The Use of Neurofeedback in Treating Trauma Symptomatology Among Juvenile-Justice Involved Youth: Is It Effective?

Background: Trauma and toxic stress can lead to changes in brain architecture causing lifelong development disruptions in physical and mental health, educational achievement, economic productivity, and longevity. Research has shown that 90% of justice-involved youth residing in residential treatment have histories of complex trauma. The neuroscientific changes that result from trauma have found to be significantly correlated with both internalizing and externalizing behaviors. Treating the effects of trauma and preventing future justice involvement is important as juvenile crime comprises the largest proportion of all crime.

Scientific advances in understanding the plasticity of the adolescent brain has the potential to change rehabilitation approaches for justice-involved youth. Neurofeedback (NFB) is an intervention guided by quantitative encephalography (qEEGs) that identifies and changes abnormal patterns of brainwave activity that are contributing to poor physical and/or mental health.

Objectives: The objectives of this study included: 1) examine if changes in brainwave activity (measured by qEEGs) as a result of NFB, will correspond to positive changes in trauma symptomatology, and 2) identify if NFB was more effective than treatment as usual in reducing trauma symptomatology among justice-involved youth.

Methods: This researcher conducted a secondary data analysis on a residential treatment facility’s quasi-experiment of LORETA Z-score NFB in reducing symptoms of internalizing and externalizing behaviors. The sample consisted of 42 diverse youth ages 11-18 who have trauma histories as indicated by the Trauma Symptom Checklist Screening Form (TSCC-SF) and juvenile justice-involved histories. NFB was administered twice a week for 15 weeks. Subjects completed a qEEG and Trauma Symptom Checklist for Children (TSCC) at baseline, mid-test, post-test, and one-month follow-up.

Results: Repeated measures analysis of variance (RMANOVA) were conducted on the 10 sub-scales of the TSSC. Results showed there was a significant interaction effect for dissociation-fantasy (F_(df=3,105) = 6.845, p<0.001, ² = 0.164). There was a significant main time effect for anxiety (F_{(df=2.13, 74.42)} = 4.10, p = 0.018, ² = 0.105), depression (F_{(df=2.32, 81.29)} = 5.69, p = 0.003, ² = 0.140), overt-dissociation (F_{(df=1.83, 60.52)} = 4.382, p = 0.019, ² = 0.117), dissociation-fantasy (F_{(df=3, 105)} = 4.028, p = 0.009, ² = 0.103) and sexual-concerns distress sub-scales (F_{(df=3, 105)} = 3.163, p = 0.028, ² = 0.083). There were a significant group effect for sexual concerns (F_{(df=1, 33)} = 6.971, p = 0.012, ² = 0.166).

Conclusion: Results indicate that NFB was more effective than treatment-as-usual at treating sexual concerns among youth in this sample. More research is needed to determine the specific areas of the brain implicated with sexual abuse to determine best treatment modalities. Results also showed that effect of NFB across the multiple time points was effective at treating the fantasy subtype of dissociation, suggesting neuroscientific approaches to treating this type of dissociation may be more effective than individual and group therapies. Overall, results of the study support the need for further research on the use of NFB with traumatized youth.