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Cognitive Control Training for Extinction in PTSD

Sponsor: VA Office of Research and Development • ClinicalTrials.gov ID: NCT06629064

Registry updated: 2026-10-09

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Description

The proposed study will test whether a working memory training (WMT) program improves fear extinction learning and its underlying neural circuitry in Veterans with posttraumatic stress disorder (PTSD). WMT is designed to improves the ability to maintain task-relevant information in mind. The project will further validate the relationship between working memory and fear extinction using novel computational and multivariate analyses that link to specific PTSD symptoms. If WMT can enhance fear extinction learning, then WMT may be a powerful adjunctive treatment that can enhance exposure therapy outcomes or be leveraged as a stand-alone treatment. This project supports the Department of Veteran Affairs mission of developing viable targets of treatment for Veterans with PTSD.

Interventions

Working Memory Training (Behavioral)
Computer-administered working memory training program. WMT is a modified working memory capacity task designed to train working memory functioning. WMT is designed to contain high interference across trials and is adaptive to performance. As participants improve working memory, the task becomes more difficult.
Sham Training (Other)
The Sham condition requires participants to complete a similar computer task for the same length of time. The Sham Training is a modified working memory capacity task designed to place less demands on working memory.

Eligibility criteria

Inclusion Criteria: * Fluent in English * Meet current DSM-5 criteria for Posttraumatic Stress Disorder * Are willing to attend 8 total remote sessions of working memory training over course of four weeks * Are willing to attend MRI scans pre and post working memory training * 4-week stability on pharmacological and psychosocial treatments Exclusion Criteria: * A lifetime history of psychotic disorders, lifetime history of bipolar disorder * Past-year severe substance use and severe alcohol use disorder. Mild-to-moderate alcohol use disorder will be allowed to enhance generalizability in our sample due to the high comorbidity of alcohol use and PTSD * History of any neurological disorder that might be associated with cognitive dysfunction (e.g., cerebrovascular accident, intracranial surgery, aneurysm, seizure disorder) * Acute suicidality requiring immediate clinical intervention * Moderate to severe traumatic brain injury (TBI). However, mild to moderate levels of TBI (mTBI) will be included * Receiving benzodiazepines or medications with anticholinergic effects that may affect fear learning measures * Inability to safely complete fMRI session (i.e., metal in body, medical implants)

Conditions

Post-Traumatic Stress Disorders Stress Disorders, Traumatic Post Traumatic Stress Disorder PTSD Trauma and Stressor Related Disorders

Locations

VA San Diego Healthcare System, San Diego, CA — San Diego, California, United States

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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