None listed
Conditions
Brief summary
Posttraumatic stress disorder (PTSD) is the most common psychiatric disorder that develops following exposure to a traumatic event, such as interpersonal violence, combat, life-threatening accidents, or natural disasters. It 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. Whilst extant treatments have shown success in reducing negative affect, they have had limited effect on increasing positive affect.This may be because extant treatments have focused solely on addressing symptoms reinforced by the withdrawal/defensive system and ignored the need to increase approach/appetitive responding, that results in increased positive affect. Modifying TF-CBT to include strategies that specifically target the approach/appetitive system may address a gap in available treatments that fail to address symptoms of dysphoria and anhedonia. Positive Affect Training aims to restore positive moods in participants alongside traditional extinction learning which reduces over-activation of the withdrawal/defensive motivation system associated with negative affect. To address the gap in augmenting the benefits of TF-CBT, this trial aims to test whether modifying TF-CBT to augment it with strategies to address anhedonia via Positive Affect Training will result in greater treatment gains relative to TF-CBT.
Interventions
There are two arms to this trial. Arm 1: Trauma-Focused Cognitive Behaviour Therapy. Arm 2: Augmented Trauma-Focused Cognitive Behaviour Therapy. Therapy is administered once-weekly 60 minute sessions by clinical psychologists over 11 weeks delivered. Trauma-Focused Cognitive Behaviour Therapy teaches the person skills in arousal reduction, exposure to trauma memories, restructuring of unrealistic thoughts, and relapse prevention. This will occur will via one-on-one sessions. All sessions will b
There are two arms to this trial. Arm 1: Trauma-Focused Cognitive Behaviour Therapy. Arm 2: Augmented Trauma-Focused Cognitive Behaviour Therapy. Therapy is administered once-weekly 60 minute sessions by clinical psychologists over 11 weeks delivered. Trauma-Focused Cognitive Behaviour Therapy teaches the person skills in arousal reduction, exposure to trauma memories, restructuring of unrealistic thoughts, and relapse prevention. This will occur will via one-on-one sessions. All sessions will be audiotaped and fidelity checks of 10% of sessions for each treatment condition will be independently rated by independent experts. The duration of the study for any participant will conclude after a 2-year follow-up assessment, resulting in participation duration of 118 weeks.
Sponsors
UNSW Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Satisfied PTSD criteria as defined by DSM-5 and measured by the Clinician-Administered PTSD Scale • Aged at least 18 years • Sufficient English language ability
Exclusion criteria
• Current psychosis • Imminent suicidal risk • Current substance dependence
Outcome results
None listed