Add disorder3/22/2023 ![]() Henceforth, the resulting negative cognitive interpretation biases commonly contribute to persistent feelings of imminent danger and threat, which can be of external (eg, ‘The world is a dangerous place’, ‘Others will only cause harm to me’) or internal (eg, ‘I will not be able to master my life’) valence. Specifically, the cognitive model by Ehlers and Clark 6 proposes that individuals who are developing symptoms of PTSD are unable to evaluate the experienced trauma as a time-limited occurrence, which does not have global, negative implications for their future life (p. 5–8 Each of these theories share the common notion that PTSD symptoms can be best elucidated by dysfunctional alterations in cognitive processes, which include but are not limited to attention, interpretation and memory. Investigating the influence of cognitive alterations on the development and maintenance of PTSD symptomatology, various models summarised under the umbrella term information processing theories have been developed. Whilst past research indicates that a large amount of individuals exposed to a traumatic event recover spontaneously, around 15% display prolonged symptoms, 2–4 which are associated with internal (cognitive biases, emotional vulnerability) as well as external (eg., previous traumatic experiences, trauma type) factors. 271), four hallmark features characterise PTSD: (1) symptoms of involuntary intrusions related to the traumatic event (eg, memories, flashbacks, nightmares), (2) persistent avoidance of trauma-related stimuli, (3) negative alterations of mood and cognition (such as persistent negative beliefs and expectations about the self, others and the world), and (4) marked alterations in arousal and reactivity associated with the trauma. Following the diagnostic guidelines described in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V, 1 p. Post-traumatic stress disorder (PTSD) is a physiological and psychological reaction following the experiencing or witnessing of a traumatic event. Outcome assessment will be conducted by intention-to-treat analysis, as well as per-protocol analysis using linear mixed models. ![]() Secondary outcomes include PTSD-related cognitive distortions and symptom severity, as well as negative affectivity. The primary outcome is interpretation bias. Outcome assessments will be conducted pretraining, 1 week post-training, 2 months post-training, as well as 1 week after the booster session (approximately 2.5 months after initial training termination). Two months after the last training session, 1 week of booster CBM treatment will be implemented, consisting of three additional training sessions. The intervention consists of 3 weeks of an app-based CBM training for interpretation bias using mental imagery, with three training sessions (20 min) per week. ![]() 130 patients diagnosed with post-traumatic stress disorder (PTSD) will be allocated to either the intervention group or the waiting-list control group receiving treatment as usual. Methods and analysis The study is a randomised controlled trial, implementing two parallel arms.
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