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Tobacco Treatment as Augmentation for Cognitive Processing Therapy for PTSD

Primary Purpose

Posttraumatic Stress Disorder, Tobacco Dependence

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Tobacco treatment
Health Education
Sponsored by
VA Office of Research and Development
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Posttraumatic Stress Disorder focused on measuring posttraumatic stress disorder, tobacco dependence, cognitive behavioral therapy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • current tobacco use (a urine cotinine level 200ng/ml),
  • motivation to quit (measured by the 7 on the Biener Contemplation ladder)
  • and a current diagnosis of PTSD [as diagnosed by the Clinician Administered PTSD Scale for DSM-5]

Exclusion Criteria:

  • Exclusion criteria will include current participation in another research study, history of bipolar I disorder,
  • schizophreniform disorders except for psychosis NOS due to presence of trauma-related sensory hallucinations,
  • cognitive impairment (<25 of the Mini Mental State Exam),
  • current suicidality/homicidality requiring clinical intervention or a suicide attempt in the past year,
  • inability to provide reliable study data (e.g., provide an adulterated urine sample,
  • provide misinformation to study staff including stating differing information to two or more staff members,
  • attempt to misrepresent self in order to avoid being excluded from the study,
  • inability to answer study questions which are used to determine eligibility),
  • current non-tobacco substance use disorder (abuse or dependence or a positive drug screen; participants who have been abstinent for greater than 3 months will be allowed to participate),
  • participation within the past 6 months in trauma-focused therapy (e.g., Prolonged Exposure, Cognitive Processing Therapy),
  • current use of tobacco cessation pharmacotherapy (i.e., nicotine replacement therapy or varenicline),
  • current use of benzodiazepines
  • serious or uncontrolled medical condition precluding unaided tobacco cessation attempts,
  • pregnancy,
  • a recent change in psychiatric medications (change occurred <2 months prior to entering the study),
  • current participation in another research study.
  • In addition, participants must agree to keep psychiatric medication doses stable for the duration of the study (except for dose adjustments for changes in medication blood levels due to tobacco cessation), unless there is a concern for participant safety.

Sites / Locations

  • VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

tobacco treatment

health education treatment

Arm Description

participants will be provided contingency management and cognitive behavioral therapy to help them quit tobacco prior to PTSD treatment

Participants will be provided education on a variety of health topics and will set health goals around each topic

Outcomes

Primary Outcome Measures

Clinician Administered PTSD Scale
posttraumatic stress disorder clinician rated symptom ratings; scores range from 0-80 (with higher scores indicating greater PTSD severity)

Secondary Outcome Measures

Percent Abstinent From Tobacco Use
biochemically confirmed abstinence from tobacco using self-report, cotinine, and CO breath samples

Full Information

First Posted
September 26, 2013
Last Updated
September 6, 2016
Sponsor
VA Office of Research and Development
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1. Study Identification

Unique Protocol Identification Number
NCT02012452
Brief Title
Tobacco Treatment as Augmentation for Cognitive Processing Therapy for PTSD
Official Title
Tobacco Treatment as Augmentation to Cognitive Processing Therapy for PTSD
Study Type
Interventional

2. Study Status

Record Verification Date
September 2016
Overall Recruitment Status
Terminated
Why Stopped
PI moving outside VA- grant not transferable
Study Start Date
December 2014 (undefined)
Primary Completion Date
January 2016 (Actual)
Study Completion Date
January 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
VA Office of Research and Development

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to examine whether tobacco affects recovery from PTSD. There are 3 goals of the study; (1) to test if quitting tobacco prior to PTSD treatment affects treatment success, (2) to test how PTSD symptoms change in those who have quit tobacco compared to those who continue to use and (3) to explore how tobacco use and tobacco withdrawal symptoms change during PTSD treatment.
Detailed Description
The proposed research aims to examine the effect of tobacco on PTSD symptoms and PTSD recovery as well as the effect of PTSD recovery on tobacco use. This study has 3 aims: (1) to evaluate whether tobacco use interferes with recovery from PTSD during empirically based, trauma focused PTSD treatment. (2) To gather preliminary data about whether tobacco use alleviates PTSD symptoms among continued tobacco users vs. recent quitters. (3) To explore the impact of recovery from PTSD treatment on tobacco use quantity and frequency, tobacco withdrawal symptoms, and craving for tobacco. To test these aims, the investigators propose a randomized two group design where 75 participants are assigned to receive either tobacco treatment (Contingency Management plus Cognitive Behavioral Therapy) or control treatment (Health Education) before completing Cognitive Processing Therapy (CPT) for PTSD. Study outcome variables will be PTSD symptom severity following CPT, PTSD symptom severity during tobacco cessation treatment, and tobacco use and tobacco withdrawal during CPT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Posttraumatic Stress Disorder, Tobacco Dependence
Keywords
posttraumatic stress disorder, tobacco dependence, cognitive behavioral therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
tobacco treatment
Arm Type
Experimental
Arm Description
participants will be provided contingency management and cognitive behavioral therapy to help them quit tobacco prior to PTSD treatment
Arm Title
health education treatment
Arm Type
Sham Comparator
Arm Description
Participants will be provided education on a variety of health topics and will set health goals around each topic
Intervention Type
Behavioral
Intervention Name(s)
Tobacco treatment
Intervention Description
participants will be provided contingency management and cognitive behavioral therapy to help them quit tobacco prior to PTSD treatment
Intervention Type
Behavioral
Intervention Name(s)
Health Education
Intervention Description
Participants will be provided education on a variety of health topics and will set health goals around each topic
Primary Outcome Measure Information:
Title
Clinician Administered PTSD Scale
Description
posttraumatic stress disorder clinician rated symptom ratings; scores range from 0-80 (with higher scores indicating greater PTSD severity)
Time Frame
end of 6 week PTSD treatment
Secondary Outcome Measure Information:
Title
Percent Abstinent From Tobacco Use
Description
biochemically confirmed abstinence from tobacco using self-report, cotinine, and CO breath samples
Time Frame
end of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: current tobacco use (a urine cotinine level 200ng/ml), motivation to quit (measured by the 7 on the Biener Contemplation ladder) and a current diagnosis of PTSD [as diagnosed by the Clinician Administered PTSD Scale for DSM-5] Exclusion Criteria: Exclusion criteria will include current participation in another research study, history of bipolar I disorder, schizophreniform disorders except for psychosis NOS due to presence of trauma-related sensory hallucinations, cognitive impairment (<25 of the Mini Mental State Exam), current suicidality/homicidality requiring clinical intervention or a suicide attempt in the past year, inability to provide reliable study data (e.g., provide an adulterated urine sample, provide misinformation to study staff including stating differing information to two or more staff members, attempt to misrepresent self in order to avoid being excluded from the study, inability to answer study questions which are used to determine eligibility), current non-tobacco substance use disorder (abuse or dependence or a positive drug screen; participants who have been abstinent for greater than 3 months will be allowed to participate), participation within the past 6 months in trauma-focused therapy (e.g., Prolonged Exposure, Cognitive Processing Therapy), current use of tobacco cessation pharmacotherapy (i.e., nicotine replacement therapy or varenicline), current use of benzodiazepines serious or uncontrolled medical condition precluding unaided tobacco cessation attempts, pregnancy, a recent change in psychiatric medications (change occurred <2 months prior to entering the study), current participation in another research study. In addition, participants must agree to keep psychiatric medication doses stable for the duration of the study (except for dose adjustments for changes in medication blood levels due to tobacco cessation), unless there is a concern for participant safety.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sandra Japuntich, PhD
Organizational Affiliation
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Official's Role
Principal Investigator
Facility Information:
Facility Name
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02130
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Tobacco Treatment as Augmentation for Cognitive Processing Therapy for PTSD

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