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Preventing Long Term Psychiatric Disability Among Those With Major Burn Injuries (SMART)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00988104
Recruitment Status : Completed
First Posted : October 1, 2009
Last Update Posted : August 24, 2018
U.S. Department of Education
Information provided by (Responsible Party):
Johns Hopkins University

Brief Summary:
The purpose of this study is to determine whether a newly developed, brief cognitive behavioral intervention, relative to supportive counseling, is effective in reducing acute stress disorder (ASD) and preventing post traumatic stress disorder (PTSD) and depression.

Condition or disease Intervention/treatment Phase
Stress Disorders, Post-Traumatic Mood Disorders Sleep Disorders Behavioral: Cognitive Behavioral Therapy Behavioral: Supportive Counseling Not Applicable

Detailed Description:

Importance: Burns are painful, life threatening and disfiguring. Severe psychological distress, pain and sleep disturbance are among the most common, enduring and disabling of secondary complications, however, no evidence based treatments exists for these complex problems in the acute burn care setting.

Design: Randomized, controlled effectiveness trial, group assignment blinded to baseline status, groups stratified by history of pre-existing psychiatric disorder.

Objectives. To develop the Safety, Meaning, Activation and Resilience Training (SMART) protocol; To evaluate its short and long-term effectiveness, relative to viable placebo, Supportive Counseling (SC), in improving key dependent measures (e.g., ASD, PTSD), mediators, and, enhancing health and function outcomes.

Setting: A leading edge, State-dedicated, regional burn center in a major, metropolitan teaching hospital serving diverse residents from large urban settings, small towns and remote rural areas.

Interventions: SMART (focused cognitive-behavioral therapy with training in anxiety management, and treatment with prolonged exposure and cognitive restructuring) will be contrasted with SC (non-directive empathy, warmth, positive regard).

Primary Outcome Measures: Health (psychological distress, sleep, pain), function (physical, psychological, social), costs (direct and indirect).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Preventing Long Term Psychiatric Disability Among Those With Major Burn Injuries: the Safety, Meaning, Activation and Resilience Trial (SMART)
Actual Study Start Date : October 16, 2007
Actual Primary Completion Date : October 15, 2015
Actual Study Completion Date : December 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Burns

Arm Intervention/treatment
Active Comparator: Cognitive Behavioral Therapy Behavioral: Cognitive Behavioral Therapy
CBT (4 sessions): 1) Cognitive therapy targeting key appraisals. 2) Prolonged exposure targeting trauma memories and reminders. 3) Active coping/Anxiety Management training mindfulness-based techniques.
Other Name: SMART

Active Comparator: Supportive Counseling Behavioral: Supportive Counseling
Supportive counseling (4 sessions): common factors among effective psychotherapies (e.g., empathy, positive regard)
Other Name: Usual Care

Primary Outcome Measures :
  1. Structured Clinical Interview for DSM IV: Mood and PTSD modules [ Time Frame: 1 week, 1 month and 6 months post-treatment ]

Secondary Outcome Measures :
  1. Davidson Trauma Scale [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  2. Patient Health Questionnaire - 9 (depression) [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  3. Insomnia Severity Index [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  4. Post Traumatic Growth Inventory [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  5. McGill pain Questionnaire [ Time Frame: 1 week, 1 month and 6 months post-treatment ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • 18 to 70 years old
  • acute burn injury
  • exceeding criteria on screening instrument at baseline (in-hospital prior to treatment): Acute Stress Disorder Scale (ASDS score ≥ 37: acute posttrauma distress).

Exclusion Criteria:

  • Age less than 18 or greater than 70 years
  • Presence of a significant cognitive / neurological or psychiatric condition precluding informed consent (e.g., psychosis, acute suicidality)
  • Inability to communicate in English
  • intubated or sedated

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00988104

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United States, Maryland
Johns Hopkins Burn Center
Baltimore, Maryland, United States, 21224
Sponsors and Collaborators
Johns Hopkins University
U.S. Department of Education
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Principal Investigator: James A Fauerbach, PhD Johns Hopkins University
Principal Investigator: Una D McCann, MD Johns Hopkins University

Additional Information:

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Responsible Party: Johns Hopkins University Identifier: NCT00988104     History of Changes
Other Study ID Numbers: NA_00002545
NIDRR H133A070045
H133A070045 ( Other Grant/Funding Number: NIDILRR )
First Posted: October 1, 2009    Key Record Dates
Last Update Posted: August 24, 2018
Last Verified: August 2018

Keywords provided by Johns Hopkins University:
Behavior Therapy
Randomized Controlled Trial

Additional relevant MeSH terms:
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Sleep Wake Disorders
Mood Disorders
Stress Disorders, Post-Traumatic
Pathologic Processes
Nervous System Diseases
Neurologic Manifestations
Signs and Symptoms
Mental Disorders
Stress Disorders, Traumatic
Trauma and Stressor Related Disorders
Wounds and Injuries