JMIR Publications

ABSTRACT

Many adolescents in residential care have been exposed to prolonged traumatic experiences such as violence, neglect, or abuse. Consequently, they suffer from posttraumatic stress. This not only negatively affects psychological and behavioral outcomes (e.g., increased anxiety, depression, and aggression), but also has adverse effects on physiological outcomes, in particular neurobiological stress systems (i.e. autonomic nervous system [ANS] and hypothalamic-pituitary-adrenal [HPA] axis activity). Although current evidence-based treatment options are effective, these have their limitations. An alternative to traditional trauma treatment are meditation-based interventions that focus on stress regulation and relaxation. Muse is a game-based meditation intervention that makes use of adolescents’ intrinsic motivation. The neurofeedback element reinforces relaxation abilities. In the present study, we examine the effectiveness of Muse in reducing posttraumatic stress and normalizing neurobiological stress reactivity in a sample of traumatized adolescents in residential care. This is a multicenter, multi-informant, and multi-method randomized controlled trial. Participants (N = 80) are adolescents (10-18 years) with clinical levels of posttraumatic symptoms who are randomized to receive either the Muse therapy sessions and treatment as usual (TAU), or TAU alone. The primary outcome is change in posttraumatic symptoms and stress from pre- to post-treatment measurement. Secondary outcomes are change in neurobiological stress reactivity under both resting and social stress conditions, and anxiety, depression, and aggression. Data are collected at three measurement moments: before the intervention, after the intervention, and at two-month follow-up. We hypothesize that traumatized adolescents who receive game-based neurofeedback meditation therapy as an addition to treatment as usual (TAU) will show reduced posttraumatic stress and normalized neurobiological stress reactivity compared to traumatized adolescents who receive TAU alone.