NCT02057081

Brief Summary

This project addresses the rehabilitation and mental health needs of married combat Veterans post-deployed from Iraq or Afghanistan with a mild traumatic brain injury (mTBI) and/or significant posttraumatic stress (PTS) or combat-related stress (CS) by providing psychoeducation, communication and problem solving skills in a multifamily group (MFG) setting. In this group, Veterans and spouses/cohabiting partners learn customized therapeutic strategies to help compensate for deficits and promote Veteran community integration, interpersonal and emotion regulation skills, and marital satisfaction. The effectiveness of the skills-based MFG will be compared to that of a health education group which offers a supportive environment and basic education without skills training through a randomized clinical trial. As there is currently no family-based intervention for Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with mTBI offered within the VA spectrum of services, this intervention fills a crucial gap in healthcare for our newest Veterans.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
249

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Oct 2014

Longer than P75 for not_applicable

Geographic Reach
1 country

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 22, 2014

Completed
15 days until next milestone

First Posted

Study publicly available on registry

February 6, 2014

Completed
8 months until next milestone

Study Start

First participant enrolled

October 9, 2014

Completed
4.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 12, 2019

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2019

Completed
9 months until next milestone

Results Posted

Study results publicly available

June 4, 2020

Completed
Last Updated

June 4, 2020

Status Verified

May 1, 2020

Enrollment Period

4.4 years

First QC Date

January 22, 2014

Results QC Date

March 13, 2020

Last Update Submit

May 18, 2020

Conditions

Keywords

Stress Disorders, Post-traumaticMild Traumatic Brain InjuryVeterans HealthVeteransSpousesCouplesPsychotherapy, GroupDepressionCouples TherapyFamily TherapyPTSDposttraumatic stress disorder

Outcome Measures

Primary Outcomes (1)

  • Change in the Community Reintegration of Injured Service Members Computer Adaptive Test (CRIS-CAT)

    The Community Reintegration of Injured Service Members Computer Adaptive Test (CRIS-CAT) was used to measure community reintegration. The measure includes 3 subscales: Extent of Participation, Perceived Limitations, and Satisfaction. A total score for each subscale is calculated by summing item responses (range= 10 to 140), with higher scores indicating greater frequency of community participation (extent of participation), greater perceived limitations to community participation (perceived limitations), and greater satisfaction with community participation (satisfaction).

    baseline, post-treatment in study month 38 after 12 bimonthly sessions, and 6-months post-treatment in study month 44

Secondary Outcomes (1)

  • Change in Caregiver Burden Inventory

    Baseline, post-treatment in study month 38 after 12 bimonthly sessions, and 6-months post-treatment in study month 44

Study Arms (2)

Treatment

EXPERIMENTAL

Intensive 14-session psychoeducational rehabilitation and skills-building intervention for couples.

Behavioral: Multifamily Group for mTBI for Couples

Control

ACTIVE COMPARATOR

Didactic 14-session educational group intervention for families.

Behavioral: Group Health Education (GHE)

Interventions

MFG-mTBI-C uses a structured problem-solving and skills training approach to provide Veterans and partners with tools and information to improve coping and help couples reconnect through positive behavioral exchanges.

Also known as: MFG-mTBI-C
Treatment

GHE is a 14-session, highly structured educational intervention providing general information on health problems that are common among the general OEF/OIF cohort including sleep and sleep problems, physical activity and exercise, and alcohol and drug use, as well as guidelines for improving health behavior in these areas.

Also known as: GHE
Control

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Eligible Veterans must have a diagnosis of mTBI in accordance with the VA/DoD Clinical Practice Guideline for Management of Concussion/Mild Traumatic Brain Injury: injury or concussion associated with at least one of the following: brief (\< 30 minutes) loss of consciousness or altered state of consciousness or post-traumatic amnesia for \< 24 hours following the injury, or they either meet diagnostic criteria for PTSD based on the MINI or have trauma- or CS of at least moderate severity, as defined by either: a) PCL score \>34; or b) CES score of \>23.
  • The TBI must be either blast-related or attributable to another discrete event (e.g., fall, fight, injury) sustained during deployment in the OEF/OIF era.
  • Post-concussive symptoms (e.g., sleep or memory problems, headache) must not be attributable to a subsequent injury or other pre-existing or concurrent neurologic disorder:
  • Eligible Veterans must also have a consenting, qualifying spouse/cohabiting partner and a Montreal Cognitive Assessment (MoCA) (Nasreddine,2005) score 19.
  • The 30-item MoCA screens for impairment in specific areas of cognitive functioning deemed necessary for participation in a 90-minute, structured group including attention and concentration, executive functions, language and conceptual thinking.
  • We have specified a MoCA cut-off at the lower end of the range for mild cognitive dysfunction (19), in order to exclude Veterans with severe memory and/or other cognitive deficits, while admitting those with more mild deficits, as these represent our target population, i.e. Veterans with a history of mTBI.

You may not qualify if:

  • a lifetime diagnosis of a major psychiatric disorder (schizophrenia, schizoaffective or bipolar disorder with psychotic features) or active psychosis based on the Structured Clinical Interview for DSM-IV-TR (SCID-L) (First et al., 2007).
  • alcohol or drug abuse or dependence with past 6 months defined by a Short Michigan Alcoholism Screening Test (SMAST) (Selzer, 1975) 3, based on the recommended cut-off for TBI survivors (Gentilello et al.,1995) or a Drug Abuse Screening Test-10 (DAST-10) (Skinner, 1982) 3.
  • "severe" inter-partner violence as defined by the revised 20-item Conflict Tactics Scale Short Form (CTS2S) (Straus \& Douglas, 2004).
  • a suicide attempt within the past 6 months (aborted and interrupted attempts) as assessed by the Columbia Suicide Severity Rating scale (C-SSRS).
  • medical condition or life event (e.g., ongoing or pending legal action in another state) that would compromise participation.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

Baltimore, Maryland, 21201, United States

Location

Manhattan Campus of the VA NY Harbor Healthcare System, New York, NY

New York, New York, 10010, United States

Location

James J. Peters VA Medical Center, Bronx, NY

The Bronx, New York, 10468, United States

Location

MeSH Terms

Conditions

Brain ConcussionStress Disorders, Post-TraumaticDepression

Interventions

Family Characteristics

Condition Hierarchy (Ancestors)

Brain Injuries, TraumaticBrain InjuriesBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesCraniocerebral TraumaTrauma, Nervous SystemHead Injuries, ClosedWounds and InjuriesWounds, NonpenetratingStress Disorders, TraumaticTrauma and Stressor Related DisordersMental DisordersBehavioral SymptomsBehavior

Intervention Hierarchy (Ancestors)

DemographyPopulation CharacteristicsSocioeconomic FactorsEpidemiologic MeasurementsPublic HealthEnvironment and Public Health

Results Point of Contact

Title
Dr. Amy Drapalski
Organization
VISN 5 Mental Illness Research, Education, and Clinical Center

Study Officials

  • Amy L Drapalski, PhD

    Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 22, 2014

First Posted

February 6, 2014

Study Start

October 9, 2014

Primary Completion

March 12, 2019

Study Completion

August 31, 2019

Last Updated

June 4, 2020

Results First Posted

June 4, 2020

Record last verified: 2020-05

Data Sharing

IPD Sharing
Will not share

Locations