PTSD 退伍军人愤怒的正念治疗
2026年4月28日 更新者：VA Office of Research and Development
研究一直表明，与没有创伤后应激障碍的退伍军人相比，患有创伤后应激障碍的退伍军人更有可能经历更高程度的愤怒并做出攻击性行为。
鉴于愤怒和攻击性会对退伍军人、他们的家人和整个社会的生活产生重大的负面影响，因此非常需要研究可以降低该人群愤怒和攻击性风险的新型干预措施。
正念可能是这样一种技术，因为它可以有效地帮助个人调节困难的情绪和减少生理反应，这两者都与创伤后应激障碍和攻击行为有关。
研究结果表明，正念干预可有效减少愤怒和攻击性行为，这与患有 PTSD 的退伍军人经历此类困难有关，并将有助于防止这些人因愤怒和攻击性行为而产生的有害后果。
研究概览
详细说明
患有创伤后应激障碍 (PTSD) 的退伍军人表现出攻击性冲动增加、难以控制愤怒和难以控制暴力行为。 失控的愤怒和攻击会给配偶、家庭成员和朋友带来恐惧和痛苦，导致关系紧张和恶化，并对退伍军人的社会、职业和其他重要功能领域产生不利影响。 此外，正如几家新闻媒体最近报道的那样，在患有 PTSD 的退伍军人中观察到社区中更严重形式的攻击和暴力行为（即杀人）。 在患有 PTSD 的退伍军人中观察到的高饮酒率进一步强调了这个问题的严重性，这进一步增加了愤怒和攻击行为的风险。
目前的治疗干预可能无法有效减少患有 PTSD 的退伍军人的愤怒和攻击行为，因为缺乏直接针对与攻击性最强烈相关的症状的技术，特别是过度兴奋和生理反应。 此外，现有的干预措施可能无法有效地帮助个人意识到和洞察他们的愤怒状态，而这对于有效管理愤怒和攻击性是必要的。 正念植根于东方冥想练习，并已成功用于减轻压力、疼痛、焦虑和抑郁。 在平民样本中，已发现正念干预可有效减少愤怒和攻击性。 迄今为止，尚未在患有 PTSD 的退伍军人中检查对愤怒和攻击性的正念。
拟议调查的主要目标是进行一项试点随机对照试验，以检验已建立的正念干预、基于正念的减压 (MBSR) 在减少患有 PTSD 的退伍军人的愤怒和攻击性方面的初步疗效。 拟议的调查还试图检查解释其影响的潜在行动机制。 将招募 60 名患有创伤后应激障碍的退伍军人，他们会遇到愤怒和攻击性问题。 这些人将完成基线评估，以评估自我报告的愤怒和攻击性水平。 然后他们将被随机分配参加在线（即虚拟）PTSD 心理教育课程或 MBSR。 完成治疗后，所有参与者将完成治疗后评估，以评估愤怒和攻击性的变化。
在稍后的日期和时间，参与者还将被要求参加一个面对面的实验室会议，在那里他们将进行创伤图像程序，然后执行旨在评估激起的攻击性的任务。 除了检查参与 MBSR 是否会降低自我报告的愤怒和攻击性水平外，本研究还将检查 MBSR 是否会减少参与者在体内暴露于创伤提醒后的攻击性。 还将探索 MBSR 的潜在作用机制及其对其他结果的影响。
研究类型
介入性
注册 (实际的)
61
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Connecticut
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West Haven、Connecticut、美国、06516-2770
- VA Connecticut Healthcare System West Haven Campus, West Haven, CT
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 75年 (成人、年长者)
接受健康志愿者
是的
描述
纳入标准：
- 参与者必须满足当前的 DSM-V 创伤后应激障碍诊断标准（创伤后应激障碍亚阈值水平的参与者也将被允许参与）。
- 参与者还必须指出当前在愤怒和攻击性方面的困难。
排除标准：
- 当前诊断为精神障碍或当前有严重症状的物质使用障碍的参与者。
- 被诊断患有无精神病特征的双相 II 型障碍的参与者和/或被诊断患有双相情感障碍且药物控制良好的个人将被允许参加。 不属于这些类别的双相情感障碍患者将被排除在外。
- 参与者也不得患有癫痫症。
- 允许参与者服用精神药物，但他们必须服用稳定剂量至少 2 个月。
- 没有工作和活跃的电子邮件帐户以及无法访问智能手机或计算机的参与者将被排除在外。
- 最后，参与者目前不得同时接受针对愤怒和攻击的个体治疗或团体治疗，目前不得接受任何基于证据的 PTSD 治疗，并且目前不得参加 WHVA 提供的改良 TREC 小组。
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：基于正念的减压
基于正念的减压 (MBSR) 是一种以小组为基础的干预，参与者将学习不同的正念冥想练习，包括身体扫描（依次将注意力集中在身体的不同部位）、坐姿冥想（将注意力集中在一个人的呼吸上）和哈他瑜伽姿势（在轻柔的伸展过程中注意不同的身体感觉）。
参与者还被教导如何在进行日常活动（包括步行、站立和进食）时练习正念。
MBSR 包括 8 节，每周两小时的课程，将以小组形式进行。
MBSR 小组将以虚拟方式进行。
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基于正念的减压 (MBSR) 是一种以小组为基础的干预，参与者将学习不同的正念冥想练习，包括身体扫描（依次将注意力集中在身体的不同部位）、坐姿冥想（将注意力集中在一个人的呼吸上）和哈他瑜伽姿势（在轻柔的伸展过程中注意不同的身体感觉）。
参与者还被教导如何在进行日常活动（包括步行、站立和进食）时练习正念。
MBSR 包括 8 节，每周两小时的课程，将以小组形式进行。
MBSR 小组将以虚拟方式进行。
其他名称：
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有源比较器：创伤康复教育班
创伤恢复教育课程 (TREC)：TREC 是一种基于团体的治疗方法，专注于提供有关 PTSD 和创伤反应的信息。
TREC 为患有 PTSD 的退伍军人提供心理教育，包括对创伤的常见反应和回避的作用、与 PTSD 相关的常见问题，以及常见的护理障碍（例如，耻辱感、适应不良的信念、恐惧）。
其他内容侧重于问题识别和目标设定、当前问题和生活问题的讨论以及治疗计划。
TREC 由 8 节课组成，每周一小时。
TREC 小组将以虚拟方式交付。
|
创伤恢复教育课程 (TREC)：TREC 是一种基于团体的治疗方法，专注于提供有关 PTSD 和创伤反应的信息。
TREC 为患有 PTSD 的退伍军人提供心理教育，包括对创伤的常见反应和回避的作用、与 PTSD 相关的常见问题，以及常见的护理障碍（例如，耻辱感、适应不良的信念、恐惧）。
其他内容侧重于问题识别和目标设定、当前问题和生活问题的讨论以及治疗计划。
TREC 由 8 节课组成，每周一小时。
TREC 小组将以虚拟方式交付。
其他名称：
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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State Anger Scale
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Self-report measure of overall state anger using the State-Trait Anger Expression Inventory-2.
Score range: 15-60; higher scores indicate greater state anger.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Trait Anger Scale
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Self-report measure of trait anger using the State-Trait Anger Expression Inventory-2.
Score range: 10-40; higher scores indicate greater trait anger.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Anger Expression In
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
Self-report measure of anger expression inward using the State-Trait Anger Expression Inventory-2.
Score range: 8-32; higher scores indicate greater frequency of experiencing anger but not expressing (i.e., suppressing) anger.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
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Anger Expression Out
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Self-report measure of anger expression outward using the State-Trait Anger Expression Inventory-2.
Score range: 8-32; higher scores indicate greater frequency of expressing anger verbally or physically.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
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Anger Control In
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
Self-report measure of anger control inward using the State-Trait Anger Expression Inventory-2.
Score range: 8-32; higher scores indicate greater frequency of attempting to control anger feelings by calming down or cooling off.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Anger Control Out
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
Self-report measure of anger control outward using the State-Trait Anger Expression Inventory.
Score range: 8-32; higher scores indicate greater frequency of controlling outward expression of angry feelings.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
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Anger Expression Index
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Total Anger score on the STAXI-2.
Score range: 0-96; higher scores indicate greater expression of anger.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Buss Perry Total Aggression Score
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Self-report measure of total aggression using the Buss-Perry Aggression Questionnaire.
Scores range from 29-203; greater scores indicate greater total aggression.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
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Buss Perry Physical Aggression
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
self-report measure assessing physical aggression using Buss Perry Aggression Questionnaire.
Scores range from 9-63; greater scores indicate greater total physical aggression.
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Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
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Buss Perry Verbal Aggression Score
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
self-report measure assessing verbal aggression using Buss Perry Aggression Questionnaire.
Scores range from 5-35; greater scores indicate greater total verbal aggression.
|
Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
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Buss Perry Anger Scale
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
self-report measure of anger using the Buss Perry Aggression Questionnaire.
Scores range from 7-49; greater scores indicate greater total anger.
|
Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
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Buss Perry Hostility Scale
大体时间：Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
self-report measure of hostility using the Buss Perry Aggression Questionnaire.
Scores range from 8-56; greater scores indicate greater total hostility.
|
Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment
|
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Provoked Aggression Subscale 1
大体时间：within 8 weeks following the completion of either of the two treatments
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An experimental lab-based paradigm designed to assess provoked aggression, the Taylor Reaction Time Task.
This subscale determines whether participants' aggression increased, decreased, or remained the same across four blocks of trials (six trials within each block).
Scores range from 0-11 within each trial, with higher scores indicating worse outcome.
Each of the six trials within each block are averaged together.
|
within 8 weeks following the completion of either of the two treatments
|
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Provoked Aggression Subscale 2
大体时间：within 8 weeks following the completion of either of the two treatments
|
An experimental lab-based paradigm designed to assess provoked aggression, the Taylor Reaction Time Task.
This subscale determines participants' initial levels of aggression.
Participants can choose from the following response options: 0, 1, 2, 3, 4, 5, 6, 7,8, 9, 10 or 20, with higher scores indicating greater initial levels of aggression.
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within 8 weeks following the completion of either of the two treatments
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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心率
大体时间：在完成两种治疗中的任何一种后的 4 周内
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在参与者接触创伤叙述时进行生理评估
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在完成两种治疗中的任何一种后的 4 周内
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皮肤电导水平
大体时间：在完成两种治疗中的任何一种后的 4 周内
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在参与者接触创伤叙述时进行生理评估
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在完成两种治疗中的任何一种后的 4 周内
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Skin Conductance Levels
大体时间：within 8 weeks following the completion of either of the two treatments
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Changes in skin conductance levels during the trauma narrative portion of the lab session.
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within 8 weeks following the completion of either of the two treatments
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Heart Rate
大体时间：within 8 weeks following the completion of either of the two treatments
|
Changes in heart rate during the trauma narrative portion of the lab session.
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within 8 weeks following the completion of either of the two treatments
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Lorig Kachadourian, PhD MA、VA Connecticut Healthcare System West Haven Campus, West Haven, CT
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2017年12月1日
初级完成 (实际的)
2023年1月31日
研究完成 (实际的)
2023年1月31日
研究注册日期
首次提交
2016年7月22日
首先提交符合 QC 标准的
2016年8月24日
首次发布 (估计的)
2016年8月30日
研究记录更新
最后更新发布 (实际的)
2026年5月1日
上次提交的符合 QC 标准的更新
2026年4月28日
最后验证
2026年4月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.