Post-Traumatic Stress Disorder Clinical Trial
Official title:
Brief Cognitive-Behavioral Treatment for Victims of Mass Violence
The objective of this randomized control trial is to compare the effectiveness of Stress Inoculation Training (SIT), a well researched psychological treatment for Post Traumatic Stress Disorder (PTSD), to that of the non-specific standard care provided in primary care settings, called Supportive Counseling (SC), on individuals who were exposed to the September 11, 2001 terrorist attack on the Pentagon, or the immediate aftermath of this attack. Both SIT and SC interventions will each be provided in one 2-hour session with eight weeks of daily systematic web-based follow up to promote self-help. The primary hypothesis of this study is that SIT will reduce the level of PTSD in participants relative to SCand to the pre-treatment levels.
Because resources are often scarce in the aftermath of disasters, a useful mental health
intervention is one that is effective, feasible, rapidly available, and efficiently
delivered to the largest proportion of affected individuals possible. In terms of treating
PTSD in other trauma contexts, there is considerable evidence that cognitive-behavioral
therapy (CBT) procedures are effective at reducing the array of PTSD symptoms. Overall, the
available evidence points to the theoretical and empirical justification for using Prolonged
Exposure (PE) and Stress Inoculation Training (SIT), two components of CBT, with patients
presenting with PTSD. A practical limitation of available studies is that they are limited
to individually administered therapy contexts that typically require between 8 and 12
sessions delivered in a specialty mental health care-setting. The labor-intensive nature of
these therapies represents a significant obstacle to provision of therapy to potentially
thousands of individuals suffering PTSD in the context of mass violence events.
The major aim of this project is to evaluate an abbreviated format of SIT that aims to
provide effective self/stress-management skills to individuals with PTSD. The rationale
behind this intervention is that with appropriate and intensive therapist input during a
single session of therapy, supplemented systematically with self-paced and self-directed
homework, promoted, prompted, and monitored via a specialized web-site and augmented by
therapist feedback and guidance delivered via the web, primary care patients with PTSD
stemming from mass violence can benefit from the strategies that have demonstrated efficacy
in reducing PTSD symptoms. Survivors of the Pentagon attack on 9/11 who present at primary
care clinics that serve the Pengaton are randomly assigned to SIT or a supportive counseling
control group. Patients’ compliance and symptoms are monitored on the web and via clinical
interview.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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