Mindfulness Treatment for Anger in Veterans with PTSD

正念治疗患有创伤后应激障碍 (PTSD) 退伍军人的愤怒

基本信息

批准号：
10505444
负责人：
Lorig Kachadourian
金额：
--
依托单位：
VA CONNECTICUT HEALTHCARE SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-11-01 至 2023-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10505444
关键词：
Accounting Adopted Aftercare Aggressive behavior Alcohol consumption Alcohols Anger Anxiety Area Attention Award Awareness Basic Science Clinical Clinical Trials Cognitive Therapy Collaborations Communities Conduct Clinical Trials Distress Education Effectiveness Emotions Exhibits Family Family member Friends Fright Galvanic Skin Response Goals Heart Rate Homicide Imagery Individual Informal Social Control Intervention Investigation Laboratories Meditation Mental Depression Mindfulness Training Neurosciences Occupational Outcome Pain Participant Patient Self-Report Physiological Pilot Projects Plant Roots Population Post-Traumatic Stress Disorders Postdoctoral Fellow Procedures Randomized Randomized Controlled Trials Reaction Time Reporting Research Research Personnel Risk Sampling Scientist Societies Spouses Statistical Data Interpretation Stress Symptoms Techniques Testing Therapeutic Intervention Time Training Trauma Trauma recovery Veterans Violence anger management base design efficacy evaluation emotion regulation experience follow-up in vivo insight interest military veteran mindfulness mindfulness intervention mindfulness meditation mindfulness-based stress reduction news novel novel therapeutic intervention prevent programs psychoeducational public health relevance recruit research study social trait trauma exposure treatment comparison

项目摘要

DESCRIPTION: (provided by applicant) Military Veterans suffering from posttraumatic stress disorder (PTSD) have been shown to exhibit increases in anger and aggressive behavior. Dysregulated anger and aggression can create fear and distress in spouses, family members, and friends resulting in deteriorated relationships, and can have a detrimental impact on Veterans' social, occupational and other important areas of functioning. Standard Cognitive Behavioral Therapy (CBT)-based interventions for anger and aggression are limited in part because they do not directly target the specific PTSD symptoms most strongly associated with aggression, namely increased hyperarousal and physiological reactivity. Further, they do not assist individuals in achieving awareness and insight into their anger states, which is necessary for effective management of anger and aggression. Mindfulness involves the self-regulation of attention on one's immediate experience and adopting an orientation of acceptance toward one's present experiences. Research studies conducted with civilians have found mindfulness to be effective in reducing anger and aggression. To date, no research has examined the effectiveness of mindfulness in decreasing anger and aggression among Veterans with PTSD. The proposed study aims to examine the initial efficacy of an established mindfulness intervention, Mindfulness Based Stress Reduction (MBSR) in decreasing trauma-related anger and aggression in Veterans with PTSD. The proposed project also aims to examine potential mechanisms of action accounting for its effects. Dr. Kachadourian is a postdoctoral fellow in the Clinical Neurosciences Division o the National Center for PTSD at the West Haven VA who has conducted basic research on alcohol, PTSD, anger, and aggression. Her current interests include conducting clinical trials to test novel therapeutic approaches like mindfulness meditation in treating anger and aggression among military Veterans with PTSD. TRAINING GOALS: The objectives for this CDA-2 application include advancing Dr. Kachadourian's expertise in conducting clinical trial research and advanced statistical analyses, and increasing her proficiency in mindfulness interventions. This will be accomplished through a rigorous program of formal didactics, collaboration with researchers experienced in clinical trials research and in mindfulness, PTSD, anger, and aggression, and a randomized controlled pilot study examining the initial efficacy of MBSR in decreasing anger and aggression among Veterans with PTSD. METHODS: Sixty Veterans with PTSD experiencing problems with anger and aggression will be randomly assigned to participate in a PTSD psychoeducational course (Trauma Recovery Education Class or TREC) or MBSR. All participants will attend a baseline, post-treatment, and 3-month follow-up session to assess changes in self-reported anger and aggression over time. At the post-treatment session, participants will also engage in a trauma-imagery procedure using trauma narratives developed at the baseline session. They then will participate in a laboratory paradigm designed to assess provoked aggression. In addition to examining whether participation in MBSR decreases self-reported levels of anger and aggression, this study will examine whether MBSR decreases aggression in participants after being exposed to trauma reminders in vivo. The extent to which mindfulness reduces physiological reactivity and increases emotion regulation will also be examined. The key question in this study is whether mindfulness decreases anger and aggression in Veterans with PTSD. Through this award, Dr. Kachadourian will be able to achieve her long-term goal of becoming an independent VA scientist with expertise in testing novel clinical interventions to treat problematic anger and aggression in military Veterans with PTSD.

描述：（由申请人提供）患有创伤后应激障碍 (PTSD) 的退伍军人已被证明会表现出愤怒和攻击性行为的增加，失调的愤怒和攻击性可能会给配偶、家人和朋友带来恐惧和痛苦，导致人际关系恶化，并可能产生痛苦影响。基于标准认知行为疗法 (CBT) 的针对退伍军人的社交、职业和其他重要功能领域的愤怒和攻击性干预措施受到限制，部分原因是它们不能直接针对与攻击性最相关的特定 PTSD 症状，即过度警觉和攻击性增加。生理此外，它们不能帮助个人认识和洞察自己的愤怒状态，而这对于有效管理愤怒和攻击性是必要的，涉及对自己的直接经历进行自我调节并采取接受的态度。目前的经验表明，正念可以有效减少患有创伤后应激障碍的退伍军人的愤怒和攻击性。基于正念的既定干预措施减轻压力（MBSR）可减少患有创伤后应激障碍（PTSD）的退伍军人的创伤相关愤怒和攻击性。 Kachadourian 博士是国家中心临床神经科学部门的博士后研究员，旨在研究其影响的潜在作用机制。她目前的兴趣包括进行临床试验，以测试正念冥想等新颖的治疗方法，以治疗患有创伤后应激障碍的退伍军人的愤怒和攻击性。目标：本次 CDA-2 应用的目标包括提高 Kachadourian 博士在进行临床试验研究和高级统计分析方面的专业知识，并提高她在正念干预方面的熟练程度。这将通过严格的正式教学计划以及与经验丰富的研究人员的合作来实现。临床试验研究和正念、创伤后应激障碍、愤怒和攻击性，以及一项随机对照试点研究，检验了MBSR在减少患有创伤后应激障碍的退伍军人中的愤怒和攻击性方面的初步功效。方法：60名患有创伤后应激障碍的退伍军人。愤怒和攻击性问题的参与者将被随机分配参加 PTSD 心理教育课程（创伤恢复教育课程或 TREC）或 MBSR。所有参与者都将参加基线、治疗后和 3 个月的随访课程，以评估创伤后应激障碍的变化。在治疗后的过程中，参与者还将使用在基线过程中开发的创伤叙述进行自我报告的愤怒和攻击行为，然后他们将参与旨在评估引发的攻击行为的实验室范例。除了考察是否参与在MBSR降低了自我报告的愤怒水平和攻击性降低之后，这项研究将考察MBSR是否会在体内暴露于创伤提醒后降低参与者的攻击性以及正念生理反应和增加情绪调节的程度。这项研究的问题是，正念是否可以减少患有创伤后应激障碍 (PTSD) 的退伍军人的愤怒和攻击性。通过该奖项，Kachadourian 博士将能够实现她的长期目标，即成为一名独立的退伍军人管理局科学家，拥有测试新的临床干预措施来治疗有问题的愤怒的专业知识。和攻击性患有创伤后应激障碍 (PTSD) 的退伍军人。

项目成果

期刊论文数量（18）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Binge drinking following residential treatment for posttraumatic stress disorder among veterans with and without alcohol use disorder.

有或没有酒精使用障碍的退伍军人在接受创伤后应激障碍住院治疗后酗酒。

DOI：
10.1016/j.jpsychires.2021.09.024
发表时间：
2021
期刊：
Journal of psychiatric research
影响因子：
4.8
作者：
Meshberg-Cohen,Sarah;Gross,GeorginaM;Kachadourian,LorigK;Harpaz-Rotem,Ilan
通讯作者：
Harpaz-Rotem,Ilan

Resilience in the Face of the COVID-19 Pandemic: A National Study of US Military Veterans.

DOI：
10.4088/pcc.21br03075
发表时间：
2021-11-11
期刊：
The primary care companion for CNS disorders
影响因子：
0
作者：
Kachadourian, Lorig;Tsai, Jack;Pietrzak, Robert H
通讯作者：
Pietrzak, Robert H

Psychological Resilience to the Challenges of Physical Aging in Older U.S. Veterans: Results From the 2019-2020 National Health and Resilience in Veterans Study.

DOI：
10.1016/j.jagp.2021.04.013
发表时间：
2021-12
期刊：
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
影响因子：
0
作者：
Asch RH;Kachadourian L;Southwick SM;Esterlis I;Pietrzak RH
通讯作者：
Pietrzak RH

Mindfulness as a mediator between trauma exposure and mental health outcomes: Results from the National Health and Resilience in Veterans Study.