Alpha-Theta Brainwave Neuro-Feedback Therapy for Vietnam Veterans with Combative Post-Traumatic Stress Disorder

Peniston, E.G. & Kulkosky, P.J.

Extensive clinical studies have demonstrated the consistent and devastating after-effects that combat can have on the human psyche. Post-Traumatic Stress Disorder (PTSD) in veterans has been known to involve maladaptive behavior issues including chronic states of anxiety, recurring nightmares, flashbacks, depression, panic attacks, and vivid re-experiencing of extremely traumatic combative experiences.

There is promising evidence that EEG alpha-theta neurofeedback training can be used as an effective treatment for stress disorders. This study focused on 3 objectives: (1) evaluating the effectiveness of EEG neurofeedback in treating combat-related nightmares of traumatic situations; (2) determining the effectiveness of neurofeedback therapy in reducing the use of psychotropic medications in treating PTSD; (3) comparing personality changes in PTSD patients who have been treated with EEG neurofeedback training versus traditional medical therapy.

The veterans assigned to the brainwave training group underwent eight 30-minute sessions of temperature biofeedback training and thirty 30-minute sessions of alpha-theta neurofeedback training. Prior to these sessions, a medical psychotherapist introduced the subjects to training exercises intended to relax the body and quiet the mind. They then applied these techniques when asked to recall the traumatic combat events visualized in their nightmares and flashbacks. The attainment of a “theta state” was then coupled with both positive temperature and audio feedback. The “theta state” is evocative of hypnagogia, or the transitional state between wakefulness and sleep. It has been observed to support the accessing of unconscious states. The veterans assigned to the traditional medical control group were treated with psychotropic medications coupled with individual and group therapy.

Following the training sessions, subjects in the brainwave training group reported reduced PTSD symptoms and reduced anxiety-provoking traumatic recurring nightmares and flashbacks. Only 3 of the 15 veterans assigned to the brainwave training group reported disturbing nightmares or flashbacks after a 30-month follow-up period. They also had significant reductions in their antidepressant and antianxiety medication use. Subjects of the brainwave training group additionally showed significantly lower Minnesota Multiphasic Inventory (MMPI) PTSD scores, which evaluate a variety of factors such as anxiety, obsessiveness, and depression.  It appeared that the alpha-theta neurofeedback therapy allowed these veterans to become conscious of their repressed combat-related, anxiety-provoking events by reliving them through hypnagogic imagery. By comparison, the veterans in the traditional medical treatment group did not see improvement in the reduction of traumatic nightmares/flashbacks, psychotropic medication use, or MMPI PTSD scores. All fourteen subjects of this group had relapsed by 30 months after treatment. As a result, brainwave neurofeedback training appears to be clinically superior for long-term prevention of PTSD relapse and stands out as a promising alternative to traditional treatment modalities. It has even been suggested that traditional medical treatments such as group therapy and individual psychotherapy only reinforce and ventilate post-traumatic stress behaviors.

A Pilot Study of Neurofeedback for Chronic PTSD

Mark Gapen, Bessel A. van der Kolk, Ed. Hamlin, Laurence Hirshberg, Michael Suvak & Joseph Spinazzola

This study looked at the effect of neurofeedback on PTSD patients. They had seventeen participants who completed forty sessions of neurofeedback therapy. Their PTSD symptoms were assessed six different times, including before, during, and after the treatment sessions. There was a statistically significant decrease in PTSD symptoms over the course of the study. However, there was not complete recovery after the forty sessions; on average, it was a twenty point reduction in DTS score. Overall, this study shows that neurofeedback does help with PTSD symptoms.

The Effect of Neurofeedback Training on PTSD Symptoms of Depression and Attention Problems Among Military Veterans

William D. Smith

PTSD affects a significant amount of our military veterans, as well as survivors of many other different kinds of trauma. It can have many debilitating symptoms, such as depression, attention problems, substance abuse, and many others. There are a variety of treatments, but they do not always work. They also have many risks due to the surfacing of suppressed memories of trauma and the side-effects of the drugs.

This study investigates the effect of neurofeedback on the depression and attention symptoms of military PTSD patients. Attention was broken down into three categories: omissions (failure to respond to a visual stimulus), commissions (responding when there is no visual stimulus), and response time. Ten war veterans with PTSD diagnoses were given thirty sessions of neurofeedback training. Their depression and attention scores were tested before and after the thirty sessions. The researchers found a statistically significant drop in depression levels after the neurofeedback treatment. For attention, however, there was a statistically significant improvement in the area of commissions, but not in the other two. These findings support the idea that neurofeedback can be used as a treatment for some PTSD patients. However, due to a lack of control group, further research should be done to truly see the effects of neurofeedback.

 

A Randomized Controlled Study of Neurofeedback for Chronic PTSD

This study examined the effects of neurofeedback on PTSD patients. It took 52 patients ad split them into two different groups: waitlist (control) or neurofeedback (experimental). They evaluated the PTSD symptoms  before treatment, after six weeks of treatment, immediately after treatment, and one month after treatment using four different PTSD scales (traumatic events screening inventory, Clinician Administered PTSD scale, the Davidson Trauma Scale, and the Inventory of Altered Self-Capacities). The neurofeedback group had treatment twice per week for twelve weeks. Comparing the post and pre-assessments, the neurofeedback group had significantly fewer people meet the criteria for PTSD; only 23.3% of the people after neurofeedback met the criteria for PTSD. This seems to suggest that neurofeedback is an option for treating chronic PTSD and should be investigated further.