Transdiagnostic Behavior Therapy Vs TAU for Adjustment Disorder Following Traumatic Event Exposure

NCT ID: NCT06433271

Last Updated: 2024-12-06

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

RECRUITING

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-08

Study Completion Date

2029-01-31

Brief Summary

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Adjustment Disorder (AjD) is the most common mental health condition diagnosed in Active Duty personnel, and is diagnosed following an extreme stress event such as traumatic loss of a comrade, serious accident or injury, or other intense stress event. Despite its high prevalence, no evidence based treatment for AjD has been subjected to randomized controlled trials. This study seeks to build on the research team's pilot work across several disorders study to benefit service members and Veterans with AjD, a highly prevalent but frequently inadequately treated condition.

The investigators will compare the effects of Transdiagnostic Behavior Therapy (TBT) vs treatment as usual which is Moving Forward Problem Solving Therapy (TAU-PST) on AjD symptom outcomes. The investigators hypothesize that TBT will result in greater overall symptom reduction compared to TAU-PST.

Detailed Description

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Adjustment Disorder (AjD) is the most common mental health condition diagnosed in Active Duty personnel, and is diagnosed following an extreme stress event such as traumatic loss of a comrade, serious accident or injury, or other intense stress event. Despite its high prevalence, no evidence based treatment for AjD has been subjected to randomized controlled trials.

Currently, the VA suggests a problem solving cognitive behavioral therapy, but this recommendation is not based on replicated, randomized controlled trials. Transdiagnostic Behavior Therapy (TBT), is based on key 'active components' of existing evidence based treatments such as Prolonged Exposure and Behavioral Activation, has been designed by this research team to be easily trained and inexpensively disseminated, and has been evaluated in a series of pilots with anxiety and depression disorders that, importantly, represent the key symptom classes of adjustment disorder.

Thus, the rationale for the proposed trial is that the research team has done preliminary efficacy testing of an easily exportable intervention that has impact on the key symptoms of adjustment disorder, and the standard of evidence demands replicated, randomized controlled trials to determine if initial signals of positive effect are sustained.

The study will use a 2 group repeated measures randomized controlled design to evaluate effectiveness of TBT for AjD compared to treatment as usual (TAU-PST). Participants will be randomly assigned in equal numbers (n = 75; N = 150) to one of two treatment arms: (1) TBT or (2) TAU-PST. Participants assigned to TBT will receive 6, 30-45-minute, manualized, individual therapy sessions. Participants assigned to TAU-PST will receive 6, 30-45-minute sessions of Problem-Solving Therapy. Dependent measures will include Department of Defense (DoD) specified common data elements and specific measures of AjD, PTSD, anxiety, depression, and functioning collected by blinded assessors at baseline, post-treatment, 3-month, and 6-month follow-up.

Conditions

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Adjustment Disorders Mental Disorder

Keywords

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Veterans Military Personnel

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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Transdiagnostic Behavior Therapy (TBT)

Participants will receive 6, 30-45-minute, manualized, individual therapy sessions.

Group Type EXPERIMENTAL

Transdiagnostic Behavior Therapy (TBT)

Intervention Type BEHAVIORAL

TBT manualized treatment incorporates daily exposure exercises from up to four categories of avoidance that are most characteristic of the emotional disorders (i.e., situational, interoceptive, imaginal, and positive emotional).

Active Comparator: Treatment as Usual-Problem Solving Therapy (TAU-PST)

Participants will receive 6, 30-45-minute, manualized, individual therapy sessions.

Group Type ACTIVE_COMPARATOR

Treatment as Usual-Problem Solving Therapy (TAU-PST)

Intervention Type BEHAVIORAL

PST is an evidence- based psychotherapy implemented in VA Primary Care - Mental Health Integration (PC-MHI), with hundreds of VA providers trained in the intervention nationally. The primary aim of PST is to improve a patient's ability to cope with stressful events by adopting an adaptive perspective to stressors and using goal-focused, problem-solving behaviors to manage the problems associated with the stressors.

Interventions

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Transdiagnostic Behavior Therapy (TBT)

TBT manualized treatment incorporates daily exposure exercises from up to four categories of avoidance that are most characteristic of the emotional disorders (i.e., situational, interoceptive, imaginal, and positive emotional).

Intervention Type BEHAVIORAL

Treatment as Usual-Problem Solving Therapy (TAU-PST)

PST is an evidence- based psychotherapy implemented in VA Primary Care - Mental Health Integration (PC-MHI), with hundreds of VA providers trained in the intervention nationally. The primary aim of PST is to improve a patient's ability to cope with stressful events by adopting an adaptive perspective to stressors and using goal-focused, problem-solving behaviors to manage the problems associated with the stressors.

Intervention Type BEHAVIORAL

Other Intervention Names

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Moving Forward Problem Solving Therapy

Eligibility Criteria

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Inclusion Criteria

* Adult male or female over the age of 18 that has served, or is currently serving, in the military.
* Stable psychotropic medication for at least 4 weeks if applicable
* Current DSM-5 diagnosis of Adjustment Disorder

Exclusion Criteria

* Active psychosis
* Suicidal ideation with clear intent
* Severe substance use
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ralph H. Johnson VA Medical Center

FED

Sponsor Role collaborator

U.S. Army Medical Research and Development Command

FED

Sponsor Role collaborator

The University of Texas Health Science Center, Houston

OTHER

Sponsor Role lead

Responsible Party

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Ronald E. Acierno

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ron Acierno, PhD

Role: PRINCIPAL_INVESTIGATOR

McGovern Medical School at UTHealth Houston

Locations

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Ralph H. Johnson VA Health Care System

Charleston, South Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Stephanie M Hart, MPH

Role: CONTACT

Phone: 8435775011

Email: [email protected]

Facility Contacts

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Stephanie M Hart, MPH

Role: primary

Michelle Pompei, MPH

Role: backup

Ron Acierno, PhD

Role: backup

Daniel Gros, PhD

Role: backup

References

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Gros DF. Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. Psychiatry Res. 2014 Dec 15;220(1-2):275-82. doi: 10.1016/j.psychres.2014.08.018. Epub 2014 Aug 15.

Reference Type BACKGROUND
PMID: 25193379 (View on PubMed)

Gros DF, Allan NP. A randomized controlled trial comparing Transdiagnostic Behavior Therapy (TBT) and behavioral activation in veterans with affective disorders. Psychiatry Res. 2019 Nov;281:112541. doi: 10.1016/j.psychres.2019.112541. Epub 2019 Aug 29.

Reference Type BACKGROUND
PMID: 31514043 (View on PubMed)

Gros DF, Merrifield C, Rowa K, Szafranski DD, Young L, McCabe RE. A Naturalistic Comparison of Group Transdiagnostic Behaviour Therapy (TBT) and Disorder-Specific Cognitive Behavioural Therapy Groups for the Affective Disorders. Behav Cogn Psychother. 2019 Jan;47(1):39-51. doi: 10.1017/S1352465818000309. Epub 2018 May 29.

Reference Type BACKGROUND
PMID: 29807553 (View on PubMed)

Gros DF, Szafranski DD, Shead SD. A real world dissemination and implementation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. J Anxiety Disord. 2017 Mar;46:72-77. doi: 10.1016/j.janxdis.2016.04.010. Epub 2016 Apr 27.

Reference Type BACKGROUND
PMID: 27158076 (View on PubMed)

Other Identifiers

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PR230007

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

Pro00134707

Identifier Type: -

Identifier Source: org_study_id