Mobile Intervention for Veterans With PTSD and Anger

VA Office of Research and Development

Status: Completed

Conditions: Posttraumatic Stress Disorder; Anger

Treatments: Behavioral: Mobile Intervention for Reducing Anger (MIRA); Behavioral: Mindfulness Intervention

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT03733028

D2965-W

Details and patient eligibility

About

Anger is the mostly commonly reported reintegration concern among combat Veterans, especially those with PTSD. Problematic anger is associated with significant functional impairment. In the current project, the investigators will pilot-test a newly developed mobile app, entitled Mobile Intervention for Reducing Anger (MIRA), among Veterans with PTSD and problematic anger. The project will compare the MIRA app to a contact control condition. The investigators hypothesize that Veterans with PTSD and problematic anger will find the MIRA app acceptable and will be willing to use it to reduce their anger difficulties and improve psychosocial and occupational functioning.

Full description

Anger is the mostly commonly reported reintegration concern among combat Veterans, especially those with PTSD. Problematic anger is associated with significant functional impairment. One of the mechanisms associated with problematic anger and aggression is hostile interpretation bias, i.e., a tendency to interpret ambiguous interpersonal situations as hostile. The investigator has previously developed and piloted a computer-based interpretation bias modification intervention that successfully reduces both hostile interpretation bias and anger outcomes. In the current project, the investigators will pilot-test a mobile application version of the existing computer-based intervention, entitled Mobile Intervention for Reducing Anger (MIRA), among Veterans with PTSD and problematic anger. The project will compare the MIRA app to a contact control condition to evaluate the feasibility of recruitment, randomization, and retention procedures. The investigators will also utilize psychophysiological and electronic diary monitoring to determine whether this assessment could be used as an outcome or mechanistic variable in a subsequent randomized clinical trial application focused on evaluating the efficacy of the MIRA intervention.

Enrollment: 30 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Veterans diagnosed with PTSD, established via the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
• Reporting a score of 12 on the 5-item Dimensions of Anger Reactions Scale
• Able to read at least 6th grade level material

Exclusion criteria

• Expect to be unstable on their medication regimen during the study
• Currently in a period of active psychosis or mania
• Exhibit current prominent suicidal or homicidal ideation requiring immediate intervention
• Receiving (or plan to receive) other anger management psychotherapy or trauma-focused therapy for PTSD (i.e., prolonged exposure, cognitive processing therapy during the course of the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

Mobile Intervention for Reducing Anger (MIRA)

Experimental group

Description:

Participants in this arm will be provided with a device that has the MIRA application (app) and asked to use the app for a period of 4 weeks.

Treatment:

Behavioral: Mobile Intervention for Reducing Anger (MIRA)

Mindfulness Intervention

Active Comparator group

Description:

Participants in this arm will be provided with a device that has the Mindfulness application (app) and asked to use the app for a period of 4 weeks.

Treatment:

Behavioral: Mindfulness Intervention