The primary objectives of the current study are 1) to investigate the effect of the MEST and SLEE-P on targeting overgeneral autobiographical memory, sleep disturbance, and posttraumatic stress symptoms in refugees with PTSD, and 2) to explore…
ID
Source
Brief title
Condition
- Anxiety disorders and symptoms
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Primary outcome measures are autobiographical memory specificity, sleep
quality, and posttraumatic stress symptoms as measures by the weekly
measurements.
Secondary outcome
Secondary outcome measures are weekly measures of sleep quality, nightmares and
dreams, memory problems, autobiographical memory specificity, and the interview
about sleep and memory problems.
Background summary
The effectiveness of Narrative Exposure Therapy (NET) in treating posttraumatic
stress disorder (PTSD) in refugees may be limited by a reduced ability to
recall specific episodic details from autobiographical memory. Sleep disruption
has been associated with reduced specificity of autobiographical recollections
and when targeted may accelerate recovery from PTSD. It is hypothesized that
receiving the Memory Specificity Training (MEST) or a cognitive behavioural
sleep training (SLEE-P) as preparatory interventions may alleviate PTSD and
anxiety symptoms and improve autobiographical memory specificity (in the
context of MEST) or sleep quality (in the context of SLEE-P). In addition,
following the MEST or SLEE-P is expected to potentially contribute to the
treatment effectiveness of subsequent NET.
Study objective
The primary objectives of the current study are 1) to investigate the effect of
the MEST and SLEE-P on targeting overgeneral autobiographical memory, sleep
disturbance, and posttraumatic stress symptoms in refugees with PTSD, and 2) to
explore whether these effects may contribute to treatment outcomes of
subsequent NET.
The secondary objectives are 1) to describe changes in autobiographical memory
specificity, sleep quality, and PTSD symptoms over the course of treatment, 2)
to describe changes in dream character and posttraumatic nightmares during the
course of treatment, and 3) to qualitatively describe autobiographical memory,
sleep quality, and (posttraumatic) dream characters in refugees with PTSD.
Study design
The current study is a multiple baseline study with double randomization to a)
baseline period (3, 4 or 5 weeks) and b) one of three conditions (MEST + NET;
SLEE-P + NET; waiting list + NET). Participants will complete the
Autobiographical Memory Test (AMT), the Pittsburgh Sleep Quality Index (PSQI)
including its addendum for PTSD, and the PTSD checklist for DSM-5 (PCL-5) at
baseline, pre-MEST/SLEE-P, post-MEST/SLEE-P (pre-NET for the waiting list
group) and post-NET. Weekly measures of PTSD symptoms, sleep quality,
posttraumatic nightmares and dreams, autobiographical memory specificity and
memory problems will be administered during the baseline, treatment, and
follow-up phases. The baseline measurement additionally consists of a checklist
about traumatic experiences (LEC-5) and an interview on memory and sleep.
Intervention
Participants in the MEST condition will receive six one-hour therapist-guided
MEST sessions that focus on practicing retrieving specific autobiographical
memories as a response to cue words. Participants in the SLEE-P condition will
receive six one-hour therapist-guided training sessions that focus on
psychoeducation about sleep (problems), challenging distorted sleep-related
cognitions, and relaxation exercises. Participants in the waiting list control
condition will not receive an intervention before NET.
Study burden and risks
The burden on the participants consists of the additional measurements that
have been added for research purposes. Some measurements are part of regular
care. For participants in the study, questionnaires that are administered as
part of the Routine Outcome Monitoring (ROM) in regular care will be minimized
to limit the number of measurements. The measurements that are added in the
context of the study are comparable in terms of burden to the measurements as
part of regular trauma care.
Participants within the MEST and SLEE-P group receive a preparatory
intervention (MEST or SLEE-P) consisting of 6 weekly individual sessions of 1
hour. These interventions are preparatory and non-intensive in nature and are
expected to have positive effects on PTSD and related complaints.
For all participants, regular care (trauma therapy) will not change as a result
of participation in this study.
There are no additional risks associated with participation in this study
beyond the risks associated with regular trauma care for which participants are
already registered.
Nienoord 10
Diemen 1112 XE
NL
Nienoord 10
Diemen 1112 XE
NL
Listed location countries
Age
Inclusion criteria
The main inclusion criteria are: a) 18 years or older, b) having a refugee
background, c) meeting DSM-5 diagnostic criteria for PTSD as established by a
psychiatrist or clinical psychologist at intake, d) currently on the waiting
list for Narrative Exposure Therapy (NET) in the outpatient clinic of ARQ
Centrum*45, and e) willingness to participate in the research (being able to
understand/willing to sign informed consent).
Exclusion criteria
Main exclusion criteria include: a) IQ estimated below 80, b) acute crisis
(acute suicidality, acute severe psychosis), c) persistent substance
dependence, d) change of sleep medication in the month prior to the start of
the study, and e) having previously received the MEST or a cognitive behavioral
sleep intervention.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL82876.041.22 |