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Trial registered on ANZCTR

Registration number
Ethics application status
Date submitted
Date registered
Date last updated
Type of registration
Retrospectively registered

Titles & IDs
Public title
Evaluation of a cognitive-behavioral writing therapy (Integrative testimonial therapy –ITT) of traumatised war children of the II. World War: A randomized trial
Scientific title
The efficacy of Integrative Testimonial Therapy for traumatised war children of the II. World War suffering from PTSD
Secondary ID [1] 290337 0
nil known
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Anxiety 3153 0
Depression 3158 0
Quality of life 3159 0
Post Traumatic Stress Disorder (PTSD) 3164 0
posttraumatic growth 300608 0
self-efficacy 300609 0
Condition category
Condition code
Mental Health 3319 3319 0 0
Other mental health disorders

Study type
Description of intervention(s) / exposure
The treatment manual consists of 11 writing sessions of 45 minutes within 6 weeks. During a first diagnostic phase, an overview about the psychological and physical health status of the patient is provided.
The treatment manual includes 3 components. The first component includes the reconstruction of the biography of the patient (7 writing sessions). In each session the patient is urged to describe a defined period of his/her life, therefore a consistent biography is generated at the end of the therapy.
2 writing sessions concerning the traumatic event of the patient during the II. WW or right after it are combined with the biographic component. In these 2 writing sessions the patient is requested to write about the trauma in detail.
This narrative exposition allows the patient to integrate the fragmented memories into a more consistent biography.
During the last component of the treatment (cognitive reappraisal, 2 writing sessions) the patient should write down his/her point of view on the traumatic experience and his/her life from the current perspective.
The communication between patient and therapist takes place via internet or letter.
Intervention code [1] 2893 0
Treatment: Other
Comparator / control treatment
Individuals assigned to the waiting-list receive the same treatment after being reassessed after a period of 6 weeks.
Control group

Primary outcome [1] 4208 0
Posttraumatic stress scale (PDS)
Timepoint [1] 4208 0
At pre-treatment, post-treatment, 3-months-follow-up, 6 months-follow-up, 12 months-follow-up
Secondary outcome [1] 7101 0
Depression - Brief Symptom Inventory (BSI)
Timepoint [1] 7101 0
At pre-treatment, post-treatment, 3-months-follow-up, 6 months-follow-up, 12 months-follow-up
Secondary outcome [2] 7120 0
Quality of Life - EUROHIS-Quality of Life 8-item index (EUROHIS-QOL)
Timepoint [2] 7120 0
At pre-treatment, post-treatment, 3-months-follow-up, 6 months-follow-up, 12 months-follow-up
Secondary outcome [3] 7122 0
Anxiety - Brief Symptom Inventory (BSI)
Timepoint [3] 7122 0
At pre-treatment, post-treatment, 3-months-follow-up, 6 months-follow-up, 12 months-follow-up
Secondary outcome [4] 328412 0
Post traumatic growth Inventory(PTGI)
Timepoint [4] 328412 0
pre, post, 3,6, 12-month follow up
Secondary outcome [5] 328413 0
Timepoint [5] 328413 0
pre, post, 3,6, 12 month follow up
Secondary outcome [6] 328414 0
Locus of control
Timepoint [6] 328414 0
pre, post, 3,6, 12 months follow up

Key inclusion criteria
Traumatic experience during the II. WW, born during 1920 and 1946, civil victim of war, speaking German
Minimum age
65 Years
Maximum age
No limit
Both males and females
Can healthy volunteers participate?
Key exclusion criteria
Significant cognitive impairement, suicidal intentions, substance abuse, physical disorders which complicate a participation, psychotic experiences, currently receiving psychotherapy elsewhere

Study design
Purpose of the study
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
central randomized by computer
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
simple randomization by computer
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?

Intervention assignment
Other design features
Not Applicable
Type of endpoint(s)
Statistical methods / analysis

Recruitment status
Date of first participant enrolment
Date of last participant enrolment
Date of last data collection
Sample size
Accrual to date
Recruitment outside Australia
Country [1] 967 0
State/province [1] 967 0

Funding & Sponsors
Funding source category [1] 3391 0
Name [1] 3391 0
catania gGmbH
Address [1] 3391 0
Turmstrasse 21
10559 Berlin
Country [1] 3391 0
Primary sponsor type
Christine Knaevelsrud
Treatment Center for Torture Victims
GSZ Moabit
Turmstraße 21
10559 Berlin
Secondary sponsor category [1] 3036 0
Name [1] 3036 0
Philipp Kuwert
Address [1] 3036 0
Clinic for Psychiatry and Psychotherapy University of Greifswald
Rostocker Chaussee 70
18437 Stralsund
Country [1] 3036 0

Ethics approval
Ethics application status
Ethics committee name [1] 5423 0
Ernst-Moritz-Arndt-University Greifswald
Ethics committee address [1] 5423 0
Ethics committee country [1] 5423 0
Date submitted for ethics approval [1] 5423 0
Approval date [1] 5423 0
Ethics approval number [1] 5423 0

Brief summary
Recent studies of the consequences of former childhood war trauma in older adults reveal associations between trauma and posttraumatic symptoms (Posttraumatic stress disorder, PTSD) as well as physical health.
Only a few case studies have been reported on the efficacy of interventions adressing PTSD in older adults experiencing trauma in their childhood. The present study aims to examine the efficacy of a newly developed therapeutic cognitive-behavioral writing therapy (ITT) for traumatised war children of the II. WW.

Traumatised former war children (65 years+) with (subtreshold) PTSD are allocated at random to 11 writing sessions of a manualized writing approach over 6 weeks or a waiting list control group. We expect ITT to be useful for childhood traumatised older adults with current PTSD symptoms. We hypothesize that the intervention will significantly improve clinical symptoms of PTSD. Furthermore, we expect improvements in secondary outcomes such as anxiety, depression and quality of life.

If ITT proves to be an effective treatment for PTSD in former war children, our results will lend to support to the establishment of ITT in this group of patients. This study could make a contribution towards savings in health expenditure as it may provide the basis for a selective and directed use of psychotherapeutic interventions in a population that make enormous use of the health service.
Trial website
Trial related presentations / publications
Böttche, M., Pietrzak, R. H., Kuwert, P. & Knaevelsrud, C. (2015). Typologies of posttraumatic stress disorder in treatment-seeking older adults. International Psychogeriatrics.

Böttche, M., Kuwert, P., Pietrzak, R. H., & Knaevelsrud, C. (2015). Predictors of outcome of an Internet-based cognitive-behavioral therapy for posttraumatic stress disorder in older adults. Psychology and Psychtherapy: Theory, Research and Practice, DOI: 10.1111/papt.12069.

Knaevelsrud, C., Böttche, M., Pietrzak, R. H., Freyberger, H. J., Renneberg, B. & Kuwert, P. (2014) Integrative Testimonial Therapy (ITT) - a therapist-assisted internet-based writing therapy for traumatized child survivors of the 2nd World War with posttraumatic stress. Journal of Nervous and Mental Disease, 202(9), 651-658

Böttche, M., Berth, H., Knaevelsrud, C. & Kuwert, P. (2014). Affektverläufe in einer internetbasierten Schreibtherapie für ältere Kriegstraumatisierte. Zeitschrift für Gerontologie und Geriatrie, 47, 214-220.
Public notes

Principal investigator
Name 28590 0
Prof Christine Knaevelsrud
Address 28590 0
Habelschwerdter Allee 45
14195 Berlin
Country 28590 0
Phone 28590 0
0049 (0)30 838 55736
Fax 28590 0
Email 28590 0
Contact person for public queries
Name 11747 0
Dr Maria Böttche
Address 11747 0
Treatment Center for Torture Victims
GSZ Moabit
Turmstrasse 21
10559 Berlin
Country 11747 0
Phone 11747 0
+49 (0)30 303 906 23
Fax 11747 0
+49 (0)30 303 906 71
Email 11747 0
Contact person for scientific queries
Name 2675 0
Prof Dr. Christine Knaevelsrud
Address 2675 0
Freie Universität Berlin,
Habelschwerdter Allee, 45
14195 Berlin
Country 2675 0
Phone 2675 0
0049 (0)30 838 55736
Fax 2675 0
+49 (030) 838-458472
Email 2675 0

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