NCT04793776

Brief Summary

PTSD is one of the most prevalent mental health conditions affecting Veterans who have served since 9/11. Veterans with posttraumatic stress disorder (PTSD) report difficulty controlling impulsive aggression (IA). An inability to manage one's emotions (emotion dysregulation) is an underlying mechanism of IA. Reducing IA and increasing use of PTSD evidence-based psychotherapies are two critical missions for the Veterans Health Administration. The proposed research supports these missions by comparing a 3- session emotion regulation treatment (Manage Emotions to Reduce Aggression) to a control group in order to determine if MERA can reduce IA and prepare Veterans for PTSD treatment. By enhancing Veterans' abilities to cope with trauma-related emotions and feel equipped to initiate PTSD treatments, this research aims to help Veterans decrease IA and ultimately recover from PTSD.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
204

participants targeted

Target at P75+ for not_applicable

Timeline
7mo left

Started Jan 2022

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress89%
Jan 2022Dec 2026

First Submitted

Initial submission to the registry

March 8, 2021

Completed
3 days until next milestone

First Posted

Study publicly available on registry

March 11, 2021

Completed
10 months until next milestone

Study Start

First participant enrolled

January 3, 2022

Completed
4.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2026

Expected
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 30, 2026

Last Updated

June 8, 2026

Status Verified

June 1, 2026

Enrollment Period

4.7 years

First QC Date

March 8, 2021

Last Update Submit

June 4, 2026

Conditions

Keywords

Stress Disorders, Post-TraumaticAggressionEmotion RegulationVeteransPsychotherapy

Outcome Measures

Primary Outcomes (1)

  • Change in Overt Aggression Scale (OAS)

    Overt Aggression Scale is a 17-item self-report measure that assesses frequency of verbal and physical aggression against self, other, and objects and while driving over the past week. Veterans' self-reported aggressive acts will be summed to create an OAA total score. Minimum score = 0; there is no maximum score as Veterans can report as many episodes of aggression as they engage in.

    Treatment group differences in change from Session 1 to posttreatment assessment (duration of 11 weeks).

Secondary Outcomes (1)

  • Change in Difficulties in Emotion Regulation Scale (DERS)

    Treatment group differences in change from Session 1 to posttreatment assessment (duration of 11 weeks).

Other Outcomes (1)

  • Evidence Based Psychotherapy (EBP) Initiation

    Treatment group differences in EBP initiation at 6 months posttreatment.

Study Arms (2)

Manage Emotions to Reduce Aggression (MERA)

EXPERIMENTAL

MERA is 3 individual 90-minute sessions delivered over 3 weeks.

Behavioral: Manage Emotions to Reduce Aggression

Present Centered Psychotherapy (PCT)

ACTIVE COMPARATOR

PCT delivered in 3 individual 90-minute sessions over 3 weeks.

Behavioral: Present Centered Psychotherapy

Interventions

PCT will serve as the comparison group. PCT assists Veterans in understanding and coping with current difficulties, such as aggression, but does not provide systematic training in emotion regulation skills.

Also known as: PCT
Present Centered Psychotherapy (PCT)

MERA begins with education about the adaptive nature of emotions, how childhood and military experiences can influence emotion regulation, and how combat requires different emotion regulation strategies than most civilian environments. MERA use modeling and practice with feedback to teach cognitive-behavioral and acceptance-based emotion regulation skills.

Also known as: MERA
Manage Emotions to Reduce Aggression (MERA)

Eligibility Criteria

Age18 Years - 64 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Male and female Veterans who deployed to combat zones since 9/11.
  • Currently meets criteria for full or subthreshold PTSD, determined by the Clinician-Administered PTSD Scale for DSM-5
  • Engaged in at least 3 self-reported aggressive acts (e.g., yelling, throwing objects, hitting objects/people) in the last month, measured by the Overt Aggression Scale
  • Impulsive aggression is his/her primary form of aggression, determined by the Impulsive Premeditated Aggression Scale
  • Each Veteran must allow an independent aggression rater (live-in partner, family member, or roommate above 18 years of age)\] verify the number of aggressive acts, using the Overt Aggression Scale.
  • Agreement not to change psychotropic medications through the duration of the study.

You may not qualify if:

  • Currently suicidal with intent of self-harm in the last week.
  • Currently homicidal with plans to hurt a specific person.
  • Unable to complete self-report measures.
  • Meets diagnostic criteria for bipolar disorder or psychotic disorder.
  • Had a psychotropic medication change within 4 weeks prior to the baseline assessment. Veterans receiving general mental health services or engaging in usual care will be allowed to participate.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

James A. Haley Veterans' Hospital, Tampa, FL

Tampa, Florida, 33612, United States

RECRUITING

Michael E. DeBakey VA Medical Center, Houston, TX

Houston, Texas, 77030, United States

RECRUITING

MeSH Terms

Conditions

Stress Disorders, Post-TraumaticAggressionEmotional Regulation

Condition Hierarchy (Ancestors)

Stress Disorders, TraumaticTrauma and Stressor Related DisordersMental DisordersAberrant Motor Behavior in DementiaBehavioral SymptomsBehaviorSocial BehaviorSelf-Control

Study Officials

  • Shannon R. Miles, PhD

    James A. Haley Veterans' Hospital, Tampa, FL

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Shannon R Miles, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Participants and outcome assessors will be masked to treatment assessment. Therapist will be masked to outcome data.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This randomized clinical trial (RCT) is designed to examine if a brief emotion regulation treatment, MERA, is efficacious at reducing aggression compared to present centered therapy (PCT) in Veterans with full or subthreshold PTSD. The investigators will use a parallel group RCT design, a 1:1 allocation ratio, and a superiority (MERA \> PCT) framework. The study will follow the SPIRIT 2013 Checklist that is recommended for RCT protocols.
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 8, 2021

First Posted

March 11, 2021

Study Start

January 3, 2022

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

December 30, 2026

Last Updated

June 8, 2026

Record last verified: 2026-06

Data Sharing

IPD Sharing
Will share

Final data sets underlying publications resulting from the proposed research will be shared outside VA in electronic format through the mechanism(s) indicated below. * A De-identified, Anonymized Dataset will be created and shared. * Final de-identified data sets underlying publications resulting from the proposed research will be available outside the VA using the following mechanism, electronic format through e-mail upon request, after results are published. Data sets will also be available through collaborators and other investigators upon request prior to publication.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
Time Frame
After results of study are published.
Access Criteria
After results of study are published and according to the VA record control schedule, which is currently a maximum of 6 years.

Locations