Prof. Dr. Kemal Arıkan
Psychiatrist

Post-Traumatic Stress Disorder and Neurofeedback

Travma Sonrası Stres Bozukluğu ve Nörofeedback

Post-Traumatic Stress Disorder (PTSD) is defined as the negative thoughts, negative changes in cognitions and mood, involuntary physiological reactions, and physiological deteriorations that disrupt the functionality of the individual, which occur as a result of directly experiencing a destructive incident (danger of death, being assaulted, etc.), witnessing a destructive incident or seeing a relative experience a destructive incident.

Neurofeedback (NF) is a promising method for interventions in psychophysiological deteriorations with Post-Traumatic Stress Disorder. Neurofeedback in PTSD is recommended to eliminate the deficiencies in cognitive control. Neurofeedback is a non-invasive intervention aiming to control the symptoms by retraining the cerebral activity through operant conditioning.

There are some studies conducted with refugee groups, by which the effectiveness of the NF training on the Post-Traumatic Stress Disorder is measured. The complex nature of the refugee trauma requires a custom multilateral approach in addition to cognitive behavioral therapy and pharmacotherapy.

Refugees experience serious psychological problems due to the traumatic incidents and losses they have gone through. PTSD is estimated to be particularly occurring ten times more in refugees. Moreover, refugees continue to face stressful situations, such as having the provisional protection status in other countries as well as the struggle to relocate and to adapt to the country.

Depression, anxiety and somatic disorders are the prevalent comorbidities in refugees as they accompany PTSD. This population has a high prevalence of traumatic brain damage as they experience high levels of torture.

A study, which was carried out with refugees diagnosed with Post-Traumatic Stress Disorder, has striking results. As a result of the study, which was carried out between refugees, who have received both trauma consultation and Neurofeedback treatment (NFT), and those that have only received trauma consultation, it was found that the trauma, anxiety and depression symptoms of the refugee group that received NF and trauma consultation were significantly lower compared to the refugee group that received only trauma consultation.

The patients were also subjected to a computed test, which is called the Go/No-go (do-don’t) test, measuring the data processing function of the brain. In the test task, low behavioral performance and low P3 amplitude were observed during the inhibition of emotionally-disturbing words.  This case is associated with the deteriorated cognitive control in PTSD. It was observed that NF healed the symptoms in PTSD and normalized the cognitive control indicators (the go/no-go test). The lack of cognitive control causes traumatized individuals to move away from traumatic memories and to regulate their emotional reactions in the face of stimulating situations.

The results are promising in that the neurofeedback training can become an effective complementary method in the PTSD treatment and that it can increase the cognitive controls of the effect mechanism.

SOURCE:
– Askovic, M., Watters, A. J., Coello, M., Aroche, J., Harris, A. W. F., & Kropotov, J. (2019). Evaluation of Neurofeedback for Posttraumatic Stress Disorder Related to Refugee Experiences Using Self-Report and Cognitive ERP Measures. Clinical EEG and Neuroscience.
– DSM-V, Amerika Psikiyatri Birliği, Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı,5. Baskı, Tanı Ölçütleri Başvuru Elkitabı, Çev. Köroğlu E, Hekimler Yayın Birliği,Ankara, 2014.

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