Mobile Intervention for Veterans With PTSD and Anger

Not Applicable

Completed

Interventions: Behavioral: Mindfulness Intervention
Behavioral: Mobile Intervention for Reducing Anger (MIRA)

Brief Summary: Anger is the mostly commonly reported reintegration concern among combat Veterans, especially those with PTSD. Problematic anger is associated with significant functional impairment. In the current project, the investigators will pilot-test a newly developed mobile app, entitled Mobile Intervention for Reducing Anger (MIRA), among Veterans with PTSD and problematic anger. The project will compare the MIRA app to a contact control condition. The investigators hypothesize that Veterans with PTSD and problematic anger will find the MIRA app acceptable and will be willing to use it to reduce their anger difficulties and improve psychosocial and occupational functioning.

Detailed Description: Anger is the mostly commonly reported reintegration concern among combat Veterans, especially those with PTSD. Problematic anger is associated with significant functional impairment. One of the mechanisms associated with problematic anger and aggression is hostile interpretation bias, i.e., a tendency to interpret ambiguous interpersonal situations as hostile. The investigator has previously developed and piloted a computer-based interpretation bias modification intervention that successfully reduces both hostile interpretation bias and anger outcomes. In the current project, the investigators will pilot-test a mobile application version of the existing computer-based intervention, entitled Mobile Intervention for Reducing Anger (MIRA), among Veterans with PTSD and problematic anger. The project will compare the MIRA app to a contact control condition to evaluate the feasibility of recruitment, randomization, and retention procedures. The investigators will also utilize psychophysiological and electronic diary monitoring to determine whether this assessment could be used as an outcome or mechanistic variable in a subsequent randomized clinical trial application focused on evaluating the efficacy of the MIRA intervention.

Recruitment & Eligibility

Inclusion Criteria

Veterans diagnosed with PTSD, established via the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
Reporting a score of 12 on the 5-item Dimensions of Anger Reactions Scale
Able to read at least 6th grade level material

Exclusion Criteria

Expect to be unstable on their medication regimen during the study
Currently in a period of active psychosis or mania
Exhibit current prominent suicidal or homicidal ideation requiring immediate intervention
Receiving (or plan to receive) other anger management psychotherapy or trauma-focused therapy for PTSD (i.e., prolonged exposure, cognitive processing therapy during the course of the study

Arm && Interventions

Group	Intervention	Description
Mindfulness Intervention	Mindfulness Intervention	Participants in this arm will be provided with a device that has the Mindfulness application (app) and asked to use the app for a period of 4 weeks.
Mobile Intervention for Reducing Anger (MIRA)	Mobile Intervention for Reducing Anger (MIRA)	Participants in this arm will be provided with a device that has the MIRA application (app) and asked to use the app for a period of 4 weeks.

Primary Outcome Measures

Name	Time	Method
Feasibility as Measured by Percentage of Recruitment Goal Met	Through study completion (approximately 2 years)	Patient recruitment goal feasibility goal will be met if recruitment is 75% or greater of recruitment expectation. Recruitment expectation is 20 in each arm.
Average Number of Treatment Sessions Completed by MIRA App Users	Post-treatment assessment visit (approximately one month after enrollment)	Our App utilization goal will be met if MIRA app utilization rates are greater than 50% of expected use. Expected use is defined as 20 sessions completed, and the app utilization goal will be met if participants complete, on average, at least 10 sessions.
Number of Participants Who Report Satisfaction With the MIRA App	Post-treatment assessment visit (approximately one month after enrollment)	Patient satisfaction goal will be met if 80% or greater of participants indicate that they are either "very satisfied" or "mostly satisfied" with the MIRA app on item #7 of the Client Satisfaction Questionnaire.
Number of Participants Lost to Attrition During Treatment	Post-treatment assessment visit (approximately one month after enrollment)	Treatment retention feasibility goal will be met if attrition from MIRA treatment arm is no more than 25%.