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NCT02524171: MRT

Justice-Involved Veterans and Moral Reconation Therapy

Completed NA Results posted Last updated 27 July 2023
What this trial tests

NA trial testing Moral Reconation Therapy (MRT) in Antisocial Personality Disorder in 344 participants. Completed in 30 March 2021.

Timeline
4 April 2016
Primary endpoint
30 September 2020
30 March 2021

Quick facts

Lead sponsorVA Office of Research and Development
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment344
Start date4 April 2016
Primary completion30 September 2020
Estimated completion30 March 2021
Sites3 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

VA Office of Research and Development — full company profile →

Who can join

Eligibility, any sex, with Antisocial Personality Disorder or Substance Use Disorder. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Risk for Criminal Recidivism (Criminal Thinking) Primary · 6 months (post-baseline)

The Psychological Inventory of Criminal Thinking Styles (56 items) was administered to assess criminal thinking. The measure includes scales of Mollification, Cutoff, Entitlement, Power Orientation, Super-optimism, Cognitive Indolence, and Discontinuity . Scores on these scales were summed to create a General Criminal Thinking score, which has been validated as an overall index of recidivism risk. Higher scores equate to more criminal thinking. Scores were converted to a T-score metric (M=50, SD=10), calculated in reference to norms from samples of incarcerated offenders.

GroupValue95% CI
Moral Reconation Therapy (MRT)53.6649.2 – 58.1
Usual Care (UC)53.3048.7 – 58.0
Alcohol Use Secondary · 6 months (post-baseline)

The quantity and frequency of patients' self-reported alcohol use in the past 6 months, measured with the Timeline Follow-Back interview that was administered at the 6-month follow-up interview.

GroupValue95% CI
Moral Reconation Therapy (MRT)9490 – 100
Usual Care (UC)9590 – 100
Drug Use Secondary · 6 months (post-baseline)

The quantity and frequency of patients' self-reported drug use in the past 6 months, measured with the Timeline Follow-Back interview. It was administered at each time point to calculate for the past 6 months total number of days using any drugs (marijuana, cocaine, amphetamines, heroin, other opiates, benzodiazepines, barbiturates, inhalants, or hallucinogens).

GroupValue95% CI
Moral Reconation Therapy (MRT)23.075.0 – 41.1
Usual Care (UC)15.01-3.7 – 33.7
Criminal Associates Secondary · 6 months (post-baseline)

Scale A of the Measures of Criminal Attitudes and Associates (MCAA; Mills, Kroner, \& Forth, 2002) was administered at each interview to quantify participants' associations with criminal peers, a strong predictor of criminal recidivism (Mills, Kroner, \& Hemmati, 2004). Participants were asked to consider the four adults (excluding family, co-workers, or other residents in treatment) with whom they spend the most free-time. A count variable was created by summing the number of friends for which the participant answered yes to any of the questions of criminal involvement (possible range=0-4, wh

GroupValue95% CI
Moral Reconation Therapy (MRT)0.430.2 – 0.8
Usual Care (UC)0.280.1 – 0.6
Employment Problem Severity Secondary · 6 months (post-baseline)

The Employment module of the ASI was administered at each timepoint to assess problem severity in this domain, using composite score indices (range 0 to 1); higher scores indicate greater problem severity.

GroupValue95% CI
Moral Reconation Therapy (MRT)0.580.5 – 0.7
Usual Care (UC)0.610.5 – 0.7
Alcohol Use Problem Severity. Secondary · 6 months (post-baseline)

The Alcohol module of the ASI was administered at each time point to assess problem severity in this domain, using composite score indices (ranging from 0 to 1); higher scores indicate greater problem severity. ASI composite scores such as this have long been used to provide internally-consistent evaluations of a patient in a particular problem area (Grahn \& Padyab, 2020).

GroupValue95% CI
Moral Reconation Therapy (MRT)0.090.0 – 0.2
Usual Care (UC)0.060.0 – 0.1
Legal Problem Severity Secondary · 6 months (post-baseline)

The Legal Status module of the Addiction Severity Index (ASI; McLellan et al., 2006) was administered at each interview to assess legal problem severity. The latter is based on a composite index derived from five items: Are you presently awaiting charges, trial, or sentence? How many days in the past 30 have you engaged in illegal activities for profit? How serious do you feel your present legal problems are? (0=Not at all, 4=Extremely) How important to you now is counseling or referral for these legal problems? (0=Not at all, 4=Extremely) How much money did you receive from illegal sources in

GroupValue95% CI
Moral Reconation Therapy (MRT)0.140.10 – 0.20
Usual Care (UC)0.130.10 – 0.20
Family/Social Problems Secondary · 6 months (post-baseline)

The Family/Social module of the ASI was administered at each timepoint to assess problem severity in this domain, using composite score indices (range 0 to 1); higher scores indicate greater problem severity.

GroupValue95% CI
Moral Reconation Therapy (MRT)0.10.1 – 0.2
Usual Care (UC)0.10.0 – 0.2
Risk for Criminal Recidivism (Criminal Thinking) Primary · 12 months (post-baseline)

The Psychological Inventory of Criminal Thinking Styles (56 items) was administered to assess criminal thinking. The measure includes scales of Mollification, Cutoff, Entitlement, Power Orientation, Super-optimism, Cognitive Indolence, and Discontinuity . Scores on these scales were summed to create a General Criminal Thinking score, which has been validated as an overall index of recidivism risk. Higher scores equate to more criminal thinking. Scores were converted to a T-score metric (M=50, SD=10), calculated in reference to norms from samples of incarcerated offenders.

GroupValue95% CI
Moral Reconation Therapy (MRT)50.9646.5 – 55.4
Usual Care (UC)49.8045.2 – 54.4
Alcohol Use Secondary · 12 months (post-baseline)

The quantity and frequency of patients' self-reported alcohol use in the past 6 months, measured with the Timeline Follow-Back interview that was administered at the 12-month follow-up interview.

GroupValue95% CI
Moral Reconation Therapy (MRT)9490 – 100
Usual Care (UC)9490 – 100
Drug Use Secondary · 12 months (post-baseline)

The quantity and frequency of patients' self-reported drug use in the past 6 months, measured with the Timeline Follow-Back interview. It was administered at each time point to calculate for the past 6 months total number of days using any drugs (marijuana, cocaine, amphetamines, heroin, other opiates, benzodiazepines, barbiturates, inhalants, or hallucinogens).

GroupValue95% CI
Moral Reconation Therapy (MRT)18.630.4 – 36.8
Usual Care (UC)15.03-3.6 – 33.6
Criminal Associates Secondary · 12 months (post-baseline)

Scale A of the Measures of Criminal Attitudes and Associates (MCAA; Mills, Kroner, \& Forth, 2002) was administered at each interview to quantify participants' associations with criminal peers, a strong predictor of criminal recidivism (Mills, Kroner, \& Hemmati, 2004). Participants were asked to consider the four adults (excluding family, co-workers, or other residents in treatment) with whom they spend the most free-time. A count variable was created by summing the number of friends for which the participant answered yes to any of the questions of criminal involvement (possible range=0-4, wh

GroupValue95% CI
Moral Reconation Therapy (MRT)0.370.2 – 0.7
Usual Care (UC)0.430.2 – 0.8

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse event data was collected in the 12 months post-baseline for each participant.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Moral Reconation Therapy (MRT)
Serious: 2/172 (1%)
Deaths: 7/172
Usual Care (UC)
Serious: 4/169 (2%)
Deaths: 12/169

Serious adverse events (1 terms)

ReactionSystemMoral Reconation Therapy (…Usual Care (UC)
DeathSocial circumstances

Most-reported serious reactions: Death.

Data from ClinicalTrials.gov NCT02524171 adverse events section.

Sponsor's own description

The purpose of this study is to determine whether Moral Reconation Therapy (MRT) is effective for reducing risk of criminal recidivism and improving other health-related outcomes (substance use, mental health, housing, and employment problems) among justice-involved Veterans entering residential mental health treatment programs in the Department of Veterans Affairs (VA).

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Psychological interventions for antisocial personality disorder.
    Gibbon S, Khalifa NR, Cheung NH, Völlm BA, et al · · 2020 · cited 31× · PMID 32880104 · DOI 10.1002/14651858.cd007668.pub3
  2. Study protocol: a hybrid effectiveness-implementation trial of Moral Reconation Therapy in the US Veterans Health Administration.
    Blonigen DM, Cucciare MA, Timko C, Smith JS, et al · · 2018 · cited 12× · PMID 29514649 · DOI 10.1186/s12913-018-2967-3
  3. A randomized controlled trial of moral reconation therapy to reduce risk for criminal recidivism among justice-involved adults in mental health residential treatment.
    Blonigen DM, Cucciare MA, Byrne T, Shaffer PM, et al · · 2022 · cited 6× · PMID 35404638 · DOI 10.1037/ccp0000721
  4. Disentangling the relationship between posttraumatic stress disorder, criminogenic risk, and criminal history among veterans.
    Blonigen DM, Shaffer PM, Baldwin N, Smelson D. · · 2023 · cited 3× · PMID 37816136 · DOI 10.1037/lhb0000542
  5. Substance use and criminogenic thinking: Longitudinal latent class analysis of veterans with criminal histories.
    Timko C, Vest N, Cucciare MA, Smelson D, et al · · 2022 · cited 3× · PMID 36215912 · DOI 10.1016/j.jsat.2022.108893
  6. For whom are treatments for criminal recidivism effective? Moderator effects from a randomized controlled trial of justice-involved veterans.
    Blonigen DM, Macia KS, Cucciare MA, Smelson D. · · 2024 · cited 1× · PMID 38236248 · DOI 10.1037/ccp0000864
  7. Assessing the impact of combat trauma on the severity, expression, and course of posttraumatic stress disorder in justice-involved veterans.
    Ward M, Baldwin N, Blonigen DM. · · 2025 · PMID 40455528 · DOI 10.1037/tra0001950

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