Research Centre: Phoenix Australia and Melbourne School of Psychological Sciences, University of Melbourne
Location: This study will be conducted both virtually and in person at the Phoenix Australia Traumatic Stress Clinic, located in Parkville, Melbourne, VICTORIA 3052.
Lead Researchers: Professor Kim Felmingham, Professor Meaghan O’Donnell, and Dr. Winnie Lau
HREC: This study has been reviewed and approved by the University of Melbourne Human Research Ethics Committee

After a traumatic event, it’s natural to feel worried and sad, but for some (around 30%), these emotions can evolve into debilitating disorders like PTSD. Prolonged Exposure (PE) therapy is the gold standard in treatment, aiming to reduce fear responses to trauma reminders. However, not everyone responds as expected, with some showing only partial improvement.

Researchers at Phoenix Australia, in collaboration with the Melbourne School of Psychological Sciences at the University of Melbourne, are exploring an approach built on scientific evidence that exercise increases BDNF, a protein linked to improved regulation of fear responses. By combining PE and exercise, researchers are exploring a promising avenue to elevate the effectiveness of PTSD treatment. Join this groundbreaking study which can potentially redefine PTSD treatment. Together, help take a bold step towards a future where more individuals find relief and recovery from their PTSD symptoms.

• Participants will receive a no-cost 10-week gold standard PTSD treatment delivered by trained trauma clinicians.
• Participants may experience improvements in managing symptoms of PTSD.
• Participants may receive an honorarium for completing MRI scans as part of the study.
• Participants will be contributing valuable information that may benefit those with PTSD in the future.
• Participants will be helping to advance medical research.

• If you decide to participate in the study and later feel that you no longer wish to be part of it, you can withdraw at any time.
• Any information that you provide will be kept strictly confidential, except as required by law.
• Qualified health professionals will monitor your health as it relates to the study.

• Individuals aged 18-70 who have been diagnosed with PTSD
• Must not have any medical conditions, that may put them at risk of adverse consequences. (e.g., heart, lung, nerve/muscle-related conditions)
• Must not have been diagnosed with mania or psychosis
• Must not have been diagnosed with alcohol or substance use disorder
• If currently receiving psychological treatment involving exposure therapy, Cognitive Behavioural Therapy for PTSD or other trauma focussed therapy, must be willing to pause this treatment during your participation in this study
• Must not have a history of moderate to severe traumatic brain injury, neurological disorder, or epilepsy
• Must not have been diagnosed with any hormonal or menstrual disorders
• Must not be pregnant or breastfeeding
• Must not currently be taking any beta-blockers
• Must be able and willing to participate in a moderate exertion exercise program, consisting of a repetitive stepping or cycling motion
• Must be able and willing to provide blood and saliva samples
• Must be able and willing to participate in the study virtually for approximately 10 weeks, and be able to complete the 2-hour treatment sessions during business hours (once eligibility is confirmed, the sessions will be on the same day/time every week)

The study team will explain the research in its entirety but some details are:

• Participants are randomly assigned to either prolonged exposure treatment coupled with aerobic exercise or prolonged exposure coupled with gentle stretching. Both treatment conditions contain PE, the current gold standard treatment for PTSD.
• Once allocated, participants will receive a clinical assessment session, and then 10-weekly sessions of 90-minute PE treatment, delivered by a trained clinician. Before each session, participants will engage in 20 minutes of aerobic exercise (via cycling or stepping) or engage in gentle stretching, depending on the group they have been allocated to. Each week, the total session time will take approximately two hours.
• Participants will complete a pre-treatment assessment and a post-treatment assessment, as well as a 6-month follow-up where they will answer some demographic questions and questions about their mental health.
• There is an additional optional neuroimaging assessment that can be completed prior to starting treatment. The primary aims of this assessment are to pinpoint the distinct neural circuits responsible for the process of repetitive negative thinking, avoidance behaviours, and attentional biases. The second is to determine whether measures of brain activity can help clinicians predict treatment outcomes for individual patients. Participants who opt into this assessment will undergo MRI scans and may be asked to complete additional interviews/questionnaires as part of this assessment. Participants will be eligible to receive an honorarium for completing this optional neuroimaging assessment.

Phoenix Australia
Phoenix Australia is Australia’s National Centre of Excellence in posttraumatic mental health. As a not-for-profit organization, Phoenix Australia is committed to conducting a wide range of innovative research studies and clinical trials looking into the causes, impacts, and treatment of trauma and Post-traumatic Stress Disorder. Research is conducted with a strong focus on military and veteran services, but also on the general population and within hospitals, health and community settings, emergency services, and industry and workplace sectors. It is
Phoenix’s goal to improve understanding of Posttraumatic Stress Disorder, as well as treatment outcomes for survivors of trauma.

University of Melbourne and the Melbourne School of Psychological Sciences
The University of Melbourne is the highest-ranked Australian University and is consistently delivering the highest quality of education and research across every field. The Melbourne School of Psychological Sciences is one of the Schools within the Faculty of Medicine, Dentistry, and Health Sciences at the University of Melbourne.

Please note:
Due to the ongoing impact of the COVID-19 pandemic, both virtual and face-to-face options are likely to be available in this study. This may change during the course of the project, however, the study team will inform you of the current arrangements prior to your enrollment in the trial.