Treatment of Chronic Anger and Aggression Following Military-Related Betrayal

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorThe University of Texas Health Science Center at San Antonio

About this trial

The goal of this clinical trial is to learn if a treatment designed to deal with anger and aggression from a past betrayal will work. The study will be done on active duty military service members and veterans aged 18 or older. The main questions it aims to answer are:

* Will participants be satisfied with the treatment, and is the treatment feasible to do in a military outpatient setting * Will the treatment help with anger and aggression issues.

Researchers will compare differences in groups that have different wait times (2-, 3-, or 4-weeks).

Participants will complete surveys before, during and after the treatment. The treatment will be 14 modules given twice a week. About 1 month after treatment ends, surveys will be taken again.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Adult active duty military service members and veterans aged 18 or older.

Endorses a history of military-related betrayal (on the Modified Moral Injury Questionnaire)

Endorses problematic anger in the past month (as evidenced by a score of 12 or above on the Dimensions of Anger Reactions; DAR-5)

Engaged in at least 1 self-reported act of aggression in the past 1 month (on the Overt Aggression Scale-Modified; OAS-M)

Disqualifiers

Participated in an anger management or trauma-focused intervention within the past 3 months as assessed by self-report.

Acute suicidality requiring immediate intervention, such as hospitalization as assessed by the Depressive Symptoms Index-Suicidality Subscale (DSI-SS) combined with follow up clinical interview for elevated scores.

Is currently homicidal with plans and intent to hurt a specific person and requiring immediate intervention as measured by self-report and follow-up with clinician if screened positive.

Moderate to severe brain injury as measured by inability to comprehend the informed consent document or baseline assessments.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Countering Chronic Anger and Aggression Related to Trauma and Transgressions (CART)

    Behavioral

    Countering Chronic Anger and Aggression Related to Trauma and Transgressions (CART), a novel intervention for reducing chronic anger and aggression and improving interpersonal relationships, in military personnel who have experienced military-related betrayal delivered in 14 treatment modules twice a week.

Treatment groups

40 Participants
are divided into 3 treatment groups
Group A: 2-week wait time groupExperimental treatment 1 intervention
Group B: 3-week wait time groupExperimental treatment 1 intervention
Group C: 4-week wait time groupExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Successful recruitment

Number of eligible referrals that are recruited, enrolled into the study and randomized to treatment

Time frame
Study start to last subject enrolled, approximately 1 year
2

Client satisfaction survey (CSQ-8)

The survey will assess participant acceptability using the CSQ-8, an 8-item self-report measure designed to assess client satisfaction. Each question is answered on a 4-point scale with a possible range of scores between 8-32. A higher score indicates a higher level of overall satisfaction. Mean scores will be used to determine participant satisfaction.

Time frame
1 month after study end ( at approximately 11-18 weeks)
3

Overt Aggression Scale-Modified (OAS-M)

A 17-item measure that assesses frequency of different aggression acts in outpatient settings, including verbal and physical aggression against self, other, and objects. The OAS-M is scored by summing the instances of aggression since the last assessment. The OAS-M had been administered as an interview as well as self-report and will be administered as a self-report in this study, consistent with past aggression research with veterans (Miles, Kent et al., 2020). The score is calculated using a sum total of all instances of aggression. Higher scores indicate a greater frequency of aggressive behaviors.

Time frame
Baseline to 1 month post treatment (approximately 11-18 weeks)
4

Inventory of Interpersonal Problems-Short Version (IIP-32)

A 32-item self-report assessment designed to measure interpersonal functioning. Items are scored on a five-point scale from 0 (not at all) to 4 (extremely) in response to the stem: "How much have you been distressed by this problem?" There are 8 factors and a total score. The 8 factors are: hard to be assertive, hard to be sociable, hard to be supportive, too dependent, too caring, too aggressive, hard to be involved and too open. The possible total score ranges from a T-score are 0-100. T-scores that are higher than 60 are above average and T-scores 70 or higher suggest significant interpersonal difficulty.

Time frame
Baseline to 1 month post treatment (approximately 11-18 weeks)

Secondary outcomes

1

Rate of protocol completion

The 14 modules may be completed within a 7-14 week time period by each participant.

Time frame
Treatment end (Approximately 7-14 weeks)
2

Number of modules completed

A count of how many of the 14 modules are completed

Time frame
Baseline to end of treatment (approximately 7-14 weeks)
3

Brief Inventory of Psychosocial Functioning (B-IPF)

A 7-item, self-report measures of psychosocial functioning in seven life domains: romantic relationship, relationship with children, family relationships, friendships and socializing, work, training and education, and activities of daily living. In each area on a 7-point scale ranging from 0 = Not at all to 6 = Very much. The B-IPF total score is calculated by summing the scale items completed by the respondent, dividing by the maximum possible score based upon the number of applicable items and multiplying by 100. Higher scores indicate greater psychosocial dysfunction.

Time frame
Baseline to 1 month post treatment (approximately 11-18 weeks)
4

Dimensions of Anger Reactions (DAR-5)

A 5-item self report measure that assesses anger frequency, intensity, urge to act aggressively and impact on social functioning over the past 1 month. Respondents are asked how impacted they have been on a five-point Likert scale ranging from 0-5. Items are summed to provide a total severity score (range 5-25). A score of 12 or higher indicates problematic anger.

Time frame
Baseline to 1 month post treatment (approximately 11-18 weeks)

Other outcomes

Sponsors and contacts

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