Neuroimaging the Impact of Treatment on Neural Substrates of Trust in Post-Traumatic Stress Disorder (PTSD)
Traumatic experiences can have a profound negative effect on the lives and well-being of both the people who experience them and their loved ones. For those who experience post-traumatic stress disorder (PTSD), their interpersonal difficulties and social support further impact the success of treatment such that interpersonal difficulties are associated with mistrust and predict poor treatment outcome. In this proposal, we use functional neuroimaging to understand the neurobiology of trust and mistrust in people with PTSD and to learn more about how successful treatment can improve trust and social functioning.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Basic Science
|Official Title:||Neuroimaging the Impact of Treatment on Neural Substrates of Trust in PTSD|
- Continuous whole brain imaging with standard imaging parameters for each fMRI scan [ Time Frame: Pre & post a 12 week treatment group ] [ Designated as safety issue: No ]
- Behavioral Expression of trust on the trust game [ Time Frame: Pre & post a 12 week treatment group ] [ Designated as safety issue: No ]
- The Clinician Administered PTSD Scale (CAPS) [ Time Frame: Pre & post a 12 week treatment group ] [ Designated as safety issue: No ]
- PTSD Checklist (PCL) [ Time Frame: Administered each week at weekly group sessions ] [ Designated as safety issue: No ]
|Study Start Date:||May 2011|
|Estimated Study Completion Date:||May 2013|
|Estimated Primary Completion Date:||May 2013 (Final data collection date for primary outcome measure)|
Experimental: Arm 1
Participants in group CPT-C
Behavioral: Group CPT-C
Participants will be randomly assigned to participate in CPT-C or a 12 week waitlist control group. Waitlist control subjects will participate in CPT-C after the 12 weeks.
No Intervention: Arm 2
Participants randomly assigned to the Waitlist Control Group (who will participate in CPT-C after 12 weeks).
Substantial recent data highlight the role of social functioning as a primary moderator of therapeutic response in individuals with post-traumatic stress disorder (PTSD) such that interpersonal difficulties and mistrust significantly and negatively impact treatment efficacy (Forbes et al., 2003; Forbes et al., 2005; Forbes et al., 2008). In addition, ample evidence suggests that psychotherapy improves the social and interpersonal lives of psychotherapy clients through improving clients' abilities to regulate their emotions and reduce social isolation (Yalom & Leszcz, 2005; Foy et al., 2000). While considerable research has been dedicated to exploring the neurobiology of emotional dysregulation associated with PTSD (Rauch, Shin, & Phelps, 2006; Etkin & Wager, 2007), and increasing data suggest that diverse psychotherapies affect neural functioning (Beauregard 2007), very little is understood about the neurobehavioral pathology underlying the debilitating interpersonal difficulties in PTSD, or the neurobiological mechanisms accompanying the improvements in social functioning that occur with efficacious therapy.
Thus, the broad goals of this project are two-fold. First, we seek to examine the neural substrates associated with interpersonal dysfunction in PTSD using a social exchange game previously developed to assess interpersonal trust and cooperation in healthy (King-Casas et al., 2005) and psychiatric groups (Chiu et al., 2008; King-Casas et al., 2008). Second, we seek to examine changes in neurobehavioral substrates of social functioning following treatment for veterans with PTSD. Specifically, we propose to use functional magnetic resonance imaging (fMRI) and behavior within a well-characterized Trust Game to examine the neural substrates associated with interpersonal trust and cooperation in veterans with PTSD prior to and following empirically supported psychotherapy cognitive processing therapy (CPT) for PTSD.
|United States, Texas|
|Michael E. DeBakey VA Medical Center (152)|
|Houston, Texas, United States, 77030|
|Principal Investigator:||Wright Williams, PhD||Michael E. DeBakey VA Medical Center (152)|