Meditation for Emotional Numbing in Post-Traumatic Stress Disorder
Condition: Prolonged Post-traumatic Stress Disorder
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional
Phase: Phase 1

Summary: 
      For individuals suffering from posttraumatic stress disorder (PTSD), the emotional numbing
      and isolation that are a core aspect of their suffering and consistently impedes remediation
      often remains after first-line treatments are administered. Few interventions have proven
      successful for enhancing the empathy and social connectedness that will ultimately allow
      patients to flourish, and the search for target therapies is made more difficult by the fact
      that very little is known about the underlying physiology of emotional numbing and social
      isolation. The proposed study is designed to (1) investigate the hormonal, neural and
      immunological biomarkers related to emotional numbing, and (2) test whether cognitively-based
      compassion training (CBCT), an intervention designed and proven to enhance empathy, will
      reduce emotional numbing and increase empathy and social connectedness in veterans. To this
      end, thirty medically healthy males diagnosed with PTSD who continue to report emotional
      numbing symptoms after prolonged exposure therapy will receive 8 weeks of training in CBCT.
      Prior to, and again after the training, the investigators will assess patients' levels of
      oxytocin, inflammation, and self-reported emotional numbing and social connectedness. The
      investigators will also assess their neural response during a video task that assesses their
      ability to accurately read others' emotions. The investigators hypothesize that oxytocin,
      neural activity, and inflammation will predict social numbing, isolation, and empathy, and
      also that CBCT will positively impact the social outcomes that will pave the way toward
      health and well-being.
    

Detailed description: 
      Thirty otherwise medically healthy males between the ages of 25 and 55 who have previously
      met criteria for PTSD and have undergone prolonged exposure therapy (PET) yet continue to
      report emotional numbing symptoms as a chief complaint will be assessed for baseline levels
      of plasma oxytocin (OT), markers of pro-inflammatory cytokines, total mRNA expression in
      peripheral blood mononuclear cells (PBMCs), self-reported emotional numbing and social
      connectedness, and empathy. Real-world social connectedness will be assessed using an
      Electronically Activated Recorder (EAR) for two days, which will randomly record 50 second
      snippets of audio every 9 minutes and which will allow for quantification of time spent with
      others. Measures of empathy will include empathic accuracy during a dynamic empathic accuracy
      (EA) video task, which asks participants to rate what story-tellers are feeling while they
      tell positively and negatively valenced autobiographical stories. Because previous studies
      have shown that PTSD may interfere with subtle social processing skills and because one of
      the primary aims of this proposal is to uncover specific biomarkers related to self-reported
      emotional numbing, the investigators will also assess eye gaze and arousal covariance
      (correlation between skin conductance of video subject and that of study participant) during
      the EA task. Following baseline assessments, participants will participate in 8 weeks of
      CBCT, which entails twice-weekly meetings consisting of didactic information sessions and
      approximately 20 minutes of CBCT practice. Participants will be asked to practice at home for
      20 minutes per day, and will be given a audio compact discs to guide at-home meditation. Upon
      completion of CBCT (Time 2), and again after 8-12 weeks (Time 3), all Time 1 assessments will
      be repeated.
    

Intervention name(s): Compassion Training
Intervention type(s): Behavioral
Other intervention name(s): Cognitively-Based Compassion Training; CBCT
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: PTSD; empathy; meditation; compassion; inflammation; oxytocin; fMRI