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| Name | Class |
|---|---|
| University of Arizona | OTHER |
| Oregon State University | OTHER |
| Boston University | OTHER |
| The University of Texas Health Science Center at San Antonio |
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The goal of this two-arm pilot randomized controlled trial is to test a behavioral intervention that integrates three evidence-based cognitive behavioral interventions (written exposure therapy; WET, cognitive behavioral therapy for insomnia; CBT-I, and cognitive behavioral therapy for nightmares; CBT-N) among firefighters. The main questions it aims to answer are:
We will beta test the intervention in 1-2 groups of 3-5 firefighters. Then we will randomize 50 participants to immediate or delayed (2-4 week waitlist) treatment. Consented participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Immediate Intervention | Experimental | Will begin treatment within 2 weeks of randomization. |
|
| Delayed Intervention | Active Comparator | Will be scheduled to begin treatment within 4-6 weeks of randomization. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Written Exposure Therapy (WET) | Behavioral | WET is a trauma-focused intervention in which individuals write about their worst traumatic experience following scripted instruction from the therapist. |
| Measure | Description | Time Frame |
|---|---|---|
| Clinician Administered PTSD Scale (CAPS-5) | The CAPS-5 is a structured clinical interview that assesses the presence and severity of PTSD symptoms. | Change from baseline to post treatment (~4 weeks post baseline) |
| Structured Clinical Interview for DSM-5 Sleep Disorders- Revised (SCISD-R) | The SCISD-R is a semi-structured interview designed to obtain a sleep history and screen for certain sleep disorders and diagnose others, including insomnia, hypersomnia, circadian rhythm sleep-wake disorders, sleep-disordered breathing, and parasomnias. | Change from baseline to post treatment (~4 weeks post baseline) |
| Insomnia Severity Index (ISI) | The ISI assesses perceived severity of insomnia. | Change from baseline through 3 months post treatment |
| Nightmare Disorders Index | The NDI is a self-report assessment of nightmare disorder. | Change from baseline through 3 months post treatment |
| Posttraumatic Stress Disorder Checklist (PCL-5) | Self-report measure update of the PCL designed to assess PTSD symptoms as defined by the DSM-5. | Change from baseline through 3 months post treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Trauma-Related Nightmare Survey (TRNS) | The TRNS assesses nightmare frequency, disturbance, and characteristics. | Change from baseline through 3 months post treatment |
| Self-Assessment of Sleep (SASS) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| NDRI_USA | Kansas City | Missouri | 66224 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41556892 | Derived | McLean CP, Janke S, Pruiksma KE, Taylor DJ, Sloan DM, Dietch JR, Fredman SJ, Sutherland C, Hollerbach B, Thompson SM, Tse D, Nagy S, Malek N, Haddock CK. A pilot feasibility randomized clinical trial of a culturally adapted accelerated group treatment for posttraumatic stress, insomnia, and nightmares in firefighters. Psychol Trauma. 2026 Jan 19. doi: 10.1037/tra0002090. Online ahead of print. |
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| OTHER |
| National Development and Research Institutes, Inc. | OTHER |
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| Cognitive Behavioral Therapy for Insomnia (CBTi) | Behavioral | CBTi focuses on stimulus control, eliminating maladaptive coping habits, reducing arousal, and challenging maladaptive thoughts about sleep in an effort to reduce time to fall asleep and time awake during the night. |
|
| Cognitive Behavioral Therapy for Nightmares (CBTn) | Behavioral | CBTn involves writing about a distressing or frequent nightmare, rewriting the narrative of the nightmare to target trauma-related themes, and reading the rescripted nightmare narrative. |
|
| Waitlist | Behavioral | Waitlist for delayed intervention. |
|
The SASS is a brief assessment of self-reported sleep quantity and sleep quality.
| Change from baseline through 3 months post treatment |
| Sleep Diary and Nightmare Log | The Sleep Diary and Nightmare Log assess daily subjective sleep patterns and to inform treatment recommendations. | Change from baseline through post treatment (~4 weeks post baseline) |
| Patient Health Questionnaire-9 (PHQ-9) | The PHQ-9 the severity of affective and somatic symptoms related to depression; items correspond to the diagnostic criteria for major depression disorder. | Change from baseline through 3 months post treatment |
| Depressive Symptoms Index-Suicidality Subscale (DSI-SS) | The DSI-SS is a self-report measure of suicidal ideation, plans, perceived control over ideation, and impulses for suicide. | Change from baseline through 3 months post treatment |
| Net Prompter Score | The Net Prompter Score is a single item measures of treatment acceptability that asks respondents to rate the likelihood that they would recommend the efficient treatment to a friend or colleague on a scale from 0-10. | Post treatment (~4 weeks post baseline) |
| ID | Term |
|---|---|
| D013313 | Stress Disorders, Post-Traumatic |
| D007319 | Sleep Initiation and Maintenance Disorders |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| D014850 | Waiting Lists |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D001071 | Appointments and Schedules |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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