Examination and Refinement of a Novel Treatment for Posttraumatic Stress Disorder: Processing of Positive Memories Technique (PPMT)

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7. Project Summary/Abstract Posttraumatic stress disorder (PTSD) has devastating health consequences. Experiments link PTSD with encoding/retrieval difficulties across memory types, and clinical studies have demonstrated beneficial impacts of processing positive memories on well-being. Despite such evidence, current PTSD interventions primarily target trauma memories; they also have significant dropout rates (19%-68%) and result in remission of PTSD for only ~50% of individuals. Augmentations have been proposed, however, they demonstrate modest incremental effectiveness. Addressing these limitations, the proposed study aims to examine effects of and targets underlying a novel PTSD technique focused on positive memories (Processing of Positive Memories Technique; PPMT) drawing from experimental and memory-focused/positive psychology intervention research. By reliving and emotionally engaging with salient positive memories, individuals may access and solidify positive values, affect, strengths, and cognitions. Hereby, PPMT may engage mechanistic targets to reduce PTSD symptoms including improvements in affect and in abilities to retrieve specific positive memories. Specific aims include (1) examining PPMT’s effects; (2) examining mechanistic targets underlying PPMT’s effects; and (3) refining PPMT. Methodologically, 70 individuals with PTSD will be randomly assigned to PPMT vs. Supportive Counseling (SC) arms. For Aim 1, PPMT vs. SC arms will be compared on PTSD severity (primary outcome variable; H1) and stress systems’ dysregulation (i.e., awakening salivary alpha amylase [sAA] and cortisol; Exploratory H1). It is hypothesized that the PPMT arm will report greater decreases in PTSD severity and sAA/cortisol ratios. For Aim 2, mechanistic targets underlying PPMT’s effects will be examined. It is hypothesized that PPMT-related improved affect will mediate the association between study arm (PPMT vs. SC) and changes in PTSD severity (H2). Data for H1 and Exploratory H1 will be analyzed using mixed-effects models; data for H2 will be analyzed using within-subjects cross-lag longitudinal mediation analyses. For Aim 3, quantitative/qualitative data (Feedback Surveys) will be obtained from study participants/therapists on PPMT’s feasibility (acceptability, screening, recruitment, retention, treatment adherence/fidelity), format, and content to refine PPMT; data will be analyzed using frequency and mean estimates, and a deductive (question domains) and an inductive (identification of themes) approach. Consistent with NIMH’s experimental therapeutics approach, results may highlight potential mechanisms underlying PPMT’s effects and if deficits in positive memory processes are mechanisms underlying PTSD. The proposed study will provide critical preliminary evidence on the potential significance of targeting positive memories in PTSD interventions; and opportunities to mentor students in intervention development research, PTSD assessment/intervention, and scholarly activities.