Affect, Memory, Stress Disorders, Post-Traumatic
Conditions
Brief summary
Posttraumatic stress disorder (PTSD) has devastating health consequences. Evidence-based PTSD interventions address the substantial burden of PTSD on the health of individuals and societies; however, several individuals receiving these interventions drop out and not all individuals experience improvement in PTSD symptoms. Moreover, these current PTSD interventions primarily target trauma memories. Notably, growing evidence suggests that PTSD symptoms are related to difficulties in the encoding and retrieving of positive memories as well. Thus, the proposed study will examine effects of and targets underlying a novel PTSD technique focused on narrating and detailing positive memories - Processing of Positive Memories Technique (PPMT). Methodologically, 70 individuals will be randomly assigned to PPMT vs. Supportive Counseling (SC) for this study. The aims of the proposed study include (1) examining PPMT's effects on PTSD symptom severity and stress systems' dysregulation (i.e., awakening salivary alpha amylase \[sAA\] and cortisol); (2) examining mechanisms underlying PPMT's effects; and (3) refining PPMT. It is hypothesized that the PPMT arm will report greater decreases in PTSD severity and sAA/cortisol ratios. Further, it is hypothesized that PPMT-related improved affect will mediate the association between study arm (PPMT vs. SC) and changes in PTSD severity. Lastly, feedback will be obtained from study participants on PPMT's feasibility, format, and content to refine PPMT. The proposed study may contribute preliminary evidence on the potential significance of targeting positive memories in PTSD interventions.
Interventions
BEHAVIORALProcessing of Positive Memories Technique (PPMT)
PPMT comprises of 5 sessions focused on identifying and processing positive memories. In Session 1-5, participants narrate details of one positive memory, and process the positive memory to elicit positive values, affect, strengths, and thoughts.
BEHAVIORALSupportive Counseling (SC)
SC is a 5-session, active and non-specific treatment administered weekly, which includes a discussion of the daily monitoring diary and exploration of current issues and concerns.
Sponsors
University of North Texas, Denton, TX
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* 18-65 years old * Willing/able to provide informed consent * Past month DSM-5 posttraumatic stress disorder (PTSD) diagnosis * Working knowledge of English
Exclusion criteria
* Active suicidal intent or attempts * Active psychosis * Currently receiving mental health therapy (past 3 months) * Dosage changes in psychiatric medications (past 3 months) * Currently pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) Scores | Baseline | The 20-item self-report PTSD Checklist for DSM-5 (PCL-5) assessed past-week posttraumatic stress disorder (PTSD) severity. Response options ranged from 0 (not at all) to 4 (extremely), with the possible range being from 0 to 80. Higher scores indicate more PTSD symptom severity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Awakening Salivary Alpha Amylase to Cortisol Ratio | 3 times each day for 2 consecutive days prior to first therapy session | Via a passive drool procedure, participants provided 3 whole saliva samples each day for 2 consecutive days both prior to PPMT/SC: (1) immediately upon awakening, (2) 30 minutes post-awakening, and (3) 60 minutes post-awakening. For each marker, for each day, area under the curve with respect to ground (AUCg) was calculated. The two-day average AUCg of sAA was then divided by the two-day average AUCg of cortisol to create the ratio variable. Higher sAA/cortisol ratio indicates greater stress system dysregulation and sympathetic nervous system dominance. |
| Positive and Negative Affect Schedule | Baseline | The 20-item Positive and Negative Affect Schedule (PANAS) examined past-week positive and negative affect levels. There were 10 items for each of the PANAS-Positive and PANAS-Negative subscales, which measure past-week positive and negative affect respectively. Response options ranged from 1 (not at all/very slightly) to 5 (extremely), with the possible range being from 10 to 50 for each subscale. Higher scores mean more self-reported positive affect and negative affect for the PANAS-Positive and PANAS-Negative subscales respectively. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAteka Contractor, PHD
University of North Texas Health Science Center
Participant flow
Recruitment details
The first participant was enrolled in March 2023, and the last participant was enrolled in October 2024 (average enrollment/month = 3.5 eligible participants). We recruited participants in and around the Dallas Fort Worth metroplex by disseminating information to mental health agencies, primary care offices, community partners, public places, and businesses. As needed, we used social media postings.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 30.61 years STANDARD_DEVIATION 14.14 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 10 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 48 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Positive and Negative Affect Schedule (PANAS-Negative) | 25.41 scores on a subscale STANDARD_DEVIATION 8.31 |
| Positive and Negative Affect Schedule (PANAS-Positive) | 25.48 scores on a subscale STANDARD_DEVIATION 6.63 |
| PTSD Checklist for DSM-5 | 32.73 scores on a scale STANDARD_DEVIATION 12.24 |
| Sex: Female, Male Female | 56 Participants |
| Sex: Female, Male Male | 7 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 36 | 0 / 34 |
| other Total, other adverse events | 12 / 36 | 12 / 34 |
| serious Total, serious adverse events | 0 / 36 | 0 / 34 |
Outcome results
None listed