Prevention of PTSD III: Neurocognitive Training of Emotional Regulation

Not Applicable

Completed

Conditions: Post Traumatic Stress Disorder
Major Depression
Anxiety Disorders

Interventions: Procedure: Neurocognitive retraining Web Based Intervention
Other: Control, web-based tasks

Brief Summary: The proposed work will evaluate the ability of neurocognitive retraining of executive functions and emotional regulation to reduce neurocognitive dysfunctions that follow trauma exposure and thereby prevent PTSD. The scientific rationale for this work is the hypothesis that impaired emotional regulation interferes with the expected recovery from the early responses to traumatic events, leading into a chronic disorder. In an initial phase the investigators will recruit 20 recently traumatized participants among trauma survivors admitted to a general hospital emergency room and test the planned intervention's acceptance and right 'dosing'. In the second phase the investigators will enroll 80 recent survivors into a randomized controlled study of the new intervention. The intervention will consist of web-based neurobehavioral training interventions that instill an emotional bias toward positive stimuli, improve emotion recognition and labeling, reduce resistance to emotional distraction, and enhance executive functioning. Control participants will complete web-based video games that do not have emotion-regulatory benefits. Outcome measures will include improvement in neurocognitive functioning and in PTSD symptoms.

Recruitment & Eligibility

Inclusion Criteria

Adult survivors of traumatic events consecutively admitted to a general hospital Emergency Department

Exclusion Criteria

Chronic PTSD at the time of the traumatic event. Current and lifetime psychotic or bipolar illness, current substance abuse save alcohol, medical condition precluding participation.

Arm && Interventions

Group	Intervention	Description
Neurocognitive retraining	Neurocognitive retraining Web Based Intervention	Neurobehavioral training will be delivered through the web, with prompting for training tasks accomplished through daily emails that include a single integrated log-in system using a customized implementation with OneLogin. All training tasks have "game-like" features making them visually engaging, and motivating. The training tasks provide immediate feedback about performance, and are specifically designed to target circuitry critical for executive functioning (EF) and emotional reactivity.
Control, Web Based Tasks	Control, web-based tasks	Engaging daily, for 30 days in web-based video games or reading tasks that do not specifically engage or train neurocognitive functions.

Primary Outcome Measures

Name	Time	Method
Amelioration of neurocognitive impairments that are associated with post-traumatic stress disorder	Three and nine months after a traumatic event	Impairments in emotional reactivity, emotion regulation, and executive functioning critically contribute to post-trauma psychopathology (including, but not restricted to PTSD). The primary outcome measure of this work are changes (improvements) of these functions at the immediate aftermath of treatment and six months later

Secondary Outcome Measures

Name	Time	Method
Post-traumatic Stress Disorder (PTSD) symptoms	Three and nine months after a traumatic event	Decrease in PTSD symptoms from trial's onset

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