Addressing Heightened Levels of Aggression in Traumatized Offenders With Psychotherapeutic Means

July 31, 2020 updated by: Anke Köbach, University of Konstanz

Addressing Heightened Levels of Aggression in Traumatized Offenders With Psychotherapeutic Means: A Randomized Controlled Trial in Eastern DR Congo

Heightened levels of aggression are fuelling violent incidents at all levels, especially in post-war regions. Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) aims to address trauma symptoms along with reactive and instrumental/appetitive aggression to encounter the downward cycle of perpetration and enforce a sustainable (re-)integration into civil life. In the present study, the investigators provide an adapted version of FORNET to former combatants in the North Kivu, Eastern DR Congo. Structured baseline, 3 and 6 month follow up interviews will be administered to assess the main outcome measures recent violent acts and appetitive aggression.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Participants will be recruited through local NGOs and eligible clients randomized to the treatment or waitlist control group, respectively. The treatment will be provided by supervised local counsellors after a 4-week training. At baseline, 3-month and 6-month follow up, sociodemographic data, trauma exposure, perpetrated violent acts, PTSD, recent aggression, functionality and drug dependency will be assessed. The interviews will be conducted by blind Congolese psychological interviewers after an intensive 3-weeks training and continuous supervision.

Study Type

Interventional

Enrollment (Actual)

402

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Germany
    • BW
      • Konstanz, BW, Germany, 78464
        • University of Konstanz

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years to 80 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Eligibility criteria

  • Former participant of an armed group in DR Congo
  • Involvement in violent attacks

Inclusion Criteria:

  • PTSD diagnosis or AAS sum score of 22 or higher

Exclusion Criteria:

  • Acute intoxification (alcohol or other drugs)
  • Acute psychotic symptoms
  • Sign of cerebro-organic diseases

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Narrative Exposure Therapy (FORNET, adapted version)
Version of Narrative Exposure Therapy for Forensic Offender Rehabilitation including one lifeline session and 5 exposure sessions as well as 6 group sessions adapted from behavioral-therapy approaches for addiction problems.
Behavioral: FORNET (adapted version)
Other Names:
  • Narrative Exposure Therapy for Forensic Offender Rehabilitation (adapted version)
No Intervention: Waitlist control or treatment as usual
No intervention or non-specific measures of support on request

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Appetitive aggression (sumscore; 0-60 indicating higher levels)
Time Frame: Change from baseline to 3-5 and 6-9 months post treatment
Appetitive Aggression Scale (Weierstall & Ebert, 2011)
Change from baseline to 3-5 and 6-9 months post treatment
Current violent behavior (sumscore; 0-96 indicating more acts)
Time Frame: Change from baseline to 3-5 and 6-9 months post treatment
A list of violent offenses perpetrated during the last 3 months (formerly used in Burundi; Crombach/Augsburger/Nandi)
Change from baseline to 3-5 and 6-9 months post treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
PSS-I: Posttraumatic Stress Disorder (sumscore, 0-80 indicating higher severity)
Time Frame: Change from baseline to 3-5 and 6-9 months post treatment
PTSD Symptom Scale (Foa & Tolin, 2000)
Change from baseline to 3-5 and 6-9 months post treatment

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Social acknowledgement (0-45 indicating more social acknowledgment)
Time Frame: Change from baseline to 3-5 and 6-9 months post treatment
Social Acknowledgement Questionnaire (Maerker & Mueller, 2004)
Change from baseline to 3-5 and 6-9 months post treatment
Depression (0-27 indicating higher severity)
Time Frame: Change from baseline to 3-5 and 6-9 months post treatment
Patient Health Questionnaire - 9 (Kroenke & Spitzer, 2002)
Change from baseline to 3-5 and 6-9 months post treatment
Substance use problems
Time Frame: Change from baseline to 3-5 and 6-9 months post treatment
Alcohol, Smoking and Substance Involvement Screening Test (Humeniuk et al., 2008)
Change from baseline to 3-5 and 6-9 months post treatment
Epigenetic changes
Time Frame: Change from baseline to 6-9 month post treatment
Genome wide methylation patterns (to be explored)
Change from baseline to 6-9 month post treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Konstanz

Investigators

  • Principal Investigator: Anke Köbach, PI, University of Konstanz

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2016

Primary Completion (Actual)

March 1, 2019

Study Completion (Actual)

March 1, 2019

Study Registration Dates

First Submitted

December 6, 2016

First Submitted That Met QC Criteria

December 10, 2016

First Posted (Estimate)

December 14, 2016

Study Record Updates

Last Update Posted (Actual)

August 4, 2020

Last Update Submitted That Met QC Criteria

July 31, 2020

Last Verified

July 1, 2020

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • FORNET1617

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Appetitive Aggression

Clinical Trials on FORNET (adapted version)

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Uruguay

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe