News - Mar 2018

HRI tests cognitive training program to improve symptoms of PTSD

People diagnosed with Post-Traumatic Stress Disorder (PTSD) often experience changes in cognitive functioning, such as difficulty with memory, attention, concentration, planning and organization.

Despite the fact that these challenges can severely disrupt functioning at work, school, home, or in social settings, few studies have investigated treatments aimed specifically at improving thinking skills among individuals with PTSD.

A new study led by Homewood Research Institute (HRI) and McMaster University is examining the utility of cognitive skills training in reducing symptoms of PTSD, particularly among veterans, military members and first responders. In this study, a cognitive training program called Goal Management Training (GMT) is being offered to people with PTSD for the first time.

GMT has been used successfully in other populations, including people with brain injuries, to improve concentration, memory, and organization. GMT aims to teach individuals how to stop automatic responding, monitor progress on tasks and goals, and achieve those goals.

Early research among inpatients being treated for PTSD at Homewood Health Centre suggested that GMT helps to improve thinking speed, memory and the pursuit of personal goals. GMT also led to reductions in depression and self-reported cognitive difficulties.

The next phase of research is underway. GMT is now being tested among individuals in the community with a history of military-related trauma and those who have worked as public safety personnel, such as firefighters, paramedics or police officers. Researchers predict similar results among this outpatient population. Based on studies to date, GMT holds great promise for improving quality of life and cognitive function for individuals with PTSD.

This work is generously supported by the Cowan Foundation, the Military Casualty Support Foundation, Schlegel Healthcare and the Bickell Foundation.

Do you know someone who could benefit from GMT?

HRI has announced a call for participants in Guelph and the Greater Toronto Area. An experimental trial of GMT will begin in April 2018 at the Homewood Clinic in Mississauga, Ontario.

Click for Study and Eligibility Details button

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New research explores subconscious effects of trauma triggers

Post-traumatic Stress Disorder (PTSD) can occur after a person experiences a traumatic event. Symptoms of PTSD can be debilitating and are often brought on by trauma triggers, or experiences in daily life that cause an individual to recall or re-live a traumatic memory.

Current therapies for trauma-related disorders are designed to treat people who respond to trauma triggers on a conscious level. But what if an individual isn’t aware of his or her trauma triggers? And how does the body respond when trauma triggers or threats are perceived on a subconscious level?

New research led by Dr. Daniela Rabellino, a postdoctoral fellow working alongside Dr. Ruth Lanius, Associate Clinical Scientist at Homewood Research Institute, has uncovered some answers to these important questions. And the findings may have significant implications for the field of trauma treatment.

Dr. Rabellino’s study, Neural and Autonomic Correlates of Post-Traumatic Stress Disorder During Processing of Trauma-Related Stimuli, explores the effects of trauma triggers that are presented to people with PTSD for only a few milliseconds and are thus perceived below the threshold of conscious awareness.

The subconscious processing of trauma triggers had a striking effect on both heart rate – an important measure of emotion regulation – and on the activation of midbrain structures that have been proposed to form the body’s innate “alarm system”. In other words, individuals react reflexively to trauma triggers, even when they are not consciously aware of those triggers.
Dr. Rabellino’s study has important implications for the future of trauma treatment; specifically, treatment must incorporate interventions that directly address the effects of trauma triggers that are not consciously perceived.

Body-oriented interventions, such as mindfulness practices and neurofeedback training – which can target the subconscious processing of trauma – are now being explored as adjunctive treatments for PTSD and other trauma-related disorders.

Read Dr Rabellinos Publication

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HRI research findings featured at national addiction conference

HRI research findings were featured in three presentations at a national conference hosted in Calgary, Alberta by the Canadian Centre on Substance Use and Addiction (CCSA) in November. The Issues of Substance Conference brings together addiction experts, policy makers and researchers to mobilize knowledge in the addiction field to address substance use in Canada. HRI was pleased to share updates and findings from three major projects currently underway.

Recovery Monitoring

Dr. Jean Costello, Research and Evaluation Scientist, and Courtney Ropp, Research Associate, were selected to speak about HRI’s Recovery Monitoring System. Launched as a pilot project at Homewood Health Centre in 2015, Recovery Monitoring involves the routine collection of data from patients discharged from Homewood’s Addiction Medicine Service for up to one year post-discharge to measure and assess outcomes and better understand the process of recovery.

The Recovery Monitoring System is unique in Canada and provides a thorough, ongoing and quantifiable understanding of what happens once patients are discharged from residential care. Data can be used to evaluate program effectiveness, inform quality improvements and enhance mental health and addiction policies in Canada and beyond.

HRI’s presentation focused on key findings at one year post-discharge, including changes in quality of life, social engagement, occupational performance and life satisfaction.

View the Presentation     View Infographic with Key Findings

Patients’ Perceptions of Care

In collaboration with Homewood Health Centre and well-known mental health and addiction scientist, Dr. Brian Rush, HRI is conducting research that examines how a patient’s experience or perception of care during addiction treatment impacts recovery-oriented outcomes after discharge.

Currently there is little evidence within the Canadian addiction service field about the link between a patient’s experience and their outcomes, but HRI is working to change this.

As part of the Recovery Monitoring System implemented in the Addiction Medicine Service at Homewood Health Centre, HRI collects information about a patient’s experience during treatment. Using a standardized evidence-based tool, data is collected at the time of discharge, and again at one month post-discharge, to shed light on the relationship between perceptions of care and post-discharge outcomes in residential care.

A poster presentation at the CCSA conference outlined early findings from HRI’s research, which show that a more positive perception of care at discharge predicts greater adherence to treatment recommendations after discharge, as well as improvements in recovery outcomes such as motivation and quality of life. These findings suggest that the patient experience may have a significant impact on recovery and should be monitored regularly.

Universal Screening

HRI Senior Scientist, Dr. James MacKillop, shared findings from a project that involved screening patients who have been diagnosed with addiction for a secondary – or comorbid – diagnosis of trauma. The study focused on individuals receiving care in an inpatient treatment setting and involved more 500 participants in the Addiction Medicine Service (AMS) at Homewood Health Centre.

Dr. MacKillop’s study provided important insights into the prevalence and severity of comorbid addiction and trauma within the AMS patient population. Specifically, half of the participants reported a significant history of trauma, and a higher number of females (56%) met the threshold for Post-Traumatic Stress Disorder (PTSD) as compared to males (48%).

These findings reveal the importance of screening for comorbid disorders to better inform each patient’s care plan during inpatient treatment.

Dr. MacKillop’s presentation also highlighted the potential for improved care that can result when academic researchers and treatment providers work together more closely.

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