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Trial registered on ANZCTR
Registration number
ACTRN12621001442897
Ethics application status
Approved
Date submitted
23/09/2021
Date registered
25/10/2021
Date last updated
28/09/2023
Date data sharing statement initially provided
25/10/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of an Augmented Psychological Treatment on Posttraumatic Stress Disorder (PTSD) and Depression in Emergency Service Personnel
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Scientific title
Randomised Controlled Trial of a Standard Cognitive Behavioural Treatment versus Augmented Cognitive Behavioural Treatment on PTSD and Depression in Emergency Service Personnel
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Secondary ID [1]
305399
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Posttraumatic stress disorder
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Depression
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Condition category
Condition code
Mental Health
321279
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0
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Depression
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Mental Health
321280
321280
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
There are two arms to this trial that were designed specifically for this trial. Arm 1: Cognitive Behaviour Therapy. Arm 2: Augmented Cognitive Behaviour Therapy. Cognitive Behaviour Therapy is administered on an individual basis on a once-weekly basis by a clinical psychologist either face-to-face or remotely via Zoom. Therapy comprises individual 60-minute sessions administered over 12 weeks. The intervention instructs participants on the following stress coping strategies: psychoeducation, anxiety reduction, exposure to trauma memories, and discussion of trauma memories, and relapse prevention. Treatment adherence will be assessed by checklist completed by therapists. The duration of the study for any participant will conclude after a 2-year follow-up assessment, resulting in participation duration of 121 weeks.
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Intervention code [1]
321811
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Behaviour
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Intervention code [2]
321812
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Treatment: Other
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Comparator / control treatment
Augmented Cognitive Behaviour Therapy is administered on an individual basis on a once-weekly basis by a clinical psychologist either face-to-face or remotely via Zoom. Therapy comprises individual 60-minute sessions administered over 12 weeks. The intervention instructs participants the following stress coping strategies: psychoeducation, anxiety reduction, exposure to trauma memories, and discussion of trauma memories, relapse prevention, and teaching strategies to retrieve positive personal memories. The difference between the two arms is the inclusion of strategies to retrieve positive memories in the comparator condition. Treatment adherence will be assessed by checklist completed by therapists. The duration of the study for any participant will conclude after a 2-year follow-up assessment, resulting in participation duration of 121 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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Posttraumatic stress disorder as measured by the Clinician Administered PTSD Scale.
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Assessment method [1]
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Timepoint [1]
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Pretreatment (week 0), posttreatment (week 13), primary follow-up (week 39, primary endpoint), additional follow-up (week 121).
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Secondary outcome [1]
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Depression as measured by the Beck Depression Inventory.
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Assessment method [1]
401329
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Timepoint [1]
401329
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Pretreatment (week 0), posttreatment (week 13), primary follow-up (week 39, primary endpoint), additional follow-up (week 121).
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Secondary outcome [2]
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Maladaptive appraisals as measured by the Posttraumatic Cognitive Inventory.
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Assessment method [2]
401330
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Timepoint [2]
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Pretreatment (week 0), posttreatment (week 13), primary follow-up (week 39, primary endpoint), additional follow-up (week 121).
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Secondary outcome [3]
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Quality of life as measured by the WHO Quality of Life scale.
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Assessment method [3]
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Timepoint [3]
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Pretreatment (week 0), posttreatment (week 13), primary follow-up (week 39, primary endpoint), additional follow-up (week 121).
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Secondary outcome [4]
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Alcohol use as measured by the Alcohol Use Disorder Identification Test
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Assessment method [4]
401998
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Timepoint [4]
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Pretreatment (week 0), posttreatment (week 13), primary follow-up (week 39, primary endpoint), additional follow-up (week 121).
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Eligibility
Key inclusion criteria
Meet criteria for PTSD as defined by DSM-5
Aged at least 18 years
Current or former member of Emergency Service Personnel
Sufficient English proficiency
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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
Current psychosis
Imminent suicidal risk
Current substance dependence
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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)
Participants will be adults meeting criteria for PTSD. Participants wishing to participate will be randomly allocated according to a random numbers system administered by an individual who independent of the trial and who works at a site that is independent from the trial centre.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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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
Analyses will focus primarily on intent-to-treat analysis. Using SPSS version 24, hierarchical linear mixed models (HLM) will be used to study differential effects of each treatment condition because this method effectively handles missing data by calculating estimates of trajectories. For the follow-up analyses between the two conditions, analyses will focus on linear time effects, treatment conditions, and interactions. Fixed effects parameters were tested with the Wald test (t-test, p <.05, two-sided) and 95% confidence intervals. Cohen’s (d) effect size was calculated for all analyses. The primary outcome measure will be the Clinician Administered PTSD Scale (CAPS). The primary outcome timepoint will be the 6 months assessment.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
3/01/2022
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Actual
10/12/2021
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Date of last participant enrolment
Anticipated
31/12/2022
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Actual
28/11/2022
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Date of last data collection
Anticipated
10/03/2025
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Actual
11/08/2023
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Sample size
Target
100
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Accrual to date
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Final
100
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council (NHMRC)
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Address [1]
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16 Marcus Clarke St,
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
UNSW Sydney
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Address
Anzac Pde, Kensington, NSW, 2052
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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NA
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Address [1]
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NA
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Country [1]
310786
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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UNSW Human Research Ethics Committee
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Ethics committee address [1]
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UNSW Sydney, Anzac Pde, Kensington, NSW, 2052
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Ethics committee country [1]
309519
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Australia
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Date submitted for ethics approval [1]
309519
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02/10/2021
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Approval date [1]
309519
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09/12/2021
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Ethics approval number [1]
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HC210804
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Summary
Brief summary
People in high-risk occupations, such as those in emergency service organizations, are at high risk of psychological disorders. Posttraumatic stress disorder (PTSD) is the most common psychiatric disorder that develops following exposure to a traumatic event, and emergency service personnel have markedly higher rates of PTSD. PTSD is characterised by severe and persistent stress reactions including: intrusive memories and nightmares of the trauma, hypervigilance, difficulty sleeping, emotional withdrawal, pervasive negative emotions, and avoidance of places, activities, and situations that are reminiscent of their trauma. The treatment of choice for posttraumatic stress disorder (PTSD) is trauma-focused psychotherapy. Trauma-focused psychotherapy typically commences with psychoeducation about the trauma responses, and then focuses on three major strategies: anxiety management, exposure, and cognitive restructuring. Despite support for this therapeutic approach, meta-analyses indicate that at least one-third of patients do not respond to this treatment. This situation is also evidence in treatment of PTSD in emergency service personnel. One recent advance has shown that training people to retrieve positive memories of their past can alleviate both PTSD and depression symptoms. Accordingly, this trial aims to augment TF-CBT for PTSD by comparing standard TF-CBT with TF-CBT combined with memory training. It is hypothesized that the augmented TF-CBT that includes positive memory training will result in greater reduction of PTSD and depression than standard TF-CBT.
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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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Prof Richard Bryant
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Address
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School of Psychology
Matthews Building
Anzac Pde, Kensington
University of New South Wales
NSW 2052
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Country
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Australia
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Phone
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+61405375874
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Richard Bryant
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Address
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School of Psychology
Matthews Building
Anzac Pde, Kensington
University of New South Wales
NSW 2052
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Country
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Australia
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Phone
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+61405375874
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Richard Bryant
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Address
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School of Psychology
Matthews Building
Anzac Pde, Kensington
University of New South Wales
NSW 2052
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Country
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Australia
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Phone
114436
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+61405375874
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Fax
114436
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Email
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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)?
Yes
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What data in particular will be shared?
All of the de-identified individual participant data and related data dictionaries are available
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When will data be available (start and end dates)?
Data will be available following publication of the study outcomes. There is no end date for when this data will be available.
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Available to whom?
Researchers wishing to conduct re-analyses of the data after approval from the Chief Investigator
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Available for what types of analyses?
Meta-analyses or re-analyses of subgroups
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How or where can data be obtained?
By emailing the Principal Investigator (email:
[email protected]
).
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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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