Evaluating a novel working memory training program to decrease symptoms of PTSD

描述(由申请人提供)：创伤后应激障碍(PTSD)是一种慢性和衰弱的疾病，每年影响数百万人(Kessler等人，2005年)。尽管对这种疾病有有效的心理社会和药物治疗，但多达50%的人在治疗后仍有症状(Schottenbaeur等人，2008年)。经验文献表明，认知缺陷可能通过各种机制在维持创伤后应激障碍患者的症状中发挥作用，包括对侵入性思维的认知控制减弱(Verwoerd等人，在新闻中)，以及连接前额叶认知控制功能和杏仁核活动的神经回路调节失调(McNally，2007)。拟议研究的目标是提高候选人对创伤后应激障碍症状的认知机制的理解，同时培养进行治疗研究的技能。这项应用旨在测试一种新的方法，用于基于对创伤后应激障碍的潜在认知机制的修改来接近创伤后应激障碍的治疗。为此，50名患有创伤后应激障碍的参与者将被随机分配到8节执行控制训练条件下，旨在改善工作记忆功能或控制条件。本研究的目的是：1)测试工作记忆训练计划对工作记忆表现的影响；2)检查该计划对创伤后应激障碍症状的影响。作为研究计划的补充，候选人将在拟议的授权期内实现一套培训目标。这包括1)使用功能磁共振成像和神经心理学评估的培训，2)认知科学和生物统计学的额外课程作业和研讨会，用于未来工作，3)在本科生和研究生环境中的教学经验，并提交原创作品供出版，为从事学术研究事业做准备。综上所述，这项补助金申请的研究和培训部分将有助于候选人实现在创伤后应激障碍中进行治疗结果和基本机制研究的长期目标。此外，根据NIMH概述的战略计划，这一应用程序旨在基于先前的临床研究和对该疾病的认知和神经生物学特征的知识开发一种创新的干预措施，并将促进对恐惧学习机制的了解。它旨在针对该障碍的核心认知特征，以努力减少症状。 公共卫生相关性：创伤后应激障碍影响着数以百万计的美国人，并与重大的个人痛苦和社会成本有关。目前的应用程序旨在检查一种新的工作记忆训练计划对创伤后应激障碍症状的影响。这种方法很有希望，因为它可能是一种具有成本效益和可获得的方法，可以减少与这种疾病相关的症状。

DESCRIPTION (provided by applicant): Post-traumatic stress Disorder (PTSD) is a chronic and debilitating disorder that affects millions of people each year (Kessler et al., 2005). Although effective psychosocial and pharmacological treatments exist for this disorder, as many as 50 percent of individuals still experience symptoms after treatment (Schottenbaeur et al., 2008). Empirical literature suggests that cognitive deficits may play a role in maintaining symptoms in individuals with PTSD through a variety of mechanisms, including decreased cognitive control over intrusive thoughts (Verwoerd et al., in press) and dysregulation in neural circuitry linking prefrontal cognitive control functions and amygdala activity (McNally, 2007). The goals of the proposed research are to improve the candidate's understanding of cognitive mechanisms of PTSD symptoms while building skills in conducting treatment research. The application aims to test a novel methodology for approaching PTSD treatment based on modification of underlying cognitive mechanisms of the disorder. To this end, 50 participants with PTSD will be randomly assigned to an 8-session executive control training condition designed to improve working memory functioning or a control condition. The aims of this study are 1) To test the effect of a working memory training program on working memory performance and 2) To examine the effects of this program on PTSD symptoms. The research plan is complemented by a set of training goals for the candidate to achieve over the proposed award period. These include 1) training in the use of fMRI and neuropsychological assessment 2) additional coursework and seminars in cognitive science and biostatistics for use in future work, 3) experience with teaching in the undergraduate and graduate setting and presenting original work for publication in preparation for a career in academic research. Taken together, the research and training components of this grant application will facilitate the candidate's long-term goal of conducting treatment outcome and basic mechanism research in PTSD. Moreover, as per the strategic plan outlined by NIMH, this application is designed develop an innovative intervention based on prior clinical research and knowledge of cognitive and neurobiological features of the disorder, and will advance knowledge of mechanisms of fear learning. It is designed to target core cognitive features of the disorder in an effort to reduce symptoms. PUBLIC HEALTH RELEVANCE: Post-traumatic stress disorder impacts millions of Americans, and is associated with significant personal distress as well as societal cost. The current application is designed to examine the effect of a novel working memory training program on PTSD symptoms. This approach is promising in that it may be a cost- effective and accessible method for decreasing symptoms associate with this disorder.