Acceptance and Mindfulness Based Exposure Therapy for Survivors of Cardiac Arrest (AMBET)
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ClinicalTrials.gov Identifier: NCT04596891 |
Recruitment Status :
Completed
First Posted : October 22, 2020
Last Update Posted : May 26, 2022
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The primary goal of this uncontrolled pilot trial is to examine feasibility, acceptability, safety, and preliminary efficacy of a new behavioral treatment for survivors of sudden cardiac arrest with clinically elevated symptoms of post-traumatic stress disorder (PTSD). Participants will be recruited among cardiac arrest survivors enrolled in the observational CANOE research study (CUIMC IRB# AAAR8497). Study participants will be interviewed about their symptoms and evaluated for baseline assessment before receiving eight weekly sessions of an acceptance and mindfulness-based exposure therapy (AMBET). Participants will be additionally evaluated at treatment mid-point (week 4), and at the end of treatment.
The treatment and all assessments will be conducted remotely via Zoom. To assess whether patients' physical activity is improved over the course of treatment, participants will be provided with a wearable device (Fitbit wristband) to monitor their physical activity.
The specific aims of this study are to: (1) develop an acceptable protocol for an AMBET intervention for survivors of sudden cardiac arrest with elevated PTSD symptoms (2) examine its safety and feasibility in a small sample of 14 patients (3) investigate acceptability and feasibility of the assessments and measurements including physical activity.
Condition or disease | Intervention/treatment | Phase |
---|---|---|
PTSD Cardiac Arrest | Behavioral: Psychotherapy | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 11 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Feasibility Pilot of Acceptance and Mindfulness Based Exposure Therapy for Survivors of Cardiac Arrest |
Actual Study Start Date : | March 2, 2021 |
Actual Primary Completion Date : | April 21, 2022 |
Actual Study Completion Date : | April 21, 2022 |
Arm | Intervention/treatment |
---|---|
Experimental: Intervention
Remotely delivered psychotherapy combining exposure therapy with mindfulness
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Behavioral: Psychotherapy
Eight sessions of exposure therapy combined with mindfulness delivered via videoconferencing platform. |
- Change in PTSD Symptoms over time [ Time Frame: Baseline, At 4 weeks, Post-treatment: approximately 3 months from intake ]Reduction in symptoms as measured by the Clinician Administered PTSD Scale (Caps-5: ranging from 0-80 ). from pre- to post-treatment. Lower scored mean better outcome
- Change in Medication Adherence over time [ Time Frame: End of treatment: approximately 3 months from intake ]Participants' cardiac medication adherence is measured by self-report using the Morisky Medication Adherence Scale (MMAS).Scores can range from 0-8. If a patient scores higher on the scale, they are evaluated as more adherent.
- Change in Physical Activity over time [ Time Frame: End of treatment: approximately 3 months from intake ]Participants level of physical activity is measured objectively by a wrist worn Fitbit device.
- Participant satisfaction with treatment [ Time Frame: End of treatment: approximately 3 months from intake ]Treatment satisfaction will be measured by the Client Satisfaction Questionnaire (CSQ-3)
- Proportion of participants who complete the study protocol [ Time Frame: End of treatment: approximately 3 months from intake ]Preliminary tolerability of the protocol will assessed by the number of enrolled participants who comply with all study procedures
- Change in depressive symptoms over time [ Time Frame: At Baseline, At 4 weeks, Post-treatment: approximately 3 months from intake ]Change in symptoms as measured by the Hamilton Depression Rating Scale (HDRS-17; range 0-52) from pre- to post-treatment.
- Change in interoceptive attention style over time [ Time Frame: Baseline, Post-treatment: approximately 3 months from intake ]Changes in hypervigilance driven interoceptive attention and acceptance/mindfulness-based attention will be measured by the Multidimensional Assessment of Interoceptive Awareness (MAIA).
- Change in cardiac anxiety [ Time Frame: Baseline, Post-treatment: approximately 3 months from intake ]Change in cardiac anxiety from pre- to post-treatment assessment will be assessed using the Cardiac Anxiety Questionnaire (CAQ: score range: 0-72). Lowe scores mean better outcome
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Ages Eligible for Study: | 18 Years to 85 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Males or females between the age of 18-85
- A PCL-5 score of ≥ 33 at most recent assessment (≥ 30 days post cardiac arrest)
- Hospitalization for cardiac arrest with cardiac etiology at any time in the past.
Exclusion Criteria:
- Heart failure with severe systolic dysfunction (ejection fraction ≤ 25%)
- Terminal non-cardiovascular illness with life expectancy <1 year
- History of psychiatric diagnosis of psychotic episode, psychotic disorder, schizophrenia, schizoaffective disorder
- Current severe depression determined by a) a score of >25 on the Hamilton Rating Scale for Depression (HAM-D-17-item), and b) clinical assessment.
- Significant cognitive impairment defined by Cerebral Performance Category Score ≥3, and/or MMSE score of <24 neurological impairment precluding ability to complete study questionnaires.
- Active suicidal ideation or behavior.
- Current primary diagnosis of bipolar disorder.
- Current unstable or untreated medical illness.
- Current drug or alcohol misuse: severe alcohol/cannabis or any other substance use disorder (except nicotine).
- Recent psychotropic medication change or initiation within the last 3 months.
- Initiation of other psychotherapy within the last 3 months.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04596891
United States, New York | |
New York State Psychiatric Institute | |
New York, New York, United States, 10032 |
Responsible Party: | Yuval Y Neria, Professor of Medical Psychology, Research Foundation for Mental Hygiene, Inc. |
ClinicalTrials.gov Identifier: | NCT04596891 |
Other Study ID Numbers: |
8017 |
First Posted: | October 22, 2020 Key Record Dates |
Last Update Posted: | May 26, 2022 |
Last Verified: | May 2022 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Heart Arrest Heart Diseases Cardiovascular Diseases |