Evaluation of Stress Disorders

This study has been completed.
Sponsor:
Information provided by:
National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier:
NCT00050804
First received: December 19, 2002
Last updated: March 3, 2008
Last verified: February 2004
  Purpose

The purpose of this study is to examine the short-term consequences of trauma and to determine the effectiveness of the drug sertraline in preventing and treating post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) symptoms.

ASD and PTSD are common consequences of exposure to traumatic events. Despite growing evidence of neurobiological dysfunction in ASD and PTSD, the origin of these disorders is still unknown. This study will attempt to identify psychophysiological markers of ASD and find an effective treatment for its symptoms.

Victims of serious motor vehicle collisions will be evaluated with clinical assessments and standardized questionnaires within 2 weeks after the accident. Symptoms of exaggerated startle, emotional reactivity to trauma-related and trauma-unrelated cues, and cerebellum functioning will be evaluated. Participants will be randomized to receive either sertraline or placebo (an inactive sugar pill) for 8 weeks. Psychometric testing and psychological evaluations will be conducted 4, 10, and 14 weeks after the accident and after a 2-week taper of the study medication.


Condition Intervention Phase
Acute Traumatic Stress Disorders
Post-Traumatic Stress Disorders
Drug: sertraline
Phase 4

Study Type: Interventional
Study Design: Primary Purpose: Treatment
Official Title: Efficacy of an SSRI in Acute Stress Disorder and PTSD

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Estimated Enrollment: 80
Study Start Date: December 2002
Estimated Study Completion Date: February 2004
Detailed Description:

Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are common consequences of exposure to traumatic events. Despite growing evidence of neurobiological dysfunction in ASD and PTSD, the pathogenesis of these disorders is still unknown. Drs. Osuch and Ursano (Uniformed Services University of the Health Sciences) have received support to conduct a 14-week study that will investigate the efficacy of the serotonergic medication sertraline (Zoloft) in the treatment and prevention of posttraumatic psychiatric sequelae in ASD victims. The present project is an amendment to Drs. Osuch and Ursano's study. It will attempt to identify early psychological and neurobiological abnormalities in ASD. More specifically, the present project will examine to what extent sensitization and conditioning processes, as well as emotional dysregulation, contribute to ASD. We also propose to investigate the potential association between cerebellum dysfunction and peritraumatic dissociations. To accomplish this goal, a series of three experiments will be implemented to investigate: 1) the symptom of exaggerated startle; 2) emotional reactivity to trauma-related and trauma-unrelated cues; and 3) cerebellum functioning using eyeblink conditioning. This study will inform on the short-term consequences of trauma, will help identify potential psychophysiological markers of ASD that emerge following trauma, and will examine the effects of an SSRI on preventing trauma-related neurobiological deficits.

We specifically propose to:

  1. Characterize psychophysiological responses in ASD victims shortly after trauma;
  2. Assess the effect of sertraline treatment on these psychophysiological responses.

To accomplish aim 1, non-treated ASD victims will be compared to two control groups, a non-ASD trauma group and a non-trauma healthy group. The two control groups will be used to disentangle the effect of trauma from the effect of acute stress disorder. To accomplish aim 2, the ASD sertraline group will be compared to the ASD placebo group following treatment.

Forty victims of serious motor vehicle collision (MVC) with ASD will be recruited from a community hospital emergency room and evaluated with clinical assessments, and standardized questionnaires within 2 weeks after the MVC. The subjects will then be randomized to either sertraline or placebo for 8 weeks duration. Psychometric testing and psychological evaluations will be conducted at 4, 10 weeks post-MVC, and after a 2-week taper of the medication and 2 more weeks (14 weeks post-MVC).

We hypothesize that ASD patients will show:

An enhancement or sensitization of baseline startle;

An increase in autonomic arousal and in startle amplitude to trauma-related cues;

A delayed eyeblink conditioning;

Normalization of these deficits after sertraline treatment.

This preliminary study is expected to lay the groundwork for a larger study of the early impact of traumatic events on psychophysiological and psychological processes. In the long-term, we expect to 1) better characterize the onset of symptoms and their evolution over time following trauma, 2) identify psychophysiological markers for PTSD, 3) identify ASD victims at-risk for PTSD, and 4) improve our ability to prevent the development of chronic psychopathology following trauma.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

INCLUSION CRITERIA:

Subjects will be above seventh grade education level aged 18-65 years old and free of current or past psychopathology and organic central nervous system disorders that may interfere with the tests.

EXCLUSION CRITERIA:

Ongoing medical illness that may interfere with the tests; psychiatric or neurological disorder (including seizure); Past or current substance abuse; Current psychotropic medication; current medication that may interfere with the tests; Impaired hearing; major uncorrected visual impairment, or migraine headache.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00050804

Locations
United States, Maryland
National Institute of Mental Health (NIMH)
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
  More Information

Publications:
ClinicalTrials.gov Identifier: NCT00050804     History of Changes
Other Study ID Numbers: 030036, 03-M-0036
Study First Received: December 19, 2002
Last Updated: March 3, 2008
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Acute Stress Disorder
PTSD
Treatment
SSRI
Startle
Psychophysiology
Trauma
Anxiety
Emotion

Additional relevant MeSH terms:
Stress Disorders, Post-Traumatic
Stress Disorders, Traumatic
Stress Disorders, Traumatic, Acute
Anxiety Disorders
Mental Disorders
Sertraline
Antidepressive Agents
Psychotropic Drugs
Central Nervous System Agents
Therapeutic Uses
Pharmacologic Actions
Serotonin Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Serotonin Agents
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on July 22, 2014