Computerized attention training, in the form of a specially developed video game, can significantly alleviate symptoms of post-traumatic stress disorder in combat soldiers and survivors of traffic accidents. This, according to a study carried out by researchers at Tel Aviv University in collaboration with the Israel Defense Forces, the U.S. Army and the U.S. National Institutes of Health, the results of which were just published in the American Journal of Psychiatry.
The study, involving Israeli and American soldiers who were diagnosed with PTSD, lasted one month and consisted of 15-minute sessions twice a week with a computerized attention-control training program. At the end of the study, researchers found that the treatment significantly reduced symptoms of PTSD such as anxiety, hypervigilance, avoidance of threatening situations that could remind sufferers of the original trauma and the uncontrolled and repeated reexperiencing of the initial trauma.
The study found that 65% of those treated were symptom-free. The researchers stated that these success rates as similar to those obtained by prevalent and lengthier treatment methods, such as medication or cognitive behavioral therapy. The computerized treatment still requires a series of more extensive follow-up studies in order to establish its short- and long-term effectiveness. Nevertheless, the positive results have drawn interest in the scientific community for what could be a new and inexpensive option for people who don’t respond to conventional treatment. One can envision this kind of treatment eventually becoming available over the Internet.
“PTSD is a definition that encompasses a wide variety of behaviors” says Prof. Yair Bar-Haim, head of the School of Psychological Sciences at Tel Aviv University, who led the research team. “For example, they exhibit alertness and hyper-excitability, avoidance of threats and an uncontrollable reexperiencing of the traumatic event. We identified a specific factor, in that patients with PTSD have a defective fluctuation in their system for monitoring surrounding threats.”
Bar-Haim explains that the cognitive system for attending to external threats is active in any healthy person. While walking down the street, for example, we are aware of potential dangers, such as threatening faces, sudden movements or fast-approaching cars. In people with PTSD this internal “radar” fluctuates wildly and disproportionately in relation to real threats.
The clinical trials were conducted in parallel in the unit for combat effects in the IDF Medical Corps and in the United States, where soldiers returning from Iraq or Afghanistan were participants. In each country 40 soldiers with combat experience took part.
“They were first asked to identify an arrow pointing right or left and then click on a matching marker. Threatening faces or words were then added, and the idea was to gradually normalize their patterns of attention to these perceived threats, through several sessions in front of a computer. In both countries there was a significant drop in symptoms and recovery of most of the participants,” Bar-Haim says. There was no long-term follow-up to monitor the reappearance of symptoms.
The underlying assumption is that the system responding to threats must be flexible. “We constantly assess situations and have to respond in real time,” says Bar-Haim. He, together with Ph.D. student Rany Abend, developed a tool that monitors the fluctuation of the threat-assessment system. “It took a long time to develop, but we could revisit earlier studies and calculate the effects of this monitoring system on PTSD symptoms.”
Based on the model they developed, the researchers devised a computer tool designed to rebalance the cognitive system of people with PTSD. “We were surprised by the results. They suggest that we identified the mechanism through which PTSD develops,” says Bar-Haim. “We need larger-scale clinical experiments which will include civilians with PTSD, such as a study currently underway at Columbia University in collaboration with Tel Aviv University. This is a breakthrough that could be significant in the treatment of PTSD. This is a unique event in psychology and psychiatry, whereby basic research identifies a therapeutic goal, followed by attempts to use it directly as a course of treatment with a significant relief of symptoms.”
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