An IDF soldier takes part in drills on the Golan Heights.
(photo credit: IDF)
Researchers at Tel Aviv University have developed a computer program they say can significantly improve treatment of post-traumatic stress disorder in military personnel and civilian road accident victims.
Their study, recently published in the American Journal of Psychiatry, was carried out in cooperation with the IDF, the US military and the US National Institutes of Health.
Prof. Yair Bar-Haim of TAU’s School of Psychological Sciences declared Tuesday that the research was “a breakthrough that can improve PTSD treatment in a big way.”
PTSD, said Bar-Haim, “encompasses a broad collection of behaviors. For example, vigilance and hyper-arousal, avoidance of threats and uncontrolled re-experiencing of the trauma. But we managed to identify a specific cause – that PTSD sufferers have abnormal volatility in their monitoring of threats in their environment.”
Of course, every healthy person has a cognitive system of monitoring threats in their environment, he said. “So, for example, when we’re walking in the street, part of our attention is directed toward possible threats such as dangerous faces, sharp movements, and vehicles that are speeding near us.”
But in PTSD sufferers, that internal “radar” becomes wild and disproportionate to the genuine threats.
Contrary to the popular idea that this internal system is automatic – i.e., that our reactions to threats are beyond our control – “I assumed that the need to respond to threats in the environment would be flexible, as we all [adapt to stimuli] all the time,” he said. “We have to react in real time to knocks, noises, screams and faces – and going into battle or driving a car isn’t like sitting in an office.”
With that in mind, he continued, he and doctoral student Rani Abend developed an online system for following these adjustments.
“The mathematically-computed development took a long time, but in the end, we had an efficient measuring tool that made it possible to refer back to a large number of previous studies and extrapolate from existing data the influence of the threat-monitoring system on PTSD symptoms,” Bar-Haim says.
Once they had that information, he and his team developed a computerized training program to re-balance the cognitive systems of PTSD sufferers.
“It’s important to understand that PTSD is expressed in all parts of the spectrum of human behavior – emotionally, behaviorally and physically. The interesting question is whether there is an apparatus that stands as the basis of any of these changes,” he said. “We showed that the lack of stability in threat-monitoring [systems among PTSD sufferers] is connected to the intensity of the symptoms.”
By measuring that intensity – in other words, how disproportionate the patients’ reactions to threats were – he and his team “thought it was possible to try and normalize the system to reduce the general PTSD symptoms,” he said.
The experiments were carried out in the IDF Medical Corps unit that deals with soldiers’ reactions to battle, and concurrently in Omaha, Nebraska, with US veterans who had returned from the battlefields of Afghanistan. Some 40 soldiers participated in each trial.
“The soldiers were asked to identify a simple arrow, facing right or left, and then to press the [corresponding] arrow button on the computer. To this we added threatening faces or words,” Bar-Haim explained. “The aim was to gradually normalize the patterns of reactions” – to train the soldiers to respond normally to the standard stimuli (the arrows) without overreacting to the more threatening stimuli.
“As a result, there was a significant reduction in symptoms, and a large number of the patients recovered from PTSD.”
The US research used threatening faces, while the Israeli trials used words. But the results were identical and welcome, said the TAU psychologist.
Standard PTSD treatment is psychological; it entails recognizing the trauma, talking about it, and then starting a series of behavioral and cognitive steps that involve controlled exposure to the traumatic memory. According to Bar- Haim, that is the most effective treatment, but it is not available to all who need it.
“Our country is small, but Nebraska, for example, is a large state with a thinly spread population, many of whom forgo treatment. In Israel, too, PTSD treatment is not accessible enough in the periphery,” he explained. “The advantage of what we propose is that the computer training offers high accessibility and low cost, without needing a trained psychologist or psychiatrist.”