Ignite Creation Date:
2024-05-06 @ 12:57 PM
Last Modification Date:
2024-10-26 @ 1:06 PM
Study NCT ID:
NCT03890029
Status:
COMPLETED
Last Update Posted:
2023-03-16
First Post:
2019-03-21
Brief Title:
GRIT - Goal-directed Resilience Intervention Training
Sponsor:
Morehouse School of Medicine
Organization:
Morehouse School of Medicine
Study Overview
Official Title:
Building Biobehavioral Goal-Directed Resilience Among African American Women Project GRIT
Status:
COMPLETED
Status Verified Date:
2023-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
GRIT
Brief Summary:
This research program has addressed three reactive adaptations evident in pain PTSD and obesity In this project the focus will be on PTSD as a model of stimulus-based reactive responses to unpredictability or threat and the investigators propose to test the efficacy of the goal-directed skills training GRIT program for restoring predictive responding and homeostasis The challenge of how best to cultivate psychological resilience in the face of stress trauma and social adversity among disadvantaged populations is a complex question best answered with a translational research approach This research intent is to help African American women who are dealing with stress after traumatic experiences It will specifically study Post-traumatic Stress Disorder a disorder that affects people who have experienced severe traumas It is associated with a number of overwhelming emotional symptoms These include sleep difficulties depression and anxiety flashbacks and nightmares of the traumatic events
The training is an 8-week skill building program that helps people use positive experiences from their past to cope with current difficulties The investigators will collect blood samples for future research to understand how the bodys stress response changes as a result of this training
The training is an 8-week skill building program that helps people use positive experiences from their past to cope with current difficulties The investigators will collect blood samples for future research to understand how the bodys stress response changes as a result of this training
Detailed Description:
This project will utilize an intervention that is to encompass tenets of the New Wave therapies in two important respects
1 The projects emphasis is on capacity development The projects focus reaches beyond symptoms to restore and build resilience strengths that nurture in the face of challenge The concept of resilience first entered the psychological and psychiatric literature with the study of children suffering from stress and disadvantage who nevertheless were functioning well Protective factors included the presence of caring adults and achievement at school Bonds and achievement have remained the most persistent findings in decades of research
2 The investigators aim is to restore and build capacities displaced by symptoms This will be accomplished by identifying the lost capabilities in narratives of survival and identifying neuroscience models that capture symptoms and lost capacities as bio-behavioral response systems that become visible in extreme environments Narratives of exceptional survival in extreme situations are characterized by engagement with their circumstances in ways that kept individuals well by social relatedness and by an efficient stress response For example while imprisoned in the Hanoi Hilton Robert Shumaker built a dream house and counted the feet of lumber and number of nails that would needed Fellow inmates also developed a tapping code to communicate with each other Thus Shumaker was engaged was socially connected through tapping and while engaged was not hyper-responsive to the threat around him The positive survival responses are a marked contrast to the symptoms of PTSD described earlier such as hyperarousal or intrusive thoughts What distinguishes resilient adaptation in extreme situations from PTSD is that the resilient activities are characterized by goal-directed actions while PTSD is characterized by stimulus-driven responses The distinction of goal-directed versus stimulus-based responding is extensively developed in the neuroscience and cognitive literature Action research has identified intention-based and stimulus-based actions in which self-initiated actions involve brain mechanisms and cognitive processes distinctly different from reflexive or responsive movement
Broadly conceived humans have two types of responses to the environment they act to achieve results or goals in the environment thus changing the environment or they respond to and accommodate the demands of the environment and are changed by it This distinction has its parallels in other areas of human functions Attention studies have identified voluntary control of attention endogenous that is goal-directed versus automatic reflexive control exogenous in which external objects or events claim a subjects attention A number of cortical models are relevant to goal-directed action and stimulus-based responding among them the work on intention and reactivity by Astor-Jack and Haggard or the studies of Hannus and colleagues on stimulus-driven and user-driven control of visual attention
Perhaps most relevant is the predictive and reactive control system PARCS developed by Tops and colleagues
These two basic bio-behavioral programs control behavior in different environments the reactive program being most adaptive in unpredictable environments and the predictive program most effective in highly predictable environments The reactive program is guided by momentary feedback from the environment and responses are close in time and space The predictive program guides behavior in a feed-forward manner that plans for the future simulates alternatives and makes predictions In PTSD stimulus-based responding prevails and displaces goal-directed responding at multiple levels of functioning cortical endocrine affective cognitive - indeed the entire bio-behavioral system of predictive responding
The abundant research on goal-directed action versus stimulus-based responding has few parallels in clinical psychology or psychiatry Hints emerge in eudamonic well-being that is goal-directed and required for challenging situations and goal-relevant motivational constructs of self-efficacy or locus of control This study draws on the extensive neuroscience framework to formulate a model of resilient and traumatic responses and proposes an approach that restores goal-directed responding that will simultaneously reduce the dominance of stimulus based symptoms of PTSD This is a 5 year study with the anticipation of 148 enrolled
1 The projects emphasis is on capacity development The projects focus reaches beyond symptoms to restore and build resilience strengths that nurture in the face of challenge The concept of resilience first entered the psychological and psychiatric literature with the study of children suffering from stress and disadvantage who nevertheless were functioning well Protective factors included the presence of caring adults and achievement at school Bonds and achievement have remained the most persistent findings in decades of research
2 The investigators aim is to restore and build capacities displaced by symptoms This will be accomplished by identifying the lost capabilities in narratives of survival and identifying neuroscience models that capture symptoms and lost capacities as bio-behavioral response systems that become visible in extreme environments Narratives of exceptional survival in extreme situations are characterized by engagement with their circumstances in ways that kept individuals well by social relatedness and by an efficient stress response For example while imprisoned in the Hanoi Hilton Robert Shumaker built a dream house and counted the feet of lumber and number of nails that would needed Fellow inmates also developed a tapping code to communicate with each other Thus Shumaker was engaged was socially connected through tapping and while engaged was not hyper-responsive to the threat around him The positive survival responses are a marked contrast to the symptoms of PTSD described earlier such as hyperarousal or intrusive thoughts What distinguishes resilient adaptation in extreme situations from PTSD is that the resilient activities are characterized by goal-directed actions while PTSD is characterized by stimulus-driven responses The distinction of goal-directed versus stimulus-based responding is extensively developed in the neuroscience and cognitive literature Action research has identified intention-based and stimulus-based actions in which self-initiated actions involve brain mechanisms and cognitive processes distinctly different from reflexive or responsive movement
Broadly conceived humans have two types of responses to the environment they act to achieve results or goals in the environment thus changing the environment or they respond to and accommodate the demands of the environment and are changed by it This distinction has its parallels in other areas of human functions Attention studies have identified voluntary control of attention endogenous that is goal-directed versus automatic reflexive control exogenous in which external objects or events claim a subjects attention A number of cortical models are relevant to goal-directed action and stimulus-based responding among them the work on intention and reactivity by Astor-Jack and Haggard or the studies of Hannus and colleagues on stimulus-driven and user-driven control of visual attention
Perhaps most relevant is the predictive and reactive control system PARCS developed by Tops and colleagues
These two basic bio-behavioral programs control behavior in different environments the reactive program being most adaptive in unpredictable environments and the predictive program most effective in highly predictable environments The reactive program is guided by momentary feedback from the environment and responses are close in time and space The predictive program guides behavior in a feed-forward manner that plans for the future simulates alternatives and makes predictions In PTSD stimulus-based responding prevails and displaces goal-directed responding at multiple levels of functioning cortical endocrine affective cognitive - indeed the entire bio-behavioral system of predictive responding
The abundant research on goal-directed action versus stimulus-based responding has few parallels in clinical psychology or psychiatry Hints emerge in eudamonic well-being that is goal-directed and required for challenging situations and goal-relevant motivational constructs of self-efficacy or locus of control This study draws on the extensive neuroscience framework to formulate a model of resilient and traumatic responses and proposes an approach that restores goal-directed responding that will simultaneously reduce the dominance of stimulus based symptoms of PTSD This is a 5 year study with the anticipation of 148 enrolled
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None