For every 22 soldiers who receive an intervention designed to modify their attention bias prior to deployment, one case of postcombat PTSD could be prevented, according to a study published this week in The American Journal of Psychiatry.Why It’s Relevant
Preventing PTSD in soldiers—rather than just treating symptoms—could significantly reduce health care costs and maintain high levels of troop effectiveness. As research has found an association between attentional threat avoidance and increased PTSD risk, enhancing an individual’s attention toward threatening over neutral stimuli could be a preventive strategy as part of part of a comprehensive resilience-building framework.
The Interventions
- Response-time-based: Participants were presented with a threatening face and a neutral face on a screen. They were asked to quickly tap an arrow that corresponded with the threatening face, across 160 facial pairs.
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Eye-tracking: Participants selected music and then looked at faces on a screen for 15 minutes. The music played when participants’ eyes were focused on threatening faces, then stopped when they looked at neutral faces.
- Sham: This was similar in design to the response-time intervention, but participants were only shown neutral faces and asked to quickly tap one at random.
By the Numbers
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501 male combat-bound Israeli soldiers (mean age 19 years) received one of the three interventions during their basic training.
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One year after study participants were exposed to combat, fewer than 1% of those who received response-time-based attention bias training self-reported PTSD symptoms significant enough to be considered probable PTSD.
- By comparison, 2.7% of soldiers who received an eye-tracking-based attention intervention and 5.3 % who received a sham intervention reported probable PTSD.
- The difference between the response-time intervention and sham was statistically significant, with a number-needed-to-treat estimate of 22.
The Other Side
The study findings relied on self-reported PTSD symptoms and not clinician-rated assessments that would offer more nuanced insights into clinical status.
What’s Next
“Future research, preferably in other militaries and by other researchers, could focus on refining cognitive training protocols, elucidating mechanisms of action, and exploring individual differences to maximize the clinical utility of these interventions,” the authors wrote.
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