Mindfulness for Anger in Veterans With PTSD

NCT02882802 | Completed Results DMC

• 1 other identifier: CLNA-006-15F
• Study Type: interventional
• Target: 61
• Locations: 1 country
• Sites: 1

Brief Summary

Research has consistently shown that Veterans with PTSD are more likely to experience higher levels of anger and commit aggressive acts compared to Veterans without PTSD. Given the significant negative impact that anger and aggression can have on the lives of Veterans, their families, and society at large, there is a great need to examine novel interventions that could decrease anger and aggression risk with this population. Mindfulness may be one such technique, given its effectiveness in assisting individuals in regulating difficult emotions and in decreasing physiological reactivity, which have both been implicated in PTSD and aggression perpetration. Findings showing that a mindfulness intervention is effective in reducing anger and aggressive behavior would be relevant for Veterans with PTSD experiencing such difficulties and would help prevent the detrimental consequences that can come from anger and aggression among these individuals.

Conditions

Anger; Aggression

Keywords

anger; aggression

Outcome Measures

Primary Outcomes (14)

• State Anger Scale

  Self-report measure of overall state anger using the State-Trait Anger Expression Inventory-2. Score range: 15-60; higher scores indicate greater state anger.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Trait Anger Scale

  Self-report measure of trait anger using the State-Trait Anger Expression Inventory-2. Score range: 10-40; higher scores indicate greater trait anger.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Anger Expression In

  Self-report measure of anger expression inward using the State-Trait Anger Expression Inventory-2. Score range: 8-32; higher scores indicate greater frequency of experiencing anger but not expressing (i.e., suppressing) anger.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Anger Expression Out

  Self-report measure of anger expression outward using the State-Trait Anger Expression Inventory-2. Score range: 8-32; higher scores indicate greater frequency of expressing anger verbally or physically.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Anger Control In

  Self-report measure of anger control inward using the State-Trait Anger Expression Inventory-2. Score range: 8-32; higher scores indicate greater frequency of attempting to control anger feelings by calming down or cooling off.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Anger Control Out

  Self-report measure of anger control outward using the State-Trait Anger Expression Inventory. Score range: 8-32; higher scores indicate greater frequency of controlling outward expression of angry feelings.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Anger Expression Index

  Total Anger score on the STAXI-2. Score range: 0-96; higher scores indicate greater expression of anger.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Buss Perry Total Aggression Score

  Self-report measure of total aggression using the Buss-Perry Aggression Questionnaire. Scores range from 29-203; greater scores indicate greater total aggression.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Buss Perry Physical Aggression

  self-report measure assessing physical aggression using Buss Perry Aggression Questionnaire. Scores range from 9-63; greater scores indicate greater total physical aggression.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Buss Perry Verbal Aggression Score

  self-report measure assessing verbal aggression using Buss Perry Aggression Questionnaire. Scores range from 5-35; greater scores indicate greater total verbal aggression.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Buss Perry Anger Scale

  self-report measure of anger using the Buss Perry Aggression Questionnaire. Scores range from 7-49; greater scores indicate greater total anger.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Buss Perry Hostility Scale

  self-report measure of hostility using the Buss Perry Aggression Questionnaire. Scores range from 8-56; greater scores indicate greater total hostility.

  Baseline, after 3 weeks of treatment, after 6 weeks of treatment, within 8 weeks following the completion of either of the two treatments (i.e., post-treatment), and within 5 months after completing the post-treatment assessment

• Provoked Aggression Subscale 1

  An experimental lab-based paradigm designed to assess provoked aggression, the Taylor Reaction Time Task. This subscale determines whether participants' aggression increased, decreased, or remained the same across four blocks of trials (six trials within each block). Scores range from 0-11 within each trial, with higher scores indicating worse outcome. Each of the six trials within each block are averaged together.

  within 8 weeks following the completion of either of the two treatments

• Provoked Aggression Subscale 2

  An experimental lab-based paradigm designed to assess provoked aggression, the Taylor Reaction Time Task. This subscale determines participants' initial levels of aggression. Participants can choose from the following response options: 0, 1, 2, 3, 4, 5, 6, 7,8, 9, 10 or 20, with higher scores indicating greater initial levels of aggression.

  within 8 weeks following the completion of either of the two treatments

Other Outcomes (2)

• Skin Conductance Levels

  within 8 weeks following the completion of either of the two treatments

• Heart Rate

  within 8 weeks following the completion of either of the two treatments

Study Arms (2)

Mindfulness Based Stress Reduction

EXPERIMENTAL

Mindfulness Based Stress Reduction (MBSR) is a group-based intervention in which participants are taught different mindfulness meditation practices, including body scan (focusing attention to different areas of the body in sequence), sitting meditation (focusing attention to one's breathing), and Hatha yoga postures (focusing attention to different body sensations during gentle stretching). Participants also are taught how to practice mindfulness while engaging in ordinary activities including walking, standing, and eating. MBSR consists of 8, two-hour weekly sessions and will be delivered in group format. MBSR groups will be delivered virtually.

Behavioral: Mindfulness Based Stress Reduction

Trauma Recovery Education Class

ACTIVE COMPARATOR

Trauma Recovery Education Class (TREC): TREC is a group based treatment that focuses on providing information on PTSD and traumatic reactions. TREC provides psycho-education to Veterans on PTSD, including common reactions to trauma and the role of avoidance, common problems associated with PTSD, as well as common barriers to care (e.g., stigma, maladaptive beliefs, fear). Additional content focuses on problem identification and goal setting, discussion of current problems and life issues, and treatment planning. TREC consists of 8, one-hour weekly sessions. TREC groups will be delivered virtually.

Behavioral: Trauma Recovery Education Class

Interventions

Mindfulness Based Stress Reduction BEHAVIORAL

Mindfulness Based Stress Reduction (MBSR) is a group-based intervention in which participants are taught different mindfulness meditation practices, including body scan (focusing attention to different areas of the body in sequence), sitting meditation (focusing attention to one's breathing), and Hatha yoga postures (focusing attention to different body sensations during gentle stretching). Participants also are taught how to practice mindfulness while engaging in ordinary activities including walking, standing, and eating. MBSR consists of 8, two-hour weekly sessions and will be delivered in group format. MBSR groups will be delivered virtually.

Also known as: MBSR

Mindfulness Based Stress Reduction

Trauma Recovery Education Class BEHAVIORAL

Trauma Recovery Education Class (TREC): TREC is a group based treatment that focuses on providing information on PTSD and traumatic reactions. TREC provides psycho-education to Veterans on PTSD, including common reactions to trauma and the role of avoidance, common problems associated with PTSD, as well as common barriers to care (e.g., stigma, maladaptive beliefs, fear). Additional content focuses on problem identification and goal setting, discussion of current problems and life issues, and treatment planning. TREC consists of 8, one-hour weekly sessions. TREC groups will be delivered virtually.

Also known as: TREC

Trauma Recovery Education Class

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must meet current Diagnostic and Statistical Manual of Mental Disorders (5th edition) diagnostic criteria for PTSD (participants with sub-threshold levels of PTSD will also be allowed to participate).
• Participants must also indicate current difficulties with anger and aggression.

You may not qualify if:

• Participants with a current diagnosis of psychotic disorder or current substance use disorder with severe symptoms.
• Participants diagnosed with bipolar II disorder without psychotic features and/or individuals diagnosed with bipolar disorder who are well-controlled on medication will be allowed to participate. Individuals with bipolar disorder who do not fall into either of these categories will be excluded.
• Participants also must not have a seizure disorder.
• Participants are allowed to be taking psychotropic medications, however they must be on a stable dose for at least 2 months.
• Participants who do not have a working and active e-mail account and access to a smart phone or computer will be excluded.
• Finally, participants must not currently be receiving concurrent individual therapy or group therapy focused on anger and aggression, must not be currently receiving any evidence-based treatment for PTSD, and must not currently be participating in the modified TREC group offered at the West Haven VA Medical Center.

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Connecticut Healthcare System West Haven Campus, West Haven, CT

West Haven, Connecticut, 06516-2770, United States

Location

MeSH Terms

Conditions

Aggression

Interventions

Mindfulness-Based Stress Reduction

Condition Hierarchy (Ancestors)

Aberrant Motor Behavior in Dementia; Behavioral Symptoms; Behavior; Social Behavior

Intervention Hierarchy (Ancestors)

Mindfulness; Cognitive Behavioral Therapy; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Limitations and Caveats

The project was delayed in 2017 due to a hiring freeze. Also, due to the COVID-19 pandemic: 1) In 2020 the study was suspended for one year, 2) procedures had to be modified-all research sessions had to be conducted virtually (as opposed to in-person), and 3) the in-person laboratory session was either not conducted or delayed.

Results Point of Contact

• Title: Dr. Lorig Kachadourian
• Organization: VA CONNECTICUT HEALTHCARE SYSTEM

lorig.kachadourian@va.gov

203-932-5711

Study Officials

• Lorig Kachadourian, PhD MA

  VA Connecticut Healthcare System West Haven Campus, West Haven, CT

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 22, 2016
• First Posted: August 30, 2016
• Study Start: December 1, 2017
• Primary Completion: January 31, 2023
• Study Completion: January 31, 2023
• Last Updated: May 1, 2026
• Results First Posted: May 1, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)