Clinical Research Directory

Inclusion Criteria: * English proficiency sufficient for informed consent, questionnaires/tasks, and treatment * Diagnosis of one of the following anxiety-related disorders per Quick-SCID: * Generalized Anxiety Disorder * Social Anxiety Disorder * Panic Disorder * Posttraumatic Stress Disorder * Obsessive Compulsive Disorder * Moderate level of anxiety (BAI \>16) * One failed psychological or pharmacological treatment * Stable psychiatric medication regimen for 4 weeks prior to treatment and throughout treatment * Primary clinician (e.g. psychiatrist, psychologist, therapist, APRN, PA, etc.) responsible for psychiatric care before, during, and after the trial * Agreement to abstaining from becoming pregnant from screening to two weeks after treatment (the MRI visit) Exclusion Criteria: * • Active pregnancy as determined by a urine pregnancy test * Recent (within 4 weeks) or concurrent use of rapid acting antidepressant agent (ketamine/esketamine/ECT) * History of: * Exposure to TMS within the last 3 months * Neurosurgical intervention for psychiatric disorders * Autism spectrum disorder, intellectual disability, or cognitive impairment that impairs capacity to consent * Significant neurological illness deemed to increase risk from treatment * Moderate to severe neurodegenerative disease * Untreated or insufficiently treated endocrine disorder * Treatment with investigational drug or intervention during the study period * Bipolar I disorder or schizophrenia * Anyone presenting with: * Mania or hypomania * Psychosis * Active suicidal ideation with intent and a plan (defined by Columbia Suicide Severity Rating Scale) * Contraindications to either TMS or MRI (e.g., metallic implants, severe insomnia \> 4 hours per night with hypnotic, etc.). * Current moderate or severe substance use disorder (excluding cannabis or nicotine) or demonstrating signs of acute substance withdrawal * Positive urine drug screen for illicit substances for cocaine, amphetamines, phencyclidine, and opioids, except for prescribed medications or known medications with history of resulting in a false positive * Existing tinnitus (ringing in the ears) * Any other condition deemed by the PI to interfere with the study or increase risk to the participant