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Trial registered on ANZCTR
Registration number
ACTRN12622000175774
Ethics application status
Approved
Date submitted
14/12/2021
Date registered
2/02/2022
Date last updated
9/03/2022
Date data sharing statement initially provided
2/02/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Imagery Rescripting as an adjunct treatment for depression
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Scientific title
Assessing treatment outcomes for patients with depression attending a group cognitive behavioural therapy programme by additionally treating aversive memories with Imagery Rescripting
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Secondary ID [1]
305372
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Nil
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Universal Trial Number (UTN)
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Trial acronym
DEPIR
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Depression
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Condition category
Condition code
Mental Health
321254
321254
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
All participants will receive evidence based group CBT psychological intervention (Mood and Anxiety Management Programs, MAMP), consisting of one session per day of approximately 3 hours duration, from Monday to Friday (i.e. 5 sessions per week). In addition, participants will be randomly assigned to three treatment conditions. The CBT group work is undertaken in the mornings during this time and the additional individual treatment sessions would take place over the two weeks of the group program in the afternoon, with at least one day between these individual sessions. Participants will continue to receive MAMP sessions in addition to the intervention sessions for the duration of the study period. All group treatment sessions are delivered face-to-face at the Hollywood Hospital clinic. While we will aim to complete individual sessions face-to-face, this may not always be feasible in light of the current pandemic. Therefore, sessions will be carried out via telehealth in instances where face-to-face interaction is not feasible (e.g., state lockdowns, researchers needing to quarantine/isolate). Evidence suggests that both of our proposed interventions (ImRs and CBT-based interventions) can be effectively delivered via telehealth (Osenbach et al., 2013; Paulik et al., 2021). Our preferred telehealth software will be Zoom, which has been approved for use by the Australian Psychological Society. To monitor adherence to group and individuals sessions, attendance will be monitored using a client session checklist.
Arm 1. Three individual 90 minute sessions utilising imagery rescripting (ImRs). ImRs is an evidence based psychological intervention for posttraumatic stress disorder. In ImRs, the patient is asked to focus on an aversive memory from their child-self perspective, identifying their thoughts, feelings and needs. Next they are then guided to imagine a different ending, such as someone intervening by stopping the abuse and caring for the needs of the child. Multiple suggestions are made until the patient identifies that the new imagined experience meets the core need of the child self in the original memory. The initial ImRs session would entail giving information on the intervention, establishing a safe place via imagery and identifying memories that would be targeting in subsequent session. The second and third session would involve rescripting identified memories as per ImRs procedure.
Arm 2. Three individual 90 minute sessions utilising Cognitive Behavioural Therapy Assertiveness Training (CBT-AT). CBT is an evidence based practice that is widely used in the treatment of psychological disorders. CBT-AT supports an individual to identify and alter unhelpful thoughts, feelings and behaviours. Sessions would focus on assertive communication, looking at the individuals beliefs around assertiveness and supporting them to practice more assertive behaviour
Arm 3. Treatment as usual / Delayed treatment. Participation in the group program with no additional individual sessions. however will be offered individual sessions following their six week follow up assessment.
All treatment sessions will be delivered by the researchers who are in their second year of their clinical masters and who are trained in both interventions.
The first cohort (2-4 participants) to be administered the assessments and intervention are treated as a trial and as such their data will not be included in the data analysis.
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Intervention code [1]
321782
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Behaviour
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Intervention code [2]
322637
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Treatment: Other
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Comparator / control treatment
Comparator treatment CBT-A.
Control treatment: Treatment as usual . After follow- up they will be offered either CBT-A or ImRs which ever they choose.
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Control group
Active
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Outcomes
Primary outcome [1]
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Depression, Anxiety and Stress Scale (DASS)
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Assessment method [1]
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Timepoint [1]
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Post-treatment (immediately following final session of MAP programme); 6 weeks post-treatment (primary time-point); 12 weeks post-treatment
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Secondary outcome [1]
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Structured Clinician Interview for DSM Disorders – Fifth Edition (SCID 5)
Research Version (RV) Module A
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Assessment method [1]
401240
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Timepoint [1]
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6 weeks post-treatment ( which is 6 weeks after the final session of MAP programme) ; 12 weeks post-treatment.
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Secondary outcome [2]
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Vividness of Mental Imagery scale (Vividness).
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Assessment method [2]
401241
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Timepoint [2]
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Post-treatment ( final session of MAP programme); 6 weeks post-treatment; 12 weeks post-treatment.
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Secondary outcome [3]
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Rathus Assertiveness Scale.
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Assessment method [3]
401242
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Timepoint [3]
401242
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Post-treatment ( final session of MAP programme); 6 weeks post-treatment; 12 weeks post-treatment.
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Secondary outcome [4]
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Subjective Units of Distress scale (SUDS)
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Assessment method [4]
401243
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Timepoint [4]
401243
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Post-treatment ( final session of MAP programme); 6 weeks post-treatment; 12 weeks post-treatment.
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Secondary outcome [5]
401244
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Maladaptive personality traits assessed using Young’s Schema Questionnaire – Rasch version (YSQ-R)
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Assessment method [5]
401244
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Timepoint [5]
401244
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6 weeks post-treatment (which is 6 weeks after the final session of MAP programme)
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Secondary outcome [6]
401245
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The Difficulties in Emotion Regulation Scale-Short Form (DERS-SF)
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Assessment method [6]
401245
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Timepoint [6]
401245
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Post-treatment ( final session of MAP programme); 6 weeks post-treatment; 12 weeks post-treatment.
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Secondary outcome [7]
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Ambulatory heart rate variability (HRV), assessed using handheld electrocardiography machine.
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Assessment method [7]
401343
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Timepoint [7]
401343
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Post-treatment ( final session of MAP programme); 6 weeks post-treatment; 12 weeks post-treatment.
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Eligibility
Key inclusion criteria
Participation in the Hollywood Clinic Mood and Anxiety Management Program.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
nil
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation using computer software
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a computer program
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
This is a planned sample size limited by the time schedule and group program that the participants are being recruited from. It is estimated that a sample size of approximately 45 can be obtained.
A Repeated Measures Analysis of Variance (ANOVA) will be used to investigate effects of treatment (ImRs; CBT-AT and treatment as usual (TAU)) over time (pre-treatment, post-treatment and follow-up).
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
14/03/2022
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Actual
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Date of last participant enrolment
Anticipated
31/12/2022
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Actual
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Date of last data collection
Anticipated
31/03/2023
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Actual
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Sample size
Target
45
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Hollywood Private Hospital - Nedlands
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Recruitment postcode(s) [1]
35351
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6009 - Nedlands
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Murdoch University
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Address [1]
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90 South Street,
Murdoch, WA, 6150
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Country [1]
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Australia
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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Hollywood Private Hospital Research Foundation
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Address [2]
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Locked Bag 2002,
Nedlands WA 6909
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Country [2]
310319
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Australia
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Primary sponsor type
University
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Name
Murdoch University
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Address
90 South St
Murdoch, WA, 6150
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Hollywood Private Hospital
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Address [1]
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115 Monash Ave,
Nedlands WA 6009
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Country [1]
310799
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Murdoch University Human Research Ethics Committee (HREC)
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Ethics committee address [1]
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90 South Street, Murdoch, WA, 6150
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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17/09/2021
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Approval date [1]
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08/11/2021
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Ethics approval number [1]
309499
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2021/211
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Summary
Brief summary
Research has shown that people with depression experience poorer treatment outcomes if they have had adverse childhood experiences; and that these experiences often intrude into their thinking, and at a rate similar to that of post-traumatic stress disorder (PTSD). Although cognitive behaviour therapy (CBT) has been found to be effective in the treatment of depression, a number of people treated with CBT do not recover, or relapse during follow-up. We wish to test the efficacy of an adjunct trauma-focused therapy — Imagery Rescripting (ImRs) – for the treatment of depressed patients receiving group CBT treatment. We hypothesise adjunct ImRs treatment will lead to a superior reduction in depression symptoms compared to control conditions of individual CBT and treatment as usual.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Christopher Lee
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Address
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Discipline of Psychiatry, Medical School
University of Western Australia
35 Stirling Highway Crawley WA 6009
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Country
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Australia
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Phone
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+61403050431
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Fax
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Email
114366
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[email protected]
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Contact person for public queries
Name
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Danielle Mathersul
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Address
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Murdoch University
90 South Street,
Murdoch, WA, 6150
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Country
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Australia
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Phone
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+61893606542
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Fax
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Email
114367
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[email protected]
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Contact person for scientific queries
Name
114368
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Christopher Lee
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Address
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Discipline of Psychiatry, Medical School
University of Western Australia
35 Stirling Highway Crawley WA 6009
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Country
114368
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Australia
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Phone
114368
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+61403050431
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Fax
114368
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Email
114368
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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