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

7.项目摘要/摘要 创伤后应激障碍(PTSD)具有破坏性的健康后果。实验将创伤后应激障碍与 跨记忆类型的编码/提取困难，临床研究已经证明了 处理关于幸福感的积极记忆。尽管有这样的证据，目前的创伤后应激障碍干预主要针对 创伤记忆；他们也有显著的辍学率(19%-68%)，并仅在 约50%的个人。已经提出了扩充，然而，它们表现出适度的增量。 有效性。针对这些限制，拟议的研究旨在检查影响和潜在的目标 一种新的关注积极记忆的创伤后应激障碍技术(积极记忆加工技术；PPMT) 来自实验和以记忆为重点的/积极心理学干预研究。通过重温和 在情感上参与显著的积极记忆，个人可能获得和巩固积极的价值观，影响， 强项和认知能力。因此，PPMT可以使用机械性目标来减少创伤后应激障碍症状，包括 在情感和找回特定积极记忆的能力方面的改进。具体目标包括(1) 检查PPMT的影响；(2)检查PPMT影响的机制目标；以及(3)改进 PPMT。在方法上，70名患有创伤后应激障碍的患者将被随机分配到PPMT组和支持组 咨询(SC)武器。对于目标1，PPMT和SC ARMS将在创伤后应激障碍严重程度(主要结果)方面进行比较 可变；H1)和应激系统的失调(即，唤醒唾液α淀粉酶[SaA]和皮质醇； 探索性的H1)。假设PPMT ARM将报告创伤后应激障碍严重程度和 SaA/皮质醇比值。对于目标2，将审查潜在的PPMT影响的机械性目标。这是假设的 与PPMT相关的改善的情绪将在学习ARM(PPMT与SC)和变化之间的联系中起中介作用 创伤后应激障碍严重程度(H2)。H1和探索性H1的数据将使用混合效应模型进行分析；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， 定量/定性数据(反馈调查)将从PPMT的研究参与者/治疗师那里获得 可行性(可接受性、筛选、招聘、保留、治疗依从性/保真度)、格式和内容 改进PPMT；数据将使用频率和平均值估计以及演绎(问题域)进行分析 以及归纳式(主题识别)方法。与NIMH的实验疗法一致 如果采用这种方法，结果可能会突出PPMT影响的潜在机制，如果赤字是积极的 记忆过程是创伤后应激障碍的基础机制。拟议的研究将提供关键的初步研究 在创伤后应激障碍干预中以积极记忆为目标的潜在意义的证据；以及机会 指导学生进行干预发展研究、创伤后应激障碍评估/干预以及学术研究 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.