Manage Emotions to Reduce Aggression - MERA: A Brief Aggression Treatment for Veterans with PTSD Symptoms

管理情绪以减少攻击性 - MERA：针对患有 PTSD 症状的退伍军人的简短攻击性治疗

• 批准号: 10426041
• 负责人: Shannon R. Miles
• 金额: --
• 依托单位: JAMES A. HALEY VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10426041
• 关键词: Address; Affect; Afghanistan; Aftercare; Aggressive behavior; Awareness; Behavior Control; Behavioral; Cessation of life; Charge; Cognitive; Communities; Control Groups; Dropout; Drops; Education; Emotional; Emotions; Family; Family Violence; Frequencies; Fright; Goals; Gold; Imprisonment; Impulsivity; Iraq; Knowledge; Lead; Learning; Length; Logistics; Measures; Mediating; Mental Health; Mental disorders; Methods; Mission; Modeling; Population; Post-Traumatic Stress Disorders; Psychotherapy; Randomized Clinical Trials; Regulation; Reporting; Research; Research Support; Sampling; Severities; Site; Social support; Societies; Symptoms; Testing; Time; Training; Trauma; United States Department of Veterans Affairs; Veterans; Veterans Health Administration; Wait Time; active control; active method; anger management; base; brief intervention; combat veteran; combat zone; cost; effective therapy; efficacy testing; emotion dysregulation; emotion regulation; emotional experience; evidence base; experience; follow-up; improved; innovation; male; novel; response; skill acquisition; skills; skills training; standard of care; treatment as usual

This randomized clinical trial (RCT) tests the efficacy of an emotion regulation treatment, Manage Emotions to Reduce Aggression (MERA), to decrease aggression in Veterans with posttraumatic stress disorder (PTSD) and improve PTSD treatment initiation. Background: Veterans with PTSD symptoms report difficulty controlling their aggression which can lead to devastating interpersonal and societal consequences, such as incarceration, family violence, and disruption of social support. Veterans with PTSD primarily engage in impulsive aggression (emotional, reactive, and uncontrolled) rather than premeditated aggression (deliberate, instrumental, and planned). Emotion dysregulation, or underdeveloped skills in emotional awareness, emotional acceptance, behavioral control, and/or content- appropriate regulation strategies, fully mediates the relationship between PTSD severity and impulsive aggression in Veterans. Additionally, Veterans report fearing their emotions as one reason they do not initiate PTSD evidence-based psychotherapy. Emotion regulation appears to influence both aggression and treatment initiation for Veterans with PTSD. Thus, this proposed study targets emotion regulation with the goal of reducing impulsive aggression and preparing Veterans for PTSD evidence-based psychotherapy. Research Plan: Our goal is to test the efficacy of an innovative emotion regulation training, MERA, with a RCT of 204 Afghanistan and Iraq Veterans with PTSD and impulsive aggression. MERA is provided in three sessions to address logistical barriers faced by younger Veterans who are reintegrating into their communities. MERA incorporates education, cognitive-behavioral and acceptance- based skills training. It also includes information about what emotional experiences to expect from PTSD treatments. Three sessions of present centered therapy will serve as an active control group which is consistent with treatment as usual. MERA and present centered therapy will be compared on changes in aggression from Session 1 to the 2-month posttreatment changes. We predict Veterans who complete MERA will have greater reductions in IA and emotion dysregulation as compared to Veterans who complete present centered therapy. Finally, rates of PTSD evidence-based psychotherapy initiation (attend 1 session), will be examined via a chart review 6 months post treatment. We predict Veterans who complete MERA will initiate PTSD evidence-based psychotherapies at a greater rate than Veterans who complete present centered therapy. Significance: This study supports 2 Veterans Affairs missions: reduce aggression and increase PTSD treatment initiation. PTSD is one of the most commonly occurring and costly psychiatric conditions among Veterans. Veterans with PTSD are more likely to engage in aggressive behavior than civilians with PTSD or Veterans without PTSD. Reducing aggression is a critical need for Veterans, their families, and society. Additionally, there are effective treatments that reduce PTSD symptoms, yet few Veterans receive evidence based psychotherapies for PTSD. One reason for the low rate of treatment initiation is that Veterans fear they will not be able to control their emotional responses when they begin treatment. Equipping Veterans with emotion regulation skills and knowledge about PTSD treatments may help them initiate treatment for PTSD.

这项随机临床试验（RCT）测试了情绪调节治疗的功效，管理 情绪减少侵略性（MERA），以减少创伤后压力的退伍军人的侵略性 疾病（PTSD）并改善PTSD治疗启动。背景：有PTSD症状的退伍军人 报告难以控制其侵略性，这可能导致毁灭性的人际关系和社会 后果，例如监禁，家庭暴力和社会支持的破坏。退伍军人 PTSD主要从事冲动侵略（情感，反应性和不受控制），而不是 预谋侵略（故意，工具和计划）。情绪失调，或 情感意识，情感接受，行为控制和/或内容的欠发达技能 - 适当的监管策略，充分调节PTSD严重性与冲动之间的关系 退伍军人的侵略。此外，退伍军人报告害怕情绪是他们不这样做的原因之一 启动基于PTSD的循证心理治疗。情绪调节似乎会影响两种侵略 和PTSD退伍军人的治疗启动。因此，这项拟议的研究针对的是情绪调节 减少冲动侵略并为PTSD基于PTSD的退伍军人准备的目的 心理治疗。研究计划：我们的目标是测试创新情绪调节的功效 培训，梅拉（Mera），RCT为204名阿富汗和伊拉克退伍军人，具有PTSD和冲动侵略。 梅拉（Mera 重新融入他们的社区。梅拉（Mera）纳入教育，认知行为和接受 - 基于技能培训。它还包括有关PTSD期望的情感经历的信息 治疗。目前的三个课程将作为一个主动对照组， 像往常一样与治疗一致。将在变化的变化上比较梅拉和目前的中心疗法 从会议1到2个月后的侵略性变化。我们预测老兵完成 与退伍军人相比 完整的目前中心疗法。最后，PTSD基于证据的心理治疗启动率 （参加1次会议），将通过图表审查在治疗后6个月进行检查。我们预测退伍军人 完整的Mera将以比退伍军人更高的速度发起PTSD循证心理治疗 完整的目前中心疗法。意义：本研究支持2项退伍​​军人事务任务： 减少侵略性并增加PTSD治疗起始。 PTSD是最常见的 以及退伍军人的昂贵精神病。具有PTSD的退伍军人更有可能参与 侵略性行为比没有PTSD的PTSD或退伍军人的平民。减少侵略是关键 需要退伍军人，他们的家人和社会。此外，还有有效的治疗方法可以减少 PTSD症状，但很少有退伍军人接受PTSD的基于证据的心理治疗。一个原因 较低的治疗率是退伍军人担心他们将无法控制自己的情绪 当他们开始治疗时的反应。为退伍军人提供情感调节技能和知识 关于PTSD治疗可能有助于他们开始对PTSD的治疗。