# Enhancement of PTSD Treatment with Computerized Executive Function Training

> **NIH VA IK2** · VA SAN DIEGO HEALTHCARE SYSTEM · 2020 · —

## Abstract

PTSD affects approximately 14% of OEF/OIF Veterans and leads to considerable personal and societal
costs (e.g., increased morbidity, reduced work productivity, poorer relationships). Although cognitive behavioral
therapy (CBT) is one of the most effective treatments for PTSD, a substantial portion (approximately 50%) of
individuals drop out prematurely, do not respond to treatment, or relapse. Treatment engagement is worse for
OEF/OIF Veterans, who attend fewer sessions and have higher dropout rates than civilians and Veterans from
other eras. One likely barrier to treatment engagement and effectiveness is the executive functioning problems
present in individuals with PTSD. Executive functions (EFs) are the set of higher-level cognitive skills that
organize and integrate lower-level cognitive processes in order to perform complex, goal-directed tasks. PTSD
has been associated with EF deficits, including impairments in inhibitory control, working memory, and
cognitive flexibly, as well as dysfunction in a network of brain regions that support EFs (e.g., prefrontal cortex
[PFC], cingulate). EFs are essential for CBT in order to engage the cognitive skills involved in treatment (e.g.,
self-monitoring, inhibiting distorted thoughts, flexibly generating/evaluating alternative thoughts). This is
particularly true for Cognitive Processing Therapy (CPT), a frontline CBT treatment for PTSD, which involves
identifying and challenging maladaptive trauma-related thoughts to alter their impact on emotions and
behavior. Thus, EF deficits may lead to reduced CPT engagement and responsivity. In fact, worse EF at
baseline has been associated with poorer response to CBT in several disorders (e.g., generalized anxiety
disorder, obsessive compulsive disorder, schizophrenia). Further, a study of brain functioning during an EF
task demonstrated that dysfunction in EF-related brain regions including PFC and cingulate cortex at baseline
predicted nonresponse to CBT for PTSD.
 Directly targeting EF prior to CPT via cognitive training would strengthen executive networks and likely
boost treatment effectiveness, allowing Veterans to fully engage in and benefit more from components of CPT
(e.g., cognitive restructuring). Evidence suggests that computerized cognitive training improves EF and
functioning in EF-related brain regions, increases mental health treatment completion rates, and enhances
response to CBT, though this has not yet been tested in a PTSD population. Thus, the main goal of the
proposed study is to examine whether administering computerized EF training (CEFT) immediately prior to
CPT will improve executive functioning and enhance treatment adherence, completion rates, and psychological
and functional outcomes in OEF/OIF Veterans with PTSD. Objective (neuropsychological) and subjective (self-
report) measures of EF will be collected to determine if CEFT enhances EF and if this in turn mediates the
relationship between treatment condition and PTSD symptom imp...

## Key facts

- **NIH application ID:** 9838668
- **Project number:** 5IK2RX002459-03
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** Laura Crocker
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-11-01 → 2022-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9838668

## Citation

> US National Institutes of Health, RePORTER application 9838668, Enhancement of PTSD Treatment with Computerized Executive Function Training (5IK2RX002459-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9838668. Licensed CC0.

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