An Immersion Intervention for Symptoms of PTSD in Student Veterans

NCT05309031 | Completed DMC

• 1 other identifier: UNevada
• Study Type: interventional
• Target: 13
• Locations: 1 country
• Sites: 1

Brief Summary

This study will explore the physical and psychological effects of warm water immersion to the chest on student Veterans who experience symptoms of Post-Traumatic Stress Disorder (PTSD) and may also have depression, anxiety and pain.

Conditions

Stress Disorders, Post-Traumatic

Outcome Measures

Primary Outcomes (5)

• Salivary Alpha-Amylase change is being assessed

  Salivary alpha-amylase samples will be analyzed by Salametrics, Carlsbad, CA using a Saliva Bio Oral Swab device and Swab Storage Tube, immediately placed on ice and frozen within 2 hours at -70 degrees. Frozen sample aliquots containing at least 325µL, will be shipped at one time, on dry ice for analysis using .25 µL, by a Kinetic Reaction assay, with a sensitivity of 0.4 U/ml, range of 2 - 400 U/ml. Samples are run in duplicate.

  Pre Immersion Baseline (dry) Immersion at 15 minutes (wet) and 45 minutes (wet)

• Multidimensional Mood State Questionnaire (MDMQ) Change is being assessed

  The Multidimensional Mood State Questionnaire (MDMQ) is an English version of the German Multidimensional Mood State Questionnaire. It is based on the condition diagnosis of three mood dimensions "elevated-depressed" (German) "good-bad" (English), (G Scale) "wakefulness drowsiness" (German) "awake-tired" (W Scale) and "restlessness" (German) "calm-nervous" (R scale) and considers situational effects. The reliabilities at four measurement times using split-half correlation with subsequent Spearman-Brown test extension calculation of the German version are G scale between .96 and .97, W scale between .94 and .96 and R scale between .87 and .94 (Steyer et al., 1994). Dr. Rolf Steyer confirms the scale has not been tested in English (personal communication). This scale is simple, easy to use and measures current mood.

  Pre Immersion Baseline (dry) Immersion at 15 minutes (wet) and 45 minutes (wet)

• Visual Analogue Scale (VAS) for Anxiety Change is being assessed

  Visual Analogue Scale (VAS) will measure anxiety. VAS reliability, validity, administration and scoring for anxiety and pain have been previously described (Benfield et al., 2001).Scores range between 0 and 100 mm. Lower scores mean less anxiety.

  Pre Immersion Baseline (dry) Immersion at 15 minutes (wet) and 45 minutes (wet)

• Visual Analogue Scale (VAS) for Pain Change is being assessed

  Visual Analogue Scale (VAS) will measure pain. VAS reliability, validity, administration and scoring for anxiety and pain have been previously described (Benfield et al., 2001)Scores range between 0 and 100 mm. Lower scores mean less pain.

  Pre Immersion Baseline (dry) Immersion at 15 minutes (wet) and 45 minutes (wet)

• Semi-structured interview

  Individual semi-structured interviews will be completed to explore participant's overall perceptions of the immersion intervention and its effect on their general well-being and symptoms. Interviews will be conducted in a conversational tone, using open-ended questions, and active listening techniques. An interview guide consisting of questions related to the intervention and participant cues will direct the conversation The interview will be initiated using a grand tour question, such as "Tell me about your experience while immersed in the water. How did you feel?" then proceed to more directed questions related to specific symptoms related to specific emotional and psychological responses to the intervention (immersion). All interviews will be audio-recorded and transcribed, however, if any participants do not consent to be recorded, the researcher will take notes. Interviews are expected to take approximately 30 - 60 minutes.

  Immediately following immersion

Study Arms (1)

Immersion

EXPERIMENTAL

This group will receive the immersion intervention

Other: Water Immersion

Interventions

Water Immersion OTHER

Participants will enter the pool, which has a thermoneutral temperature of 33°C (92°F), warm enough to be comfortable, but cool enough to avoid an increase in HR with similar ambient air temperature. A maximum depth of 4 to 4 feet 6 inches allows ample room participants to be immersed to the chest, float vertically and move in the pool. During 45 min of immersion, they will be instructed to stand, walk and move ad lib. Noodles will be available to hang or rest on in a vertical position. Taller participants will remain at the pool's deep end. The timeframe was chosen to approximate our previous immersion intervention length.

Immersion

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Self-report of previous military service, current enrollment as a student at UNLV, and current PTSD symptoms. They must be able to enter and exit the pool without assistance.

You may not qualify if:

• Self-report of current dental, cardiac, pulmonary or kidney disease, uncontrolled diabetes, HIV, hepatitis, mental illness (except depression), traumatic brain injury, morbid obesity, open wounds, fear of water, or missing lower extremities and presumptive or confirmed pregnancy. Pharmacologics, including antidepressants, analgesics and non-steroidal anti-inflammatories, will not be controlled for because of the difficulty of recruiting participants without comorbid depression or pain.

Sponsors & Collaborators

• University of Nevada, Las Vegas: lead

Study Sites (1)

UNLV

Las Vegas, Nevada, 89154, United States

Location

Related Publications (9)

• Benfield RD, Hortobagyi T, Tanner CJ, Swanson M, Heitkemper MM, Newton ER. The effects of hydrotherapy on anxiety, pain, neuroendocrine responses, and contraction dynamics during labor. Biol Res Nurs. 2010 Jul;12(1):28-36. doi: 10.1177/1099800410361535. Epub 2010 May 7.

  PMID: 20453024 BACKGROUND

• Epstein M, Preston S, Weitzman RE. Isoosmotic central blood volume expansion suppresses plasma arginine vasopressin in normal man. J Clin Endocrinol Metab. 1981 Feb;52(2):256-62. doi: 10.1210/jcem-52-2-256.

  PMID: 7007402 BACKGROUND

• Farhi LE, Linnarsson D. Cardiopulmonary readjustments during graded immersion in water at 35 degrees C. Respir Physiol. 1977 Jun;30(1-2):35-50. doi: 10.1016/0034-5687(77)90020-2.

  PMID: 877449 BACKGROUND

• Hammerum MS, Bie P, Pump B, Johansen LB, Christensen NJ, Norsk P. Vasopressin, angiotensin II and renal responses during water immersion in hydrated humans. J Physiol. 1998 Aug 15;511 ( Pt 1)(Pt 1):323-30. doi: 10.1111/j.1469-7793.1998.323bi.x.

  PMID: 9679185 BACKGROUND

• Johansen LB, Jensen TU, Pump B, Norsk P. Contribution of abdomen and legs to central blood volume expansion in humans during immersion. J Appl Physiol (1985). 1997 Sep;83(3):695-9. doi: 10.1152/jappl.1997.83.3.695.

  PMID: 9292451 BACKGROUND

• Nater UM, La Marca R, Florin L, Moses A, Langhans W, Koller MM, Ehlert U. Stress-induced changes in human salivary alpha-amylase activity -- associations with adrenergic activity. Psychoneuroendocrinology. 2006 Jan;31(1):49-58. doi: 10.1016/j.psyneuen.2005.05.010. Epub 2005 Jul 5.

  PMID: 16002223 BACKGROUND

• Nater UM, Rohleder N, Schlotz W, Ehlert U, Kirschbaum C. Determinants of the diurnal course of salivary alpha-amylase. Psychoneuroendocrinology. 2007 May;32(4):392-401. doi: 10.1016/j.psyneuen.2007.02.007. Epub 2007 Apr 5.

  PMID: 17418498 BACKGROUND

• Petrakova L, Doering BK, Vits S, Engler H, Rief W, Schedlowski M, Grigoleit JS. Psychosocial Stress Increases Salivary Alpha-Amylase Activity Independently from Plasma Noradrenaline Levels. PLoS One. 2015 Aug 6;10(8):e0134561. doi: 10.1371/journal.pone.0134561. eCollection 2015.

  PMID: 26247781 BACKGROUND

• de Kloet CS, Vermetten E, Geuze E, Wiegant VM, Westenberg HG. Elevated plasma arginine vasopressin levels in veterans with posttraumatic stress disorder. J Psychiatr Res. 2008 Feb;42(3):192-8. doi: 10.1016/j.jpsychires.2006.11.009. Epub 2007 Jan 11.

  PMID: 17222428 BACKGROUND

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Study Officials

• Rebecca Benfield, PhD

  University of Nevada, Las Vegas

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Single group repeated measures

Study Record Dates

• First Submitted: March 16, 2022
• First Posted: April 4, 2022
• Study Start: October 1, 2022
• Primary Completion: December 31, 2023
• Study Completion: December 31, 2023
• Last Updated: May 13, 2024

Record last verified: 2024-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)