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Present- Versus Past-focused Therapy for PTSD and Substance Use Disorder

2 mei 2019 bijgewerkt door: Karen Krinsley, VA Boston Healthcare System

Pilot Study of an Integrated Exposure-Based Model for Posttraumatic Stress Disorder and Substance Use Disorder

This study compares Creating Change, a new past-focused behavioral therapy for posttraumatic stress disorder (PTSD)/substance use disorder (SUD), to Seeking Safety, an evidence-based present-focused behavioral therapy for PTSD/SUD.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

This study evaluates a new behavioral therapy model, Creating Change (CC) for PTSD/SUD. CC helps clients explore the past as a step in their recovery process. It has major public health relevance in that it is a low-cost, flexible model designed for all trauma and substance abuse types, both genders, and all clinical settings. It has particular relevance for VA in that many veterans suffer from PTSD and SUD. The new model demonstrated positive results in two pilot studies.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

52

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Verenigde Staten
    • Massachusetts
      • Boston, Massachusetts, Verenigde Staten, 02459
        • VA Boston Healthcare System

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 65 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Meet Diagnostic and Statistical Manual (DSM-IV) criteria for current PTSD and current substance use disorder
  • Have used a substance in the 60 days prior to intake
  • Outpatient
  • Plan to stay in Boston for the next 6 months
  • If on psychiatric medication, are on a stable regimen for at least 4 weeks prior to participation in the study
  • Have a stable mailing address and live nearby enough to come to VA Boston for treatment
  • Able to sign informed consent
  • Willing to participate in all assessments and urine testing
  • Willing to provide a release of information for study staff to contact treaters as needed for clinical concerns

Exclusion Criteria:

  • Any current acute medical condition that would either interfere with the patient's ability to attend treatment, or would be of such severity as to affect the patient's psychological functioning
  • Current bipolar I disorder, schizophrenia or other psychotic disorders, mental retardation, or organic mental disorder
  • Any obvious clinical sign that the patient is not sufficiently stable to participate in the treatment, or notification by the patient's primary providers that participation would be contraindicated
  • Dangerousness that would present a threat to staff or patients (e.g., history of assault within the past 6 months)
  • The patient is mandated to treatment

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: Seeking Safety (SS)
17 sessions of present-focused therapy Seeking Safety
Gedragsmatig: Seeking Safety (SS)
Seeking Safety is a present-focused, evidence-based cognitive-behavioral therapy for integrated treatment of patients with PTSD/SUD. It is a cognitive-behavioral therapy comprising 25 topics, each a coping skill relevant to both disorders. In this study 17 of the 25 topics were conducted, one per weekly, one-hour, individual session.
Experimenteel: Creating Change (CC)
17 sessions of past-focused Creating Change
Gedragsmatig: Creating Change (CC)
Creating Change is a past-focused, integrated, cognitive-behavioral therapy for PTSD/SUD. It has 17 topics, which in this study were delivered in weekly one-hour sessions, in individual format. The treatment explores how PTSD and SUD arose and interacted across the patient's life, including constructing a narrative of its meaning, processing associated emotions and memories, and exploring themes related to these.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in PTSD Checklist total score - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
PTSD symptoms assessed via self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in diagnosis of PTSD on the MINI Neuropsychiatric Interview - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
PTSD diagnosis as assessed by a trained interviewer
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in Addiction Severity Index alcohol composite score - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Alcohol use and associated problems as measured by blinded-interviewer measure Composite. These outcome variables will be measured at baseline, end of treatment and 3-month followup.
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in Addiction Severity Index drug composite score - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Drug use and associated problems as measured by blinded-interviewer measure Composite. These outcome variables will be measured at baseline, end of treatment and 3-month followup. Urinanlysis/breathalyzer will be obtained to verify ASI self-report.
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in Quality of Life Satisfaction & Enjoyment Scale - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in Brief Symptom Inventory-Global Severity Index - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in Beliefs About Substance Use - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in General Self-Efficacy - from baseline through end of treatment and 3-month followup: Self-report measure
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in Coping Self-Efficacy Scale - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in World Assumptions Scale - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Change in Trauma Related Guilt Inventory - from baseline through end of treatment and 3-month followup
Tijdsspanne: Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup
Self-report measure
Baseline, end of treatment (approximately 4 months from baseline), and 3-month followup

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

VA Boston Healthcare System

Onderzoekers

  • Hoofdonderzoeker: Karen E. Krinsley, Ph.D., VA Boston Healthcare System
  • Hoofdonderzoeker: Lisa M Najavits, PhD, VA Boston Healthcare System

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 januari 2011

Primaire voltooiing (Werkelijk)

1 maart 2015

Studie voltooiing (Werkelijk)

1 maart 2015

Studieregistratiedata

Eerst ingediend

10 januari 2011

Eerst ingediend dat voldeed aan de QC-criteria

10 januari 2011

Eerst geplaatst (Schatting)

11 januari 2011

Updates van studierecords

Laatste update geplaatst (Werkelijk)

3 mei 2019

Laatste update ingediend die voldeed aan QC-criteria

2 mei 2019

Laatst geverifieerd

1 mei 2019

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • SPLA-CX000308-01 (VA CSRD)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

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