Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technology
Prolonged Exposure (PE) therapy is one of the most efficacious, evidence-based treatments for posttraumatic stress disorder (PTSD). A key component of PE involves in vivo exposures (IVEs) during which patients approach situations or activities in “real life” that are safe but avoided because they el...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Contemporary Clinical Trials Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451865422000576 |
| _version_ | 1811218948695261184 |
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| author | Sudie E. Back Ron Acierno Tanya C. Saraiya Bill Harley Bethany Wangelin Amber M. Jarnecke Lisa M. McTeague Delisa G. Brown Elizabeth Santa Ana Alex O. Rothbaum Robert J. Adams |
| author_facet | Sudie E. Back Ron Acierno Tanya C. Saraiya Bill Harley Bethany Wangelin Amber M. Jarnecke Lisa M. McTeague Delisa G. Brown Elizabeth Santa Ana Alex O. Rothbaum Robert J. Adams |
| author_sort | Sudie E. Back |
| collection | DOAJ |
| description | Prolonged Exposure (PE) therapy is one of the most efficacious, evidence-based treatments for posttraumatic stress disorder (PTSD). A key component of PE involves in vivo exposures (IVEs) during which patients approach situations or activities in “real life” that are safe but avoided because they elicit a fear response. Despite their critical role in treatment, little research has focused on IVEs. This gap in knowledge is primarily due to the fact that IVEs are typically conducted by patients in between therapy sessions, leaving clinicians reliant upon patient self-report. This approach has numerous shortcomings, which the current study addresses by leveraging technology to develop an innovative device that allows for physiological, biomarker-driven, therapist-guided IVEs. The new system enables clinicians to virtually accompany patients during IVEs and provides real-time physiological (heart rate, skin conductance) and self-report (subjective units of distress) data that clinicians can use to modify the exposure and optimize therapeutic value. This Small Business Innovation Research (SBIR) Phase I project aims to: (1) integrate physiological sensors and live audio/visual streaming into a system for clinicians to guide patients during IVEs; (2) determine feasibility and acceptability of the system; and (3) conduct a pilot randomized clinical trial among veterans with PTSD (N = 40) to evaluate the preliminary efficacy of the system in reducing PTSD symptoms during PE. This paper describes the rationale, design, and methodology of the Phase I project. The findings from this study have the potential to innovate clinical practice, advance the science of exposure therapy, and improve clinical outcomes. |
| first_indexed | 2024-04-12T07:16:32Z |
| format | Article |
| id | doaj.art-e0e62a95ead742db996a306d9f3b13a7 |
| institution | Directory Open Access Journal |
| issn | 2451-8654 |
| language | English |
| last_indexed | 2024-04-12T07:16:32Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Contemporary Clinical Trials Communications |
| spelling | doaj.art-e0e62a95ead742db996a306d9f3b13a72022-12-22T03:42:26ZengElsevierContemporary Clinical Trials Communications2451-86542022-08-0128100940Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technologySudie E. Back0Ron Acierno1Tanya C. Saraiya2Bill Harley3Bethany Wangelin4Amber M. Jarnecke5Lisa M. McTeague6Delisa G. Brown7Elizabeth Santa Ana8Alex O. Rothbaum9Robert J. Adams10Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; Corresponding author. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Roper Medical Office Building, 125 Doughty Street, Suite 300, SC, 29403, USA.Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USAZeriscope, Inc., Charleston, SC, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USADepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Zeriscope, Inc., Charleston, SC, USAProlonged Exposure (PE) therapy is one of the most efficacious, evidence-based treatments for posttraumatic stress disorder (PTSD). A key component of PE involves in vivo exposures (IVEs) during which patients approach situations or activities in “real life” that are safe but avoided because they elicit a fear response. Despite their critical role in treatment, little research has focused on IVEs. This gap in knowledge is primarily due to the fact that IVEs are typically conducted by patients in between therapy sessions, leaving clinicians reliant upon patient self-report. This approach has numerous shortcomings, which the current study addresses by leveraging technology to develop an innovative device that allows for physiological, biomarker-driven, therapist-guided IVEs. The new system enables clinicians to virtually accompany patients during IVEs and provides real-time physiological (heart rate, skin conductance) and self-report (subjective units of distress) data that clinicians can use to modify the exposure and optimize therapeutic value. This Small Business Innovation Research (SBIR) Phase I project aims to: (1) integrate physiological sensors and live audio/visual streaming into a system for clinicians to guide patients during IVEs; (2) determine feasibility and acceptability of the system; and (3) conduct a pilot randomized clinical trial among veterans with PTSD (N = 40) to evaluate the preliminary efficacy of the system in reducing PTSD symptoms during PE. This paper describes the rationale, design, and methodology of the Phase I project. The findings from this study have the potential to innovate clinical practice, advance the science of exposure therapy, and improve clinical outcomes.http://www.sciencedirect.com/science/article/pii/S2451865422000576Posttraumatic stress disorderPTSDTechnologyPhysiologyMilitaryVeterans |
| spellingShingle | Sudie E. Back Ron Acierno Tanya C. Saraiya Bill Harley Bethany Wangelin Amber M. Jarnecke Lisa M. McTeague Delisa G. Brown Elizabeth Santa Ana Alex O. Rothbaum Robert J. Adams Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technology Contemporary Clinical Trials Communications Posttraumatic stress disorder PTSD Technology Physiology Military Veterans |
| title | Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technology |
| title_full | Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technology |
| title_fullStr | Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technology |
| title_full_unstemmed | Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technology |
| title_short | Enhancing Prolonged Exposure therapy for PTSD using physiological biomarker-driven technology |
| title_sort | enhancing prolonged exposure therapy for ptsd using physiological biomarker driven technology |
| topic | Posttraumatic stress disorder PTSD Technology Physiology Military Veterans |
| url | http://www.sciencedirect.com/science/article/pii/S2451865422000576 |
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