- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT01189552
Depression Treatment for Low Income Substance Users (LET'S ACT)
17 februari 2017 uppdaterad av: Stacey Daughters, PhD, University of North Carolina, Chapel Hill
Depression Treatment for Urban Low Income Minority Substance Users
The objective of the current study is to evaluate the effects of a brief, behavioral activation treatment (the Life Enhancement Treatment for Substance Use; LET'S ACT) on long term outcomes of substance use, HIV risk behaviors and mechanisms of treatment response (depressive symptoms, environmental reward, behavioral activation).
Studieöversikt
Status
Avslutad
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Approximately 22% of substance users suffer from elevated depressive symptoms, which is associated with higher rates of substance abuse treatment dropout, relapse to substance use, and HIV risk behavior.
Few interventions targeting reinforcement principles have been developed to meet the specific needs of treatment seeking substance users.
One approach that may be especially appropriate in this regard is behavioral activation (BA), which aims to increase individuals' engagement in pleasant events, thereby increasing contact with positive reinforcement and decreasing the frequency of aversive events.
BA has been shown to be efficacious in the treatment of depression, and this uncomplicated and straightforward approach may be especially appropriate for the specific needs of an inner city low income substance abusing sample.
Further, BA compliments standard substance abuse treatment in several key practical and theoretical ways as it is more easily adopted by staff in these settings, more time efficient (e.g., fewer and shorter sessions, group format), more easily understood by patients who suffer from cognitive limitations due to low education level and chronic drug use, and can incorporate aspects of sobriety into its treatment components.
In an initial Stage 1 development project, a version of BA, the Life Enhancement Treatment for Substance Use (LETS ACT), was developed and specifically tailored for inner-city low income minority substance users with elevated depressive symptoms.
Results demonstrated that LETS ACT led to a significantly greater reduction in self-reported depressive symptoms and a significant increase in enjoyment and reward value of activities as compared to the TAU control group (Daughters et al., 2008).
While preliminary findings prove promising, many questions remain unanswered and several extensions of this work are necessary, including an assessment of post treatment substance use and HIV risk behavior, a contact-matched control, and a larger sample size to allow for more complex analyses of the mechanisms underlying these outcomes.
Thus, the objective of the present proposal is to follow-up on our previous Stage 1 treatment development efforts and small scale randomized control trial (RCT) with a fully-powered Stage 2 RCT comparing LETS ACT to nondirective therapy (NDT) among a sample of 263 low income depressed substance users currently receiving residential substance abuse treatment in inner-city Washington, DC.
Studietyp
Interventionell
Inskrivning (Faktisk)
263
Fas
- Inte tillämpbar
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
-
-
District of Columbia
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Washington, District of Columbia, Förenta staterna, 20002
- Salvation Army Harbor Light Treatment Center
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Maryland
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College Park, Maryland, Förenta staterna, 20742
- University of Maryland
-
-
Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
18 år till 65 år (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Beskrivning
Inclusion Criteria:
- between 18 and 65 years of age
- beginning their last month of residential treatment
Exclusion Criteria:
- limited mental competency [Mini Mental State Examination score < 23]
- psychosis
- the use of psychotropic medication for < 3 months
- the inability to give informed, voluntary, written consent to participate
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Dubbel
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Aktiv komparator: LETS ACT Behavioral Activation Treatment
LETS ACT is based on the empirically validated Behavioral Activation Treatment for Depression (BAT-D; Lejuez, Hopko, & Hopko, 2001).
LETS ACT is based on the belief that the best way to improve mood, remain sober, and to make long-term life changes is by changing and increasing one's activity level.
It has been modified to accommodate the needs of a substance using population currently receiving inpatient substance use treatment.
Treatment is provided over a 4-week period and is provided in small group format, with each group consisting of 3-5 patients.
|
LETS ACT is based on the empirically validated Behavioral Activation Treatment for Depression (BAT-D; Lejuez, Hopko, & Hopko, 2001).
Treatment includes eight sessions over a four-week period and is provided in small group format, with each group consisting of 3-5 patients.
Andra namn:
|
Placebo-jämförare: Nondirective Therapy (NDT)
In NDT, the therapist will create an accepting, nonjudgmental, empathic environment to continuously direct client attention to primary feelings, and to facilitate accepting of affective experience using supportive statements, reflective listening, and empathic communications.
Treatment is provided over a 4-week period and is provided in small group format, with each group consisting of 3-5 patients.
|
The purpose of Nondirective Therapy (NDT) is to provide group therapy interaction, allowing for the development of a close therapeutic relationship and a safe and accepting environment to facilitate change.
NDT will be conducted as outlined by Crits-Cristoph (1997).
That is, the therapist will create an accepting, nonjudgmental, empathic environment to continuously direct client attention to primary feelings, and to facilitate accepting of affective experience using supportive statements, reflective listening, and empathic communications.
Patients will received NDT in a small group format (3-5 participants) and will meet over the course of 4 weeks.
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Substance Use
Tidsram: baseline to a 12-month post treatment follow up period
|
Urine Screen and Timeline Followback
|
baseline to a 12-month post treatment follow up period
|
Beck Depression Inventory (BDI-II; Beck et al., 1996)
Tidsram: BDI-II will be evaluated from baseline to a 12-month follow up period
|
The Beck Depression Inventory is a 21-item self-report measure of depressive symptoms.
|
BDI-II will be evaluated from baseline to a 12-month follow up period
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Behavioral Activation for Depression Scale (BADS)
Tidsram: baseline to a 12-month post treatment follow up period
|
level of activation and avoidance behaviors
|
baseline to a 12-month post treatment follow up period
|
Reward Probability Index (RPI)
Tidsram: baseline to a 12-month post treatment follow up period
|
contact with environmental reward
|
baseline to a 12-month post treatment follow up period
|
Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Samarbetspartners
Utredare
- Huvudutredare: Stacey B Daughters, Ph.D., University of Maryland, College Park
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Allmänna publikationer
- Daughters SB, Braun AR, Sargeant MN, Reynolds EK, Hopko DR, Blanco C, Lejuez CW. Effectiveness of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: the life enhancement treatment for substance use (LETS Act!). J Clin Psychiatry. 2008 Jan;69(1):122-9. doi: 10.4088/jcp.v69n0116.
- Reese ED, Conway CC, Anand D, Bauer DJ, Daughters SB. Distress tolerance trajectories following substance use treatment. J Consult Clin Psychol. 2019 Jul;87(7):645-656. doi: 10.1037/ccp0000403. Epub 2019 Apr 22.
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart (Faktisk)
1 oktober 2010
Primärt slutförande (Faktisk)
1 juni 2015
Avslutad studie (Faktisk)
1 juni 2015
Studieregistreringsdatum
Först inskickad
24 augusti 2010
Först inskickad som uppfyllde QC-kriterierna
25 augusti 2010
Första postat (Uppskatta)
26 augusti 2010
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
23 februari 2017
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
17 februari 2017
Senast verifierad
1 februari 2017
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- R01DA026424 (U.S.S. NIH-anslag/kontrakt)
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