RecruitingNot ApplicableNCT06096740

Psychotherapy Effects on Reward Processing in PTSD

The Effects of Trauma-focused Psychotherapy on Reward Circuitry Function and Information Encoding

Sponsor

University of Texas at Austin

Enrollment

120 participants

Start Date

Jun 1, 2024

Study Type

INTERVENTIONAL

Conditions

Post Traumatic Stress Disorder Anhedonia PTSD Diminished Pleasure Chronic PTSD Chronic Post-Traumatic Stress Disorder

Summary

The purpose of this study is to identify how trauma-focused psychotherapy changes the function of brain circuitry in posttraumatic stress disorder (PTSD) and how this mediates improvements in the diminished ability to experience positive emotions following a traumatic or extremely stressful life event. In this instance, the investigators will be using cognitive processing therapy (CPT), a widely-utilized and evidence-based treatment for PTSD.

Eligibility

Min Age: 18 YearsMax Age: 65 Years

Inclusion Criteria4

English as primary language, and comprehension suitable to understand experimenter instructions.
Current and chronic syndromic PTSD, defined as being exposed to a DSM-5 Criterion A traumatic event, with the presence DSM-5 qualifying PTSD symptoms for at least 3 months, as assessed by the Clinician-Administered PTSD Scale for DSM-5.
Able and willing to undergo functional magnetic resonance imaging (fMRI).
Willingness to participate in repeated assessments and as part of a delayed treatment group.

Exclusion Criteria11

Evidence of current or prior history of psychosis or bipolar disorder as evidenced by self-report or clinical interview.
Active substance dependence within the past 6 months as evidenced by clinical interview.
Current regular psychiatric medication use (i.e. antidepressants), except for as-needed benzodiazepine or opiate medication no more than three times per week, on average, or for short-duration stimulant medication for attention deficit hyperactivity disorder that can be skipped within 24 hours of study visits.
A recent (\<6 months) suicide attempt or current active ideation with intent.
Unremovable ferrous metal in body.
History of neurological disorder, stroke, seizures/convulsions (except febrile seizures in childhood), epilepsy, brain surgery, electroconvulsive or radiation treatment, brain hemorrhage or tumor, or thyroid disorder.
Anyone who is pregnant or trying to become pregnant.
Current or past year (\> 3 sessions), psychotherapy with a prominent exposure or cognitive restructuring component.
Previous or current (es)ketamine treatment and/ or brain stimulation/neuromodulation treatment.
Other ongoing treatment that is likely to confound experimental effects.
Previous penetrating head injury/traumatic brain injury. Mild-to-moderate traumatic brain injury without penetrating injury is allowable.

Interventions

BEHAVIORALCognitive Processing Therapy

Cognitive processing therapy is a widely-utilized, empirically-supported treatment developed for PTSD. It is based on a cognitive theory of trauma which emphasizes the impact of trauma on belief systems and the development of "stuck points", which are unhealthy, unrealistic, and maladaptive ways of thinking that serve to maintain unhealthy beliefs and reinforce PTSD symptoms.