Neuroimaging the Impact of Treatment on Neural Substrates of Trust in Post-Traumatic Stress Disorder (PTSD)
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 50 |
| Updated: | 8/29/2018 |
| Start Date: | May 16, 2011 |
| End Date: | June 30, 2018 |
Neuroimaging the Impact of Treatment on Neural Substrates of Trust in 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, the investigators 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.
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, the investigators 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.
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, the investigators 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, the investigators seek to examine changes in neurobehavioral substrates of
social functioning following treatment for Veterans with PTSD. Specifically, the
investigators 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.
Thus, the broad goals of this project are two-fold. First, the investigators 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, the investigators seek to examine changes in neurobehavioral substrates of
social functioning following treatment for veterans with PTSD. Specifically, the
investigators 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.
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, the investigators 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, the investigators seek to examine changes in neurobehavioral substrates of
social functioning following treatment for Veterans with PTSD. Specifically, the
investigators 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.
Thus, the broad goals of this project are two-fold. First, the investigators 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, the investigators seek to examine changes in neurobehavioral substrates of
social functioning following treatment for veterans with PTSD. Specifically, the
investigators 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.
Inclusion Criteria:
- Meet criteria for PTSD on the Clinician Administered PTSD Scale (CAPS)
- Priority will be given to Veterans aged 18-50 who have had an onset of symptoms in the
past 10 years and are Veterans of Operation Enduring Freedom/Operation Iraqi Freedom
(OEF/OIF)
- Have been referred for placement in CPT treatment by a clinician in the Trauma
Recovery Program at the Michael E DeBakey VA Medical Center (MEDVAMC) or an eligible
Veteran who contacts study staff.
- Are able to see the computer display clearly with or without magnetic Resonance
imaging (MRI)-compatible corrective lenses
- Are free from current non-psychiatric medical problems impacting cognitive
functioning.
- Are cleared to participate by a treating MEDVAMC clinician
- Are able to participate in functional MRI (fMRI)
Exclusion Criteria:
- Meet Diagnostic and Statistical Manual-IV (DSM-IV)criteria for drug or alcohol abuse
in the past 30 days
- History of moderate to severe traumatic brain injury based on any of the following:
- (i) Glasgow Coma Score < 13
- (ii)alteration of consciousness > 24 hours; loss of consciousness,30 minutes
- Presence of contraindications to MRI, including but not limited to:
- claustrophobia
- pacemaker
- metal in eyes
- other implants
- Current neurological or general medical conditions known to impact cognitive and/or
emotional functioning, including but limited to:
- epilepsy
- Parkinson's disease
- Huntington's disease
- Alzheimer's disease
- stroke
- chemotherapy for cancer
- Acute psychological instability as assessed by a Michael E DeBakey VA Medical Center
(MEDVAMC) clinician or study staff
- Concurrent diagnosis of:
- schizophrenia
- schizoaffective disorder
- delusional disorder
- organic psychosis
- and subjects taking antipsychotic medication
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