The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial registered on ANZCTR


Registration number
ACTRN12614000900617
Ethics application status
Approved
Date submitted
13/08/2014
Date registered
25/08/2014
Date last updated
1/08/2018
Type of registration
Prospectively registered

Titles & IDs
Public title
The Managing Anger Trial: Examining the efficacy of a treatment for anger for serving Australian Defence members
Scientific title
In Defence members with problematic anger in the context of Posttraumatic Stress Disorder (PTSD), is a novel anger treatment effective in reducing the symptoms of anger
Secondary ID [1] 285163 0
Nil
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
anger 292754 0
Posttraumatic Stress Disorder 292804 0
Condition category
Condition code
Mental Health 293045 293045 0 0
Other mental health disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
A novel anger focused intervention for Defence members who are also experiencing PTSD has been developed. This structured, Cognitive Behavioural Therapy (CBT) -based treatment is delivered by Defence psychologists in one-on-one sessions. One hour sessions are delivered once a week, for a period of 12 weeks.
Intervention code [1] 290015 0
Treatment: Other
Intervention code [2] 290065 0
Behaviour
Comparator / control treatment
There is no control group
Control group
Uncontrolled

Outcomes
Primary outcome [1] 292916 0
Anger as assessed by the STAXI-2, DAR-5 and NAS-PI
Timepoint [1] 292916 0
Pre-treatment, post-treatment and 3 month follow-up
Secondary outcome [1] 309929 0
PTSD as assessed by the CAPS and PCL
Timepoint [1] 309929 0
Pre-treatment, post-treatment, 3 month follow-up
Secondary outcome [2] 309934 0
Alcohol use as assessed by the MINI and AUDIT
Timepoint [2] 309934 0
Pre-treatment, post-treatment and 3 month followup
Secondary outcome [3] 309935 0
Depression as assessed by the MINI and the HADS
Timepoint [3] 309935 0
Pre-treatment, post-treatment and 3 month follow-up
Secondary outcome [4] 309936 0
Anxiety as assessed by the HADS
Timepoint [4] 309936 0
Pre-treatment, post-treatment, 3 month follow-up

Eligibility
Key inclusion criteria
Identified PTSD
Problematic anger
Available to engage in 12 sessions of treatment
Minimum age
18 Years
Maximum age
No limit
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Significant alcohol dependence/abuse
Psychosis
Threat to self and/or others
Has engaged recently in focussed anger treatment

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
This trial will be advertised to participants, and participants will volunteer to participate.
Allocation will not be concealed
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will not be used
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Single group
Other design features
Phase
Not Applicable
Type of endpoint(s)
Efficacy
Statistical methods / analysis
Based on preliminary data from the small number of existing studies in this area, 30 clients has been shown to be sufficient to demonstrate a moderate to large clinical effect. Sample power calculations based on treatment response from a previous trial (Moreland 2010) suggest a sample size of n=30 is required to detect a 10 point difference on mean anger scores (as measured by the STAXI-2) at follow-up, with power set at 96% and p set at 0.05. The reduction of 10 points on the STAXI in Moreland 2010 was associated with a large clinical effect size.

Frequency statistics will be used to describe the incidence of disorders within the sample. Correlation analyses will be used to examine the relationship between variables. T-tests, repeated measures multivariate analyses and hedges’ g effect size analyses will be used to examine treatment effects.

Recruitment
Recruitment status
Stopped early
Data analysis
Data analysis is complete
Reason for early stopping/withdrawal
Participant recruitment difficulties
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,QLD

Funding & Sponsors
Funding source category [1] 289776 0
Government body
Name [1] 289776 0
Department of Defence
Address [1] 289776 0
PO Box 800
Salisbury South
SA, 5106
Country [1] 289776 0
Australia
Primary sponsor type
Individual
Name
Professor David Forbes
Address
Australian Centre for Posttraumatic Mental Health
Level 3, 161 Barry St
Carlton
VIC, 3053
Country
Australia
Secondary sponsor category [1] 288465 0
None
Name [1] 288465 0
Address [1] 288465 0
Country [1] 288465 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 291506 0
Australian Defence Human Research Ethics Committee
Ethics committee address [1] 291506 0
CP3-6-036
PO Box 7911
CANBERRA BC ACT 2600
AUSTRALIA
Ethics committee country [1] 291506 0
Australia
Date submitted for ethics approval [1] 291506 0
Approval date [1] 291506 0
01/07/2014
Ethics approval number [1] 291506 0
758-14

Summary
Brief summary
The aim of this study is to evaluate the efficacy of a novel treatment for problematic anger in Defence members who are also experiencing PTSD.

It is hypothesised that the novel anger focused intervention for Defence members will result in the primary outcome of improved (reduced levels of) anger. Secondary outcomes which may be hypothesised include improved outcomes in associated mental symptomatology including depression, anxiety, alcohol use and symptoms of posttraumatic stress.
Trial website
Trial related presentations / publications
Managing anger in the context of PTSD. Presentation at the Australasian Military Medicine Association Conference, October 2015.
Cash, R., Varker, T., McHugh, T, Metcalf, O., Howard, A., Lloyd, D., Costello, J., Said, D., & Forbes, D. (2018) Effectiveness of an anger intervention for military members with PTSD: A clinical case series, Military Medicine. https://doi.org/10.1093/milmed/usx115
Public notes

Contacts
Principal investigator
Name 50678 0
Prof David Forbes
Address 50678 0
Australian Centre for Posttraumatic Mental Health
Level 3, 161 Barry St
Carlton
VIC, 3053
Country 50678 0
Australia
Phone 50678 0
+61 03 9035 5599
Fax 50678 0
Email 50678 0
dforbes@unimelb.edu.au
Contact person for public queries
Name 50679 0
Dr Tracey Varker
Address 50679 0
Australian Centre for Posttraumatic Mental Health
Level 3, 161 Barry St
Carlton
VIC, 3053
Country 50679 0
Australia
Phone 50679 0
61390367526
Fax 50679 0
Email 50679 0
tvarker@unimelb.edu.au
Contact person for scientific queries
Name 50680 0
Prof David Forbes
Address 50680 0
Australian Centre for Posttraumatic Mental Health
Level 3, 161 Barry St
Carlton
VIC, 3053
Country 50680 0
Australia
Phone 50680 0
+61 03 9035 5599
Fax 50680 0
Email 50680 0
dforbes@unimelb.edu.au

No information has been provided regarding IPD availability
Summary results
Have study results been published in a peer-reviewed journal?
Other publications
Have study results been made publicly available in another format?
Results – basic reporting
Results – plain English summary