Taking the Pulse of Prolonged Exposure Therapy: Physiological Reactivity to Trauma Imagery as an Objective Measure of Treatment Response

Wangelin, Bethany C.; Tuerk, Peter W.

doi:10.1002/da.22449

Cited by 59 publications

(66 citation statements)

References 49 publications

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“…A number of studies report that patients who show emotional engagement during mental imagery have better treatment outcomes. Thus, patients who react physiologically during imaginal desensitization were more likely to have a successful therapeutic course of systematic desensitization (Lang et al, ; Levin, Cook, & Lang, ), and PTSD patients with enhanced skin conductance during prolonged exposure treatment reported greater symptom reduction by the end of treatment (Wangelin & Tuerk, ). It is tempting to speculate that individuals showing enhanced pupil diameter when imagining clinically relevant scenes may also show better response to treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, we investigated whether pupil diameter is similarly modulated as a function of hedonic content during mental imagery. Because emotional imagery is a key component in the assessment (Lang, McTeague, & Bradley, 2016; Wangelin & Tuerk, 2015) and treatment of mental health disorders (Foa, Hembree, & Rothbaum, 2007; Lang, Melamed, & Hart, 1970), pupil diameter could prove to be a useful psychophysiological index in a number of clinical venues.…”

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confidence: 99%

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Emotional imagery and pupil diameter

2017

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Pupil diameter is enhanced in a variety of emotional contexts, including viewing pictures, listening to sounds, and during threat of shock. In this study, we investigated pupil diameter changes during emotional imagery. Participants imagined scenes describing pleasant, unpleasant, or neutral events while pupil diameter was continuously recorded. Second by second changes in pupil diameter were analyzed to determine whether, and when, modulation of the pupil as a function of hedonic content is found. Results indicated a significant effect of hedonic content beginning shortly after script onset, with enhanced pupil diameter when imagining emotional (pleasant or unpleasant), compared to neutral, scenes. Pupil diameter during imagery covaried with rated emotional arousal, consistent with an interpretation that changes in pupil diameter during emotional imagery reflect sympathetic nervous system activity. Because emotional imagery is a key element in clinical assessment and treatment, pupil diameter could prove a useful index of emotional engagement in a variety of clinically pertinent contexts.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Emotional imagery and pupil diameter

2017

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“…A recent meta-analysis of these early studies confirmed that psychophysiological responses to trauma scripts were predictive of PTSD diagnosis [10] and were stable across time [11]. Finally, both HR and SC show decreased responding after prolonged exposure therapy for PTSD, providing potential objective measures of treatment response [12]. …”

Section: Introductionmentioning

confidence: 99%

“…Such psychophysiological measures can make a seminal contribution to the National Institutes of Mental Health Research Domain Criteria (RDoC) initiative to include biological measures in assessments of mental illness [14; 15]. The measures can both indicate treatment targets and track clinical outcomes in an objective manner [12]. …”

Section: Introductionmentioning

confidence: 99%

Mobile assessment of heightened skin conductance in posttraumatic stress disorder

et al. 2017

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Background Increased psychophysiological reactivity is a hallmark intermediate phenotype of posttraumatic stress disorder (PTSD). Individuals with PTSD exhibit greater skin conductance (SC) responses to trauma scripts than trauma survivors without PTSD. However, trauma scripts require time for development and cannot be easily used in a single visit. Thus, there is a need for a low-cost, easy-to-use, SC recording protocol for PTSD assessment. Methods Using a mobile device (eSense) connected to a portable tablet computer, we assessed SC reactivity to a standard trauma interview (STI) in 63 participants recruited from Grady Memorial Hospital in Atlanta, GA approximately one year after trauma exposure. SC response (SCR) was calculated by subtracting the SCL at the end of the baseline recording from the maximum SC level (SCL) during the STI. Results SCL was significantly higher during the STI compared to baseline (p<0.001), and individuals with PTSD showed significantly greater SCR than individuals without PTSD (p=0.006). Logistic regression using SCR with PTSD diagnosis as the outcome showed an odds ratio of 1.76 (95% CI: 1.11-2.78). Lastly, higher SCR during the STI was also significantly associated with PTSD symptom total score controlling for demographics and trauma severity (b=0.42, p=0.001). Conclusions The current study demonstrated feasibility of the use of a mobile device for assessing psychophysiological reactivity in those with PTSD. The use of this low-cost, easy-to-use mobile device to collect objective physiological data in concert with a standardized trauma interview can be easily disseminated in clinical and research settings.

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“…X ekseninde zaman (dakika), Y ekseninde ise mikrosiemens (µS) türünden genlik değerleri yer almaktadır. ,29, 31, 32, 33 ve 35). Mevcut çalışmanın sonuçları ilgili literatürde ortaya konan sonuçlarla paraleldir.…”

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Developing an auxiliary tool for treatment of specific phobias via virtual reality technology applications: An effectiveness study (tur)

Işıklı¹,

Baran²,

Aslan³

2019

J Clin Psy

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Developing an auxiliary tool for treatment of specific phobias via virtual reality technology applications: An effectiveness study SUMMARY Objective: Purpose of the study is to develop an auxiliary tool that can be used by experts working in the clinical settings for psychological support processes to adults diagnosed with simple phobia. In that realm, one another related aim is also to evaluate the effectiveness of the developed tool via behavioral and physiological measurements. Method: Eleven participants diagnosed with specific phobia (7 females X age=38.57, SD=8.89; 4 males X age=41.75, SD=13.07) by mental health specialist were exposed to virtual reality scenarios in a systematic desensitization manner. There were 6 person with cynophobia, 2 with arachnophobia, 1 with acrophobia and 2 with claustrophobia. Each of four phobia scenario sessions consisted of diffferent number of stages to be completed. None of the participants were received any drug medication for phobia before and also during the study. In addition to physiological meaurements like galvanic skin response (GSR) and heart rate (HR), subjective units of distress scale (SUDS) measurements were also taken before and after exposure to each stage as dependent variables. To compare different phobia scenarios, minimum, maximum and peak-to-peak amplitude values of the first and last exposure to the most feared stimuli for physiological records and first and last exposure SUDS values again for the most feared stimuli were analyzed with Wilcoxon Signed Rank Test. Results: The most fear/anxiety procuding stimuli comparisons for the first (pre-test) and the last (post-test) exposures in SUDS, GSR and HR measurements indicated that there was significant decrements in post-test measurements with respect to the ones for pre-tests. Discussion: Analyses of behavioral and physiological measurements obtained from the participants showed that the learned-fear-responses have a tendency to extinct after being exposed to the relevant stimuli virtually. Thus, virtual reality applications can be effectively usable in the treatment of specific phobias.

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Taking the Pulse of Prolonged Exposure Therapy: Physiological Reactivity to Trauma Imagery as an Objective Measure of Treatment Response

Cited by 59 publications

References 49 publications

Emotional imagery and pupil diameter

Emotional imagery and pupil diameter

Mobile assessment of heightened skin conductance in posttraumatic stress disorder

Developing an auxiliary tool for treatment of specific phobias via virtual reality technology applications: An effectiveness study (tur)

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