Psychosocial Rehabilitation After Moral Injury and Loss With Adaptive Disclosure

Completed · Not applicable · Has a placebo group

Conditions studied: Post-traumatic Stress Disorder, Moral Injury, Traumatic Loss

In brief

The aim of this study was to determine the efficacy of Adaptive Disclosure for Moral Injury and Loss (AD-MIL), a combat-specific psychotherapy for war-related PTSD stemming from Moral Injury (MI) and traumatic loss (TL) with Iraq and Afghanistan War Veterans with PTSD. AD-MIL will be compared to Present Centered Therapy (PCT). AD-MIL is a modified version of Adaptive Disclosure (AD), which has been modified and extended to solely treat MI and TL by targeting psychological and behavioral obstacles to occupational, relationship, and family functioning, as well as quality of life. PCT is a manualized evidenced-based PTSD treatment used to address functioning problems in several large-scale PTSD trials. The primary end-point was psychosocial functioning (improvements in social, educational and occupational functions). Secondary end-points included PTSD, depression, moral emotions (anger, shame, and guilt), alcohol use, self-compassion, and mindful/valued living.

Key facts

Study ID

NCT03056157

Run by

VA Office of Research and Development

People needed

174

Starts

2018-01-03

Expected to finish

2022-02-28

Last updated by the study team

2024-07-03

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Served in an active-duty role within the military since September 2001 (Veterans may be eligible whether or not they were deployed to a warzone)
• Met the DSM-5 diagnostic criteria for PTSD as a result of military trauma (per Clinician Administered PTSD Scale for DSM-5 [CAPS-5]) and reported non-negligible levels of associated functional impairment (Sheehan Disability Scale [SDS] score = 10)
• Prospective enrollees must have been willing to commit to 12 consecutive weekly therapy sessions lasting up to 90 minutes in duration and to complete assessment materials.

You may not qualify if…

• Bipolar or psychotic disorders.
• Current drug or alcohol dependence (other than caffeine or tobacco dependence). Prospective enrollees who had maintained sobriety for at least 6 weeks immediately prior to the time of enrollment may have been eligible.
• Evidence of traumatic brain injury severe enough to influence the ability to understand and respond to study procedures
• Suicidal or homicidal ideation severe enough to warrant immediate attention
• Concurrent enrollment in any treatment that involves: (1) systematic disclosure of troubling trauma-related memories or (2) present-focused psychosocial skills training for PTSD or (3) supportive therapy/case management on a > monthly basis or (4) any individual therapy or (5) newly (< 6 weeks) prescribed pharmacological treatment.

Where it is running

• VA San Diego Healthcare System, San Diego, CA — San Diego, California, United States
• San Francisco VA Medical Center, San Francisco, CA — San Francisco, California, United States
• VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA — Boston, Massachusetts, United States
• Minneapolis VA Health Care System, Minneapolis, MN — Minneapolis, Minnesota, United States
• Central Texas Veterans Health Care System Waco VA Medical Center, Waco, TX — Waco, Texas, United States

Full record on ClinicalTrials.gov

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