Acupuncture for Post-Traumatic Stress in Combat Veterans

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