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Trial registered on ANZCTR
Registration number
ACTRN12624000566538
Ethics application status
Approved
Date submitted
22/04/2024
Date registered
6/05/2024
Date last updated
5/07/2024
Date data sharing statement initially provided
6/05/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised control trial of digital memory flexibility training (MemFlex) as a stepped care intervention for individuals with post-traumatic stress disorder (PTSD)
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Scientific title
A randomised control trial of the effect of digital memory flexibility training (MemFlex) as a stepped care intervention on post-traumatic symptom severity and autobiographical memory in individuals with PTSD
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Secondary ID [1]
311980
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Nil known
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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:
Post-traumatic stress disorder
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Condition category
Condition code
Mental Health
330274
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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
MemFlex: The MemFlex intervention aims to improve the ability to retrieve any autobiographical memory type on demand, using cued recall exercises. Participants are never asked to retrieve negative memories or trauma memories. In particular, the intervention trains three core skills: balancing, elaboration, and flexibility. Balancing aims to improve access to personally relevant memories that are emotionally positive. Improving ease of access to positive autobiographical information aims to balance against the negative self-appraisals that drive PTSD. Elaboration aims to increase the detail and vividness of these positive memories. Flexibility explicitly trains the ability to move between specific and general levels of memory representation. These skills are gradually introduced and build upon via eight online self-guided sessions. A 45 minute Zoom call with a support worker introduces the intervention. Participants are emailed a link to access the online sessions, which involve an initial psychoeducation component, and memory recall exercises using memory cues. In the sessions, participants are trained to recall event memories and general memories, to elaborate memories with contextual, emotional and somatic details, and to flexibly move between memory types. Participants are encouraged to complete two online, self-guided sessions (~20 mins) per week for 4 weeks, and can contact the worker with any questions. Treatment adherence is monitored by the support worker through website analytics. The worker will also check in with participants 2 weeks into the trial. MemFlex participants will be able to continue any other offered activities (e.g., medication). That is, a MemFlex+ treatment as usual (in this case, waitlist for psychiatry services at Phoenix Australia) design will be used.
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Intervention code [1]
328439
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Treatment: Other
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Comparator / control treatment
Waitlist as usual: The control arm of the intervention will remain on the waitlist for treatment at Phoenix Australia. This represents current best practice. People on the waitlist for clinical services have access to a variety of supports, including general information sheets, access to support forums (e.g., groups, online chat rooms), and referral to other support services (e.g., occupational therapy, financial aid services). We will record what this group is offered, to inform later trials. Participants in the control arm of the trial will gain access to the MemFlex program after receiving therapy at Phoenix Australia.
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Control group
Active
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Outcomes
Primary outcome [1]
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Post-traumatic stress disorder
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Assessment method [1]
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Posttraumatic Checklist for DSM-5 (PCL-5; Blevins et al., 2015)
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Timepoint [1]
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Baseline and 5-weeks following (post 4-week intervention)
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Primary outcome [2]
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Autobiographical Memory
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Assessment method [2]
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Autobiographical Memory Test- Alternating Instructions (AMT-AI; Dritschel, Meltsos & McClintock, 2014).
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Timepoint [2]
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Baseline and 5-weeks following (post 4-week intervention)
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Primary outcome [3]
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Post-traumatic cognitions
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Assessment method [3]
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The Posttraumatic Cognitions Inventory
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Timepoint [3]
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Baseline and 5-weeks following (post 4-week intervention)
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Secondary outcome [1]
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Depression
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Assessment method [1]
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Patient Health Questionnaire (PHQ-9)
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Timepoint [1]
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Baseline and 5-weeks following (post 4-week intervention)
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Secondary outcome [2]
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Anxiety
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Assessment method [2]
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Generalised Anxiety Disorder Assessment (GAD-7).
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Timepoint [2]
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Baseline and 5-weeks following (post 4-week intervention)
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Secondary outcome [3]
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Trauma memory quality
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Assessment method [3]
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Trauma Memory Quality Questionnaire
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Timepoint [3]
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Baseline and 5-weeks following (post 4-week intervention)
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Secondary outcome [4]
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Acceptability
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Assessment method [4]
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Credibility / Expectancy Questionnaire (Devilly & Borkovec, 2000).
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Timepoint [4]
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Baseline and 5-weeks following (post 4-week intervention)
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Secondary outcome [5]
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Feasibility
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Assessment method [5]
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Via audit of study records, we will track number of participants (and proportion of total) that complete the screening stage, ineligible participants at screening (and reasons for this), participants consented to take part in the intervention, participants randomised, participants successfully completing intervention (successful completion is defined as not missing more than one intervention session), along with participants who drop out and reasons for this. Please note, in line with our ethical informed consent procedure, participants can discontinue or withdraw from the study at any time without giving a reason. Reasons for discontinuation/withdrawal will be recorded when possible. Data completeness for each questionnaire will be summarised, i.e. number of participants completing each questionnaire at each time point. Any unexpected adverse effects of participating in the trial will be recorded.
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Timepoint [5]
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Baseline and 5-weeks following (post 4-week intervention)
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Eligibility
Key inclusion criteria
Deemed eligible for trauma-focussed treatment services at Phoenix Australia, proficient in reading and writing in English, and have access to a computer.
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Minimum age
17
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
Severe cognitive impairment.
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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)
Allocation is completed by an independent researcher not affiliated with the project, who is blind to study objectives.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random allocation to condition using computer-generated, quasi-random numbers. Randomisation will occur on a 1:1 basis to MemFlex or waitlist-as-usual.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people analysing the results/data
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Intervention assignment
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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
All analyses will be completed in accordance with CONSORT guidelines. The impact of intervention condition (MemFlex, waitlist-as-usual) on post-intervention scores on the Posttraumatic Checklist for DSM-5 will be analysed using an ANOVA, controlling for pre-intervention scores. Statistics on percentage of eligible Phoenix Australia clients opting into the study, and percentage of participants completing the study, will also be analysed.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/05/2024
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Actual
15/05/2024
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Date of last participant enrolment
Anticipated
16/04/2025
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Actual
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Date of last data collection
Anticipated
21/05/2025
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Actual
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Sample size
Target
40
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Accrual to date
0
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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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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The University of Melbourne
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Melbourne
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Address
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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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Address [1]
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Country [1]
318510
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Melbourne Central Human Research Ethics Committee
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Ethics committee address [1]
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https://research.unimelb.edu.au/work-with-us/ethics-and-integrity/our-ethics-committees
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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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27/10/2023
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Approval date [1]
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09/02/2024
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Ethics approval number [1]
315137
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Summary
Brief summary
We have highly effective psychological therapies for post-traumatic stress disorder (PTSD), however, individuals face multiple barriers to receiving gold-standard treatments. Most prolific of these is long waiting times, due to the limited number of professionals trained in specialist PTSD treatments. Here, we aim to evaluate a simple, digital, memory-based program MemFlex, which has been demonstrated to improve PTSD symptoms, and ameliorate cognitive difficulties that predict prognosis and impede the efficacy of psychological therapy. It is expected that offering MemFlex to individuals on the waitlist for psychological therapies will improve both a) cognitive predictors of PTSD, and b) post-treatment symptoms, relative to waitlist 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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Dr Dr Caitlin Hitchock
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Address
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Redmond Barry Building, University of Melbourne, Parkville, VIC, 3010
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Country
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Australia
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Phone
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+61 412950963
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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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Dr Caitlin Hitchcock
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Address
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Redmond Barry Building, University of Melbourne, Parkville, VIC, 3010
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Country
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Australia
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Phone
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+61 412950963
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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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Dr Caitlin Hitchock
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Address
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Redmond Barry Building, University of Melbourne, Parkville, VIC, 3010
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Country
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Australia
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Phone
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+61 412950963
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Fax
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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?
Outcome measures
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When will data be available (start and end dates)?
From the end of the trial, in perpetuity
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Available to whom?
Open Science Framework (OSF) users
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Available for what types of analyses?
Any purpose
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How or where can data be obtained?
Deidentified data will be stored on OSF
Until a data repository is available, Dr Caitlin Hitchcock (
[email protected]
) can be contacted regarding the IPD.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
22217
Study protocol
387682-(Uploaded-19-04-2024-10-18-09)-Study-related document.docx
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.
Download to PDF