Trauma Suppression Training for Veterans

This single-site feasibility study adapted a web-based Think/No-Think retrieval-suppression training program, previously tested in the general population, for veterans with PTSD. At an introductory session, participants gave consent, completed baseline questionnaires, and received instructions for generating 40 personally significant events (20 negative, 20 positive), each with a cue (Hint) word and a key-detail (Response) word. After stimulus preparation (1 to 3 days), participants completed three consecutive training days. On Day 1 they rated each event and learned the 40 cue-detail pairs. On each training day they completed four runs of the Training Task: on No-Think trials (negative events) they recognized the event but stopped it from coming to mind without substituting other thoughts; on Think trials (positive events) they recalled the event and imagined it vividly. Untrained events of each valence served as baseline items. On Day 3 participants completed a cued-recall test, re-rated event vividness and affect, and completed post-training questionnaires. The protocol was revised during the study through IRB-approved amendments. Initially, participants were randomly assigned to one of four instruction conditions that differed only in the suppression strategy offered (flexible strategy, visual focus, breath focus, or heart-centered visualization), and sessions were held in person. From December 2025, all sessions could be held remotely and all participants received the flexible-strategy instruction, with the structured strategies suggested as optional aids. From February 2026, positive and negative events could be drawn from the past, present, or future rather than only past negative and future positive events.