Trial Outcomes & Findings for Using Emotion Regulation to Decrease Aggression in Veterans With PTSD (NCT NCT02724787)

NCT ID: NCT02724787

Last Updated: 2019-09-17

Results Overview

The Overt Aggression Scale (OAS) is a 17-item self-report measure that assesses frequency of different aggression acts, including verbal and physical aggression against self, other, and objects. Theoretical minimum score = 0; there is no bounded maximum value. Higher values = greater frequency of aggression.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

24 participants

Primary outcome timeframe

Given 3 weeks after last MERA session. Assess aggressive events in past week.

Results posted on

2019-09-17

Participant Flow

Participant milestones

Participant milestones
Measure
Open Trial
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Overall Study
STARTED
24
Overall Study
COMPLETED
22
Overall Study
NOT COMPLETED
2

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Using Emotion Regulation to Decrease Aggression in Veterans With PTSD

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Open Trial
n=24 Participants
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Age, Continuous
39.17 years
STANDARD_DEVIATION 7.86 • n=5 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
Sex: Female, Male
Male
24 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
19 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Number of Overt Aggression Scale
30.79 events
STANDARD_DEVIATION 24.0 • n=5 Participants
Difficulties in Emotion Regulation
117.92 units on a scale
STANDARD_DEVIATION 19.1 • n=5 Participants
Emotion Regulation Questionnaire
Suppression Subscale
17.42 units on a scale
STANDARD_DEVIATION 4.75 • n=5 Participants
Emotion Regulation Questionnaire
Cognitive Reappraisal Subscale
25.42 units on a scale
STANDARD_DEVIATION 7.71 • n=5 Participants

PRIMARY outcome

Timeframe: Given 3 weeks after last MERA session. Assess aggressive events in past week.

Population: 22 participants completed the treatment. 20 participants returned for the post-treatment assessment.

The Overt Aggression Scale (OAS) is a 17-item self-report measure that assesses frequency of different aggression acts, including verbal and physical aggression against self, other, and objects. Theoretical minimum score = 0; there is no bounded maximum value. Higher values = greater frequency of aggression.

Outcome measures

Outcome measures
Measure
Open Trial
n=20 Participants
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Overt Aggression Scale
14.2 events
Standard Deviation 11.40

PRIMARY outcome

Timeframe: Given 3 weeks after last MERA session. Assess emotion dysregulation in past month.

Population: 22 participants completed the treatment. 20 participants returned for the post-treatment assessment.

The Difficulties in Emotion Regulation Scale (DERS) is a 36- item self-report measure with 6 different emotion-dysregulation factors: nonacceptance of emotional responses, difficulties engaging in goal-directed behaviors, impulse-control difficulties, lack of emotional awareness, limited access to emotion regulation strategies, and lack of emotional clarity. Total score was used in this study. Theoretical minimum value = 36; theoretical maximum value = 180. Higher scores indicate worse emotion regulation.

Outcome measures

Outcome measures
Measure
Open Trial
n=20 Participants
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Total Score Difficulties in Emotion Regulation Scale
107.45 score on a scale
Standard Deviation 19.51

PRIMARY outcome

Timeframe: Given 3 weeks after last MERA session. Assess emotion regulation strategies used in past week.

Population: 22 participants completed the treatment. 20 participants returned for the post-treatment assessment.

ERQ is a 10-item self-report measure with 2 factors that assess specific emotion regulation strategies: cognitive reappraisal (6 items; changing the way one thinks about a situation) and expressive suppression (4 items; not expressing the emotion outwardly but feeling it internally). More effective emotion regulation is indicated by higher cognitive reappraisal scores and lower expressive suppression scores. Theoretical minimum score for cognitive reappraisal = 6; theoretical maximum score = 42. Theoretical minimum score for expressive suppression = 4; theoretical maximum score = 28.

Outcome measures

Outcome measures
Measure
Open Trial
n=20 Participants
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Emotion Regulation Questionnaire
Suppression Subscale
16.85 score on a scale
Standard Deviation 3.44
Emotion Regulation Questionnaire
Cognitive Reappraisal
26.55 score on a scale
Standard Deviation 5.83

PRIMARY outcome

Timeframe: Given 3 weeks after last MERA session.

Population: 22 participants completed the treatment. 20 participants returned for the post-treatment assessment.

The exit interview was created by the study team and has 3 questions that asks: 1.) how understanding the therapist was, 2.) how helpful the therapist was in learning skills, and 3.) how helpful MERA was in managing emotions. Scale for all questions: * 1 = Not at all understanding / helpful * 2 = A little bit understanding / helpful * 3 = Moderately understanding / helpful * 4 = Very understanding / helpful Higher scores reflect greater understanding or helpfulness.

Outcome measures

Outcome measures
Measure
Open Trial
n=20 Participants
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Exit Interview - Ratings of Therapist and Treatment
How understanding therapist was
3.94 score on a scale
Standard Deviation 0.24
Exit Interview - Ratings of Therapist and Treatment
How helpful therapist was
3.68 score on a scale
Standard Deviation 0.75
Exit Interview - Ratings of Therapist and Treatment
How helpful MERA was
3.15 score on a scale
Standard Deviation 0.88

PRIMARY outcome

Timeframe: Given 3 weeks after last MERA session. Assess emotion regulation strategies used in past week.

Population: 22 participants completed the treatment. 20 participants returned for the post-treatment assessment.

The exit interview was created by the study team and has 8 questions that asks: 1.) "Are you using \_\_\_\_\_skill?". Scores = percentage of the sample that was using the skill during the week before the post treatment assessment. Percentages could range from 0% to 100% of the sample. Higher scores represent more of the sample using the skill.

Outcome measures

Outcome measures
Measure
Open Trial
n=20 Participants
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Exit Interview - Use of Skills
Controlled breathing
17 Participants
Exit Interview - Use of Skills
Remember values
14 Participants
Exit Interview - Use of Skills
Grounding
14 Participants
Exit Interview - Use of Skills
Realistic thoughts
14 Participants
Exit Interview - Use of Skills
Progressive muscle relaxation
12 Participants
Exit Interview - Use of Skills
Visualization
12 Participants
Exit Interview - Use of Skills
Recognizing emotions
12 Participants
Exit Interview - Use of Skills
Increasing positive emotions
7 Participants

Adverse Events

Open Trial

Serious events: 3 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Open Trial
n=24 participants at risk
All Veterans will receive the same emotion regulation treatment titled, Manage Emotions to Reduce Aggression. Manage Emotions to Reduce Aggression (MERA): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Blood and lymphatic system disorders
Hospitalization
4.2%
1/24 • AE data were collected after the consent form was signed until the post-treatment assessment, an average of 10 weeks.
We considered any clinically significant deterioration in physical, psychological, mental, cognitive, or psychosocial health status of the subject as a change from baseline as an AE. We did not use specific Adverse Event Terms.
Psychiatric disorders
Increase in symptoms
8.3%
2/24 • AE data were collected after the consent form was signed until the post-treatment assessment, an average of 10 weeks.
We considered any clinically significant deterioration in physical, psychological, mental, cognitive, or psychosocial health status of the subject as a change from baseline as an AE. We did not use specific Adverse Event Terms.

Other adverse events

Adverse event data not reported

Additional Information

Dr. Shannon Miles

James A. Haley Veterans' Hospital

Phone: 813-972-2000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place