NET in Iranian Women Suffering From Post Traumatic Stress Symptoms

Efficacy of Narrative Exposure Therapy (NET) in a Sample of Iranian Women Exposed to Intimate Partner Violence (IPV)

The proposed study seeks to investigate to what extent Narrative Exposure Therapy (NET) is an effective treatment for the reduction of symptoms of Post-Traumatic Stress Disorder (PTSD) and depression and for the improvement of daily functioning in Iranian women who have experienced intimate partner violence (IPV). In addition, the study seeks to investigate whether NET therapy could lead to the reduction of Intimate Partner Violence (IPV) within their marriage.

Study Overview

• Status: Completed
• Conditions: Mental Disorders; Domestic Violence
• Intervention / Treatment: Other: Treatment-as-usual; Behavioral: Narrative Exposure Therapy

• Study Type: Interventional
• Enrollment (Actual): 34
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Iran, Islamic Republic of
  • Tehran, Iran, Islamic Republic of
    • Mental Health Clinics

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 60 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• being victims of Intimate Partner Violence and seeking help at target clinics in order to reduce their psychological symptoms, currently living together with their partner/husband, meeting the set cut-off point on the PTSD scale according to DSM-IV.

Exclusion Criteria:

• schizophrenia, epilepsy, mental retardation, drug abuse and mal-nourishment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Treamtent-as-usual; Treatment-as-usual can be defined as the commonly used psychotherapy for abused women in Iran, such as medical therapy and/or supportive psychotherapy.	Other: Treatment-as-usual; Treatment-as-usual was defined as the commonly used psychotherapy for abused women in Iran, such as medical therapy and/or supportive counseling. Regarding supportive counselling, the sessions included: Life skill education CBT techniques ACT techniques Finding resources to stop violence Discussing marital and sexual conflicts with the presence of husbands Working on their children problems Improvement of communication skills
Experimental: Narrative Exposure Therapy; Narrative Exposure Therapy (NET) is a standardized short-term approach based on the principles of cognitive behavioral exposure therapy and testimony therapy for the treatment of PTSD resulting from organized violence.	Behavioral: Narrative Exposure Therapy; Narrative Exposure Therapy (NET) is a treatment approach that was developed by a research group of the University of Konstanz (Schauer, Neuner, & Elbert, 2005, 2011). In NET, the patient repeatedly talks about the most arousing traumatic events in detail while re-experiencing the emotions associated with this event. In the process, the patient constructs a narration of his life, focusing on the detailed report of the traumatic experiences.; Other Names: NET

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Posttraumatic Diagnostic Scale (PDS/PSS-I).	The PDS/PSS-I is a 17-item screening instrument on a 4-point-Likert-scale (0 = not at all to 3 = very much). The PDS aims at assessing all Diagnostic and Statistical Manual (DSM-IV) criteria of a Post Traumatic Stress Disorder (PTSD), and thus it includes information about the nature of the traumatic event and the level of functional interference.	Symptoms will be assessed at pre-treatment-point and post-treatment-point (up to 6-month follow-ups)
The Patient Health Questionnaire-9 (PHQ-9)	The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module	At pre-treatment-point, post-treatment-point, and 3- and 6-month follow-ups
The Hopkins Symptom Checklist-25 (HSCL-25)	The Hopkins Symptom Checklist 25 would be used to screen for symptoms of depression and anxiety.	At pre-treatment-point, post-treatment-point, and 3- and 6-month follow-ups
Perceived Stress Scale-4	The Perceived Stress Scale (PSS) would be used to assess the perception of stress over the course of the last month preceding the interview	At pre-treatment-point, post-treatment-point and 3- and 6-month follow-ups

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Composite Abuse Scale (CAS)	The CAS, a 30-item validated research instrument, is a widely used self-report questionnaire of behaviors that women describe as abusive by their partners. It is a self-report measure that provides standardized sub scale scores on four dimensions of intimate partner abuse. The four dimensions are Severe Combined Abuse, Emotional Abuse, Physical Abuse, and Harassment, scaled from 0 (never) to 5 (daily) over a period of 12-month.	At pre-treatment-point, post-treatment-point, and 3- and 6-month follow-ups
The Work and Social Adjustment Scale (WSAS)	The WSAS is a widely used 5-item measure of disability. Its psychometric properties were analyzed and shown in different studies and disorders (Mataix-Cols et al, 2005; Mundt et al, 2002).	At pre-treatment-point, post-treatment-point and 3- and 6-month follow-ups
The Life Events Checklist	The Life Events Checklist (LEC) is a brief, 17-item, self-report measure designed to screen for potentially traumatic events in a respondent's lifetime. The LEC assesses exposure to 16 events known to potentially result in PTSD or distress and includes one item assessing any other extraordinarily stressful event not captured in the first 16 items.	At pre-treatment-point, post-treatment-point and 3- and 6-month follow-ups
Checklist of family violence	This checklist assessing the incidence of domestic violence was developed by Catani (2002) and includes questions on physical abuse, verbal violence, neglect and sexual abuse as well as witnessing intimate partner violence between parents.	At pre-treatment-point, post-treatment-point and 3- and 6-month follow-ups

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Borderline Symptom List (BSL-23)	The BSL-23 is a shortened form of the full version of the BSL-95. The self-report questionnaire assesses borderline-specific symptomatology on a five response scale ranging from 0 (not at all) to 4 (very strongly).	At pre-treatment-point, post-treatment-point and 3- and 6-month follow-ups

Collaborators and Investigators

• Sponsor: University of Konstanz
• Collaborators: Tehran University of Medical Sciences
• Investigators: Study Chair: Thomas Elbert, Professor, University of Konstanz

Publications and helpful links

General Publications

• Hameed M, O'Doherty L, Gilchrist G, Tirado-Munoz J, Taft A, Chondros P, Feder G, Tan M, Hegarty K. Psychological therapies for women who experience intimate partner violence. Cochrane Database Syst Rev. 2020 Jul 1;7(7):CD013017. doi: 10.1002/14651858.CD013017.pub2.

Study record dates

Study Major Dates

• Study Start: November 1, 2012
• Primary Completion (Actual): December 1, 2015
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: November 15, 2012
• First Submitted That Met QC Criteria: November 20, 2012
• First Posted (Estimate): November 21, 2012

Study Record Updates

• Last Update Posted (Actual): April 26, 2017
• Last Update Submitted That Met QC Criteria: April 24, 2017
• Last Verified: April 1, 2017

More Information

Terms related to this study

• Keywords: Depression; Post Traumatic Stress Disorder; Narrative Exposure Therapy; Intimate Partner violence
• Additional Relevant MeSH Terms: Mental Disorders
• Other Study ID Numbers: TO-10122012-UK