Emotions Clinical Trial
Official title:
Biomarkers of Clinical Response to Cognitive Treatment of PTSD in Youth
This study will examine how brain activation changes as a result of behavioral treatment for posttraumatic stress disorder (PTSD) in adolescents. The investigators will conduct functional magnetic resonance imaging (fMRI) scans before and after the widely-used trauma-focused cognitive behavioral therapy to better understand how the brain recovers from illness. This study will provide much needed information about brain abnormalities in abused youth, and could lead to improvements in behavioral treatments for patients who do not respond to current treatments.
This is a neuroimaging study of changes in brain function associated with trauma-focused
cognitive behavioral therapy (TF-CBT)for abused youth suffering from PTSD. By scanning
patients before and after treatment, the investigators will identify mediators (potential
mechanisms) of recovery from PTSD.
Childhood maltreatment is unfortunately common, and can lead to significant problems in
school, emotional difficulties, and physical ailments. Frequently, abused children develop
symptoms of posttraumatic stress disorder (PTSD), such as re-experiencing aspects of the
trauma, avoiding trauma-related situations, and suffering from chronic hyperarousal. PTSD
can inflict significant stress-related damage on the brain at any age, but may be
particularly damaging during developmental periods such as adolescence. Therefore, effective
treatments for PTSD in youth are critical, and this depends in part on our ability to
understand the neural abnormalities underlying pediatric PTSD, and the brain changes
accompanying recovery from PTSD.
TF-CBT is the "gold-standard" treatment for this population however, some patients continue
to experience symptoms of PTSD following treatment. Examining neural changes associated with
successful treatment may suggest adjunctive or additional steps to enhance recovery in
non-responders or partly responsive patients.
The investigators will assess brain activation in response to an emotion-related task in 40
adolescents with PTSD before and after a 12 week TF-CBT treatment, conducted at Stanford
University. The fidelity of TF-CBT treatment will be assured through ongoing consultation
between clinicians and treatment co-creator Judith Cohen, M.D. Neuroimaging analyses will
assess patterns of activation associated with response to TF-CBT. Also, the investigators
will scan 30 age-matched healthy controls recruited from the same community, to compare with
patients to identify abnormalities in brain structure and function in the PTSD group.
Controls will be scanned before and after a 12-week interval as well, to allow analyses of
test/retest reliability of fMRI measures in this age group.
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Endpoint Classification: Bio-equivalence Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Basic Science
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