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Strength at Home Couples Program (PTSD-Focused Relationship Enhancement Therapy for Returning Veterans)

Primary Purpose

Aggression, Post Traumatic Stress Disorders

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Strength at Home Couples Group
Supportive Group Therapy
Sponsored by
Boston VA Research Institute, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Aggression focused on measuring Intimate partner aggression, Couples intervention, PTSD, Veterans, Prevention, Violence Prevention, Prevention of pertetration of intimate partner aggression.

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • couples must have been in a committed relationship for at least six months
  • veterans and their partners must be over the age of 18
  • male members of the couple report no occurrence of physical aggression during the last six months in their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al, 1996)
  • female members of the couple may report that they have engaged in low level aggression during the past six months in their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al., 1996)
  • one partner of the couple averages at or below a score of 29 on the 6-item Quality of Marriage Index (QMI; Norton, 1983) or a 100 or below on the Dyadic Adjustment Score (DAS; Spanier, 1976), which are cutoff scores often used to distinguish distressed and non-distressed couples (e.g., Slep, Heyman, Williams, Van Dyke, & O'Leary, 2006), or one member of the couple endorses veteran-perpetrated psychological aggression (defined as scoring above the 75%ile on the CTS2 minor psychological aggression subscale, or any endorsement of items on the severe psychological aggression subscale on the CTS2 or the Dominance/Intimidation scale of the Multidimensional Measure of Emotional Abuse, MMEA; Murphy & Hoover, 1999;)
  • both members of the couple provide research consent

Exclusion Criteria:

  • reading difficulties prevent valid completion of the assessment instruments
  • the participant evidences severe organicity or active psychosis
  • the participant expresses prominent suicidal or homicidal ideation
  • the participant meets diagnostic criteria for alcohol and/or drug dependence, if not in early full remission or sustained partial remission
  • female members of the couple report their violence includes the use of weapons during the past six months in their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al., 1996)
  • violence perpetrated by female members of the couple produces injuries in men
  • male members of the couple indicate they are fearful of the female partner
  • male members of the couple report they are physically violent in any way during the past six months or severely violent in the past 12 months of their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al., 1996)
  • male members of the couple have had any bruising or injuries inflicted by the female partner during the past six months in their current relationship. Criteria b through d will be assessed using the Mini-International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) and clinical interview

Sites / Locations

  • National Center for PTSD, VA Boston Healthcare System
  • Providence VA Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Strength at Home Couples Group

Supportive Group Therapy

Arm Description

PTSD-Focused Cognitive Behavioral Therapy for Couples

Supportive therapy for couples

Outcomes

Primary Outcome Measures

Evidence of change in incidence and frequency of intimate partner physical assault and psychological aggression assessed by questionnaires and clinical interviews.

Secondary Outcome Measures

Evidence of change in risk factors (i.e. PTSD symptoms, anger, relationship satisfaction) implicated in the development of IPA assessed by questionnaires, clinical interviews, and psychophysiological measurements.

Full Information

First Posted
January 22, 2009
Last Updated
July 11, 2017
Sponsor
Boston VA Research Institute, Inc.
Collaborators
Centers for Disease Control and Prevention
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1. Study Identification

Unique Protocol Identification Number
NCT00827879
Brief Title
Strength at Home Couples Program (PTSD-Focused Relationship Enhancement Therapy for Returning Veterans)
Official Title
Strength at Home Couples Program (Formerly: PTSD-Focused Relationship Enhancement Therapy for Returning Veterans and Their Partners)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
February 2009 (undefined)
Primary Completion Date
October 2014 (Actual)
Study Completion Date
October 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Boston VA Research Institute, Inc.
Collaborators
Centers for Disease Control and Prevention

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the project is to develop and test a couples-based relationship enhancement group intervention for married or partnered Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans to prevent the perpetration of intimate partner aggression (IPA) among participants.
Detailed Description
The focus of this project is to produce a well-defined and standardized intervention, labeled Strength at Home Couples Group, that can improve intimate relationship satisfaction, decrease the likelihood of relationship aggression, increase the intimacy and closeness of the relationship, and help with anger management. We hope to learn more about how to improve relationships, how to prevent anger and violence, and about what factors help people successfully complete treatment. Strength at Home Couples Group will incorporate components of several interventions for PTSD and IPA and will target mechanisms implicated in the PTSD-IPA association. The development of this type of integrated intervention is critical due to high rates of PTSD-IPA co-occurrence and the pressing need to efficiently address both problems among military veterans. Specific aims of this project are: (1) to develop and standardize Strength at Home Couples Group for male combat veterans, including the development of a clinician-friendly intervention manual detailing Strength at Home Couples Group, along with intervention adherence measures and therapist training and certification procedures; (2) to test the efficacy of Strength at Home Couples Group for OEF/OIF/OND veterans by conducting a multiple site randomized trial comparing 10 sessions of Strength at Home Couples Group to 10 sessions of a supportive group therapy (ST) condition; and (3) to explore differences in compliance and process factors across conditions.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aggression, Post Traumatic Stress Disorders
Keywords
Intimate partner aggression, Couples intervention, PTSD, Veterans, Prevention, Violence Prevention, Prevention of pertetration of intimate partner aggression.

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
156 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Strength at Home Couples Group
Arm Type
Experimental
Arm Description
PTSD-Focused Cognitive Behavioral Therapy for Couples
Arm Title
Supportive Group Therapy
Arm Type
Placebo Comparator
Arm Description
Supportive therapy for couples
Intervention Type
Behavioral
Intervention Name(s)
Strength at Home Couples Group
Other Intervention Name(s)
PTSD-Focused Relationship Enhancement Therapy, Returning Veterans and Partners
Intervention Description
A multiple site randomized trial will compare 10 sessions of PF-RET to 10 sessions of a supportive group therapy. PF-RET focuses on 1) deployment stress and traumatic experiences impacting intimate relationships; 2) communication between intimate partners; 3) conflict and anger management; and 4) closeness and intimacy.
Intervention Type
Behavioral
Intervention Name(s)
Supportive Group Therapy
Other Intervention Name(s)
Psychological/Behavioral Placebo Control
Intervention Description
A general support group designed to enhance support for healthy relationship building.
Primary Outcome Measure Information:
Title
Evidence of change in incidence and frequency of intimate partner physical assault and psychological aggression assessed by questionnaires and clinical interviews.
Time Frame
Change determined by assessments pre and post treatment, 6 months, 12 months, and 18 months following treatment
Secondary Outcome Measure Information:
Title
Evidence of change in risk factors (i.e. PTSD symptoms, anger, relationship satisfaction) implicated in the development of IPA assessed by questionnaires, clinical interviews, and psychophysiological measurements.
Time Frame
Change determined by assessments pre and post treatment, 6 months, 12 months, and 18 months following treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: couples must have been in a committed relationship for at least six months veterans and their partners must be over the age of 18 male members of the couple report no occurrence of physical aggression during the last six months in their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al, 1996) female members of the couple may report that they have engaged in low level aggression during the past six months in their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al., 1996) one partner of the couple averages at or below a score of 29 on the 6-item Quality of Marriage Index (QMI; Norton, 1983) or a 100 or below on the Dyadic Adjustment Score (DAS; Spanier, 1976), which are cutoff scores often used to distinguish distressed and non-distressed couples (e.g., Slep, Heyman, Williams, Van Dyke, & O'Leary, 2006), or one member of the couple endorses veteran-perpetrated psychological aggression (defined as scoring above the 75%ile on the CTS2 minor psychological aggression subscale, or any endorsement of items on the severe psychological aggression subscale on the CTS2 or the Dominance/Intimidation scale of the Multidimensional Measure of Emotional Abuse, MMEA; Murphy & Hoover, 1999;) both members of the couple provide research consent Exclusion Criteria: reading difficulties prevent valid completion of the assessment instruments the participant evidences severe organicity or active psychosis the participant expresses prominent suicidal or homicidal ideation the participant meets diagnostic criteria for alcohol and/or drug dependence, if not in early full remission or sustained partial remission female members of the couple report their violence includes the use of weapons during the past six months in their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al., 1996) violence perpetrated by female members of the couple produces injuries in men male members of the couple indicate they are fearful of the female partner male members of the couple report they are physically violent in any way during the past six months or severely violent in the past 12 months of their current relationship on the Revised Conflict Tactics Scale (CTS2; Straus et al., 1996) male members of the couple have had any bruising or injuries inflicted by the female partner during the past six months in their current relationship. Criteria b through d will be assessed using the Mini-International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) and clinical interview
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Casey T Taft, Ph.D.
Organizational Affiliation
National Center for PTSD, VA Boston Healthcare System
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Suzannah Creech, PhD
Organizational Affiliation
Providence VA Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Center for PTSD, VA Boston Healthcare System
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02130
Country
United States
Facility Name
Providence VA Medical Center
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02908
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Norton, R. (1983). Measuring marital quality: A critical look at the dependent variable. Journal of Marriage and the Family, 45, 141-151.
Results Reference
background
Citation
Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996). The Revised Conflict Tactics Scales (CTS2): Development and preliminary psychometric data. Journal of Family Issues,17, 283-316.
Results Reference
background
Citation
Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 154-28.
Results Reference
background
PubMed Identifier
10397625
Citation
Murphy CM, Hoover SA. Measuring emotional abuse in dating relationships as a multifactorial construct. Violence Vict. 1999 Spring;14(1):39-53.
Results Reference
background
PubMed Identifier
27599224
Citation
Taft CT, Creech SK, Gallagher MW, Macdonald A, Murphy CM, Monson CM. Strength at Home Couples program to prevent military partner violence: A randomized controlled trial. J Consult Clin Psychol. 2016 Nov;84(11):935-945. doi: 10.1037/ccp0000129. Epub 2016 Sep 5.
Results Reference
derived

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Strength at Home Couples Program (PTSD-Focused Relationship Enhancement Therapy for Returning Veterans)

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