EEG and Actigraphy Biomarkers of Written Exposure Therapy for Posttraumatic Stress Disorder

This randomized interventional study will examine neurophysiological and behavioral biomarkers of response to Written Exposure Therapy in adults with PTSD. Approximately 200 participants will be randomly assigned to Written Exposure Therapy or a neutral writing condition. Both conditions will involve five weekly writing sessions. Participants will undergo repeated EEG assessments to measure brain activity and actigraphy monitoring to characterize sleep and daily activity. These assessments will occur at scheduled time points before treatment, during the five-week intervention period, and after treatment. Clinical assessments will include repeated measures of PTSD symptoms throughout the study and clinician-administered assessments before and after the intervention. The study has three main objectives. First, it will evaluate changes in EEG and sleep measures from before to after the intervention and determine whether those changes are associated with improvement in PTSD symptoms. Second, it will examine weekly changes to identify the earliest point at which neurophysiological or sleep-related changes can be detected. Third, it will test whether baseline EEG, sleep, and clinical characteristics can predict treatment response and identify subgroups of participants with distinct response patterns. The study is intended to improve understanding of the biological and behavioral mechanisms associated with Written Exposure Therapy and support the future development of personalized approaches to PTSD treatment.