Neurofeedback: A noninvasive treatment for symptoms of posttraumatic stress disorder in veterans
This paper discusses positive therapeutic gains made with veterans whose primary treatment for PTSD was artifact corrected neurofeedback. Assessments completed after both 20 and 40 half-hour sessions of treatment identified significant improvements for both auditory and visual attention using the IVA-2 CPT and the veterans reported significant improvements in their well-being based on the General Well-Being Scale (GWBS). It was discovered that neurofeedback impacted individuals’ overall auditory attention and that the IVA-2 global auditory test scores significantly improved after both 20 (p < .007, Cohen’s d = 0.5) and 40 training sessions (p < .0001, Cohen’s d = 0.8). Veterans were found to have significant enhancements specifically in auditory vigilance (p < .03), processing speed (p < .0009) and focus (p < .01). The IVA-2 global measure of visual attention was also found to show significant improvements after 20 sessions (p < .004, Cohen’s d = 0.5) and after 40 sessions (p < .06, Cohen’s d = 0.4). Specific improvements in visual processing speed (p < .04) and focus (p< .02) were identified after 40 sessions. Ratings of well-being also significantly improved after treatment (p < .001, Cohen’s d = 0.8) with 84% of the veterans improving five points or more on the GWBS. These improvements in well-being were found to be significantly correlated with increases in veterans’ overall auditory attention (r = .44, p < .03) and auditory processing speed (r = .57, p < .005).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author. www.psychiatry.org/psychiatrists/practice/dsm.
Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40, 180–189,
Atkinson, B. (1999). The emotional imperative psychotherapists cannot afford to ignore. Family Therapy Networker, 23, 22-33, http://www.thecouplesclinic.com/pdf/ emotional_imperative.pdf.
Baum, B. (1997). The Healing Dimensions: Revolving Trauma in the Body, Mind and Spirit. Tucson, AZ: West Press, (pp. 1-114).
Benson, H. (1975). The Relaxation Response. New York: William Morrow, (pp. 16-18, 66-74).
Breuer, J. & Freud, S. (1966). Studies on Hysteria. New York: Basic Books, (pp. 55-82).
Buckley, T.C., Blanchard, E.B., & Neill, W.T. (2000). Information processing and PTSD: A review of the empirical literature. Clinical Psychology Review, 28, 1041-1065,
Budzynski, T.H. (1999). From EEG to neurofeedback. In J.R. Evans & A. Arbarbanel (Eds.), Introduction to Quantitative EEG and Neurofeedback. San Diego: Academic Press, (pp. 65-79).
Demos, J.N. (2005). Getting Started With Neurofeedback. New York: W.W. Norton & Company.
Dupuy, H.J. (1977). The General Well-being Schedule. In I. McDowell & C. Newell (Eds.), Measuring health: a guide to rating scales and questionnaire (2nd ed.) (pp. 206-213). USA: Oxford University Press.
Fazio, A.F. (1977). A Concurrent Validational Study of the NCHS General Well-Being Schedule. Hyattsville, MD: US Department of Health, Education, and Welfare, National Center for Health Statistics, Vital & Health Statistics, Series 2, No. 73, DHEW Publication No. [HRA] 78–1347.
Hammond, D.C. (2011). What is neurofeedback: An update. Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience, 15, 305-336, http://dx.doi.org/10.1080/10874208.2011.623090
Karl, A., Malta, L.S., & Maercker, A. (2006). Meta-analytic review of event-related potential studies in post-traumatic stress disorder. Biological Psychology, 71, 123-147, https://doi.org/10.1016/j.biopsycho.2005.03.004
Maddux, C. D. (2010). [Review of the IVA+Plus: Integrated Visual and Auditory Continuous Performance Test]. In R. A. Spies, J. F. Carlson, & K. F. Geisinger (Eds.), The eighteenth mental measurements yearbook (pp. 434-437). Lincoln, NE: Buros Institute of Mental Measurements.
Mason, L.A. & Brownback, T.S. (2001). Optimal functioning training with EEG biofeedback for clinical populations: A case study. Journal of Neurotherapy, 5, 33-42,
Mirsky, A. F., Anthony, B. J., Duncan, C. C., Ahearn, M. B., &
Kellam, S. G. (1991). Analysis of the elements of attention: A neuropsychological approach. Neuropsychology Review, 2, 109-145, https://doi.org/10.1007/BF01109051
Nakayama, T., Toyoda, H., Ohno, K., Yoshiike, N., & Futagami, T. (2000). Validity, reliability and acceptability of the Japanese version of the General Well-Being Schedule (GWBS). Quality of Life Research, 9, 529-539, https://doi.org/10.1023/A:1008940902849
NIMH - Post-Traumatic Stress Disorder. (Feb 2016). Retrieved January 13, 2017, from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
Nunez, P.L. (1981). Electric Fields of the Brain. New York, Oxford University Press, (pp. 349-400).
Othmer, S., & Othmer, S.F. (2009). Post-traumatic stress disorder – The neurofeedback remedy. Biofeedback, 37, 24-31, http://doi.org/10.5298/1081-5937-37.1.24.
Peniston, E.G. & Kulkosky, P.J. (1991). Alpha-theta brainwave neurofeedback therapy for Vietnam veterans with combat-related posttraumatic stress disorder. Medical Psychotherapy: An International Journal, 4, 47-60,
Poston, W. S. C., Olvera, N. E., Yanez, C., Haddock, C. K., Dunn, J. K., Hanis, C. L., & Foreyt, J. P. (1998). Evaluation of the factor structure and psychometric properties of the General Well-Being Schedule (GWB) with Mexican American women. Women and Health, 27, 49-62, http://dx.doi.org/10.1300/J013v27n03_04
RAND, 2008. One in Five Iraq and Afghanistan Veterans Suffer from PTSD or Major Depression | RAND. Retrieved January 13, 2017, from http://www.rand.org/news/press/2008/04/17.html
Robbins, J. (2000). A Symphony in the Brain. New York: Atlantic Monthly Press, (pp. 160-162).
Sachinvala, N., von Scotti, H., McGuire, M., Fairbanks, L., Bakst, K., McGuire, M., & Brown, N. (2000). Memory, attention, function, and mood among patients with chronic posttraumatic stress disorder. Journal of Nervous and Mental Disease, 188, 818-823, http://journals.lww.com/jonmd/Abstract/2000/12000/Memory,_Attention,_Function,_and_Mood_among.5.aspx.
Sandford, J.A. & Sandford, S.E. (2015). IVA-2 Integrated Visual and Auditory Continuous Performance Test Manual. Richmond, VA. BrainTrain.
Speckmann, J.E. & Elger, J.E. (1987). Introduction to the neurophysiological basis of the EEG and DC potentials. In Niedermeyer, E., & Lopes da Silva, F. (Eds.) Electroencephalography. Baltimore, Urban & Schwarzenberg, (Ch. 2, pp. 1-16).
Taylor, J. E., Poston W. S., II, Haddock, C. K., Blackburn, G. L., Heber, D., Heymsfield, S. B., et al. (2003). Psychometric characteristics of the General Well-Being Schedule (GWB) with African-American women. Quality of Life Research, 12, 31-39, https://link.springer.com/article/10.1023%2FA%3A1022052804109?LI=true
Thompson, M., & Thompson, L. (2003). The Neurofeedback Book: An Introduction to Basic Concepts in Applied Psychophysiology. White Ridge, CO: The Association for Applied Psychophysiology and Biofeedback, (pp. 70 – 108).
Tinius, T. P. (2003). The Integrated Visual and Auditory Continuous Performance Test as a neuropsychological measure. Archives of Clinical Neuropsychology, 18(5), 199-214. https://doi.org/10.1016/S0887-6177(02)00144-0
Uddo, M., Vasterling, J. J., Brailey, K., & Sutker, P. B. (1993). Memory and attention in combat-related post-traumatic stress disorder (PTSD). Journal of Psychopathology and Behavioral Assessment, 15, 43-52, https://doi.org/10.1007/BF00964322
van der Kolk, B.A., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016). A randomized controlled study of neurofeedback for chronic PTSD. Plos ONE, 11, 1-18. https://doi.org/10.1371/journal.pone.0166752
van der Kolk, B.A., McFarlane, A.C., & Weisaith, L. (1996). Traumatic stress: The Effects of Overwhelming Experience on Mind, Body, and Society. New York: Guilford Press, (pp. 226-229).
Vasterling, J.J., Brailey, K., Constans, J. I., & Sutker, P. B. (1998). Attention and memory dysfunction in posttraumatic stress disorder. Neuropsychology, 12,125-133, http://psycnet.apa.org/doi/10.1037/0894-4188.8.131.52
Vasterling, J.J., Duke, L.M., Brailey, K., Constans, J.I., Allain, A.N., & Sutker, P.B. (2002). Attention, learning, and memory performances and intellectual resources in Vietnam veterans: PTSD and no disorder comparisons. Neuropsychology, 16, 5-14, http://psycnet.apa.org/doi/10.1037/0894-4184.108.40.206
White, N., & Richards, L. (2009). Alpha-theta neurotherapy and the neurobehavioral treatment of addictions, mood disorders and trauma. In T. H. Budzynski , H. K Budzynski , J.R. Evans & A. Arbarbanel (Eds., 2nd ed.), Introduction to Quantitative EEG and Neurofeedback: Advanced Theory and Applications. San Diego: Academic Press, (pp. 143-164).
Wylie, M.S. (2004). The limits of talk. Psychotherapy Networker, 28, 30-36, http://dubielgray.com/wp-content/uploads/2014/08/Networker.pdf.
Copyright (c) 2017 Connie McReynolds, Jodi Bell, Tina M Lincourt
This work is licensed under a Creative Commons Attribution 4.0 International License.Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).