Resilience Among Trauma Survivors
NCT Number: NCT06484803
Status: ENROLLING_BY_INVITATION
Study Type: OBSERVATIONAL
Conditions: PTSD
Sponsor: Tel-Aviv Sourasky Medical Center
Collaborators: Tel Aviv University
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 150
Study Design: Observational Model: |Time Perspective: p
Start Date: 2021-10-14
Completion Date: 2024-09-30
Locations: Sourasky Medical Center, Tel Aviv, Israel

Summary:
A major gap remains in understanding the neurobehavioral mechanism of individuals' variability in the dynamic process of responding to traumatic events. To address this gap, the proposed study is focused on two dominant survival processes: acute stress response and motivational behavior. Investigating the involvement of these processes in long-term recovery from a documented traumatic event, our study extends a prior longitudinal investigation in our lab that systematically assessed the neurobehavioral factors contributing to the development of PTSD.

Primary Outcome Measures: PTSD Clinical trajectories, Change in PTSD symptoms measured by change in Clinician-Administered PTSD Scale. The Clinician-Administered PTSD Scale is used to assess PTSD diagnostic status and symptom severity. We use both CAPS-V (according to DSM-4) and CAPS-5 (according to DSM-5) at 4 time points after exposure (1mo, 6mo, 14mo, \~60mo)., Approximately 6 years|Change in PTSD symptoms following the October 7th, 2023 events, Measured by the PTSD Checklist (PCL-5), a self-report measure (20 items) assessing the severity of PTSD symptoms, reflecting the diagnostic criteria of DSM-5. The PCL-5 total score can range from 0-80; with higher scores reflecting greater severity., Half an hour|Change in anxiety symptoms following the October 7th, 2023 events, Measured by the Beck Anxiety Inventory (BAI), a self-reported measure (21 items) of concurrent anxiety symptoms., Half an hour|Change in depressive symptoms following the October 7th, 2023 events, Measured by the Beck Depression Inventory (BDI), a self-reported measure (21 items) of depression symptoms and intensity, which was proven to be a good predictor of chronic PTSD at one week and one month after trauma., Half an hour
Secondary Outcome Measures: Neural response to acute stress induction and PTSD resilience, During functional Magnetic Resonance Imaging (fMRI) session, an acute stress induction task known as The Montreal Imaging Stress Task (MIST) is administered. MIST is a psychosocial acute stress induction task incorporating mental arithmetic and social evaluation, tailored to the requirements of the fMRI environment. The task comprises three conditions: rest, training (control), and test (stress).

The outcome will be measured as the changes in the salience network (e.g. amygdala, insula, ACC), default mode network (PCC, hippocampus), and central executive network (e.g. dorsolateral PFC), during acute stress induction vs control condition. These alterations will be correlated with Post-Traumatic Stress Disorder (PTSD) resilience, operationalized by the CAPS score., 4 hours|Neural measures of reward and punishment and PTSD resilience, A motivational task (Punishment, Reward, and Incentive Motivation Game; Primo) is conducted during an fMRI session. PRIMO is a dynamic motivational task designed to manipulate motivational aspects within the constraints of the fMRI environment. Neural measures of reward and punishment will be assessed during fMRI scanning. The region of interest (ROI) analysis of the ventral striatum (VS) and ventromedial prefrontal cortex (vmPFC) will be defined. Additionally, other mesolimbic nodes will be delineated based on a meta-analysis of reward-related literature. The outcome will be measured as the association between PTSD resilience, operationalized by the delta between the CAPS scores, and the contrast between reward vs punishment during the PRIMO task., 4 hours|Neurobehavioral Measures of Approach-Avoidance Conflict Related to PTSD Resilience, During the fMRI scanning session, neurobehavioral measures of approach-avoidance conflict will be evaluated as participants engage in the PRIMO task (see above). ROI analysis of the VS and ventral tegmental area (VTA) will be defined. Moreover, other mesolimbic nods will be defined based on a meta-analysis of approach-avoidance conflict. The outcome will be measured as the association between PTSD resilience, operationalized by the delta between the CAPS scores, and approach regions under high vs low goal conflict in the game (PRIMO)., 4 hours