Post Traumatic Stress DisorderPTSDNCT06218381
The Effects of Very Brief Exposure on PTSD in U.S. Combat Veterans
A study testing Very Brief Exposure to Combat Images in people with Post Traumatic Stress Disorder, run by Children's Hospital Los Angeles at 1 site in United States.
Trial summary
The goal of this clinical trial is to develop a new behavioral treatment for U.S. combat veterans with post-traumatic stress disorder (PTSD), very brief exposure to combat-related stimuli. The main questions it aims to answer are: 1. Read more about this study
- Who is it for?
- Ages 18 to 50 yearsHealthy volunteers can take part
- Conditions the study is for
- Post Traumatic Stress Disorder
- What is being tested?
- Very Brief Exposure to Combat Images
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteUnited States
- Study dates
- 22 Mar 2024to Jul 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Patient Population
- Males and females ages 18-50
- Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) diagnosis of PTSD
- Traumatic event is a combat-based experience (e.g., being injured, watching a buddy be killed)
- Minimum score of 18 on the Combat Experience Scale (CES)
- Minimum score of 3 or more on Primary Care (PC)-PTSD-5
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- Participants with other cooccurring psychiatric disorders (e.g., anxiety, ADHD) will be included to ensure a representative sample.
- Healthy Population
- Males and Females, ages 18-50
Who cannot join
- Patient Population
- Treatment for PTSD, substance abuse, or mental health concerns in the past 6 months
- 10 or more years since the combat trauma
- Acute intoxication
- Severe level of Substance Dependence (6 or more DSM-V symptoms)
- Prior diagnosis of Autistic Spectrum Disorders
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- Current or past psychotic disorders or active psychotic symptoms
- Current Bipolar I Disorder
- Dementia
- Neurological or serious medical conditions (e.g., stroke, epilepsy/ seizure disorder, cancer, Lupus, HIV+);
- Traumatic brain injury
- Healthy Population
- Ferromagnetic implants (e.g., pacemaker), metal braces, retainers, tattoos or permanent make up w/ metallic content, transdermal medicinal patches that cannot be removed
- Neurological or serious medical conditions (e.g., stroke, epilepsy/ seizure disorder, cancer, Lupus, HIV+);
- Lifetime Diagnosis of PTSD, Tourette's Syndrome, Bipolar Disorder, Substance Dependence, Eating Disorder, Autism Spectrum Disorder, a psychotic disorder, Acute Stress Disorder
- Lifetime history of traumatic event defined as a life-threatening event involving physical attack, guns, fire or explosion (i.e the kinds of traumatic events combat veterans are likely to experience)
- Traumatic Brain Injury
- Birth at less than 37 weeks gestational age
- Claustrophobia
- Anxiety Disorder, Mood Disorder, Substance Abuse Disorder, Adjustment Disorder in past 2 years
- Treatment for mental health concern in past 2 years
- Pregnant Females
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
Brain Imaging Lab
Los Angeles, California, 90027
Courtney Marcelino, 323-361-6456, cmarcelino@chla.usc.edu
About this study
The goal of this clinical trial is to develop a new behavioral treatment for U.S. combat veterans with post-traumatic stress disorder (PTSD), very brief exposure to combat-related stimuli. The main questions it aims to answer are:
- How does Very Brief Exposure (combat images and control everyday images) and Visible Exposure to combat stimuli affect brain activity and subjective fear ratings?
- To what extent are participants aware of the stimuli presented and tolerating the exposures?
All participants will view both very brief exposure and visible exposure to combat stimuli in the functional magnetic brain imaging (fMRI) scan. They will provide ratings of fear, awareness, and tolerability. Researchers will compare U.S. combat veterans with PTSD and healthy controls to confirm differences in brain region activation and ratings.
Read the detailed description
The prevailing treatment for Post-traumatic Stress Disorder (PTSD) is exposure: the confrontation of traumatic memories, in one form or another. Although exposure therapies are effective for combat related PTSD, confronting traumatic memories is inherently aversive, which may contribute to problems with patient acceptance. For example, trauma-focused PTSD therapies have higher dropout rates than non-trauma-focused therapies, and combat vets who drop out in real-world practice have more avoidance behaviors and greater arousal than those who remain in treatment. Study investigators have developed an alternative form of exposure that has been repeatedly shown to reduce behavioral, physiological, and self-reported fear symptoms in phobic persons without having them directly confront feared situations, and thus without causing them to experience emotional distress. In Very Brief Exposure (VBE), a series of pictures representing a person's fears (e.g., a combat scene with arousing visuals) is presented very briefly (17 ms), followed by a masking stimulus that prevents conscious recognition of each picture. This sequence of picture-mask stimuli is repeated many times in an exposure session.
The goal is to develop a new behavioral treatment for U.S. combat veterans with PTSD, VBE to combat-related stimuli by:
- Identifying the unique effects of masked exposure to combat-related images (VBE) on the brain activity of U.S. combat veterans with PTSD. Study investigators will conduct a randomized controlled trial of VBE during fMRI scanning by manipulating awareness of exposure to combat-related stimuli, comparing the effects of VBE and (barely) visible exposure to these stimuli on the brain activity of 40 combat veterans with PTSD. Visible exposure to combat images is an active control condition that demonstrates the advantages of implicit exposure (VBE) in engaging extinction circuits and reducing fear responses. These advantages are not merely the consequences of exposure, but of how that exposure is delivered. The study thesis is that exposure is more effective, both in terms of circuit activity and fear responses, when delivered implicitly. Study investigators will manipulate the number of exposure sessions within each treatment group in order to identify the optimal number of sessions.
- Directly relating the effects of VBE on neural activity to those on behavioral symptoms of PTSD. Subjective fear levels will be measured. In statistical analyses, changes in brain activity induced by VBE will be directly related to its ensuing effects on all of these measures, and the neural mechanisms that mediate the reduction of PTSD symptoms will thereby be inferred.
- Conditions
- Post Traumatic Stress Disorder
- Being tested
- Very Brief Exposure to Combat Images
- Keywords
- Post Traumatic Stress Disorder, Veteran, Very Brief Exposure
- Medical subject headings
- Stress Disorders, Post-Traumatic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Very Brief Exposure to Combat ImagesOther
In VBE, a series of pictures representing a person's fears (e.g., a combat scene with arousing visuals) is presented very briefly (17 ms), followed by a masking stimulus that prevents conscious recognition of each picture. This sequence of picture-mask stimuli is repeated many times in an exposure session.
| Study group | Role | What they receive |
|---|---|---|
| Image Exposure Arm | Experimental | This within-subjects design study will have all participants view three types of exposure during fMRI scanning: VBE to combat images, VBE to masked everyday scenes (control), and conscious visible exposure to the same images (control). Receives: Other: Very Brief Exposure to Combat Images |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Activation of Frontostriatal and Prefrontal Brain Regions to combat stimuli in PTSD
A hypothesis-driven, group-level analysis will test brain activity, measured as Blood Oxygen Level Dependent (BOLD) response, in 4 regions of interest while minimizing Type II error.
Measured: Day 2
Secondary outcomes (3)
Fear induced by exposure to combat stimuli in PTSD in veteran group as measured by fear scale
After each block of 10 combat stimuli trials, participants rate levels of fear on a 10-point, 1-10 visual analogue scale with these anchor point: "1 - No fear", "5 - Moderate but Tolerable Fear", and "10 - Very Intense Fear".
Measured: Day 2
Fear induced by exposure to combat stimuli in PTSD in healthy participants as measured by fear scale
After each block of 10 combat stimuli trials, participants rate levels of fear on a 10-point, 1-10 visual analogue scale with these anchor point: "1 - No fear", "5 - Moderate but Tolerable Fear", and "10 - Very Intense Fear".
Measured: Day 2
Fear induced by exposure to combat stimuli in PTSD in veteran group as measured by fear scale
After each block of 10 combat stimuli trials, participants rate levels of fear on a 10-point, 1-10 visual analogue scale with these anchor point: "1 - No fear", "5 - Moderate but Tolerable Fear", and "10 - Very Intense Fear".
Measured: Days 3-7
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Jan 2024
- Study start22 Mar 2024
- Primary completionDec 2026 (estimated)
- Study completionJul 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Post Traumatic Stress DisorderStudies of the same condition, open and under way.
- More trials run by Children's Hospital Los AngelesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Children's Hospital Los Angeles
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Bradley Peterson, Children's Hospital Los Angeles
- Investigators
- Bradley M Peterson, MD, Principal investigator, Children's Hospital Los Angeles
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06218381
- Sponsor's protocol ID
- CHLA-20-00782
- Acronym
- PTSD
- Status last verified
- Jul 2026
- First submitted
- 9 Jan 2024
- Last updated
- 29 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Very Brief Exposure on PTSD in U.S. Combat Veterans
- ClinicalTrials.gov ID
- NCT06218381
- Acronym / sponsor ID
- PTSD / CHLA-20-00782
- Conditions
- Post Traumatic Stress Disorder
- Keywords
- Post Traumatic Stress Disorder, Veteran, Very Brief Exposure
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Children's Hospital Los AngelesUniversity, hospital or other
- Study start
- 22 Mar 2024 (actual)
- Primary completion
- Dec 2026 (estimated)
- Study completion
- Jul 2027 (estimated)
- First posted
- 23 Jan 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to develop a new behavioral treatment for U.S. combat veterans with post-traumatic stress disorder (PTSD), very brief exposure to combat-related stimuli. The main questions it aims to answer are:
- How does Very Brief Exposure (combat images and control everyday images) and Visible Exposure to combat stimuli affect brain activity and subjective fear ratings?
- To what extent are participants aware of the stimuli presented and tolerating the exposures?
All participants will view both very brief exposure and visible exposure to combat stimuli in the functional magnetic brain imaging (fMRI) scan. They will provide ratings of fear, awareness, and tolerability. Researchers will compare U.S. combat veterans with PTSD and healthy controls to confirm differences in brain region activation and ratings.
Detailed description
The prevailing treatment for Post-traumatic Stress Disorder (PTSD) is exposure: the confrontation of traumatic memories, in one form or another. Although exposure therapies are effective for combat related PTSD, confronting traumatic memories is inherently aversive, which may contribute to problems with patient acceptance. For example, trauma-focused PTSD therapies have higher dropout rates than non-trauma-focused therapies, and combat vets who drop out in real-world practice have more avoidance behaviors and greater arousal than those who remain in treatment. Study investigators have developed an alternative form of exposure that has been repeatedly shown to reduce behavioral, physiological, and self-reported fear symptoms in phobic persons without having them directly confront feared situations, and thus without causing them to experience emotional distress. In Very Brief Exposure (VBE), a series of pictures representing a person's fears (e.g., a combat scene with arousing visuals) is presented very briefly (17 ms), followed by a masking stimulus that prevents conscious recognition of each picture. This sequence of picture-mask stimuli is repeated many times in an exposure session.
The goal is to develop a new behavioral treatment for U.S. combat veterans with PTSD, VBE to combat-related stimuli by:
- Identifying the unique effects of masked exposure to combat-related images (VBE) on the brain activity of U.S. combat veterans with PTSD. Study investigators will conduct a randomized controlled trial of VBE during fMRI scanning by manipulating awareness of exposure to combat-related stimuli, comparing the effects of VBE and (barely) visible exposure to these stimuli on the brain activity of 40 combat veterans with PTSD. Visible exposure to combat images is an active control condition that demonstrates the advantages of implicit exposure (VBE) in engaging extinction circuits and reducing fear responses. These advantages are not merely the consequences of exposure, but of how that exposure is delivered. The study thesis is that exposure is more effective, both in terms of circuit activity and fear responses, when delivered implicitly. Study investigators will manipulate the number of exposure sessions within each treatment group in order to identify the optimal number of sessions.
- Directly relating the effects of VBE on neural activity to those on behavioral symptoms of PTSD. Subjective fear levels will be measured. In statistical analyses, changes in brain activity induced by VBE will be directly related to its ensuing effects on all of these measures, and the neural mechanisms that mediate the reduction of PTSD symptoms will thereby be inferred.
Study design
- Primary purpose
- Basic science
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Image Exposure Arm | Experimental | Other: Very Brief Exposure to Combat ImagesThis within-subjects design study will have all participants view three types of exposure during fMRI scanning: VBE to combat images, VBE to masked everyday scenes (control), and conscious visible exposure to the same images (control). |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (9 listed)
- Patient Population
- Males and females ages 18-50
- Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) diagnosis of PTSD
- Traumatic event is a combat-based experience (e.g., being injured, watching a buddy be killed)
- Minimum score of 18 on the Combat Experience Scale (CES)
Key exclusion criteria (22 listed)
- Patient Population
- Treatment for PTSD, substance abuse, or mental health concerns in the past 6 months
- 10 or more years since the combat trauma
- Acute intoxication
- Severe level of Substance Dependence (6 or more DSM-V symptoms)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Very Brief Exposure to Combat ImagesIn VBE, a series of pictures representing a person's fears (e.g., a combat scene with arousing visuals) is presented very briefly (17 ms), followed by a masking stimulus that prevents conscious recognition of each picture. This sequence of picture-mask stimuli is repeated many times in an exposure session. | Other | Image Exposure Arm |
Primary outcome
Mean Activation of Frontostriatal and Prefrontal Brain Regions to combat stimuli in PTSD
Time frame: Day 2
A hypothesis-driven, group-level analysis will test brain activity, measured as Blood Oxygen Level Dependent (BOLD) response, in 4 regions of interest while minimizing Type II error.
3 secondary outcomes
Fear induced by exposure to combat stimuli in PTSD in veteran group as measured by fear scale
Time frame: Day 2
Fear induced by exposure to combat stimuli in PTSD in healthy participants as measured by fear scale
Time frame: Day 2
Fear induced by exposure to combat stimuli in PTSD in veteran group as measured by fear scale
Time frame: Days 3-7
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Bradley M Peterson, MD principal investigator
Children's Hospital Los Angeles
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Very Brief Exposure to Combat Images in people with Post Traumatic Stress Disorder, run by Children's Hospital Los Angeles at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 29 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Courtney Marcelino (323-361-6456, cmarcelino@chla.usc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mean Activation of Frontostriatal and Prefrontal Brain Regions to combat stimuli in PTSD (time frame: Day 2). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jul 2026.