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

7.项目总结/摘要 创伤后应激障碍（PTSD）对健康有着毁灭性的影响。实验将PTSD与 不同记忆类型的编码/检索困难，临床研究表明， 处理关于幸福的积极记忆。尽管有这样的证据，目前的PTSD干预主要针对 创伤记忆;他们也有显着的辍学率（19%-68%），并导致缓解创伤后应激障碍，只有 约50%的人。已经提出了增强，但是，它们显示出适度的增量， 有效性针对这些局限性，拟议的研究旨在审查 一种专注于积极记忆的新型PTSD技术（积极记忆处理技术; PPMT） 从实验和记忆集中/积极心理学干预研究中得出。通过重温和 在情感上参与突出的积极记忆，个人可以访问和巩固积极的价值观，影响， 力量和认知。因此，PPMT可能涉及机械靶点以减少PTSD症状，包括 改善情感和检索特定积极记忆的能力。具体目标包括（1） 检查PPMT的影响;（2）检查PPMT影响的机制目标;（3）改进 PPMT。从方法学上讲，70名PTSD患者将被随机分配到PPMT组和支持性治疗组。 辅导（SC）武器。对于目标1，将比较PPMT与SC组的PTSD严重程度（主要结局 变量; H1）和应激系统的失调（即，唤醒唾液α淀粉酶[sAA]和皮质醇; 探索性H1）。假设PPMT组将报告PTSD严重程度的更大降低， sAA/皮质醇比率。对于目标2，将研究PPMT效应背后的机制目标。据推测 PPMT相关的情感改善将介导研究组（PPMT vs. SC）与变化之间的关联 PTSD严重程度（H2）。将使用混合效应模型分析H1和探索性H1的数据; H2的数据 将使用受试者内交叉滞后纵向中介分析进行分析。对于目标3， 将从PPMT的研究参与者/治疗师处获得定量/定性数据（反馈调查） 可行性（可接受性、筛选、招募、保留、治疗依从性/保真度）、格式和内容， 细化PPMT;将使用频率和平均估计值以及演绎（问题域）分析数据 归纳法（确定主题）。与NIMH的实验疗法一致 方法，结果可能会突出潜在的机制PPMT的影响，如果赤字在积极的 记忆过程是创伤后应激障碍的潜在机制这项研究将提供关键的初步 在PTSD干预中针对积极记忆的潜在意义的证据;以及机会 指导学生在干预发展研究，创伤后应激障碍评估/干预，和学术 活动

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.