scholarly journals Proof of Concept for the Autobiographical Memory Flexibility (MemFlex) Intervention for Posttraumatic Stress Disorder

2021 ◽  
pp. 216770262098257
Author(s):  
Ali Reza Moradi ◽  
Maryam Piltan ◽  
Mohammad Hasan Choobin ◽  
Parviz Azadfallah ◽  
Peter Watson ◽  
...  

Autobiographical memory distortions are a key feature of posttraumatic stress disorder (PTSD). In this proof-of-concept randomized controlled trial ( N = 43), we evaluated an autobiographical memory flexibility intervention, MemFlex. We aimed to determine whether the mechanism-focused intervention, which aims to improve autobiographical memory processes, may also affect other cognitive predictors of PTSD and potentially reduce PTSD symptoms in Iranian trauma survivors diagnosed with PTSD. Results indicated significant, moderate to large between-groups effect sizes in favor of MemFlex, relative to wait-list control, for the targeted cognitive mechanism of autobiographical memory flexibility and PTSD symptoms. A large, significant effect was also observed on maladaptive posttraumatic cognitions—a strong predictor of PTSD prognosis, which is a key target of high-intensity cognitive therapies for PTSD. Findings support future completion of a scaled-up trial to evaluate treatment efficacy of MemFlex for PTSD to determine whether MemFlex may offer a culturally adaptive, low-cost, low-intensity intervention able to improve cognitive mechanisms of PTSD.

2021 ◽  
Vol 9 (2) ◽  
pp. 294-301 ◽  
Author(s):  
Maryam Piltan ◽  
Ali Reza Moradi ◽  
Mohammad Hassan Choobin ◽  
Parviz Azadfallah ◽  
Sara Eskandari ◽  
...  

Reduced ability to retrieve specific autobiographical memories is a well-defined feature of posttraumatic stress disorder (PTSD), and science-driven interventions have emerged to improve memory specificity and thereby symptoms. However, research in depressed samples indicates that the ability to flexibly move between retrieval of specific and general memory types (i.e., memory flexibility) may more accurately conceptualize autobiographical memory deficits in emotional disturbance. In this study, we evaluated memory specificity and memory flexibility in Iranian trauma survivors ( N = 63) with and without PTSD relative to community control participants. Trauma-exposed participants had experienced a serious road-traffic accident. Results indicated that individuals with PTSD experienced reduced memory specificity and memory flexibility relative to trauma-exposed participants and community control participants. A small sample size limits the strength of conclusions, although good statistical power was obtained. Findings suggest that reduced memory flexibility may be a transdiagnostic marker of emotional disturbance and support further development of memory flexibility interventions for PTSD.


2021 ◽  
Vol 10 (19) ◽  
pp. 4522
Author(s):  
Chris M. Hoeboer ◽  
Danielle A. C. Oprel ◽  
Rianne A. De Kleine ◽  
Brian Schwartz ◽  
Anne-Katharina Deisenhofer ◽  
...  

Background: Differences in effectiveness among treatments for posttraumatic stress disorder (PTSD) are typically small. Given the variation between patients in treatment response, personalization offers a new way to improve treatment outcomes. The aim of this study was to identify predictors of psychotherapy outcome in PTSD and to combine these into a personalized advantage index (PAI). Methods: We used data from a recent randomized controlled trial comparing prolonged exposure (PE; n = 48), intensified PE (iPE; n = 51), and skills training (STAIR), followed by PE (n = 50) in 149 patients with childhood-abuse-related PTSD (CA-PTSD). Outcome measures were clinician-assessed and self-reported PTSD symptoms. Predictors were identified in the exposure therapies (PE and iPE) and STAIR+PE separately using random forests and subsequent bootstrap procedures. Next, these predictors were used to calculate PAI and to retrospectively determine optimal and suboptimal treatment in a leave-one-out cross-validation approach. Results: More depressive symptoms, less social support, more axis-1 diagnoses, and higher severity of childhood sexual abuse were predictors of worse treatment outcomes in PE and iPE. More emotion regulation difficulties, lower general health status, and higher baseline PTSD symptoms were predictors of worse treatment outcomes in STAIR+PE. Randomization to optimal treatment based on these predictors resulted in more improvement than suboptimal treatment in clinician assessed (Cohens’ d = 0.55) and self-reported PTSD symptoms (Cohens’ d = 0.47). Conclusion: Personalization based on PAI is a promising tool to improve therapy outcomes in patients with CA-PTSD. Further studies are needed to replicate findings in prospective studies.


2021 ◽  
pp. 1-10
Author(s):  
Kathryn Trottier ◽  
Candice M. Monson ◽  
Stephen A. Wonderlich ◽  
Ross D. Crosby

Abstract Background Eating disorders (EDs) and posttraumatic stress disorder (PTSD) frequently co-occur and can share a functional relationship. The primary aim of this initial randomized controlled trial was to determine whether integrated cognitive-behavioral therapy (CBT) for co-occurring ED-PTSD was superior to standard CBT for ED in improving PTSD symptoms. Intervention safety and desirability, as well as the relative efficacy of the treatments in improving anxiety, depression, and ED symptomatology, were also examined. Methods Following a course of intensive ED treatment, individuals with ED-PTSD were recruited to participate and randomized to integrated CBT for ED-PTSD or standard CBT for ED. The sample consisted of 42 individuals with a range of ED diagnoses. Outcomes were assessed at end-of-treatment, 3-, and 6-month follow-up using interview and self-report measures. Results Mixed models revealed significant interactions of time and therapy condition on clinician-rated and self-reported PTSD symptom severity favoring Integrated CBT for ED-PTSD. Both treatments were associated with statistically significant improvements in PTSD, anxiety, and depression. Improvements were maintained at 3- and 6-month follow-up. There was good safety with both interventions, and satisfaction with both treatments was high. However, there was a stronger preference for integrated treatment. Conclusions Integrating CBTs for PTSD and ED following intensive ED treatment is safe, desirable, and efficacious for improving PTSD symptoms. Future studies with larger sample sizes are needed to determine whether Integrated CBT for ED-PTSD provides benefits over standard CBT for ED with respect to ED outcomes.


2010 ◽  
Vol 218 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Slawomira J. Diener ◽  
Herta Flor ◽  
Michèle Wessa

Impairments in declarative memory have been reported in posttraumatic stress disorder (PTSD). Fragmentation of explicit trauma-related memory has been assumed to impede the formation of a coherent memorization of the traumatic event and the integration into autobiographic memory. Together with a strong non-declarative memory that connects trauma reminders with a fear response the impairment in declarative memory is thought to be involved in the maintenance of PTSD symptoms. Fourteen PTSD patients, 14 traumatized subjects without PTSD, and 13 non-traumatized healthy controls (HC) were tested with the California Verbal Learning Test (CVLT) to assess verbal declarative memory. PTSD symptoms were assessed with the Clinician Administered PTSD Scale and depression with the Center of Epidemiological Studies Depression Scale. Several indices of the CVLT pointed to an impairment in declarative memory performance in PTSD, but not in traumatized persons without PTSD or HC. No group differences were observed if recall of memory after a time delay was set in relation to initial learning performance. In the PTSD group verbal memory performance correlated significantly with hyperarousal symptoms, after concentration difficulties were accounted for. The present study confirmed previous reports of declarative verbal memory deficits in PTSD. Extending previous results, we propose that learning rather than memory consolidation is impaired in PTSD patients. Furthermore, arousal symptoms may interfere with successful memory formation in PTSD.


2016 ◽  
Vol 37 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Nicole L. Hofman ◽  
Austin M. Hahn ◽  
Christine K. Tirabassi ◽  
Raluca M. Gaher

Abstract. Exposure to traumatic events and the associated risk of developing Posttraumatic stress disorder (PTSD) symptoms is a significant and overlooked concern in the college population. It is important for current research to identify potential protective factors associated with the development and maintenance of PTSD symptoms unique to this population. Emotional intelligence and perceived social support are two identified protective factors that influence the association between exposure to traumatic events and PTSD symptomology. The current study examined the mediating role of social support in the relationship between emotional intelligence and PTSD symptoms. Participants included 443 trauma-exposed university students who completed online questionnaires. The results of this study indicated that social support mediates the relationship between emotional intelligence and reported PTSD symptoms. Thus, emotional intelligence is significantly associated with PTSD symptoms and social support may play an integral role in the relationship between emotional intelligence and PTSD. The current study is the first to investigate the role of social support in the relationship between emotional intelligence and PTSD symptoms. These findings have important treatment and prevention implications with regard to PTSD.


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