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Author ORCID Identifier

https://orcid.org/0000-0001-8519-0437

Date Available

5-6-2026

Year of Publication

2026

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Arts and Sciences

Department/School/Program

Psychology

Faculty

Jessica Burris

Faculty

Thomas Adams

Abstract

Posttraumatic stress disorder (PTSD) is a common and often disabling psychiatric disorder associated with an increased risk of multiple mental and physical health conditions. Exposure therapy is a gold standard treatment for PTSD, but attrition rates and treatment response are notable limitations. Animal and human research collectively indicate that aerobic exercise can enhance preclinical and experimental models of exposure by improving consolidation of fear-extinction memories. To date, only one clinical trial has attempted to translate exercise augmented exposure therapy for PTSD. The current study is an open-label pilot clinical trial aiming at gauging the effectiveness of a brief eight-session PTSD treatment augmented by aerobic exercise.

A community sample (n=6) of adults with PTSD received eight sessions of standardized brief exposure therapy (BET) and aerobic exercise. The acceptability and feasibility of the BET and exercise protocol were examined through participants’ perceptions of treatment, engagement with treatment, and therapists' adherence to the treatment protocol. A staggered baseline single case experimental design (SCED) was utilized to evaluate the efficacy of the intervention by examining changes in self-report PTSD Checklist for DSM-5 (PCL-5) scores across baseline (A), treatment (B), and follow-up (C) phases. Data were analyzed visually (i.e., levels, trends, and variability) and quantitatively across phases. Non-overlap of PCL-5 scores between phases was quantified using Tau-U analyses across participants, Hedges’ g standardized mean difference, and the Reliable Change Index.

Participants rated the BET and exercise protocol as an acceptable treatment, resulting in more improvements than they originally expected. During treatment, only one session was late canceled (2% of sessions), zero sessions had no-shows, and zero participants dropped out of treatment. Visual Analysis indicated a significant effect of the BET and exercise treatment on PTSD symptom severity (PCL-5) scores, evidenced by reductions of scores (means and non-overlap) across participants from baseline, treatment, and follow-up phases. Between-case effect sizes indicate a significant reduction in PTSD symptom severity from the baseline to treatment (meta-analytic Tau-U = -0.57, p < .001; between-case Hedges’ g = 0.31) and follow-up (meta-analytic Tau-U =-0.65, p < .001; between-case Hedges’ g = -1.97) phases.

Findings indicate that the eight-session brief imaginal exposure and exercise treatment reduces PTSD symptoms and is an acceptable and feasible treatment. Findings highlight the need for future large-scale clinical trials to evaluate the additive effect of exercise using an imaginal exposure treatment for PTSD.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2026.248

Archival?

Archival

Funding Information

Funding was provided by the University of Kentucky's psychology department through student research funds.

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