Efficacy Of A Cognitive Behavioral Therapy To Decrease Threat Appraisal In HIV Participants Initiating Antiretroviral

NCT ID: NCT03878186

Last Updated: 2021-03-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-26

Study Completion Date

2023-08-31

Brief Summary

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Studies in the field of health and HIV indicate that threat appraisal is associated with poor adherence to treatment, anxiety, poor quality of life, avoidance behavior, less antiretroviral adherence, negative affect, social, instrumental and emotional stress, depression, global distrés, poor subjective health and psychological distres. Most psychological interventions have been oriented to behavioral aspects, leaving aside cognitive aspects such as threat appraisal, so is necessary to investigate psychological treatments and its impact in threat appraisal an in an clinical and psychological outcomes.

Primary objective: To evaluate the efficacy of a cognitive behavioral therapy (CBT) to decrease threat appraisal in comparison with Usual Care (UC) in HIV patients initiating antiretroviral treatment at week 8.

Secondary objectives: To evaluate the effect of a cognitive behavioral therapy intervention compared with Usual Care in HIV patients initiating antiretroviral treatment in the following variables: challenge appraisal, affect (positive and negative), adherence, quality of life, anxiety and depression, HIV viral load and loss to follow-up at weeks 8, 20 and 52.

Exploratory objectives: To assess the threat appraisal cut-off value that predicts favorable outcomes in adherence, virologic suppression, retention in care and adverse events at week 52.

The study is an open label, single center, parallel group clinical trial, in which 50 participants will be randomly assigned using a blocked design to one of the 2 arms: Usual Care (single individual psycho-educative session) or Cognitive Behavioral Therapy (Usual care + 6 sessions of individual Cognitive Behavioral Therapy). The sample will be conformed with 50 adults with HIV, naïve to ARV treatment, starting care at INCMNSZ, who have scores of threat appraisal ≥40 in the CEAT scale, without severe mental disorders or cognitive impairment. We will use independent t test and chi square and intention to treat analysis for the primary outcome, also for secondary outcomes t student for continuous variables, chi square for categorical variables and per protocol analysis in participants adherent to the intervention.

Detailed Description

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Conditions

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HIV Threat Appraisal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT). Participants will receive the usual care and 6 sessions of cognitive behavioral therapy

Group Type EXPERIMENTAL

Usual Care (UC)

Intervention Type OTHER

Usual Care: single in-person psycho-educative session with information about HIV, transmission, natural history of the disease, importance of antiretroviral adherence. All the information is based on guidelines and information sheets from InfoVIHt

Cognitive Behavioral Therapy (CBT)

Intervention Type BEHAVIORAL

Cognitive behavioral therapy (CBT): Usual Care + Cognitive-behavioral therapy program intervention (AppraHIV). This intervention involves 7 in-person weekly sessions based on Adjuvant Psychological Therapy centered in three areas: cognitive appraisal, affect and adherence and self-care, everyone with different techniques: cognitive techniques, diaphragmatic breathing, scheduling pleasurable activities, use of pillbox, solving problems, planning for the future, etc. The intervention was manualized (according to Template for Intervention Description and Replication TIDieR), piloted and validated.

Usual Care (UC)

Participants will receive Usual Care only

Group Type OTHER

Usual Care (UC)

Intervention Type OTHER

Usual Care: single in-person psycho-educative session with information about HIV, transmission, natural history of the disease, importance of antiretroviral adherence. All the information is based on guidelines and information sheets from InfoVIHt

Interventions

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Usual Care (UC)

Usual Care: single in-person psycho-educative session with information about HIV, transmission, natural history of the disease, importance of antiretroviral adherence. All the information is based on guidelines and information sheets from InfoVIHt

Intervention Type OTHER

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT): Usual Care + Cognitive-behavioral therapy program intervention (AppraHIV). This intervention involves 7 in-person weekly sessions based on Adjuvant Psychological Therapy centered in three areas: cognitive appraisal, affect and adherence and self-care, everyone with different techniques: cognitive techniques, diaphragmatic breathing, scheduling pleasurable activities, use of pillbox, solving problems, planning for the future, etc. The intervention was manualized (according to Template for Intervention Description and Replication TIDieR), piloted and validated.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* At least 18 years of age
* HIV diagnosis confirmed
* Naïve to antiretroviral treatment
* Threat appraisal greater than or equal to 40%
* Enrolled at INCMNSZ for medical care
* Be able to read and write
* Willing and able to provide written informed consent

Exclusion Criteria

* Psychotic symptoms
* Severe depression
* Severe anxiety
* Suicide risk
* Substance dependence
* Cognitive dysfunction
* Psychological or psychiatric treatment within previous 3 months
* Require emergency medical attention
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto Nacional de Psiquiatría Dr. Ramón de la Fuente

OTHER

Sponsor Role collaborator

National Institute of Medical Sciences and Nutrition, Salvador Zubiran

OTHER

Sponsor Role lead

Responsible Party

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Jessica Mejía Castrejón

Doctoral student. Staff psychologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jessica Mejía Castrejón

Role: PRINCIPAL_INVESTIGATOR

Universidad Nacional Autonoma de Mexico

Locations

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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Mexico City, , Mexico

Site Status

Countries

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Mexico

References

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Ahrari S, Mohammadpour A, Amouzeshi Z, Agha-Yousefi A. The Relationship between Cognitive Appraisal and Adherence to Medical Regimens in Type 2 Diabetic Patients. J Caring Sci. 2014 Dec 1;3(4):277-85. doi: 10.5681/jcs.2014.030. eCollection 2014 Dec.

Reference Type BACKGROUND
PMID: 25717457 (View on PubMed)

Kennedy P, Lude P, Elfstrom ML, Smithson E. Cognitive appraisals, coping and quality of life outcomes: a multi-centre study of spinal cord injury rehabilitation. Spinal Cord. 2010 Oct;48(10):762-9. doi: 10.1038/sc.2010.20. Epub 2010 Mar 9.

Reference Type BACKGROUND
PMID: 20212500 (View on PubMed)

Bigatti SM, Steiner JL, Miller KD. Cognitive appraisals, coping and depressive symptoms in breast cancer patients. Stress Health. 2012 Dec;28(5):355-61. doi: 10.1002/smi.2444. Epub 2012 Aug 10.

Reference Type BACKGROUND
PMID: 22888085 (View on PubMed)

Nogueda-Orozco MJ, Fresán-Orellana A, Vite-Sierra A, Sánchez-Sosa JJ, Robles-García R. Escala de apreciación cognitiva del VIH/SIDA: Adaptación y evaluación psicométrica en población mexicana. Psicología Iberoamericana, 14; 55-60, 2015.

Reference Type BACKGROUND

Pakenham K, Rinaldis M. Development of the HIV/AIDS Stress Scale. Psychology and Health, 17(2):203-219, 2002

Reference Type BACKGROUND

Pakenham KI, Rinaldis M. The role of illness, resources, appraisal, and coping strategies in adjustment to HIV/AIDS: the direct and buffering effects. J Behav Med. 2001 Jun;24(3):259-79. doi: 10.1023/a:1010718823753.

Reference Type BACKGROUND
PMID: 11436546 (View on PubMed)

Meade CS, Wang J, Lin X, Wu H, Poppen PJ. Stress and coping in HIV-positive former plasma/blood donors in China: a test of cognitive appraisal theory. AIDS Behav. 2010 Apr;14(2):328-38. doi: 10.1007/s10461-008-9494-x. Epub 2009 Jan 6.

Reference Type BACKGROUND
PMID: 19127424 (View on PubMed)

Robles R, Páez F. Estudio sobre la traducción al español y las propiedades psicométricas de las escalas de afecto positivo y negativo (PANAS). Salud mental, 26(1): 69-75, 2003.

Reference Type BACKGROUND

Remor E. Valoración de la adhesión al tratamiento antirretroviral en pacientes VIH positivo. Psicothema,14 (2): 262-267, 2002.

Reference Type BACKGROUND

Pena de Leon E, Aguilar Gaytan SS, Suarez Mendoza AA, Reyes Teran G. [A validation of the MOS-HIV quality of life measure in HIV-infected patients in Mexico]. Rev Panam Salud Publica. 2007 May;21(5):313-9. doi: 10.1590/s1020-49892007000400007. Spanish.

Reference Type BACKGROUND
PMID: 17697485 (View on PubMed)

Lopez-Alvarenga JC, Vazquez-Velazquez V, Arcila-Martinez D, Sierra-Ovando AE, Gonzalez-Barranco J, Salin-Pascual RJ. [Accuracy and diagnostic utility of the Hospital Anxiety and Depression Scale (HAD) in a sample of obese Mexican patients]. Rev Invest Clin. 2002 Sep-Oct;54(5):403-9. Spanish.

Reference Type BACKGROUND
PMID: 12587414 (View on PubMed)

Robles R, Morales M, Jimenez LM, Morales J. Depresión y ansiedad en mujeres con cáncer de mama: el papel de la afectividad y el soporte social. Psicooncología, 6:191-201, 2009.

Reference Type BACKGROUND

Molina-Lopez A, Cruz-Islas JB, Palma-Cortes M, Guizar-Sanchez DP, Garfias-Rau CY, Ontiveros-Uribe MP, Fresan-Orellana A. Validity and reliability of a novel Color-Risk Psychiatric Triage in a psychiatric emergency department. BMC Psychiatry. 2016 Feb 10;16:30. doi: 10.1186/s12888-016-0727-7.

Reference Type BACKGROUND
PMID: 26860593 (View on PubMed)

Mejia-Castrejon J, Sierra-Madero JG, Belaunzaran-Zamudio PF, Fresan-Orellana A, Molina-Lopez A, Alvarez-Mota AB, Robles-Garcia R. Development and content validity of EVAD: A novel tool for evaluating and classifying the severity of adverse events for psychotherapeutic clinical trials. Psychother Res. 2024 Apr;34(4):475-489. doi: 10.1080/10503307.2023.2239448. Epub 2023 Aug 8.

Reference Type DERIVED
PMID: 37552872 (View on PubMed)

Other Identifiers

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REF. 2695

Identifier Type: -

Identifier Source: org_study_id

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