The Effect of Using the Combat Attention App on the Risk of Post-traumatic Symptoms

Military service and reserve duty in combat units entails exposure to traumatic events that require mental adjustment. In light of the results of controlled studies that proved the effectiveness an response-time based mechanized training protocol in reducing risk for post-trauma symptoms in deployed combat soldiers, the Israeli Defense Forces decided at the beginning of the Iron Swords War to implement an internet-based App of the intervention. Soldiers and combat reservists were invited to use the Combat Attention App. The purpose of this study is to examine the effectiveness of the Combat Attention App in relation to a control group of soldiers who did not use the App in reducing risk for post-traumatic stress symptoms of deployed soldiers.

Study Overview

• Status: Not yet recruiting
• Conditions: PTSD - Post Traumatic Stress Disorder
• Intervention / Treatment: Behavioral: Combat Attention Training

Detailed Description

Participants who used the Combat Attention App before combat deployment and a group of matched (age and sex) participants who did not use the App will be compared on PTSD, depression, and anxiety symptoms post deployment.

• Study Type: Observational
• Enrollment (Estimated): 1000

Contacts and Locations

• Study Contact: Name: Yair Bar-Haim, PhD; Phone Number: +972-3-6405465; Email: yair1@tauex.tau.ac.il
• Study Contact Backup: Name: Chelsea Gober Dykan, MA; Phone Number: +972-3-6405465; Email: chelseagober@mail.tau.ac.il

Study Locations

• Israel
  • Tel Aviv, Israel
    • Tel Aviv University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of enlisted and reservist soldiers who participated in the Iron Swards war and either used or did not use the attention App.

Description

Inclusion criteria:

• Age over 18 years.
• Served as an enlisted soldier or reservist during the Iron Swards War.
• Used the Combat Attention App or can serve as a matched control who did not use the App.
• Colloquial Hebrew sufficient to fill out the research questionnaires.

Exclusion criteria:

• Below 18 years of age.
• Colloquial Hebrew that is insufficient to fill out the research questionnaires.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Attention App Users; Soldiers who used the App and completed at least one training session	Behavioral: Combat Attention Training; The Combat Attention App is a response-time based mechanized preventive intervention designed to train combat soldiers' attention toward threats before combat exposure in order to reduce the risk for combat-related post-trauma symptoms. In light of the results of controlled studies that proved the efficacy of this preventive intervention, the Israel Defense Forces (IDF) decided at the beginning of the Iron Swords War (October 7th, 2023) to implement an internet-based App of the intervention, and soldiers and combat reservists were invited to train on the Combat Attention App.
Non Users; Soldiers matched on age, sex, and specialty to the Attention App Users group who never used the App

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PTSD Checklist for DSM-5 (PCL-5)	Measures PTSD symptoms according to DSM-5	January-June 2025
IDF Medical Records	Holds all the medical information and contact with health/mental health professionals during one's service	January-June 2025

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Combat Experiences Scale	Measures the occurrence of specific combat events	January-June 2025
Patient Health Questionnaire 9 (PHQ-9)	Measures Depression symptoms according to DSM-5	January-June 2025
Attention Bias Questionnaire (ABQ)	Measures subjective experiences of attention allocation to threats	January-June 2025
GAD-7	measures symptoms of generalized anxiety disorder	January-June 2025
Dissociative Experiences Scale (DES)	measures dissociative symptoms associated with trauma exposure	January-June 2025

Collaborators and Investigators

• Sponsor: Tel Aviv University
• Investigators: Principal Investigator: Yair Bar-Haim, PhD, Tel Aviv University

Publications and helpful links

General Publications

• Wald I, Fruchter E, Ginat K, Stolin E, Dagan D, Bliese PD, Quartana PJ, Sipos ML, Pine DS, Bar-Haim Y. Selective prevention of combat-related post-traumatic stress disorder using attention bias modification training: a randomized controlled trial. Psychol Med. 2016 Sep;46(12):2627-36. doi: 10.1017/S0033291716000945. Epub 2016 Jul 5.

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: October 31, 2024
• First Submitted That Met QC Criteria: November 25, 2024
• First Posted (Actual): November 29, 2024

Study Record Updates

• Last Update Posted (Actual): April 11, 2025
• Last Update Submitted That Met QC Criteria: April 8, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Trauma and Stressor Related Disorders; Mental Disorders; Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
• Other Study ID Numbers: TAU-Combat-Attention

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No