The objective of this study is to determine if acupuncture is an effective treatment option for treating combat Veterans with PTSD.

Inclusion Criteria:

• Veteran Age 18 to 55
• DSM-5 criteria for chronic PTSD on Clinical Administered PTSD Scale (CAPS-5)
• CAPS-5 score of ≥ 26 and meeting criteria for each of 4 symptoms

Exclusion Criteria:

• Current and past six-months psychosis

• Substance dependence within 6 months (evidence of tolerance and/or withdrawal)

• Thyroid disease

• Decisional incapacity (e.g., dementia)

• Centrally acting medications that have a potential effect on biological expression (e.g., beta-blockers, opiates, and ≥10mg equivalent of diazepam/day)

• Pain levels requiring opiate medications

• Known exposure to chemicals or physical trauma that cause neuropsychiatric sequelae

• Severe depression (Beck Depression Inventory-II score ≥30)

• A diagnosed and untreated sleep breathing disorder (SBD)

• High risk of a SBD as indicated by snoring ≥50 of nights plus one of any

  1. Any witnessed apnea
  2. Feeling non-refreshed in the morning ≥50 of mornings
  3. Daytime sleepiness indicated by falling asleep with routine tasks such as watching TV or reading

• Non-response to ≥2 evidence-based PTSD treatments (adequate medication of 12 weeks or completion to PE, CPT or an intensive program)

• Treatment non-adherence indicated by stopping treatment or >3 missed appointments in the course of PTSD EBT

• High dissociation as indicated by a score of ≥25 on the Dissociative Experiences Scale - II

• Past chronic PTSD prior to military service

• Current active psychotherapy for PTSD

• Having acupuncture in the past year

• Pregnancy