N/A
N=36
Group CBT for Aggression in Veterans
Aggression · Anger · Posttraumatic Stress Disorder
Bottom Line
View on ClinicalTrials.gov: NCT02233517 ↗Enrolled (actual)
36
Serious AEs
8.3%
Results posted
May 2019
Primary outcome: Primary: Change in Mean Scores on the Conflicts Tactics Scale (CTS) From Baseline to Post-treatment, 3 Month and 6 Month Follow-up. — 0.50; 1.24; 0.22; 1.06 units on a scale — p=0.84
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Cognitive Behavioral Therapy (Behavioral); Present Centered Therapy (Behavioral)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Jul 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change in Mean Scores on the Conflicts Tactics Scale (CTS) From Baseline to Post-treatment, 3 Month and 6 Month Follow-up. |
0.50; 1.24; 0.22; 1.06; 0.61; 1.19 | 0.84 |
| PRIMARY Change in Mean Scores on the Dimensions of Anger Reactions Scale (DAR) Over 16 Time Points: Baseline, 12 Treatment Sessions, Post-treatment, 3-month and 6-month Follow-up |
40.2; 41.2; 34.6; 36.8; 35.8; 38.2 | 0.26 |
| PRIMARY Change in Mean Scores on the Novaco Anger Scale (NAS) From Baseline to Post-treatment, 3-month Follow-up, and 6-month Follow-up. |
74.2; 75.9; 74.3; 76.1; 74.8; 76.3 | 0.90 |
| SECONDARY Change in Mean Scores on the Community Reintegration of Service Members Computer Adaptive Test From Baseline to Post-treatment. |
41.1; 41.0; 40.7; 41.1; 38.4; 37.9 | 0.05 |
| SECONDARY Change in Mean Scores on the World Health Organization Disability Assessment Schedule, Version 2.0 (WHO-DAS 2.0) Over 16 Time Points: Baseline, 12 Treatment Sessions, Post-treatment, 3-month and 6-month Follow-up. |
19.3; 24.6; 21.6; 20.7; 20.1; 22.4 | <0.0001 sig |
| SECONDARY Change in Mean Scores on the Inventory of Psychosocial Functioning (IPF) From Baseline to Post-treatment, 3 Month and 6 Month Follow-up. |
47.7; 53.4; 48.5; 52.7; 50.5; 54.8 | 0.59 |
| SECONDARY The McMaster Family Assessment Device (FAD) |
2.81; 2.50; 2.72; 2.60; 2.89; 2.58 | 0.25 |
Summary
Posttraumatic stress disorder (PTSD) robustly predicts anger and aggression, and U.S. Iraq/Afghanistan-era combat Veterans report that treatment for anger and aggression is among their top priorities. PTSD-related anger and aggression are associated with profound functional impairments, yet to date there are no empirically-supported treatments for Veterans with PTSD and aggression. Effective group treatment programs could improve functioning and facilitate community reintegration for these Veterans. Given that anger impedes progress in treatment of PTSD symptoms, group anger treatment could also improve Veterans' capacity to benefit from individually-administered empirically-supported therapy for PTSD such as prolonged exposure or cognitive processing therapy.
Eligibility Criteria
Inclusion Criteria
A Veteran will meet criteria for inclusion if he/she meets all of the following criteria:
- Current PTSD based on the CAPS;
- served in combat (regardless of era or country of combat service);
- can speak and write fluent conversational English;
- at least 18 years of age;
- report problems with irritability, anger, or aggression within the past month. Problems with anger and aggression will be defined via the "rule of 4": Inclusion in the study will require a CAPS-V score > 2 on item 15 (E1), "irritable or angry and showed it in your behavior" item within the past month.
Exclusion Criteria
A Veteran will be excluded from participation if he/she:
- is expected to be unstable on his/her medication regimen during the study;
- currently meets criteria for Bipolar I Disorder or a primary psychotic disorder as determined by the Structured Clinical Interview for the DSM (most current version available) (SCID);
- is receiving (or plan to) other anger-management psychotherapy during the course of the study;
- will be undergoing empirically supported psychotherapy for PTSD during the treatment component of the study;
- meets criteria for substance dependence (other than nicotine) within the past month as determined by the SCID; or
- is determined to have moderate or severe impairment related to traumatic brain injury as measured by the Brief Traumatic Brain Injury Screen and consultation with the Veteran's provider.
Data sourced from ClinicalTrials.gov (NCT02233517). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.