Ignite Creation Date:
2024-05-06 @ 3:22 PM
Last Modification Date:
2024-10-26 @ 1:48 PM
Study NCT ID:
NCT04617769
Status:
COMPLETED
Last Update Posted:
2024-01-11
First Post:
2020-10-30
Brief Title:
Effects of Antagonistic Actions in Response to Trauma Exposure
Sponsor:
University of Texas at Austin
Organization:
University of Texas at Austin
Study Overview
Official Title:
Effects of Antagonistic Actions in Response to Trauma Exposure
Status:
COMPLETED
Status Verified Date:
2024-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The overarching objective of this study is to investigate the use of antagonistic actions as a treatment augmentation strategy for enhancing emotional processing during exposure to trauma-relevant stimuli To accomplish this participants N 84 reporting exposure to a combat sexual assault physical assault or motor vehicle accident Criterion A trauma will be randomized to one of three experimental conditions a Psychoeducation alone PSYED b Psychoeducation followed by repeated exposure to trauma-videoclips PSYED EXP or c Psychoeducation followed by repeated exposure to trauma-videoclips while engaging in antagonistic actions PSYED EXP AA Antagonistic action strategies during exposure to the trauma-videoclips will include a adopting an open posture b eating a palatable snack c smiling and d wishing on high levels of emotional distress
The investigators expect that a those randomized to receive psychoeducation alone will show less improvement relative to the two groups that receive psychoeducation plus repeated exposure to trauma-videoclips b those receiving psychoeducation in combination with repeated exposure to trauma-videoclips while performing antagonistic actions will show significantly enhanced treatment outcome at the one-month follow-up relative to the other two treatment arms c participants with greater PTSD symptom severity are likely to have a poorer treatment outcome to PSYED alone d changes in trauma-related threat appraisals coping self-efficacy and safety behaviors will each independently mediate the effects of treatment and e participants displaying reductions in their emotional reactivity are more likely to have a reduction in PTSD symptoms
The investigators expect that a those randomized to receive psychoeducation alone will show less improvement relative to the two groups that receive psychoeducation plus repeated exposure to trauma-videoclips b those receiving psychoeducation in combination with repeated exposure to trauma-videoclips while performing antagonistic actions will show significantly enhanced treatment outcome at the one-month follow-up relative to the other two treatment arms c participants with greater PTSD symptom severity are likely to have a poorer treatment outcome to PSYED alone d changes in trauma-related threat appraisals coping self-efficacy and safety behaviors will each independently mediate the effects of treatment and e participants displaying reductions in their emotional reactivity are more likely to have a reduction in PTSD symptoms
Detailed Description:
Over 70 of Americans are exposed to trauma during their lifetime and approximately 56 will meet diagnostic criteria for posttraumatic stress disorder Posttraumatic stress disorder PTSD can significantly interfere with social functioning work and increase ones risk for other physical and mental health problems Trauma-focused psychotherapies for PTSD have been shown to outperform more traditional supportive psychotherapy or pharmacotherapy and have become the first line of treatment for PTSD However the impact of trauma-focused therapy such as Prolonged Exposure PE is reduced due to high rates of attrition ranging from 385 to 50 Thus there is a clear need to develop treatments for PTSD that are more palatable
Preliminary evidence suggests that exposure-based treatment may be enhanced by having patients engage in antagonistic actions eg smiling laughing adopting an open posture wishing on threatening outcomes during exposure to the feared target Prior research found that these actions increased the efficacy of exposure therapy among a sample of 88 patients with acrophobia Specifically participants were instructed to stand at the railing and look over the edge while shaking their head to induce dizziness standing at the edge without holding onto the railing or walking towards the railing with their eyes closed and hands behind their back Participants in the antagonistic action exposure group exhibited a significantly greater reduction in peak fear over the course of the study compared to all other groups 89 reduction versus 54 Although promising augmenting exposure therapy with antagonistic actions has yet to be tested for enhancing exposure therapy for PTSD For the present study antagonistic actions will include a adopting an open posture b eating a palatable snack c smiling and d wishing on high levels of emotional distress eg come on distress hit me with your best shot
There is a gap in the literature on antagonistic actions related specifically to trauma exposure By better understanding mechanisms underlying reactions to a trauma video clip and trauma symptom development the investigators can begin to reduce the debilitating effects of psychopathology following exposure to traumatic events in the future
The study is a 3 x 3 mixed model experimental design with treatment Condition as a three-level between-subjects factor and assessment period baseline vs posttreatment vs follow-up as a three-level within subjects factor Participants N 84 reporting exposure to a combat sexual assault physical assault or motor vehicle accident Criterion A trauma will complete a battery of baseline trauma-related symptom measures followed by a trauma memory provocation involving watching a brief trauma-relevant videoclip during which behavioral and subjective indices of emotional reactivity will be collected Participants will be stratified based on their trauma symptom severity PCL-5 and trauma type LEC-5 and then randomized to one of three conditions a Psychoeducation alone PSYED b Psychoeducation followed by repeated exposure to trauma-videoclips PSYED EXP or c Psychoeducation followed by repeated exposure to trauma-videoclips while engaging in antagonistic actions PSYED EXP AA Antagonistic action strategies during exposure to the trauma-videoclips will include a adopting an open posture b eating a palatable snack c smiling and d wishing on high levels of emotional distress eg come on distress hit me with your best shot
Participants randomized to the two trauma videoclip exposure arms will receive six 3-minute video exposure trials with an inter-trial interval of 2 minutes during which participants will complete ratings of a peak subjective distress during the trauma-videoclip b anticipated subjective distress for the next trial and c level of confidence for coping with their own trauma memory
Preliminary evidence suggests that exposure-based treatment may be enhanced by having patients engage in antagonistic actions eg smiling laughing adopting an open posture wishing on threatening outcomes during exposure to the feared target Prior research found that these actions increased the efficacy of exposure therapy among a sample of 88 patients with acrophobia Specifically participants were instructed to stand at the railing and look over the edge while shaking their head to induce dizziness standing at the edge without holding onto the railing or walking towards the railing with their eyes closed and hands behind their back Participants in the antagonistic action exposure group exhibited a significantly greater reduction in peak fear over the course of the study compared to all other groups 89 reduction versus 54 Although promising augmenting exposure therapy with antagonistic actions has yet to be tested for enhancing exposure therapy for PTSD For the present study antagonistic actions will include a adopting an open posture b eating a palatable snack c smiling and d wishing on high levels of emotional distress eg come on distress hit me with your best shot
There is a gap in the literature on antagonistic actions related specifically to trauma exposure By better understanding mechanisms underlying reactions to a trauma video clip and trauma symptom development the investigators can begin to reduce the debilitating effects of psychopathology following exposure to traumatic events in the future
The study is a 3 x 3 mixed model experimental design with treatment Condition as a three-level between-subjects factor and assessment period baseline vs posttreatment vs follow-up as a three-level within subjects factor Participants N 84 reporting exposure to a combat sexual assault physical assault or motor vehicle accident Criterion A trauma will complete a battery of baseline trauma-related symptom measures followed by a trauma memory provocation involving watching a brief trauma-relevant videoclip during which behavioral and subjective indices of emotional reactivity will be collected Participants will be stratified based on their trauma symptom severity PCL-5 and trauma type LEC-5 and then randomized to one of three conditions a Psychoeducation alone PSYED b Psychoeducation followed by repeated exposure to trauma-videoclips PSYED EXP or c Psychoeducation followed by repeated exposure to trauma-videoclips while engaging in antagonistic actions PSYED EXP AA Antagonistic action strategies during exposure to the trauma-videoclips will include a adopting an open posture b eating a palatable snack c smiling and d wishing on high levels of emotional distress eg come on distress hit me with your best shot
Participants randomized to the two trauma videoclip exposure arms will receive six 3-minute video exposure trials with an inter-trial interval of 2 minutes during which participants will complete ratings of a peak subjective distress during the trauma-videoclip b anticipated subjective distress for the next trial and c level of confidence for coping with their own trauma memory
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None