PTSD Affect Labeling Study

INCLUSION CRITERIA Inclusion Criteria for All Veteran Participants (Ps): All Ps must be veterans with deployment experience. Ps must meet DSM-IV criterion "A" for PTSD, which requires exposure to a traumatic event involving actual or threatened physical injury or death. This trauma must have occurred during military service, but may take a variety of forms (e.g., injury to self, witnessing death of another, etc.). Ps must be 18-45 years old (18-60 for non-fMRI Ps) since normal age-related structural and functional variations in participants above and below this age range could prevent accurate comparison of neural activity across participants. Ps must be English-speaking as translation of all study materials into other languages would be cost-prohibitive. Both male and female participants are allowed. Ps who will complete the fMRI must be right-handed in order to allow comparison of neural activity across participants. Additional Inclusion Criterion for PTSD Participants (PTSDs): PTSDs must meet full DSM- IV criteria for PTSD with a trauma related to their military service, as assessed by the CAPS. Additional Inclusion Criterion for Healthy Control Participants (HCs): HCs must not meet DSM-IV criteria for current/lifetime PTSD or any other current Axis I disorders. Inclusion Criteria for Non-Veteran Healthy Controls: Must be 18-45 years old Must be English-speaking Male or female participants are allowed EXCLUSION CRITERIA Exclusion Criteria for All fMRI Participants: Ps must not have any metallic implants or other non-removable metal in the body (e.g., shrapnel, surgical staples or screws, etc.) as this would preclude them from undergoing any MRI scanning. Ps must not be claustrophobic in order to be able to complete all fMRI procedures. Ps must not be pregnant (as assessed by verbal report) as the research question is not pregnancy-related. Ps must not have any serious unstable medical illnesses. Ps must not have intellectual impairment, bipolar disorder, psychosis, delusional disorder, or suicidality. Ps must not have any organic brain damage, including a history of moderate to severe traumatic brain injury (TBI), as this would confound analyses comparing activations across subjects. A history of mild TBI is allowed. Ps must not meet DSM-IV criteria for Substance Dependence within the last six months due to both the possibility of neural changes associated with the substance use, and issues of participant safety. Ps must not have made any recent modifications to psychotropic medication status (i.e., within the last 1 month for benzodiazepines and within the last 3 months for SSRI and SSNIs). Ps must not have recently initiated or made changes to any psychotherapy (within the last 3 months). Ps must not have had any chronic or repeated neglect/maltreatment, sexual abuse, physical abuse, emotional abuse, or domestic violence prior to the age of 7 (as assessed with the Early Trauma Inventory and CAPS), given evidence for adverse brain development and structural abnormalities in this subgroup of individuals. Exclusion Criteria for All Non-fMRI Participants: Ps must not be pregnant (as assessed by verbal report) as the research question is not pregnancy-related. Ps must not have any serious unstable medical illnesses. Ps must not have intellectual impairment, bipolar disorder, psychosis, delusional disorder, or suicidality. Ps must not meet DSM-IV criteria for Substance Dependence within the last six months due to issues of participant safety. Ps must not have made any recent modifications to psychotropic medication status (i.e., within the last 1 month for benzodiazepines and within the last 3 months for SSRI and SSNIs). Ps must not have recently initiated or made changes to any psychotherapy (within the last 3 months). Additional Exclusion Criterion for PTSD Participants (PTSDs): The investigators will exclude highly-dissociative individuals, defined as those who score 15 or higher on the Clinician Administered Dissociative States Scale (Bremner et al., 1998). While the majority (i.e., 70%) of individuals with PTSD are characterized by prefrontal under-regulation and limbic over-responding to trauma cues, research has also identified a subgroup of PTSD individuals, up to 30%, who are characterized as highly 'dissociative' and exhibit the opposite neural pattern to trauma cues, i.e., abnormally low and over-regulated amygdala responses (Lanius et al., 2010). The current proposal focuses on the former, larger group of less-dissociation-prone PTSD individuals with inhibitory deficits, as this appears to be the group for whom inhibitory enhancement may be particularly helpful. Accordingly, the investigators will exclude those with high levels of baseline dissociative symptomology in this first proof-of-concept study. Exclusion Criteria for Non-Veteran Healthy Controls: Ps must not have been exposed to a DSM-IV defined traumatic event. Ps must not meet criteria for any current DSM-IV Axis I disorder and must not have intellectual impairment or current suicidality. Ps must not be pregnant (as assessed by verbal report) as the research question is not pregnancy-related. Ps must not have any serious unstable medical illnesses. Ps must not be currently receiving treatment for a psychiatric problem (including psychotherapy and psychotropic medication).