NCT06096740

Psychotherapy Effects on Reward Processing in PTSD

The Effects of Trauma-focused Psychotherapy on Reward Circuitry Function and Information Encoding

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 120 (estimated)
• Sponsor: University of Texas at Austin · Academic / Other
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this study is to identify how trauma-focused psychotherapy changes the function of brain circuitry in posttraumatic stress disorder (PTSD) and how this mediates improvements in the diminished ability to experience positive emotions following a traumatic or extremely stressful life event. In this instance, the investigators will be using cognitive processing therapy (CPT), a widely-utilized and evidence-based treatment for PTSD.

Detailed description

The goals of the study are as follows: 1. Quantify, under conditions of safety (no threat), how PTSD psychotherapy alters reward circuit function and information encoding. 2. Identify how presence of threat augments PTSD psychotherapy effects on reward circuit function and information encoding. 3. (Exploratory). Identify how, following psychotherapy, changes in reward circuit function and information encoding under conditions of safety and threat are associated with improvements in symptoms of diminished positive affect (DimPA). To accomplish the goals of the study, the investigators propose a neuroimaging-coupled, randomized clinical trial of immediate vs. delayed individual cognitive processing therapy (CPT) in individuals (N=120) with a primary diagnosis of chronic PTSD. Individuals will undergo, prior to randomization, clinical and neurobiological assessment with functional magnetic resonance imaging (fMRI) during completion of several reward processing paradigms. Two of these involve both a normal "safe" context and a threat context manipulation (threat of mild electrodermal shock that is periodically cycled throughout the task). Another paradigm involves making decisions to either approach reward or forego a reward when this decision conflicts with the likelihood of an aversive outcome. This is known as approach-avoidance conflict (AAC). This battery will provide a comprehensive characterization of reward processing behavior and circuit function and establish its relationship to treatment processes, as well as how such processes may vary as a function of threat.

Conditions

• Post Traumatic Stress Disorder
• Diminished Pleasure
• Anhedonia
• PTSD
• Chronic PTSD
• Chronic Post-Traumatic Stress Disorder

Interventions

Type	Name	Description
BEHAVIORAL	Cognitive Processing Therapy	Cognitive processing therapy is a widely-utilized, empirically-supported treatment developed for PTSD. It is based on a cognitive theory of trauma which emphasizes the impact of trauma on belief systems and the development of "stuck points", which are unhealthy, unrealistic, and maladaptive ways of thinking that serve to maintain unhealthy beliefs and reinforce PTSD symptoms.

Timeline

• Start date: 2024-06-01
• Primary completion: 2029-03-01
• Completion: 2029-05-01
• First posted: 2023-10-24
• Last updated: 2024-07-09

Locations

1 site across 1 country: United States