Anthony King, Ph.D.; University of Michigan Medical School; Intramural PTSD Investigator-Initiated Research Award

We're conducting research on post-traumatic stress disorder in combat veterans. The CDMRP has provided funding to allow us to do a 4-year study in which we'll be doing treatment development of a new psychotherapy which incorporates mind/body exercises, what we call mindfulness training or meditation as well as techniques of self-compassion. With this funding we'll be able to complete out-treatment development, make a manualized treatment which can then be portable and disseminated as well as test the efficacy of this treatment in the PTSD clinic in what's called a randomized controlled trial. So we'll have a comparison of our mind/body and mindfulness treatment compared to basically good group psychotherapy. So we'll have a randomized control trial, we expect to have about 80 patients all together. The interventions will be delivered by VA psychologists trained in both PTSD therapy as well as in the mind/body techniques that we are developing. We'll also have, which I think is quite exciting, as part of this a nested functional MRI neuroimaging study as well. So we want to try and understand what is the effect of having PTSD symptoms on the brain and then how does good therapy and then specifically our mind/body interventions how may these change the patterns of brain activity in response to emotional processing, for example, or threat detection. The techniques that we're using, which we call either mind/body techniques or mindfulness or self-compassion, may seem a little exotic. But in fact these are very basic practices, which are really just employing basic psychological functions. Some of these are quite ancient. So, for example, mindfulness training which is contained in a number of meditative traditions as well as in traditions such as martial arts and chi-gong and yoga. So these are techniques which are very basic human activities which have been around for a very long time, but we are very interested in incorporating them in modern psychotherapy. We're not proposing that VA psychologists or that our patients become expert meditators or chi-gong masters or anything like that, but our therapies are designed to be easily accessible. They will require some specialized training. The therapists, as part of the study, have undergone a couple of week-long trainings to get specific skills in doing mind/body awareness techniques similar to, as I said, similar to like what's found in chi-gong and yoga. They've also spent some time doing mindfulness meditation and developing self-compassion techniques. Our primary focus is on providing some relief from some of the very difficult symptoms of post-traumatic stress disorder. As part of the study the participants, the patients, will have a full psychiatric interview before they begin treatment, after the treatment and then at 3 and 6 months follow-ups. And this is really our primary goal is to try and come up with the most effective group therapy for PTSD. Group therapies are very efficient, but there is not a lot of evidence that they're that affective. They're very widely used, but the changes in symptom scores are just not as great as individual therapy at this point. So this is one of the driving impetus toward wanting to do this work is can we engage veterans more in between the groups? Can we have them doing some exercises, actually doing some work they do on their own? We also have a number of other factors through which we measure, in which we think may be important mediators of change. Such as there is actually scales for mind/body awareness for emotional regulation for symptoms of depression and stress. We also have what I think is innovative, is the capacity to do functional neuroimaging work which may help us understand what are the mechanisms. Is there really something different going on here? And I think the combination of demonstrating efficacy and investing in the mechanisms, and especially if we do find a new mechanism, I think that this will be very, very helpful or very persuasive to the American public and to the military and to the VA-maybe there's something here that we really should consider moving some of these exercises to standard practice.