Soni-Tricker, Amit; (2024) Childhood Trauma as a Moderator in a Study of Compassionate Imagery Training with Adjunctive Non-Invasive Vagus Nerve Stimulation: An Exploratory Secondary Analysis. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Introduction: A variety of non-invasive techniques have been developed for the modulation or influence of the activity of the human brain and nervous system. These techniques have received rapidly growing research interest in recent years, including around the effects of combining them with psychotherapy for a variety of psychological disorders, including anxiety and trauma-related disorders.// Aims: The current review aimed to build on previous reviews in what is a fast-moving area of research, to explore the effect of combining non-invasive brain stimulation or neuro-modulation techniques with psychotherapy (techniques) for anxiety and trauma-related disorders, relative to psychotherapy (techniques) alone.// Method: Studies had to meet inclusion criteria related to the population, research design including an appropriate comparison, and reporting of outcome measures. Twelve studies meeting inclusion criteria were identified from four electronic databases (Medline, PsycInfo, Embase and WebOfScience) and references from previous relevant reviews. Data was synthesised using a meta-analysis where data was available, and with a narrative synthesis to complement this.// Results: The meta-analyses revealed that there were no significant differences between groups receiving psychotherapeutic interventions with versus without an active non-invasive neurostimulation intervention. Through the narrative synthesis, the results were mixed with what were deemed broadly positive results in five studies, neutral results in six studies and negative results in one study. The proposed mechanisms of interaction between the stimulation and psychotherapy varied in their clarity and extent to which they aligned with current theoretical understanding of psychotherapy (techniques) processes.// Conclusions: The review produced less optimistic results than previous reviews suggesting that a combination of psychotherapy and non-invasive neurostimulation does not consistently enhance the effects of psychotherapy alone for anxiety disorders and trauma-related disorders, with no clear site of stimulation, or combination of psychotherapy and non-invasive neurostimulation intervention producing consistently reproduced enhancing effects. Further research with carefully chosen, theoretically grounded protocols is needed to reach a consensus on whether there is an additional benefit of combining non-invasive neurostimulation and psychotherapy for anxiety and trauma-related disorders, and if so in what protocols

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