Published Work from Our Team and Collaborators
Our Partners
- University of Sydney
- University of NSW
- Macquarie University
- Westmead Institute for Medical Research
Mirjana Askovic, Nerissa Soh, James Elhindi & Anthony W.F. Harris (2023)
Neurofeedback for post-traumatic stress disorder: systematic review and meta-analysis of clinical and neurophysiological outcomes
European Journal of Psychotraumatology, Volume 14, 2023 – Issue 2
This paper details the findings of a systematic review and meta-analysis which examines ten clinical trials which were conducted to answer the question: how effective is NFB in addressing PTSD and other associated symptoms across different trauma populations, and are these improvements related to neurophysiological changes?
Highlights from the paper include:
- Neurofeedback (NFB) was found to have moderate beneficial effects on PTSD symptoms, and positive effects on secondary outcomes such as depression and anxiety, according to a meta-analysis of seven randomised controlled trials (RCTs).
- The beneficial effects of NFB were observed across diverse populations, including those with different types of trauma (military and civilians) and from different ethnic backgrounds.
- Results suggest that modulation of alpha rhythm might be a viable NFB protocol in patients with PTSD, as changes in neurophysiological functioning, such as connectivity in the Default Mode Network (DMN) and Salience Network (SN), were observed post-NFB and were correlated with a decrease in PTSD severity.
Darius Rountree-Harrison, Shlomo Berkovsky & Maria Kangas (2023)
Heart and brain traumatic stress biomarker analysis with and without machine learning: A scoping review
International Journal of Psychophysiology 185 (2023) 27–49
This paper looks at the enigma of post-traumatic stress disorder (PTSD) and how it is embedded in a complex array of physiological responses to stressful situations that result in disruptions in arousal and cognitions that characterise the psychological disorder. A total of 124 papers based on adult samples were identified comprising 19 machine learning studies involving EEG and ECG. A further 21 studies using EEG data, and 84 studies employing ECG meeting all other criteria but not employing machine learning were included for comparison. This paper discussing the emerging trends, algorithms used and their success is provided, along with areas for future research.
Liddell B.J. (2019)
Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees.Journal of Traumatic Stress, 00, 1-11
Journal of Traumatic Stress, 00, 1-11.
This paper examined PTSD and Complex PTSD (CPTSD) symptom profiles (co-occurring PTSD and disturbances in self-organization [DSO] symptoms) and their premigration, postmigration, and demographic predictors, using latent class analysis (LCA), in a cohort of 112 refugees resettled in Australia. The findings are consistent with the ICD-11 model of CPTSD and highlight the contributions of cumulative trauma to CPTSD and PTSD profiles as well as of contextual stress from visa uncertainty to DSO symptom profiles in refugee cohorts, particularly those characterized by affect dysregulation.
Askovic M., Watters A., Coello M., Aroche J., Harris A. & Kropotov J. (2019)
Evaluation of Neurofeedback Therapy for Refugee Related Posttraumatic Stress Using Self-report and Cognitive ERP Measures
Clinical EEG and Neuroscience, 10, 1-8.
This paper describes preliminary results of a pilot study that indicate a possible benefit of neurofeedback for remediating PTSD. We hypothesised that neurofeedback helped to improve cognitive control, observed as normalization of the P3 NOGO. The shift in P3 NOGO in clients who also remitted from trauma symptoms is consistent with the hypothesis that an improvement in cognitive control underlies recovery from PTSD. Further confirmation of the effectiveness and mechanisms of the treatment now requires a randomised controlled trial.
Liddell, B. J., et al. (2019)
Neural Correlates of Posttraumatic Stress Disorder Symptoms, Trauma Exposure, and Postmigration Stress in Response to Fear Faces in Resettled Refugees
Clinical Psychological Science, 7(4), 811–825.
This paper examines the influence of PTSD symptoms, cumulative trauma, and recent postmigration stress on neural reactivity and regional coupling within the refugee sample. Cumulative trauma and postmigration stress but not PTSD symptoms correlated with fear-related brain activity and connectivity. Trauma exposure correlated with stronger activity but overall decreased connectivity in the bilateral posterior insula/rolandic operculum, postcentral gyrus, ventral anterior cingulate cortex, and posterior cingulate gyrus. Postmigration stress correlated with fusiform gyrus hyperactivity and increased connectivity in face-processing networks. Findings highlight the impact of past trauma and recent postmigration stress on fear-related neural responses within refugees over and above PTSD symptoms.
Askovic M, Watters AJ, Aroche J, Harris AWF (2017)
Neurofeedback as an adjunct therapy for treatment of chronic posttraumatic stress disorder related to refugee trauma and torture experiences: Two case studies
Australasian Psychiatry, 25(4): 358-363.
This paper describes the assessment and application of neurofeedback integrated into the treatment of two clients with chronic PTSD. The details of our treatment schedule, symptoms and quantitative electrophysiological (EEG) data for each case was described. Both clients achieved significant reduction in symptoms of PTSD and improvement in daily functioning post neurofeedback therapy. Quantitative electroencephalogric measures indicated a normalisation of EEG markers relating to trauma, including overarousal at rest and working memory function. If replicated, the improvements demonstrated in this population would be generalizable to all chronic PTSD.
Askovic M. & Gould D. (2009)
Integration of Neurofeedback in the Therapeutic Work with Torture and Trauma Survivors: A Case Study
Biofeedback Journal (2009); 37 (2), 56-62.
This paper describes a case study of a 14-year-old African refugee boy who survived multiple traumas related to war, displacement, and deprivation. Traumatized from the age of 2, his presentation was primarily one of affect dysregulation. This paper describes how neurofeedback was integrated with psychotherapy to address both the core hyperarousal and the unavailability of the necessary cortical and behavioural skills required to regulate affect.
Aroche J., Tukelija S. & Askovic M. (2009)
Neurofeedback in Work with Refugee Trauma: Rebuilding Fragile Foundations
Biofeedback Journal (2009); 37(2), 53-55.
This paper describes the Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), established by the Australian government to provide specialized services for the many torture and trauma survivors accepted as refugees in Australia. Of the clients served by STARTTS, 30% present with post traumatic stress disorder. The authors report on the integration of neurofeedback into the psychotherapy provided to these individuals.
Askovic M. & Fisher S. (2006)
THE CASE of PABLO DIEGO: The Integration of Neurofeedback in Therapeutic Work with a Torture Survivor
STARTTS.
This paper describes a case of a 62 year-old man who had been tortured by the Pinochet regime in Chile over twenty years earlier. The authors describe his neurofeedback treatment at STARTTS and reflect on the impact of torture and trauma experiences on the nervous system.