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Posttraumatic Stress DisorderNCT06429293

Impact of Cognitive Behavioral Therapy on PTSD-CVD Link

A study testing Cognitive processing therapy in people with Posttraumatic Stress Disorder, run by Massachusetts General Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a pilot randomized controlled trial to assess the impact of a first-line treatment for posttraumatic stress disorder (PTSD) (Cognitive Processing Therapy; CPT) versus waitlist control on mechanisms of cardiovascular disease (CVD) risk. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Posttraumatic Stress Disorder
What is being tested?
Cognitive processing therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6 participants
Where
1 siteUnited States
Study dates
1 Jul 2023to 1 Jul 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • age 18-65 years (upper limit chosen to optimize changes in brain activation that diminish with age);
  • criterion A trauma exposure and PTSD symptoms (clinically significant symptoms in at least two symptom clusters);
  • subclinical atherosclerotic CVD (e.g., coronary, cerebrovascular, or peripheral arterial plaque or calcifications on imaging), clinical atherosclerotic CVD (e.g., myocardial infarction or revascularization), or increased risk for atherosclerotic CVD (i.e., >2 of hypertension, diabetes mellitus, hyperlipidemia, and active smoking) ability to understand and sign informed consent
  • fluent English speaker.

Who cannot join

  • history of stroke, brain surgery, seizure
  • use of certain CVD medications (e.g., beta-blockers, high-intensity statins [e.g., rosuvastatin 20/40 mg and atorvastatin 40/80 mg], PCSK-9 inhibitors);
  • psychiatric or cardiovascular medication change within 4 weeks (i.e., stable regimen is allowed);
  • currently in PTSD therapy;
  • neurological or systemic inflammatory disease/current anti-inflammatory therapy;
  • moderate/severe alcohol/substance use disorder;
Show all 9Show fewer
  • current mania/psychosis;
  • weight >300 lbs., claustrophobia, pregnancy, metal implants that are incompatible with magnetic resonance imaging (MRI), or uncontrolled hyperglycemia (for imaging);
  • significant radiation exposure (>2 nuclear tests, computed tomography images, or fluoroscopic procedures) for research purposes during the preceding 12-months.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

Other trials in United States

About this study

Official title: Impact of Cognitive Behavioral Therapy on Neural, Inflammatory, & Autonomic Markers in a Sample With PTSD and Cardiovascular Risk: Protocol for a Pilot Randomized Controlled Trial

This is a pilot randomized controlled trial to assess the impact of a first-line treatment for posttraumatic stress disorder (PTSD) (Cognitive Processing Therapy; CPT) versus waitlist control on mechanisms of cardiovascular disease (CVD) risk. Further, this study will test the hypothesis that CPT reduces CVD risk through its effects on inflammation and autonomic function and that these changes are driven by changes in stress-related neural activity (SNA)

Read the detailed description

This study is a randomized controlled trial of CPT compared to waitlist control that is testing the effects of CPT on mechanisms of the PTSD-CVD link. Enrollment began in 2023 and is projected to continue through 2026. Participants include individuals with PTSD and CVD risk recruited from the Boston area (N = 30). Treatment assignment is randomized and stratified by sex. Participants are randomized to CPT (n = 15) or waitlist control (n = 15). Potentially eligible participants complete a screening visit to confirm inclusion/exclusion criteria. Upon confirmation of eligibility, participants are scheduled for a baseline session, where they complete surveys, brain and peripheral imaging, and resting measures of autonomic function. Following the baseline visit, participants are randomized into CPT or the waitlist control group. Those randomized to CPT complete sessions via telehealth. Following a 12-week treatment period, participants attend the post-treatment visit, consisting of the same assessments administered at baseline. Participants randomized to waitlist are offered CPT upon completion of the post-treatment visit.

Being tested
Cognitive processing therapy
Keywords
Cardiovascular disease, Inflammation, Autonomic function, Stress-related neural activity
Medical subject headings
Stress Disorders, Post-Traumatic, Cardiovascular Diseases, Inflammation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cognitive processing therapyBehavioural

    The active intervention is Cognitive Processing Therapy (CPT) is a gold-standard cognitive behavioral therapy for PTSD. The CPT intervention consists of 12 60-minute sessions teaching skills to challenge trauma-relevant cognitions that are distorted or unhelpful. Trauma-relevant cognitions fall into five themes that are highlighted during treatment: safety, trust, power/control, esteem, and intimacy. The empirical base for CPT is strong with numerous studies demonstrating that it results in significant reduction of PTSD symptoms regardless of trauma type and that it is 89% more effective than control treatment. CPT has been successfully implemented in virtual formats with comparable efficacy levels to that of in-person CPT. CPT sessions for this study will be conducted virtually by a CPT-trained clinician

Study groups in NCT06429293
Study groupRoleWhat they receive
Cognitive processing therapyExperimental12 week treatment period of cognitive processing therapy followed by a post-treatment visit.
Receives: Behavioral: Cognitive processing therapy
Control waitlistNo interventionParticipants randomized to waitlist are offered CPT upon completion of the post-treatment visit.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Arterial inflammation

    Measured via FDG-PET imaging

    Measured: Baseline and 12-weeks

  2. Heart rate variability

    Calculated from the average resting HRV collected at baseline and post-treatment visits

    Measured: Baseline and 12-weeks

Secondary outcomes (9)
  1. Leukopoiesis

    Measured as bone marrow activity via FDG-PET imaging

    Measured: Baseline and 12-weeks

  2. Heart rate

    Heart rate in beats per minute

    Measured: Baseline and 12-weeks

  3. Blood pressure

    Systolic and diastolic pressure

    Measured: Baseline and 12-weeks

  4. MRI based arterial plaque components (such as necrotic tissue, loose connective tissue, and hemorrhage)

    MRI measurements of atherosclerotic plaque components including necrotic tissue, loose connective tissue, and hemorrhage using black-blood imaging techniques

    Measured: Baseline and 12-weeks

  5. MRI based arterial wall thickness

    Measurements of wall thickness as an assessment of atherosclerotic plaque

    Measured: Baseline and 12-weeks

  6. MRI based brain structure assessments of volume and density

    Structural assessment of brain centers to assess volume and density of neural centers involved in the stress response

    Measured: Baseline and 12-weeks

  7. MRI based brain connectivity (by measuring changes in blood flow across networks of neural centers at rest and with an emotional task)

    Connectivity assessment using mapping on functional MRI at baseline and in response to emotional faces of neural centers involved in the stress response to determine the interplay between neural centers before and after therapy by measuring alterations in blood oxygen content under various conditions in different parts of the brain

    Measured: Baseline and 12-weeks

  8. MRI based brain activation (via measuring blood flow in important neural centers at rest and with an emotional task using functional MRI)

    Activation assessment using functional MRI at both rest and in response to emotional faces of neural centers involved in the stress response before and after therapy by measuring blood flow under various conditions to different parts of the brain

    Measured: Baseline and 12-weeks

  9. Axonal integrity of resting neural connections between brain centers using MRI

    Measurement of axonal integrity using diffusion tensor imaging on MRI to determine the strength connections between important brain centers and neural networks related to stress perception in PTSD before and after therapy

    Measured: Baseline and 12-weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 May 2024
  2. Study start1 Jul 2023
  3. Primary completion1 Jul 2026
  4. Study completion1 Jul 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants are randomized to 12 weeks of cognitive processing therapy or waitlist control.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
6 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06429293
Sponsor's protocol ID
2023P001621
Status last verified
Oct 2026
First submitted
8 May 2024
Last updated
7 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Deidentified data from primary endpoints and analyses will be made available on a public website following study completion.

Publications

  • Edmondson D, Cohen BE. Posttraumatic stress disorder and cardiovascular disease. Prog Cardiovasc Dis. 2013 May-Jun;55(6):548-56. doi: 10.1016/j.pcad.2013.03.004. Epub 2013 Apr 6.

    PubMed 23621964
  • Edmondson D, von Kanel R. Post-traumatic stress disorder and cardiovascular disease. Lancet Psychiatry. 2017 Apr;4(4):320-329. doi: 10.1016/S2215-0366(16)30377-7. Epub 2017 Jan 19.

    PubMed 28109646
  • Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995 Dec;52(12):1048-60. doi: 10.1001/archpsyc.1995.03950240066012.

    PubMed 7492257
  • Goldstein RB, Smith SM, Chou SP, Saha TD, Jung J, Zhang H, Pickering RP, Ruan WJ, Huang B, Grant BF. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Soc Psychiatry Psychiatr Epidemiol. 2016 Aug;51(8):1137-48. doi: 10.1007/s00127-016-1208-5. Epub 2016 Apr 22.

    PubMed 27106853
  • Ehlers A, Suendermann O, Boellinghaus I, Vossbeck-Elsebusch A, Gamer M, Briddon E, Martin MW, Glucksman E. Heart rate responses to standardized trauma-related pictures in acute posttraumatic stress disorder. Int J Psychophysiol. 2010 Oct;78(1):27-34. doi: 10.1016/j.ijpsycho.2010.04.009. Epub 2010 May 5.

    PubMed 20450940
  • Jovanovic T, Norrholm SD, Sakoman AJ, Esterajher S, Kozaric-Kovacic D. Altered resting psychophysiology and startle response in Croatian combat veterans with PTSD. Int J Psychophysiol. 2009 Mar;71(3):264-8. doi: 10.1016/j.ijpsycho.2008.10.007. Epub 2008 Nov 5.

    PubMed 19013485
  • Buckley TC, Kaloupek DG. A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosom Med. 2001 Jul-Aug;63(4):585-94. doi: 10.1097/00006842-200107000-00011.

    PubMed 11485112
  • Pan X, Kaminga AC, Wen SW, Liu A. Catecholamines in Post-traumatic Stress Disorder: A Systematic Review and Meta-Analysis. Front Mol Neurosci. 2018 Dec 4;11:450. doi: 10.3389/fnmol.2018.00450. eCollection 2018.

    PubMed 30564100
  • Brudey C, Park J, Wiaderkiewicz J, Kobayashi I, Mellman TA, Marvar PJ. Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease. Am J Physiol Regul Integr Comp Physiol. 2015 Aug 15;309(4):R315-21. doi: 10.1152/ajpregu.00343.2014. Epub 2015 Jun 10.

    PubMed 26062635
  • Kim TD, Lee S, Yoon S. Inflammation in Post-Traumatic Stress Disorder (PTSD): A Review of Potential Correlates of PTSD with a Neurological Perspective. Antioxidants (Basel). 2020 Jan 26;9(2):107. doi: 10.3390/antiox9020107.

    PubMed 31991875
  • Schneider M, Schwerdtfeger A. Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis. Psychol Med. 2020 Sep;50(12):1937-1948. doi: 10.1017/S003329172000207X. Epub 2020 Aug 28.

    PubMed 32854795
  • Ge F, Yuan M, Li Y, Zhang W. Posttraumatic Stress Disorder and Alterations in Resting Heart Rate Variability: A Systematic Review and Meta-Analysis. Psychiatry Investig. 2020 Jan;17(1):9-20. doi: 10.30773/pi.2019.0112. Epub 2020 Jan 25.

    PubMed 31995968
  • Moon E, Lee SH, Kim DH, Hwang B. Comparative Study of Heart Rate Variability in Patients with Schizophrenia, Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder. Clin Psychopharmacol Neurosci. 2013 Dec;11(3):137-43. doi: 10.9758/cpn.2013.11.3.137. Epub 2013 Dec 24.

    PubMed 24465250
  • Seligowski AV, Steuber ER, Hinrichs R, Reda MH, Wiltshire CN, Wanna CP, Winters SJ, Phillips KA, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Guffanti G, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI Jr, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Murty VP, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Luna B, Harte SE, Elliott JM, Koenen KC, Kessler RC, McLean SA, Ressler KJ, Jovanovic T. A prospective examination of sex differences in posttraumatic autonomic functioning. Neurobiol Stress. 2021 Aug 21;15:100384. doi: 10.1016/j.ynstr.2021.100384. eCollection 2021 Nov.

    PubMed 34485632
  • Seligowski AV, Grewal SS, Abohashem S, Zureigat H, Qamar I, Aldosoky W, Gharios C, Hanlon E, Alani O, Bollepalli SC, Armoundas A, Fayad ZA, Shin LM, Osborne MT, Tawakol A. PTSD increases risk for major adverse cardiovascular events through neural and cardio-inflammatory pathways. Brain Behav Immun. 2024 Mar;117:149-154. doi: 10.1016/j.bbi.2024.01.006. Epub 2024 Jan 11.

    PubMed 38218349

Questions about this trial

What is this clinical trial studying?

A study testing Cognitive processing therapy in people with Posttraumatic Stress Disorder, run by Massachusetts General Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Arterial inflammation (time frame: Baseline and 12-weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06429293, which also lists 47 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Oct 2026.

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