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Hybrid Dialectical Behavior Therapy for Veterans to Further Reduce Emotion Regulation Problems and Trauma Symptoms (REFRESH)

11 juin 2026 mis à jour par: Arkin

REfreshment of Dialectical Behaviour Therapy for Veterans to Further Reduce Symptoms and Prevent Relapse of Post-traumatic Stress Disorder and Emotion Regulation Symptoms by Guided Self-Help

Around 10% of post-active veterans experience post-traumatic stress disorder (PTSD) many years post-mission. PTSD in veterans is frequently associated with challenges in emotion regulation, aggression, suicidality, and financial and psychosocial stress. In 2018, a 12-week clinical treatment programme, the Veterans Intensive Treatment Unit (VIBU), was developed for veterans experiencing these psychiatric symptoms, for whom conventional treatments had proven ineffective. The VIBU provides patients with trauma-focused and dialectical behaviour therapy (DBT). A recent study revealed that the VIBU was effective in reducing psychiatric symptoms. However, a recurrence of symptoms was observed in patients a few months after discharge. Consequently, an aftercare programme consisting of hybrid DBT is offered to consolidate and repeat the DBT skills and apply them in daily life.

Aperçu de l'étude

Statut

Recrutement

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Estimé)

24

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

  • Adult veteran (18 years or older), treated at Sinai Center, with knowledge of DBT
  • Primairy diagnosis of PTSD, determined with CAPS-5, resulting from war-related traumas
  • Stable for four weeks on their medication (type and doses)
  • Able to to do online homework assignments and communicate with their therapist via an eHealth platform
  • Dutch speaking

Exclusion Criteria:

  • Chronic psychosis (psychotic features as comorbidity from PTSD is allowed) or bipolar disorder type 1
  • IQ below 80 or cognitive disorders
  • Severe self-harming behaviour, such as auto-mutilation or suicidal ideations as main problem
  • Following day treatments or other intensive treatment for residual symptoms

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Hybrid DBT
All participants will follow the same hybrid DBT program (i.e., group sessions, individual sessions and online homework assignments). Randomization will determine the length of the waiting period between baseline and start of the intervention (i.e., hybrid DBT).
Comportemental: Hybrid dialectical behavior therapy
Hybrid DBT will be provided to veterans who have followed a 3-month inpatient DBT treatment. The hybrid DBT will include face-to-face skill groups, online individual sessions and online homework assignements.
Autres noms:
  • DBT
  • Dialectical behavior therapy

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
PTSD Checklist for the DSM-5 (PCL-5)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
One of the two main outcomes of this study is PTSD symptom score. The self-report questionnaire contains 20 questions with answer options ranging from '0 = Not at all' to '4 = Extremely', resulting in a score between 0-80. A higher score indicates more likelyhood of having PTSD.
From the baseline to the end of the follow-up period (between 12-17 months)
Difficulties in Emotion Regulation Scale Short Form (DERS-SF)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
One of the two main outcomes of this study is emotion dysregulation severity. The self-report questionnaire contains 18 questions with answer options from '1 = Almost never' to '5 = Almost always', resulting in a score between 18-90. A higher score indicates more difficulties with regulation emotions.
From the baseline to the end of the follow-up period (between 12-17 months)

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
REFRESH - monitoring
Délai: From enrollment to (favourably) the end of the follow-up period (between 12-17 months)
Weekly short questionnaire (i.e., 10 questions) specifically tailored to this population to monitore PTSD, emotion regulation, substance use and DBT skills. Answer options range from '1 = Totally disagree' to '10 = Totally agree', resulting in a score between 10-100. A higher score means a worse outcome.
From enrollment to (favourably) the end of the follow-up period (between 12-17 months)

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Outcome Questionnaire (OQ-30.2)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This self-report questionnaire gives an indication of overall psychiatric symptoms and entails 30 items. Answers options go from '0 = almost never' to '4 = almost alywas'. The score ranges between 0-120, with a higher score indicating a worse outcome.
From the baseline to the end of the follow-up period (between 12-17 months)
Alcohol Use Disorders Identification Test (AUDIT)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This self-report questionnaire contains 10 items with answer options from '0 = never' to '4 = high usage', resulting in a score between 0-40. A higher score indicates having alcohol problems.
From the baseline to the end of the follow-up period (between 12-17 months)
Drug Use Disorders Identification Test (DUDIT)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This self-report questionnaire contains 11 items with answer options from '0 = never' to '4 = high usage', resulting in a score between 0-40. A higher score indicates having drug problems.
From the baseline to the end of the follow-up period (between 12-17 months)
Individual Recovery Outcome Counter (i-ROC)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaires measures wellbeing outcomes. This self-report questionnaire of 12 items uses answer options from '1 = Never' to '6 = Always', resulting in a score ranging between 12-72. A higher score indicates a better outcome.
From the baseline to the end of the follow-up period (between 12-17 months)
General Self-Efficacy Scale (GSES)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaire measures self-efficacy. This self-report questionnaire of 10 items, with answer options from '1 = Not at all true' to '4 = Exactly true', with scores ranging from 10-40. A higher score indicates more self-efficacy.
From the baseline to the end of the follow-up period (between 12-17 months)
Dialectical behavioral therapy skills (DBT-skills)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaire asks participants about their use of DBT skills. This self-report questionnaire of 17 items has answer options from '1 = never' to '5 = often', giving a score rangen between 17-85. A higher score indicates a positive outcome.
From the baseline to the end of the follow-up period (between 12-17 months)
Level of Personality Functioning Scale (LPFS 2.0)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaire measures the level of personality functioning. This self-report questionnaire contains 12 items, with answers ranging from '1 = not often true' to '4 = often true', resulting in a score between 12-48. A higher score indicates a worse outcome.
From the baseline to the end of the follow-up period (between 12-17 months)
Inventarisatielijst Sociale Betrokkenheid (ISB)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaire is about social wellbeing. This self-report questions contains 11 items, with results from '1 = almost never' to '4 = almost always', resulting in a score between 11-44. A higher score indicates a positive outcome.
From the baseline to the end of the follow-up period (between 12-17 months)
Aggression questionnaire (AGQ)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaire measures different forms of aggression. This self-report questionnaire contains 29 items, with answer from '1 = Extremely uncharacteristic' to '5 = Extremely characteristic', resulting in a score between 29-145. A higher score indicates a worse outcome.
From the baseline to the end of the follow-up period (between 12-17 months)
Suicidal Ideation Attributes Scale (SIDAS)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaire measures suicidal ideation. This self-report questionnaire contains 5 items, with answer from '0 = Not at all' to '10 = Completely', resulting in a score between 0-50. A higher score indicates a higher level of suicidal ideation.
From the baseline to the end of the follow-up period (between 12-17 months)
Non-Suicidal Self-Injury Assement Tool screener (NSSI-AT screener)
Délai: From the baseline to the end of the follow-up period (between 12-17 months)
This questionnaire measures self-injurious behavior. This self-report questionnaire contains 7 items asking about the frequency and severity of self-injurious behaviour. There is no scoring.
From the baseline to the end of the follow-up period (between 12-17 months)
Childhood Trauma Questionnaire (CTQ)
Délai: At baseline
This questionnaire assess childhood maltreatment. This self-report questionnaire contains 28 items, with answers from '1 = Never true' to '5 = Very often true', resulting in a score between 28-140. A higher score indicate a worse outcome.
At baseline

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Arkin

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 juin 2026

Achèvement primaire (Estimé)

1 septembre 2028

Achèvement de l'étude (Estimé)

1 octobre 2028

Dates d'inscription aux études

Première soumission

23 février 2026

Première soumission répondant aux critères de contrôle qualité

11 juin 2026

Première publication (Réel)

17 juin 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

17 juin 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

11 juin 2026

Dernière vérification

1 juin 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • REFRESH
  • NL-010470 (Identificateur de registre: METC Amsterdam)

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Description du régime IPD

Very sensitive personal information.

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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