NCT05789329

Brief Summary

Trauma-related guilt is common and impairing among trauma survivors, particularly among Veterans with posttraumatic stress disorder (PTSD). The investigators' work shows that a brief treatment targeting trauma-related guilt, Trauma Informed Guilt Reduction Therapy (TrIGR), can reduce guilt and PTSD and depression symptoms. Whether TrIGR is no less effective than longer, more resource heavy PTSD treatments disseminated by by VA, like cognitive processing therapy (CPT), is the next critical question that this study will seek to answer. 158 Veterans across two VA sites will be randomized to TrIGR or CPT to evaluate changes in PTSD, depression, guilt and shame symptoms across the two treatments.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
158

participants targeted

Target at P75+ for not_applicable

Timeline
17mo left

Started Jun 2023

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

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress68%
Jun 2023Sep 2027

First Submitted

Initial submission to the registry

March 15, 2023

Completed
14 days until next milestone

First Posted

Study publicly available on registry

March 29, 2023

Completed
2 months until next milestone

Study Start

First participant enrolled

June 1, 2023

Completed
3.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2027

Expected
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2027

Last Updated

June 26, 2025

Status Verified

June 1, 2025

Enrollment Period

3.8 years

First QC Date

March 15, 2023

Last Update Submit

June 25, 2025

Conditions

Keywords

PTSDtraumamoral injuryinterventionguiltshame

Outcome Measures

Primary Outcomes (1)

  • change in Clinician Administered PTSD Scale - 5 (CAPS-5)

    Clinician Administered PTSD Scale - 5 (CAPS-5) - score range 0 - 80; higher scores are indicative of more severe PTSD symptoms. Reduction in scores is considered a positive outcome.

    baseline to 28 weeks later

Secondary Outcomes (3)

  • change in Patient Health Questionnaire - 9 (PHQ-9)

    baseline to 28 weeks later

  • Trauma Related Guilt Inventory (TRGI)

    baseline to 28 weeks later

  • Trauma Related Shame Inventory (TRSI)

    baseline to 28 weeks later

Study Arms (2)

Trauma Informed Guilt Reduction Therapy (TrIGR)

EXPERIMENTAL

behavioral intervention aimed to reduce trauma-related guilt and shame

Behavioral: Trauma Informed Guilt Reduction Therapy

Cognitive Processing Therapy (CPT)

ACTIVE COMPARATOR

behavioral intervention aimed at reducing PTSD symptoms

Behavioral: Cognitive Processing Therapy

Interventions

behavioral intervention aimed to reduce trauma-related guilt and shame

Also known as: TrIGR
Trauma Informed Guilt Reduction Therapy (TrIGR)

behavioral intervention aimed at reducing PTSD symptoms

Also known as: CPT
Cognitive Processing Therapy (CPT)

Eligibility Criteria

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

You may qualify if:

  • U.S. Veterans age 18 or older;
  • meets diagnostic criteria for PTSD or subthreshold PTSD;
  • a score of 2 or higher ("true" to "extremely true") on feeling trauma-related guilt much or all of the time or scoring 3 or higher ("very true" or "extremely true") on at least one guilt cognition factor (hindsight bias/responsibility, wrongdoing, or lack of justification) on the Trauma Related Guilt Inventor.
  • not currently receiving trauma-focused treatment such as CPT or PE; and
  • willingness to attend psychotherapy and assessment sessions.

You may not qualify if:

  • Impaired mental status as measured by the Montreal Cognitive Assessment (MoCA) (score \< 21) and confirmed by a neuropsychologist,
  • Veterans with significant current risk of suicidal/homicidal behavior will be referred to more appropriate treatment;
  • Current severe substance use disorder (in the past two months) based on DSM-5 criteria;
  • Current unmanaged psychosis or mania;
  • life threatening or unstable medical illness; or
  • inability to read.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

VA San Diego Healthcare System, San Diego, CA

San Diego, California, 92161-0002, United States

RECRUITING

James A. Haley Veterans' Hospital, Tampa, FL

Tampa, Florida, 33612, United States

RECRUITING

MeSH Terms

Conditions

Stress Disorders, Post-TraumaticWounds and Injuries

Interventions

2-cyclohexylidenhydrazo-4-phenyl-thiazole

Condition Hierarchy (Ancestors)

Stress Disorders, TraumaticTrauma and Stressor Related DisordersMental Disorders

Study Officials

  • Sonya B. Norman, PhD

    VA San Diego Healthcare System, San Diego, CA

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Sonya B Norman, PhD

CONTACT

Kaitlyn Panza, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
A computer-generated masked randomization sequence will be provided and held by a statistician not otherwise involved in the study. Randomization will be stratified by site and gender.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Participants will be randomly assigned to Trauma Informed Guilt Reduction Therapy (TrIGR) or Cognitive Processing Therapy (CPT).
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 15, 2023

First Posted

March 29, 2023

Study Start

June 1, 2023

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

September 30, 2027

Last Updated

June 26, 2025

Record last verified: 2025-06

Data Sharing

IPD Sharing
Will share

A de-identified, anonymized dataset without personal identifiers will be generated and shared with those who request and are granted access (see access criteria). Any HIPAA identifiers, or combinations of variables that could be used for re-identification, will be excluded, as will any proprietary information. The plan does not include any access to individually identifiable or proprietary data. Therefore, this plan will ensure the protection of personal privacy, the confidentiality of individually identifiable private information, and the security of proprietary data and information.

Shared Documents
STUDY PROTOCOL
Time Frame
After publication of the primary outcome paper.
Access Criteria
Requests for access must be made in writing signed by a requester from the United States and include an email address for delivery and an assurance that the recipient will not attempt to identify or re-identify any individual. The request should reference the publication underlying the request.

Locations