Using Emotion Regulation to Decrease Aggression in Veterans With PTSD
Condition: Chronic Post-Traumatic Stress Disorder
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic; Aggression
Study type: Interventional

Summary: 
      Impulsive aggression (IA) is common among Veterans with posttraumatic stress disorder (PTSD),
      and PTSD is one of the most prevalent post deployment mental health conditions affecting
      Afghanistan and Iraq Veterans. 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.

      This research supports these missions by providing a 3-session emotion regulation training
      (Manage Emotions to Reduce Aggression) to Veterans in order to teach them how to manage
      emotions and prepare for PTSD treatment. This is an open trail, so all Veterans who meet the
      inclusion criteria will be allowed to receive the treatment. Each Veteran's level of
      aggression and emotion dysregulation will be measured at the beginning and end to the
      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.
    

Detailed description: 
      In this pilot study for the Consortium to Alleviate PTSD, Shannon Miles, PhD, of the James A.
      Haley Veterans' Hospital in Tampa, Florida, and her study team will work with post-9/11
      combat Veterans with PTSD and impulsive aggression. The Veterans will be identified as having
      impulsive aggression if they report having engaged in at least three episodes of aggression
      within the past month. The investigators will provide training in emotion regulation via an
      innovative three-session training called Managing Emotions to Reduce Aggression, or MERA.

      The goal of the pilot study is to test the feasibility of MERA in reducing impulsive
      aggression. A secondary goal is to prepare Veterans for psychotherapy for PTSD. One reason
      that too few Veterans seek PTSD treatment may be that they fear that they will not be able to
      control their emotional responses when they begin treatment. The investigators for this study
      believe that equipping Veterans with emotion regulation skills and knowledge about PTSD
      treatments may help them initiate, complete, and benefit from evidence-based psychotherapies.

      MERA is provided in a three-session, condensed time frame to make it accessible to Veterans
      whose careers, school, and families compete with treatment time. The training is delivered in
      a group format and incorporates emotion education, cognitive-behavioral and acceptance-based
      skills training, and information about what emotional experiences to expect from PTSD
      treatments. Study participants will undergo weekly assessments for emotion regulation and
      aggression. Following the MERA training, study participants will be followed by CAP
      investigators to monitor whether they seek out, receive, and complete evidence-based
      psychotherapies for PTSD.
    

Intervention name(s): Manage Emotions to Reduce Aggression (MERA)
Intervention type(s): Behavioral
Intervention description(s): MERA is a 3-session group treatment that teaches Veterans the purpose of emotions, how trauma and combat can increase emotions, and how to better regulate them. The skills use cognitive-behavioral and mindfulness techniques to help Veteran better regulate their emotions. These skills are commonly used in clinical practice, but have not been delivered in 3 sessions.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Post-traumatic stress disorder; Veterans; Aggression; Emotion regulation