- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03755401
Post-Traumatic Stress Disorder Focused Psychodynamic Psychotherapy (RCT of TFPP)
November 2, 2023 updated by: Montefiore Medical Center
A Pilot Randomized Controlled Trial of Trauma-Focused Psychodynamic Psychotherapy (TFPP) at the VA in Veterans With PTSD
This is a randomized controlled trial of Trauma-Focused Psychodynamic Psychotherapy (TFPP) in comparison with TAU (at the VA) in a 2:1 ratio in 75 Veterans with PTSD who have not responded to standard treatment at the VA.
Study Overview
Detailed Description
Veterans with PTSD are a highly vulnerable population with tremendous disability and unmet needs.
Few VA patients with PTSD now actually receive evidence-based psychotherapy because current exposure-based treatments have low uptake.
The project goal is to expand the range of PTSD psychotherapy treatments available at Veterans Administration Medical Centers.
This pilot trauma recovery proposal takes the next step in translating a brief efficacious psychotherapy developed and tested for panic disorder, Panic Focused Psychodynamic Psychotherapy (PFPP) for Veterans with PTSD at the VA New York Harbor Healthcare System (VA NYHHCS).
PFPP was developed, manualized, and studied in RCTs over the past two decades.
We hope that Trauma-Focused Psychodynamic Psychotherapy (TFPP), an adaptation of PFPP, with its high response rates in panic disorder with/without agoraphobia, and non-exposure protocol, will fill crucial gaps in Veteran care.
A major challenge facing psychotherapy research is translating and implementing efficacious therapies to the community.
No psychodynamic psychotherapy for anxiety or PTSD has achieved this in the US.
This pilot RCT represents a paradigm shift in its approach to trauma.
TFPP will be the only PTSD treatment for Veterans to incorporate Veterans' input into refinement of the treatment as this project progresses.
TFPP targets aspects of traumatic experience and approaches Veterans' lives more broadly than the symptom-focused treatments the VA currently offers our traumatized Veterans.
Study Type
Interventional
Enrollment (Estimated)
75
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 Contact
- Name: Cory K Chen, Ph.D.
- Phone Number: 4002 (212) 686-7500
- Email: Cory.Chen@va.gov
Study Contact Backup
- Name: Emily Villeveuve
- Phone Number: 3003 (212) 686-7500
- Email: Emily.Villeneuve@va.gov
Study Locations
-
-
New York
-
New York, New York, United States, 10010
- Recruiting
- VA New York Harbor Healthcare System - Manhattan Campus
-
Contact:
- Lauren Wash
- Phone Number: 3003 212-686-7500
- Email: Lauren.Wash@va.gov
-
Contact:
- Cory K Chen, Ph.D.
- Phone Number: 4002 212-686-7500
- Email: Cory.Chen@va.gov
-
-
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 68 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Reporting moderate PTSD, as defined by a CAPS score of >40
Have at least one of the following history with CPT and/or PE:
- offered and declined
- dropped out of treatment
- been determined unsuitable by their treatment team
- received treatment but continue to experience symptoms meeting entrance criteria.
- Require stabilization on psychiatric medication for 2 month period prior to entry into study to avoid confounding treatments
Exclusion Criteria:
- Presence of SCID-5 assessed psychotic disorder, bipolar disorder, or substance use that would interfere with trial demands
- Severe suicidality that would require immediate crisis management
- Organic mental syndromes, delirium, or unstable medical conditions that would interfere with trial demands
- Inability to meet trial demands.
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 |
---|---|
Experimental: TFPP
TFPP is a manualized 16-24 session psychodynamic psychotherapy targeted on trauma symptoms of PTSD
|
Trauma-Focused Psychodynamic Psychotherapy
Other Names:
|
Active Comparator: TAU
TAU in this study is treatment for PTSD as currently delivered at the VA
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treatment as usual at the VA for PTSD
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in PTSD symptoms as per DSM-5 as measured by CAPS-5
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Clinician-Administered PTSD Scale for DSM-5 (CAPS-5).
Low score indicates fewer PTSD symptoms, high score indicates more PTSD symptoms.
|
baseline, 16 weeks (termination), 3 month follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in anxiety symptoms as measured by HARS.
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Hamilton Anxiety Rating Scale (HARS).
Low score indicates fewer state anxiety symptoms, high score indicates greater state anxiety symptoms
|
baseline, 16 weeks (termination), 3 month follow-up
|
Change in reflective capacity as measured by RF score.
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Reflective Function Scale (RF).
Low score indicates poor ability to reflect on relationships and self, high score, indicates better capacity to reflect on others and self.
|
baseline, 16 weeks (termination), 3 month follow-up
|
Change in depression symptoms as measured by HDRS.
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Hamilton Depression Rating Scale (HDRS).
Low score indicates few depressive symptoms, high score indicates high level of depressive burden (depression)
|
baseline, 16 weeks (termination), 3 month follow-up
|
Change in mental and physical symptoms as measured by VR-12.
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Veterans RAND 12-Item Health Survey (VR-12).
The results of the VR-12 are summarized as two scores - a Mental Component Score (MCS) and a Physical Component Score (PCS).
The scores may be reported as Z-scores (difference compared to the population average, measured in standard deviations).
The United States population average PCS and MCS are both 50 points.
The United States population standard deviation is 10 points.
Therefore, each increment of 10 points above or below 50 corresponds to one standard deviation away from the population average.
|
baseline, 16 weeks (termination), 3 month follow-up
|
Change in work and social adjustment as measured by WSAS.
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Work and Social Adjustment Scale (WSAS).
Low score indicates good social and work adjustment, high score indicates impairment socially and at work.
|
baseline, 16 weeks (termination), 3 month follow-up
|
Change in degree of limitation in ability to work as measured by WLQ
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Work Limitations Questionnaire (WLQ).
Low score indicates few limitations at work, high score indicates many limitations at work
|
baseline, 16 weeks (termination), 3 month follow-up
|
Childhood abuse history and trauma with CTQ
Time Frame: baseline
|
Childhood Trauma Questionnaire (CTQ).
Several different domains: Emotional Abuse: None=5-8; Low=9-12; Moderate=13-15; Severe=16+ Physical Abuse: None=5-7; Low=8-9; Moderate=10-12; Severe=13+ Sexual Abuse: None=5; Low=6-7; Moderate=8-12; Severe=13+ Emotional Neglect: None=5-9; Low=10-14; Moderate=15-17; Severe=18+ Physical Neglect: None=5-7; Low=8-9; Moderate=10-12; Severe=13+
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baseline
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Change in adult separation anxiety symptoms as measured by the SCI-SAS
Time Frame: baseline, 16 weeks (termination), 3 month follow-up
|
Separation anxiety-child and adult measure rating scale (SCI-SAS).
Separate scores generated for childhood separation anxiety and adult separation anxiety.
Low scores indicate few separation anxiety symptoms, high scores indicate large separation anxiety burden.
|
baseline, 16 weeks (termination), 3 month follow-up
|
Assessment of life events on LEC.
Time Frame: baseline
|
Life Events Checklist (LEC).
No composite score-tracks traumatic life events
|
baseline
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Barbara Milrod, MD, Weill Medical College of Cornell University
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.
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)
November 2, 2018
Primary Completion (Estimated)
January 1, 2025
Study Completion (Estimated)
January 1, 2025
Study Registration Dates
First Submitted
November 13, 2018
First Submitted That Met QC Criteria
November 26, 2018
First Posted (Actual)
November 28, 2018
Study Record Updates
Last Update Posted (Actual)
November 7, 2023
Last Update Submitted That Met QC Criteria
November 2, 2023
Last Verified
November 1, 2023
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- 2021-13720
- 1UL1TR002384-02 (U.S. NIH Grant/Contract)
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
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.
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