Motion-assisted, multi-modular memory desensitisation and reconsolidation
Why is a New Treatment Needed?
Over the past 20 years, a number of treatments have been shown to result in clinically meaningful improvements for many military personnel and veterans with PTSD, for example the trauma-focused interventions Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE). Unfortunately, these and other first-line treatments do not help every PTSD sufferer and many continue to experience distressing symptoms despite having received the best evidenced treatments currently available. It is, therefore, vital that better treatments are developed for military personnel and veterans suffering with treatment resistant PTSD.
What is 3MDR?
Modular Motion assisted Memory Desensitization and Reconsolidation (3MDR) is a new treatment, developed in The Netherlands, that incorporates key elements of successful treatments such as Virtual Reality Exposure (VRE) and Eye Movement Desensitization Reprocessing (EMDR) and adds motion through walking on a treadmill. Exposure to self-selected images of deployment, enhanced with walking, music and emotion-provoking pictures, aims to eliminate avoidance during exposure and promote presence. Participants walk a repetitive cycle whilst talking and viewing their images. This is an important distinction between 3MDR and traditional trauma focused techniques as patients learn to move through their avoidance and face their fears by, literally, approaching their traumatic memories. The treatment uses the The Motek Gait Real-time Analysis Interactive Lab (GRAIL) system with its dual-belt treadmill, motion-capture system and synchronized Virtual Reality (VR) environment, which comprises a 180° projection screen with 4 projectors and a surround sound system.
How Does 3MDR Work?
No-one knows exactly how 3MDR works and it is likely that similar mechanisms to other trauma-focused interventions are involved. In addition, it is hypothesised that by introducing dual tasks (for example, walking and viewing images) that use working memory resources, there is less memory available for other memory processes, making the recollection of memories less vivid and less emotional.
Preliminary results from research conducted by the originators of 3MDR in the Netherlands regarding the efficacy of 3MDR in veterans with treatment resistant, combat-related PTSD are promising, with a decrease in PTSD symptoms and no dropout rates.
What does the 3MDR Study in Cardiff Aim to Achieve?
A pilot study involving two military veterans with PTSD in The Netherlands showed a decrease in PTSD symptoms following treatment with 3MDR and no significant adverse effects. This "proof of concept" means the time is now right to explore the potential efficacy of 3MDR further. Our aim is to determine if 3MDR is able to reduce symptoms in British military veterans with treatment-resistant, combat-related PTSD, to a significantly greater degree than being on a waiting list and without causing adverse effects.
Who can take part?
Participants are aged 18 or over, provide informed consent, meet DSM5 criteria for combat-related PTSD and treatment-resistance defined as prior trauma focused psychological treatment without loss of PTSD diagnosis.
What Does the Study Involve?
A phone call from a member of our research team to check eligibility, discuss the details of the study and answer any questions.
Giving informed consent and then daily self-monitoring of symptoms for two weeks.
A face to face interview with a researcher at Cardiff University to explore participants' backgrounds, experiences and trauma-related symptoms, supplemented by self-completed questionnaires.
The 3MDR therapy is delivered weekly over 9 weeks (two weeks preparation, 6 weeks 3MDR and one concluding session) by experienced psychological therapists. Participants are randomly allocated to receive 3MDR therapy immediately or after a wait of 12 weeks.
Follow-up interviews, involving similar questions, are conducted 12 weeks and 26 weeks after randomisation.
This video is a webinar introducing the work we have been doing on 3MDR: