Treatment of Post-TBI Depression
Treatment of Post-TBI Depression - A Randomized Clinical Trial
調査の概要
詳細な説明
Goals Demonstrate the efficacy of cognitive behavioral therapy (CBT), both immediately after treatment and in the long term, in alleviating post-TBI depression.
Examine the relationship between improved mood, participation, and life satisfaction.
Implement exploratory analyses of the relationships between person and injury characteristics and outcomes of treatment.
Maximize potential application to clinical practice by:
Implementing the treatment in a clinical context so that its utility is demonstrated in a setting that maximizes ecological validity, and Creating and disseminating a manual detailing CBT treatment. This study is a randomized clinical trial that compares two treatment conditions: CBT and supportive psychotherapy (SPT). CBT has been shown to be effective in diverse studies. In this study, CBT has been shaped to be used specifically with people with typical post-TBI cognitive challenges. All participants will be given an opportunity to immediately receive a randomly assigned psychotherapy intervention to potentially enhance coping. Both CBT and SPT will involve 16 sessions of individual treatment. The initial session will be 90 minutes, with remaining sessions 50 minutes. In both treatments, participants will be seen for three months, with sessions twice weekly for the first month and once a week subsequently. The research assistants who will administer pre- and postintervention evaluation instruments will be blind to each participant's randomly assigned treatment condition. Evaluation instruments will be administered at baseline and at three points of follow-up: one week, six months, and one year after treatment. A detailed manual describing treatment methods will be developed based on the intervention.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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New York
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New York、New York、アメリカ、10029-6574
- Icahn School of Medicine at Mount Sinai
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Being at least 18years old
- Having a TBI as a result of a blow to the head followed by a loss of consciousness or period of being dazed and confused or a period of post traumatic amnesia or clinical signs of altered neurological function; this information must be medically documented (e.g., emergency medical record, hospital record, neuroradiological report, or neurological exam or record of physician's visit within 24 hours of injury)
- Being at least 6 months post injury
- Being English-speaking
- Having residential telephone service
- Living within 1.5 hours of New York City
- Having at least a sixth-grade reading level
- Meeting DSM-IV criteria for a current depressive mood disorder
- Not being in psychotherapy and being willing to abstain from seeking psychotherapy during the course of participation
- Being willing to complete questionnaires and interviews about mood, thinking skills, community participation and life satisfaction
- Agreeing to participate, verified by completion of informed consent and HIPAA documents.
- Individuals who meet criteria and are currently using prescribed mood medications will be included in the study if dosage has been stable for sixty days.
Exclusion Criteria:
- Pre-existing neurological disorder, including brain injury from an etiology other than trauma
- History of mental retardation
- Lack of capacity to sign informed consent
- Taking antidepressant medications for less than six months
- Having any changes in antidepressant medications in the last six months
- History of current or past psychosis or mania
- Current substance abuse
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Treatment Arm 1
Individual psychotherapy focused on identifying and correcting maladaptive cognitions and behaviors with the goal of improving mood.
The intervention has adapted CBT specifically to address cognitive deficits associated with TBI, which compound the cognitive distortions typical of depression.
CBT therapists embed compensatory strategies within treatment sessions to address cognitive limitations of each participant.
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Individual psychotherapy focused on identifying and correcting maladaptive cognitions and behaviors with the goal of improving mood.
The intervention has adapted CBT specifically to address cognitive deficits associated with TBI, which compound the cognitive distortions typical of depression.
CBT therapists embed compensatory strategies within treatment sessions to address cognitive limitations of each participant.
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実験的：Treatment Arm 2
A client-centered individual psychotherapy treatment approach designed to address depressive disorders commonly experienced by individuals following a TBI.
In line with traditional supportive psychotherapy approaches, the objective of SPT is to improve the individual's ability to deal with problems of daily living more effectively through problem identification, praise, reassurance, encouragement, psychoeducation, advice, anticipatory guidance, and expanding awareness.
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A client-centered individual psychotherapy treatment approach designed to address depressive disorders commonly experienced by individuals following a TBI.
In line with traditional supportive psychotherapy approaches, the objective of SPT is to improve the individual's ability to deal with problems of daily living more effectively through problem identification, praise, reassurance, encouragement, psychoeducation, advice, anticipatory guidance, and expanding awareness.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
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Remission of depression (DSM-IV diagnosis no longer met)
時間枠：baseline
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baseline
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Remission of depression (DSM-IV diagnosis no longer met)
時間枠：one week after treatment completion
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one week after treatment completion
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Remission of depression (DSM-IV diagnosis no longer met)
時間枠：six months after treatment completion
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six months after treatment completion
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Remission of depression (DSM-IV diagnosis no longer met)
時間枠：one year after treatment completion
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one year after treatment completion
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Increased participation (Participation Objective, Participation Subjective)
時間枠：baseline
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baseline
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Improved quality of life (Life-3).
時間枠：baseline
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baseline
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Increased participation (Participation Objective, Participation Subjective)
時間枠：one week after treatment completion
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one week after treatment completion
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Increased participation (Participation Objective, Participation Subjective)
時間枠：six months after treatment completion
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six months after treatment completion
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Increased participation (Participation Objective, Participation Subjective)
時間枠：one year after treatment completion
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one year after treatment completion
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Improved quality of life (Life-3).
時間枠：one week after treatment completion
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one week after treatment completion
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Improved quality of life (Life-3).
時間枠：six months after treatment completion
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six months after treatment completion
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Improved quality of life (Life-3).
時間枠：one year after treatment completion
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one year after treatment completion
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協力者と研究者
捜査官
- 主任研究者：Wayne Gordon, Ph.D.、Icahn School of Medicine at Mount Sinai
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。