Increasing Psychological Resilience in Combat Soldiers Applying Advanced Eye-Tracking-Based Attention Bias Modification

NCT ID: NCT05294848

Last Updated: 2025-04-11

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 501 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-06-30
• Study Completion Date: 2024-06-21

Brief Summary

Military service in combat units entails exposure to traumatic events that require mental adjustment. To develop and efficiently apply attention bias modification interventions aimed at enhancing soldiers' mental resilience, it is essential to test the efficiency of such training programs in RCTs. The purpose of the current study is to examine the efficiency of a new attention eye-tracking-based training protocol, in comparison to an RT-based training protocol, and to a control group, in reducing risk for post-trauma symptoms in combat deployed soldiers.

Detailed Description

Following the explanation to participants regarding the study process, those who give written consent to participate will be randomly placed into one of three groups: GCFT (N=180), ABMT (N=180), and a neutral control group - RT-based task (N=180). The study will include 3 measurement points: before attention training (in basic training before deployment), after attention training (in basic training camp, still before deployment), and after a combat deployment cycle (6-12 months - to be determined based on the military deployment mission of the participants). In each measurement point, the participants will complete computerized tasks to measure attention and will complete self-report questionnaires.

Conditions

PTSD; Depression; Anxiety Disorders

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

Gaze-Contingent Feedback Training (toward threat)

In the task, 30 different matrices, each consisting of 16 faces, will be presented. Each matrix includes 8 angry faces and 8 neutral, 8 women and 8 men, and the locations are counterbalanced between matrices. The participants are asked to view the matrices in any way they choose, and the eye-tracking camera records their viewing location relative to the stimuli presented on the screen. At the beginning of each training session, the soldier will choose to which music he would like to listen during the 12-minute session from a diverse list of music. After calibrating the eye-tracker, the participant will be instructed to view matrices of faces as he chooses, as described above in the assessment task. The music chosen by the participant will play only when he is looking at threatening faces and it will stop when he looks at neutral faces. Thus, a change in viewing patterns is expected by implementing operant conditioning principles.

Group Type: EXPERIMENTAL

Gaze-Contingent Feedback Training

Intervention Type: BEHAVIORAL

Feedback according to participants' viewing patterns, in order to modify their attention toward threat stimuli.

RT-Based Attention Bias Modification (toward threat)

A dot-probe task of 160 trials. Trials begins with a fixation cross (+), on which the participant is asked to focus (500ms). Then two face stimuli (one angry one neutral) are presented above and below the fixation cross (500ms). After the stimuli disappear, a target probe (right- or left-pointing arrowhead) appears in place of one of the face stimuli. The participant is asked to indicate which target probe was presented using a predetermined key. The target probe will remain on the screen until response, after which a new trial will begin.

Participants are instructed to identify the probe type as quickly and accurately as possible.

In the training task, all of the target probes will appear in the threat location (angry face). Thus, over multiple trials, learning is expected to occurs such that the threatening face predicts the location of the target probe, thereby achieving the desired change in attention pattern.

Group Type: ACTIVE_COMPARATOR

Attention Bias Modification

Intervention Type: BEHAVIORAL

Attention training via repeated trials of a dot-probe task intended to direct attention toward threat stimuli using threat and neutral face stimuli.

Neutral Control

This condition is also based on the dot-probe task (see Active Comparator) with a fundamental difference. In this task, only neutral faces will be displayed, and therefore, while participants are exposed to the same task parameters, there will be no attention training and there will be no exposure to threat stimuli.

Group Type: PLACEBO_COMPARATOR

Neutral Control

Intervention Type: BEHAVIORAL

Dot-probe task using only neutral stimuli with no training toward threat

Interventions

Gaze-Contingent Feedback Training

Feedback according to participants' viewing patterns, in order to modify their attention toward threat stimuli.

Intervention Type: BEHAVIORAL

Attention Bias Modification

Attention training via repeated trials of a dot-probe task intended to direct attention toward threat stimuli using threat and neutral face stimuli.

Intervention Type: BEHAVIORAL

Neutral Control

Dot-probe task using only neutral stimuli with no training toward threat

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Each soldier from the allocated cohort who gives written consent will be able to participate in the study.

Exclusion Criteria

• Hebrew proficiency is insufficient to complete the study questionnaires.

• Minimum Eligible Age: 18 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: Yes

Sponsors

Tel Aviv University

OTHER

Sponsor Role: lead

Responsible Party

Yair Bar-Haim

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Yair Bar-Haim, PhD

Role: PRINCIPAL_INVESTIGATOR

Tel Aviv University

Locations

Tel Aviv University

Tel Aviv, , Israel

Countries

Israel

References

Wald I, Fruchter E, Ginat K, Stolin E, Dagan D, Bliese PD, Quartana PJ, Sipos ML, Pine DS, Bar-Haim Y. Selective prevention of combat-related post-traumatic stress disorder using attention bias modification training: a randomized controlled trial. Psychol Med. 2016 Sep;46(12):2627-36. doi: 10.1017/S0033291716000945. Epub 2016 Jul 5.

Reference Type: BACKGROUND

PMID: 27377418 (View on PubMed)

Other Identifiers

TAU-GCFTresilience

Identifier Type: -

Identifier Source: org_study_id