Examining the effects of outdoor recreational experiences on military veterans with PTSD

ISRCTN ISRCTN59395217
DOI https://doi.org/10.1186/ISRCTN59395217
Secondary identifying numbers Essex_NC1408_2
Submission date
31/01/2020
Registration date
06/02/2020
Last edited
07/06/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Exposure to the natural environment is increasingly thought to benefit psychological health. Recent reports also suggest that outdoor activities that include recreational pursuits (such as surfing or fishing) coupled with the opportunity to socialize with others in similar circumstances may be helpful to military veterans experiencing Post-Traumatic Stress Disorder (PTSD). This study will evaluate this possibility.

Who can participate?
Military veterans with a diagnosis of post-traumatic stress disorder

What does the study involve?
Veterans with PTSD will be allocated to either an active outdoor recreational pursuit (angling) or a waitlist control group (this group will receive the intervention at a later date). We will measure changes to their symptoms (PTSD, depression, anxiety and other aspects of well-being) 2 weeks before the intervention, 2 weeks after the intervention for both groups; The waitlist participants will be also be reassessed two weeks after they subsequently completed the intervention and both groups will be followed up 4 months post-intervention.

What are the possible benefits and risks of participating?
The participants for this study are military veterans with PTSD and other anxiety-related issues. They, therefore, have mental health problems but this is a defining aspect of the study and cannot be undertaken with participants without these issues. It is not thought there are any risks in this study above and beyond those normally encountered in everyday life.

It is thought that exposure to an outdoor recreational experience will be beneficial in terms of decreased anxiety, depression and PTSD-symptoms and increased well-being.

Where is the study run from?
Department of Psychology, University of Essex (UK)

When is the study starting and how long is it expected to run for?
May 2015 to December 2015

Who is funding the study?
This study did not receive any funding

Who is the main contact?
Dr. Nicholas Cooper
ncooper@essex.ac.uk

Contact information

Dr Nicholas Cooper
Scientific

Department of Psychology
University of Essex
Wivenhoe Park
Colchester
CO4 3SQ
United Kingdom

ORCiD logoORCID ID 0000-0002-4315-3299
Phone +44 (0)1206 873781
Email ncooper@essex.ac.uk

Study information

Study designRandomized waitlist-controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Community
Study typeTreatment
Participant information sheet Not available in web format, please use contact details to request a participant information sheet.
Scientific titleExamining the effects of outdoor recreational experiences on the mental health and well-being of military veterans with post-traumatic stress disorder (PTSD): a randomized controlled trial
Study hypothesisIt is hypothesized that participants in the intervention group will experience a reduction in PTSD-related symptomology and an increase in subjective well-being relative to participants in a wait list control group, as a consequence of a short, outdoor, recreational activity.
Ethics approval(s)Approved 28/08/2014, the University of Essex Ethics Committee (Science & Health Ethics Sub-Committee, University of Essex, Wivenhoe Park, CO4 3SQ; reo-governance@essex.ac.uk; +44 (0)1206 87356), ref: NC1408
ConditionPost-traumatic stress disorder (PTSD)
InterventionThe intervention is designed to deliver an outdoor recreational activity (fishing) in a peer group context and to facilitate opportunities to socialize and to discuss military experience or PTSD experience if the participant so wishes. The intervention lasts 2 days (1 night) and will take place at a rural, lakeside location.

Participants will be randomly allocated to one of the two levels of the between-groups factor (to either active intervention or waitlist control). They will be sequentially numbered and allocated to condition by means of an online blocked randomization tool.

Each participant will complete questionnaires to assess their PTSD, depression, anxiety, and stress. The intervention group participants will be given these at 2 weeks before they receive the intervention, at 2 weeks following the intervention. The waitlist participants will be also be assessed at baseline and four weeks later. The waitlist group will also be reassessed two weeks after they subsequently completed the intervention. Both groups will be followed up 4 months post-intervention.
Intervention typeBehavioural
Primary outcome measure1. PTSD symptoms assessed by the PCL-5 at baseline, 2 weeks and 4 months
2. Depression assessed by the Patient Health Questionnaire (PHQ-9) at baseline, 2 weeks and 4 months
3. Anxiety assessed by the General Anxiety Disorder (GAD-7) at baseline, 2 weeks and 4 months
Secondary outcome measures1. Perceived stress assessed by the 10-item Perceived Stress Scale (PSS) at baseline, 2 weeks and 4 months
2. General social functioning assessed by the Work and Social Adjustment scale (WSAS) at baseline, 2 weeks and 4 months
3. Positive change in psychological growth assessed by the Psychological Wellbeing Post-Traumatic Changes Questionnaire (PWB-PTCQ) at baseline, 2 weeks and 4 months
Overall study start date14/05/2015
Overall study end date18/12/2015

Eligibility

Participant type(s)Other
Age groupAll
SexBoth
Target number of participants25
Total final enrolment18
Participant inclusion criteria1. Military veteran
2. Diagnosis of post-traumatic stress disorder (PTSD)
Participant exclusion criteriaCurrently receiving psychological therapy for PTSD
Recruitment start date13/07/2015
Recruitment end date27/07/2015

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Department of Psychology, University of Essex
Wivenhoe Park
Colchester
CO4 3SQ
United Kingdom

Sponsor information

University of Essex
University/education

Wivenhoe Park
Colchester
CO4 3SQ
England
United Kingdom

Phone +44 (0) 1206 873591
Email lglover@essex.ac.uk
Website http://www.essex.ac.uk/
ROR logo "ROR" https://ror.org/02nkf1q06

Funders

Funder type

Not defined

investigator initiated and funded

No information available

Results and Publications

Intention to publish date01/03/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryStored in repository
Publication and dissemination planThe results of the intervention will be published in a peer-reviewed international journal. They will also be presented at relevant national and international conferences and will be disseminated widely through social and conventional media platforms.
IPD sharing planThe datasets generated during and/or analyzed during the current study will be stored in a publically available repository. Our data are stored in an online repository OSF Home.
https://osf.io/63hrb/?view_only=2c8ffabdc8a64e77ba649c47f6df6c75 .
Data are de-identified participant data (IPD) and age and gender removed from the data sets because the small sample size risks identification. The data can be downloaded by anyone with the link. The link will also be provided in the published paper.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 25/11/2020 26/01/2021 Yes No
Protocol (other) 28/03/2023 No No

Editorial Notes

07/06/2023: Internal review.
28/03/2023: A link to the protocol file was added.
26/01/2021: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
05/02/2020: Trial’s existence confirmed by the University of Essex Ethics Committee.