Using Technology to Enhance PTSD Treatment
Center of Alcohol and Substance Use (CAS) faculty member Dr. Tanya Saraiya [LINK: https://alcoholstudies.rutgers.edu/people/leadership/dr-tanya-saraiya/], and colleagues at the Medical University of South Carolina (MUSC), examined modifications to prolonged exposure treatment (PE) for posttraumatic stress disorder (PTSD). Broadly, PE uses in vivo exposures in which an individual with PTSD faces fear-provoking situations associated with their traumatic experiences in a safe environment. Despite strong support for PE, many people who are treated do not reach symptom remission. The expectation that in vivo exposures need to occur at least once per day, typically without clinician guidance, may contribute to nonadherence or suboptimal implementation.
To increase the successful implementation of in vivo exposures in the context of PE, Dr. Saraiya and her colleagues at MUSC harnessed wearable technology (“Bio Ware”) during in vivo exposures. Using Bio Ware, clinicians provided virtual guidance through in vivo exposures, allowing for maximization of exposures without increasing burden to either the clinician or the person in treatment. Bio Ware includes a small camera and two-way audio so the clinician can see the individual’s surroundings during the exposure and provide real time feedback. Bio Ware also tracks physiological responses (e.g., heart rate) during the exposures, providing quantitative metrics of distress and affective response.
In a sample of adults meeting criteria for PTSD, PE using Bio Ware with at least three guided exposures was compared to PE using Bio Ware without guided exposures. PTSD symptom reduction occurred in both groups for people completing treatment. Of these, people receiving PE + Guided Bio Ware showed significantly greater reductions in PTSD symptoms and depressive symptoms than the PE Non-Guided group. Study participants reported finding the Bio Ware technology acceptable, demonstrating a willingness to use the technology. These findings highlight a promising avenue for increasing the effectiveness of PE for PTSD. Next steps include replicating results in larger, more diverse samples; comparing exposures with and without the Bio Ware technology; and examining how physiological data relates to symptom reductions.
References:
Foa, E., Hembree, E. A., Rothbaum, O, & Rauch, S. (2019). Prolonged Exposure Therapy for PTSD: Emotional processing of traumatic experiences—Therapist guide (Treatments that work), 2nd edition. New York, NY: Oxford University Press.
Saraiya, T. C., Jarnecke, A. M., Rothbaum, A. O., Wangelin, B., McTeague, L. M., Acierno, R., … & Back, S. E. (2022). Technology-enhanced in vivo exposures in Prolonged Exposure for PTSD: A pilot randomized controlled trial. Journal of Psychiatric Research, 156, 467-475. doi: 10.1016/j.jpsychires.2022.10.056. Online ahead of print.
This work was completed at the Medical University of South Carolina, supported by funding from the National Institutes of Mental Health (Grant #R43 MH122045).