Clinical Research Directory

Inclusion Criteria: 1. Adults aged 18 years or older. 2. History of at least one adverse life event documented by the List of Threatening Experiences (LTE, lifetime version, Brugha et al., 1985). 3. PHQ-9 score of 10 or above at screening. 4. Able to attend therapy sessions in person or via secure video. 5. Provides written informed consent. Exclusion Criteria: 1. Active suicidal ideation with plan (PHQ-9 item 9 score of 3). 2. Current psychotic symptoms. 3. Currently receiving other psychotherapy at enrollment. 4. Substance dependence requiring medical management. 5. Current or concurrent enrollment in any Painhunting training, educational, workshop, or reading-group program during the trial period or the three months preceding enrollment. (Note: this exclusion criterion is being applied retroactively via a documented audit, following surfacing of a single case of concurrent exposure. See 'Protocol Deviations and Quality Assurance' below.) Eligibility rationale: The prior protocol specified interpersonal loss (bereavement, divorce, relationship dissolution) within a 0 to 180 month window. Amendment 3 broadens this to any adverse life event documented by LTE. The LTE is a 12-item instrument designed specifically for depression research, with lifetime-version adaptations validated in multiple populations. Using LTE as the documentation instrument provides a defensible, research-standard definition of adverse life event exposure and removes the artificial narrowing to interpersonal losses alone.