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RecruitingNCT07658157Updated Jun 25, 2026

Exposure by Assessment: Effects of Daily AMQ-Based EMA of an Intrusive Trauma Memory in PTSD

An interventional study of AMQ-based ecological momentary assessment of an intrusive memory and AMQ-based ecological momentary assessment of an emotionally neutral memory in PTSD, sponsored by Tel Aviv University. Recruiting at 1 site in Israel. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-06-25.

Sponsored by Tel Aviv University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

Intrusive re-experiencing is a hallmark of PTSD. The study applies ecological momentary assessment (EMA) of participants' trauma memories (active group) vs. EMA of a neutral memory (control group) to test whether the active intervention can reduce intrusive symptoms severity and overal PTSD symptom severity in general.

Read the detailed description

Intrusive re-experiencing is a defining burden for many people with PTSD, often disrupting routines and making it hard to participate in care. Intrusion symptoms tend to be resistant to change, even when broader PTSD symptoms improve (Bar-Haim et al., 2021; Levi et al., 2022). This pattern underscores the need for brief, remote approaches tuned to everyday intrusion dynamics.

The study tests a home-based intervention requiring minimal clinician input that aims to reduce intrusive symptoms. Ecological momentary assessment (EMA) offers such an opportunity. Although typically used for data collection, Pollmann et al. (2024) reported preliminary evidence suggesting that two weeks of EMA focused on a traumatic intrusive memory (TR-IM) were followed by reductions in intrusion symptoms, while other symptom clusters remained comparatively unchanged. Pollmann et al. used prompts adapted from the Autobiographical Memory Questionnaire (AMQ; Rubin et al., 2003). However, in the absence of a control condition, it remains uncertain whether the observed change reflects targeted, safe-context activation of the traumatic memory, a general cognitive-distancing effect from repeated ratings regardless of target, or a different process altogether. A further methodological limitation is that EMA completion depended on participants' spontaneous recollection of the TR-IM in the preceding hours. As a result, responses were intermittent and varied across days and individuals, leading to uneven exposure and data gaps.

The present study aims to test the mechanism in question as well as to create a different setting in which all participants answer the questionnaire at each EMA prompt. Adults with PTSD who report active intrusions will be randomized to one of two otherwise identical 10-day EMA protocols: (1) daily AMQ-based prompts that explicitly target a personally identified TR-IM, or (2) the same prompts targeting a neutral, non-intrusive memory. Primary outcomes will be baseline to post-treatment change and baseline to follow-up change on clinician-rated CAPS-5 total score and CAPS-5 Cluster B indices. Secondary outcomes will be self-reported PCL-5 total score and cluster B scores.

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Conditions studied

03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adults aged 18-70
  • Posttraumatic stress disorder
  • intrusive symptoms.

Exclusion criteria

Exclusion Criteria:

  • Psychotic or bipolar disorder
  • Heavy use of drugs or alcohol
  • Prominent personality disorder
  • Significant risk of harm to self or others
  • Current trauma-focused treatment
  • Reporting intrusions as thoughts only rather than as memories
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Care provider, Investigator, Outcomes assessor)
Enrollment
50 participants (estimated)

Study arms

  • Sham comparator
    Neutral Memory

    Participants allocated to this arm will complete AMQ-based ecological momentary assessments (EMAs) focused on an emotionally neutral memory identified at the beginning of the trial.

    Other: AMQ-based ecological momentary assessment of an emotionally neutral memory

  • Active comparator
    Intrusive Memories

    Participants allocated to this arm will complete AMQ-based ecological momentary assessments (EMAs) focused on an intrusive memory identified at the beginning of the trial.

    Other: AMQ-based ecological momentary assessment of an intrusive memory

Interventions

  • OtherAMQ-based ecological momentary assessment of an intrusive memory

    Participants allocated to this intervention will complete daily AMQ-based ecological momentary assessment (EMA) prompts for 10 days, focused on a personally identified intrusive traumatic memory. The target memory will be selected at the beginning of the trial. The EMA prompts will assess phenomenological and emotional characteristics of the memory, including features related to vividness, emotional intensity, nowness/reliving, and intrusiveness. This intervention is intended to examine whether repeated, low-burden assessment of an intrusive traumatic memory by the participant would be associated with changes in PTSD symptom severity.

  • OtherAMQ-based ecological momentary assessment of an emotionally neutral memory

    Participants allocated to this intervention will complete daily AMQ-based ecological momentary assessment (EMA) prompts for 10 days, focused on a personally identified neutral, non-intrusive autobiographical memory. The target memory will be selected at the beginning of the trial. The EMA prompts will be otherwise identical to those administered in the intrusive-memory arm and will assess phenomenological and emotional characteristics of the selected memory. This control intervention is intended to distinguish the effects of repeated memory-focused assessment in general from effects specific to repeated assessment of an intrusive traumatic memory.

05

What researchers measure

Primary outcomes

  1. Change from Baseline in Clinician-Rated PTSD Symptom Severity as Assessed by the CAPS-5 Total Severity Score at Post-Intervention and Follow-Up

    Clinician-rated PTSD symptom severity will be assessed using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) total severity score. Change from baseline will be evaluated at post-intervention and follow-up. Higher CAPS-5 total severity scores indicate greater PTSD symptom severity.

    Time frame: From baseline to post-intervention - 10 days; Follow-up data will be collected 15-30 days following the post-intervention assessment.

  2. Change from Baseline in Clinician-Rated PTSD Intrusion Symptom Severity as Assessed by the CAPS-5 Cluster B Severity Score at Post-Intervention and Follow-Up

    PTSD intrusion symptom severity will be assessed using the Cluster B severity score of the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Cluster B includes clinician-rated symptoms of intrusive memories, distressing dreams, dissociative reactions/flashbacks, psychological distress at reminders, and physiological reactions to reminders. Change from baseline will be evaluated at post-intervention and follow-up. Higher CAPS-5 Cluster B scores indicate greater intrusion symptom severity.

    Time frame: From baseline to post-intervention - 10 days; Follow-up data will be collected 15-30 days following the post-intervention assessment.

Secondary outcomes

  1. Change from Baseline in Self-Reported PTSD Symptom Severity as Assessed by the PCL-5 Total Score at Post-Intervention and Follow-Up

    Self-reported PTSD symptom severity will be assessed using the PTSD Checklist for DSM-5 (PCL-5) total score. The PCL-5 is a self-report measure assessing PTSD symptoms over the past specified time period. Change from baseline will be evaluated at post-intervention and follow-up. Higher PCL-5 total scores indicate greater PTSD symptom severity.

    Time frame: From baseline to post-intervention - 10 days; Follow-up data will be collected 15-30 days following the post-intervention assessment.

  2. Change from Baseline in Self-Reported PTSD Intrusion Symptom Severity as Assessed by the PCL-5 Cluster B Score at Post-Intervention and Follow-Up

    Self-reported PTSD intrusion symptom severity will be assessed using the Cluster B score of the PTSD Checklist for DSM-5 (PCL-5). Cluster B reflects intrusion symptoms, including intrusive memories, distressing dreams, dissociative reactions/flashbacks, emotional distress at reminders, and physical reactions at reminders. Change from baseline will be evaluated at post-intervention and follow-up. Higher PCL-5 Cluster B scores indicate greater self-reported intrusion symptom severity.

    Time frame: From baseline to post-intervention - 10 days; Follow-up data will be collected 15-30 days following the post-intervention assessment.

06

Study locations

1 of 1 sites recruiting
07

References and documents

Publications

  • Weathers FW, Bovin MJ, Lee DJ, Sloan DM, Schnurr PP, Kaloupek DG, Keane TM, Marx BP. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychol Assess. 2018 Mar;30(3):383-395. doi: 10.1037/pas0000486. Epub 2017 May 11. PubMed 28493729 ↗
  • Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092. PubMed 16717171 ↗
  • Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57. PubMed 9881538 ↗
  • Rubin DC, Schrauf RW, Greenberg DL. Belief and recollection of autobiographical memories. Mem Cognit. 2003 Sep;31(6):887-901. doi: 10.3758/bf03196443. PubMed 14651297 ↗
  • Levi, O., Ben-Yehuda, A., Pine, D. S., & Bar-Haim, Y. (2022). A sobering look at treatment effectiveness of military-related posttraumatic stress disorder. Clinical Psychological Science. Advance online publication.
  • Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x. PubMed 11556941 ↗
  • Goulart AC, Bismarchi D, Rienzo M, Syllos DH, Wang YP. Dimensions of Anger Reactions (DAR-5): a useful screening tool for anger in the general population. Int J Psychiatry Clin Pract. 2021 Nov;25(4):421-429. doi: 10.1080/13651501.2020.1821893. Epub 2020 Sep 25. PubMed 32975451 ↗
  • Cloitre M, Shevlin M, Brewin CR, Bisson JI, Roberts NP, Maercker A, Karatzias T, Hyland P. The International Trauma Questionnaire: development of a self-report measure of ICD-11 PTSD and complex PTSD. Acta Psychiatr Scand. 2018 Dec;138(6):536-546. doi: 10.1111/acps.12956. Epub 2018 Sep 3. PubMed 30178492 ↗
  • Bovin MJ, Marx BP, Weathers FW, Gallagher MW, Rodriguez P, Schnurr PP, Keane TM. Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans. Psychol Assess. 2016 Nov;28(11):1379-1391. doi: 10.1037/pas0000254. Epub 2015 Dec 14. PubMed 26653052 ↗
  • Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001 Jul;2(4):297-307. doi: 10.1016/s1389-9457(00)00065-4. PubMed 11438246 ↗
  • Bar-Haim Y, Stein MB, Bryant RA, Bliese PD, Ben Yehuda A, Kringelbach ML, Jain S, Dan O, Lazarov A, Wald I, Levi O, Neria Y, Pine DS. Intrusive Traumatic Reexperiencing: Pathognomonic of the Psychological Response to Traumatic Stress. Am J Psychiatry. 2021 Feb 1;178(2):119-122. doi: 10.1176/appi.ajp.2020.19121231. No abstract available. PubMed 33517759 ↗
  • Azriel O, Britton JC, Gober CD, Pine DS, Bar-Haim Y. Development and validation of the Attention Bias Questionnaire (ABQ). Int J Methods Psychiatr Res. 2022 Jun;31(2):e1905. doi: 10.1002/mpr.1905. Epub 2022 Mar 17. PubMed 35297127 ↗
  • Pollmann Y, Clancy KJ, Devignes Q, Ren B, Kaufman ML, Rosso IM. Specific symptom change associated with ecological momentary assessments of intrusive trauma memories. NPP Digit Psychiatry Neurosci. 2024 Oct 30;2(1):18. doi: 10.1038/s44277-024-00019-4. PubMed 41360934 ↗

Individual participant data

Plan to share: No

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Registry details

Key details

Study ID
NCT07658157
Lead sponsor
Tel Aviv University
Responsible party
Yair Bar-Haim (Professor, Tel Aviv University) — Principal investigator
First posted
Jun 18, 2026
Start date
Jun 14, 2026
Primary completion
Oct 2026 (estimated)
Completion
Jun 2027 (estimated)
Last update
Jun 25, 2026

Study contacts

Yuval Heimann, MA Student
Contact
yuvalheimann@mail.tau.ac.il
+972545698181
Yair Bar-Haim, PhD
Contact
yair1@tauex.tau.ac.il
972-52-7346610
Yair Bar Haim, Professor
principal investigator · Tel Aviv University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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