could maintain their success with PE with reduced CTSA expert involvement. 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, were replicated to examine the generalizability of our training procedures.
Biological and Psychological Correlates of PTSD (Primary Grant)
This study, funded by the National Institute of Mental Health, was a collaboration between Dr. Foa from the University of Pennsylvania and Rachel Yehuda, PhD, of the Mt. Sinai School of Medicine, New York City. Dr. Shawn Cahill was a co-investigator on this grant and served as the study coordinator for the University of Pennsylvania site. The study benefited from the combined expertise of the University of Pennsylvania team, on the psychological treatment of PTSD, and Dr. Yehuda on 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 was 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. The study intended to determine whether biological variables associated with PTSD represented "trait-like" variables that did not change with symptom resolution, and therefore could reflect a biological vulnerability to developing PTSD. Alternatively, biological variables could reflect "state" variables that changed with symptom resolution. Women with symptoms of PTSD lasting at least one year were recruited to participate in the study.
Cognitive Behavior Therapy Augmentation of Serotonin Reuptake Inhibitors (SRI) for OCD
This NIMH-funded 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, PhD) 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.
Sertraline and Prolonged Exposure in the Treatment of PTSD
This was a three-center study that included the University of Pennsylvania (Edna B. Foa, PhD, PI), Duke University (Jonathan Davidson, MD, PI), and Emory University (Barbara Rothbaum, PhD, PI) and was funded by Pfizer, Inc. The study coordinator for the University of Pennsylvania site was Shawn P. Cahill, PhD. The goal of this study was to determine whether adding prolonged exposure to medication improved treatment outcome.
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, PhD, and the study coordinator was Elizabeth A. Hembree, PhD.
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 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, PhD, 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, PhD, 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.
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, PhD, PI) and at Duke University (Jonathan Davidson, MD, PI).
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.