Imagery Rescripting for Posttraumatic Nightmares in Rural Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans With Posttraumatic Stress Disorder (PTSD)
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Purpose
Many service members returning from Iraq and Afghanistan have difficulties adjusting back to civilian life. Research shows that symptoms of posttraumatic stress disorder (PTSD) are particularly high in returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans, and that combat-related nightmares and sleep disturbances are common in veterans with PTSD. This is of concern because people with these problems will often use unhealthy ways of coping. Although combat-related nightmares and difficulty sleeping are highly distressing, there are helpful treatments that do not involve taking medication. One of these treatments teaches specific skills to help people improve their sleep habits and to change their nightmares so that they are less upsetting. This treatment can be very helpful and research shows that people experience decreases in the frequency and severity of their nightmares, decreased symptoms of depression and PTSD, and improved sleep quality and quantity after completing treatment. However, because this treatment has only been studied with civilians, it is not clear how well this treatment works for returning veterans. This study tests how well this treatment works in treating combat nightmares in veterans who also have PTSD from experiencing a traumatic event.
| Condition | Intervention |
|---|---|
|
Stress Disorders, Post-Traumatic Sleep Disorders |
Behavioral: MEDVAMC Nightmare Treatment Behavioral: Telepsychiatry Nightmare Treatment |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Imagery Rescripting for Posttraumatic Nightmares in Rural Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans With Posttraumatic Stress Disorder (PTSD) |
- Clinician Administered PTSD Scale (CAPS), Posttraumatic Stress Symptom Scale-Self-Report (PSS-SR) & Beck Depression Inventory-II (BDI-II) [ Time Frame: Baseline & post-treatment ] [ Designated as safety issue: No ]
- Posttraumatic Cognitions Inventory (PTCI). [ Time Frame: Baseline & post-treatment ] [ Designated as safety issue: No ]
- The Pittsburgh Sleep Quality Index-Addendum for PTSD (PSQI) [ Time Frame: Baseline & post-treatment ] [ Designated as safety issue: No ]
- Trauma Related Nightmare Survey (TRNS). [ Time Frame: Baseline & post-treatment ] [ Designated as safety issue: No ]
- Mini-International Neuropsychiatric Interview (MINI) [ Time Frame: Baseline ] [ Designated as safety issue: No ]
- Treatment Evaluation Inventory (TEI) [ Time Frame: Post-treatment ] [ Designated as safety issue: No ]
- Client Satisfaction Questionnaire (CSQ) [ Time Frame: Post-treatment ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 7 |
| Study Start Date: | January 2010 |
| Study Completion Date: | August 2010 |
| Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
MEDVAMC Nightmare Treatment
|
Behavioral: MEDVAMC Nightmare Treatment
Veteran Nightmare Treatment Using Imagery Rescripting
|
|
Experimental: 2
Videoconferencing nightmare Treatment
|
Behavioral: Telepsychiatry Nightmare Treatment
Veteran Nightmare Treatment Using Imagery Rescripting Through Videoconferencing
|
Eligibility| Ages Eligible for Study: | 18 Years to 64 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients for the open trial will be
- OEF/OIF veterans (aged 18-64);
- English-speaking;
- currently enrolled in the Trauma Recovery Program (TRP) at the Michael E. DeBakey Veteran Affairs Medical Center (MEDVAMC);
- reporting at least one combat or war zone associated PTNM in the past week;
- have an existing PTSD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM); and
- consenting to be in an open trial for treatment of PTNM. In addition, patients must agree to allow their assessment and therapy sessions to be video/audiotaped for the purposes of supervision.
Pilot Study: Patients for the pilot study will be
- OEF/OIF veterans (aged 18-64);
- English-speaking;
- currently enrolled in the Conroe CBOC for their primary or mental health care;
- reporting at least one combat or war zone associated PTNM in the past week;
- have an existing PTSD ICD-9-CM diagnosis; and
- consenting to be in the pilot study for treatment of PTNM. In addition, patients must agree to allow their assessment and therapy sessions to be video/audiotaped for the purposes of supervision.
Exclusion Criteria:
Patients will be excluded for the following reasons:
- current active suicidal/homicidal ideation and intent;
- current substance dependence;
- a diagnosis of bipolar or psychosis;
- active participation in another psychosocial treatment for PTSD;
- prescribed the medication Prazosin (a psychotropic medication for the treatment of nightmares).
Patients interested in receiving the intervention will not be excluded if they are taking psychotropic medication (except for Prazosin) and may continue to take their medication as prescribed throughout the study.
Contacts and Locations| United States, Texas | |
| Michael E. DeBakey VA Medical Center (152) | |
| Houston, Texas, United States, 77030 | |
| Principal Investigator: | Mary E. Long, PhD | Michael E. DeBakey VA Medical Center (152) |
More Information
No publications provided
| Responsible Party: | Long, Mary - Principal Investigator, Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT00837382 History of Changes |
| Other Study ID Numbers: | H-24157 |
| Study First Received: | February 3, 2009 |
| Last Updated: | September 28, 2010 |
| Health Authority: | United States: Federal Government |
Additional relevant MeSH terms:
|
Sleep Disorders Parasomnias Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Nervous System Diseases |
Neurologic Manifestations Signs and Symptoms Mental Disorders Anxiety Disorders |
ClinicalTrials.gov processed this record on May 22, 2013