CAP - Using Emotion Regulation to Decrease Aggression in Veterans with PTSD

CAP - 使用情绪调节来减少患有 PTSD 退伍军人的攻击性

• 批准号: 9254201
• 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: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9254201
• 关键词: Address; Affect; Afghanistan; Aggressive behavior; Anxiety; Awareness; Behavior Control; Behavioral; Charge; Clinic; Cognitive; Data; Development; Drops; Education; Educational process of instructing; Effectiveness; Emotional; Emotions; Enrollment; Family; Family Violence; Feasibility Studies; Fright; Goals; Healthcare; Imprisonment; Impulsivity; Individual; Injury; Interpersonal Violence; Interview; Iraq; Judgment; Knowledge; Lead; Length; Logistics; Measures; Mediating; Mental Health; Mission; Modeling; Outcome; Pilot Projects; Post-Traumatic Stress Disorders; Provider; Psychotherapy; Questionnaires; Recovery; Recruitment Activity; Regulation; Research; Research Support; Sampling; Schools; Severities; Social support; Societies; Symptoms; System; Testing; Time; Training; Trauma; Treatment outcome; Veterans; Work; base; career; cost; effective therapy; effectiveness measure; emotion dysregulation; emotion regulation; emotional experience; evidence base; health administration; improved; innovation; public health relevance; response; skill acquisition; skills; skills training; treatment response

 DESCRIPTION (provided by applicant): This pilot study tests the feasibility of an emotion regulation training, Manage Emotions to Reduce Aggression (MERA), to decrease aggression in Veterans with posttraumatic stress disorder (PTSD) and improve PTSD treatment outcomes. Background: Aggression is common among Veterans with PTSD and can lead to devastating interpersonal and societal consequences, such as incarceration, family violence, and disruption of treatment-facilitating factors, such as 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, fear of anxiety predicts which Veterans failed to complete PTSD evidence-based psychotherapy. Emotion regulation appears to influence both aggression and treatment outcomes in 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 feasibility of an innovative emotion regulation training, MERA, with an open trial of 20 Afghanistan and Iraq Veterans with PTSD and impulsive aggression. MERA is provided in a 3-session condensed time frame to address logistical barriers faced by younger Veterans who have careers, school, and families that compete with treatment time. The training is delivered in a group format and incorporates emotion education, cognitive-behavioral and acceptance-based skills training, and information about what emotional experiences to expect from PTSD treatments. Veterans will complete emotion regulation and aggression measures weekly. The study's feasibility will be examined using Veterans' judgments of MERA, in addition to recruitment (number of referrals versus those who opt-out), enrollment (proportion screened versus enrolled), initiation (attend 1 session), and completion (attend all 3 sessions) rates. MERA's preliminary effectiveness will be estimated with pre- to 1-month post training changes in aggression and emotion regulation. We predict Veterans who complete MERA will have reductions in IA and emotion dysregulation. Finally, rates of PTSD evidence-based psychotherapy initiation (attend 1 session), engagement (attend at least 2 sessions), and completion (therapist indicates termination is appropriate) will be examined 6 months post MERA. We predict Veterans who complete MERA will initiate, engage, and complete PTSD evidence-based psychotherapies at a greater rate than Veterans who do not complete MERA. Significance: This study supports 2 Veterans Affairs missions: reduce aggression and increase PTSD treatment initiation. First, PTSD is one of the most commonly occurring and costly psychiatric conditions among Veterans, and Veterans with PTSD are more likely to engage in aggressive behavior than civilians with PTSD. Reducing aggression is a critical need for Veterans, their families, and society to reduce interpersonal violence, incarceration, and injury. Secondly, there are effective treatments that have been shown to reduce PTSD symptoms, yet few Veterans with PTSD receive PTSD evidence-based psychotherapies. One reason for the low rate of treatment initiation may be 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, complete, and benefit from PTSD evidence-based psychotherapies.

 描述（由申请人提供）： 这项试点研究测试了情绪调节训练“管理情绪以减少攻击性”(MERA) 的可行性，以减少患有创伤后应激障碍 (PTSD) 的退伍军人的攻击性并改善 PTSD 治疗结果。 背景：攻击性在患有 PTSD 的退伍军人中很常见，并且可以。导致毁灭性的人际和社会后果，例如监禁、家庭暴力和治疗促进因素的破坏，例如社会支持。患有创伤后应激障碍的退伍军人主要表现出冲动攻击（情绪化、反应性和不受控制）。与有预谋的攻击行为（故意的、工具性的和有计划的）相比，情绪意识、情绪接受、行为控制和/或内容适当的调节策略方面的技能欠发达，完全调节了退伍军人的 PTSD 严重程度和冲动攻击行为之间的关系。此外，对焦虑的恐惧预示着哪些退伍军人未能完成基于创伤后应激障碍（PTSD）的循证心理治疗，情绪调节似乎会影响患有创伤后应激障碍（PTSD）退伍军人的攻击性和治疗结果，因此，这项研究的目标是减少情绪调节。冲动攻击和为退伍军人准备 PTSD 循证心理治疗研究计划：我们的目标是测试创新情绪调节训练 MERA 的可行性，对 20 名患有 PTSD 和冲动攻击的阿富汗和伊拉克退伍军人进行公开试验。在 3 个疗程的浓缩时间内，解决年轻退伍军人面临的后勤障碍，这些退伍军人的职业、学校和家庭都与治疗时间竞争。基于接受的技能培训，以及关于退伍军人每周完成情绪调节和攻击性措施的信息，除了招募（推荐数量与推荐数量）之外，还将使用退伍军人对 MERA 的判断来检查该研究的可行性。 MERA 的初步效果将通过培训前至培训后 1 个月的变化来估计我们预测完成 MERA 的退伍军人的 IA 和情绪失调将会减少。我们预计完成 MERA 的退伍军人将比未完成 MERA 的退伍军人更高的比例开始、参与和完成 PTSD 循证心理治疗。意义：这项研究支持退伍军人事务部的两项任务：减少攻击性并增加 PTSD 治疗起始时间，PTSD 是退伍军人中最常见且代价高昂的精神疾病之一，患有 PTSD 的退伍军人比患有 PTSD 的平民更有可能出现攻击性行为。减少攻击性是退伍军人、他们的家人和社会减少人际暴力、监禁和伤害的迫切需要。其次，有有效的治疗方法已被证明可以减轻 PTSD 症状，但很少有患有 PTSD 的退伍军人接受治疗。创伤后应激障碍 (PTSD) 循证心理治疗启动率低的原因之一可能是退伍军人担心他们在开始治疗时无法控制自己的情绪反应。为退伍军人提供情绪调节技能和有关创伤后应激障碍 (PTSD) 治疗的知识可能有助于他们开始治疗。 、完整并受益于 PTSD 循证心理治疗。