Mechanisms Underlying the Efficacy of Prolonged Exposure

Phase

N/A

Condition

Post-traumatic Stress Disorders

Treatment

Prolonged Exposure Therapy for Posttraumatic Stress Disorder

Clinical Study ID

NCT05663151

1577670

Ages 18-90
All Genders

Study Summary

The primary objective of this research is to collect pilot data that demonstrates that proposed neural, psychophysiological and subjective markers measured before, during, and after treatment change over the course of Prolonged Exposure therapy (PE) for posttraumatic stress disorder (PTSD). The aims of the study are to: (1) examine theoretically informed mechanisms as pre-treatment predictors of PE treatment efficacy, (2) characterize how neural, psychophysiological, and subjective markers measured before, during, and after treatment change over the course of PE, and (3) examine proposed mechanisms of change as measures of PE treatment efficacy. This is a longitudinal study of predictors of exposure therapy efficacy that will be conducted within the context of a standard 10 session PE treatment trial, with independent multimodal assessment batteries administered at pre-treatment, mid-treatment, post-treatment, and at 1-month follow-up. This data will be used to support a future NIMH and/or VA grant submission.

Eligibility Criteria

Inclusion

Inclusion Criteria:

a diagnosis of PTSD as defined by DSM-5 (as indicated by meeting diagnostic criteriaon the CAPS-5)
interest in starting PE (as indicated during the informed consent process)
Veteran

Exclusion

Exclusion Criteria:

Current or past history of schizophrenic or other psychotic disorders,
Untreated Bipolar Disorder or a history of a manic/mixed episode within the last 6months,
Severe traumatic brain injury,
Major neurological problems,
Current substance use disorder,
Active risk to self or others,
Current participation in cognitive-behavioral therapy,
Previously received > 2 sessions of Prolonged Exposure, and
Having no memory of their traumatic event.
For participants who are currently prescribed psychotropic medication, they will beeligible for the study provided medication use has been stable for 2 months prior toenrollment and remains stable throughout participation

Study Design

Prolonged Exposure Therapy for Posttraumatic Stress Disorder

January 01, 2024

January 01, 2027

Study Description

Proposed research sets to collect pilot data to examine how the proposed neural, psychophysiological and subjective markers measured before, during, and after treatment change over the course of Prolonged Exposure (PE) therapy for posttraumatic stress disorder (PTSD). Fifty participants will be screened with the goal of obtaining 15 participants to complete the study. Participants will complete ten 60-minute sessions of PE. During each PE session, participants will be outfitted with a NINscan device to record psychophysiological measures including skin conductance, heart rate, and facial EMG, as well as neural measures of LPFC activity. Multimodal assessment batteries will be scheduled to take place at pre-treatment, mid-treatment (i.e., post session 5), post-treatment (i.e., post-session 10), and at 1-month follow-up. These sessions will include a battery of self-report measures, clinician-administered diagnostic interviews, and script-driven imagery (SDI) procedures with physiologic and neural recordings. The primary outcome measure will be PTSD symptom change on the CAPS-5 and the secondary outcome measures will be a) change in self-reported symptom severity, b) premature treatment dropout, and c) change in psychophysiological reactivity and LPFC activity during the SDI procedures. This proposed research will inform theoretical models of exposure therapy efficacy, with the goal of enhancing prolonged exposure therapy.

Connect with a study center

VA Boston Healthcare System
Boston, Massachusetts 02116
United States
Active - Recruiting

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