DESCRIPTION: In this revised CDA-2 proposal, Dr. Orff proposes to study a behavioral therapeutic approach, Cognitive Behavioral Therapy for Insomnia (CBT-I) for veterans with a history of mild traumatic brain injury (mTBI) and current insomnia. There are three aims to this project: 1) determine the efficacy of CBT-I relative to Sleep Education in veterans with insomnia following mTBI; 2) evaluate sleep efficiency as a mediator of distal effects of CBT-I on symptoms of comorbid depression and PTSD and global functioning and disability; 3) examine the effects of moderator variables (e.g., depression, PTSD, physical pain) on CBT-I treatment outcomes. Dr. Orff plans to enroll 70 OEF/OIF/OND veterans who, following baseline assessments, will be randomly assigned to six weeks of either CBT-I or Sleep Education. The two conditions are matched appropriately for time and attention. These patients will be followed over the six weeks and assessed for changes in sleep and other outcomes. Applicant: Dr. Henry Orff has a 1988 BA in Health and Society and Psychology from University of Rochester, a 2010 PhD in Clinical Psychology from SDSU/UCSD, and post-doctoral appointments. He has been interested in sleep research since 1996 when he was a research assistant in a sleep lab. He lists 23 publications, seven of which are first authored. He was awarded a F31 NRSA pre-doctoral fellowship. He is at the right point in his career to pursue this CDA-2 award. Mentor/s: The mentoring team is excellent and well suited for Dr. Orff's purposes. All (except Dr. Golshan) are trained as clinical psychologists and all have written strong letters of endorsement. Elizabeth Twamley, PhD, will be the primary mentor for randomized clinical trials and rehabilitation of veterans with mTBI. She is Chief of the Neuropsychology Unit, Center of Excellence for Stress and Mental Health, and an Associate Professor of Psychiatry at UCSD. She has developed and tested two interventions for veterans with TBI. She is well funded and published and has good mentoring experience. She will meet weekly with Dr. Orff and devote 5% time. Philip Gehrman, PhD, will be the mentor for CBT-I and treatment fidelity. He is the Director of the Behavioral Sleep Medicine Program at the Philadelphia VAMC and Assistant Professor of Psychology in Psychiatry at U. Penn. He focuses on insomnia and is a national trainer for CBT-I. He is well published and also has good mentoring experience. He will meet with Dr. Orff by phone or skype and devote 5% time. Amy Jak, PhD, will serve as the mentor for mTBI and neuropsychology. She is the Director of TBI Cognitive Rehabilitation at the VA San Diego and an Assistant Professor of Psychiatry at UCSD. She is the co-director of the UCSD/VA psychology internship program. She is well published and has good mentoring experience. She will meet with the candidate monthly and devote 5% tim...