Treating Common Mental Disorders in Women in Mozambique by Addressing Intimate Partner Violence in Couples

亲密伴侣暴力（IPV），抑郁，焦虑和创伤后应激的潜在风险因素 精神障碍（常见精神障碍; CMD）是一种具有最高发病率的破坏性公共卫生问题 发生在撒哈拉以南的非洲。旨在减少IPV的心理健康干预措施往往不包括男性， 这可以通过夫妻模式治疗来解决然而，以夫妇为基础的治疗往往排除 与IPV一起生活的夫妇。这个K23奖的目标是扩大候选人的技能，并准备 她对以夫妇为基础的心理健康干预措施进行独立研究， 社会决定因素，如IPV，以改善心理健康成果和成果的可持续性。拟议 培训计划包括来自领先专家的指导，课程和研讨会，参加和 在科学会议上发表，并开发合作手稿以供出版， 能力（1）男性的参与和心理健康治疗;（2）适应基于证据的 治疗CMD以解决夫妇IPV;（3）随机对照试验的方法和分析， 夫妇;和（4）作为一个独立的调查员成功的职业生涯的技能。 这些培训目标和活动将与在莫桑比克进行的一项研究的目标保持一致， 世界上最贫穷的国家，心理健康治疗差距很大。莫桑比克半数妇女 在过去一年中被证实暴露于IPV，并且存在高的CMD患病率。候选 PRIDE（Partnerships in Research to Implement and Disseminate Sustainable and 可扩展的EBP，U19 MH 113203），这是一个与莫桑比克卫生部合作的项目，正在扩展- 在全省范围内使用人际咨询（IPC）治疗CMD的综合精神卫生保健。 然而，规模扩大没有考虑到CMD的协调治疗和并发症的问题。 夫妻间的IPV研究计划的总体目标是调查减少CMD的可行性， 女性通过夫妇为基础的治疗，解决CMD和情境IPV（亲密关系之间的不和谐） （二）暴力行为升级为身体暴力）。这项研究有三个具体目标。第一个目标是确定 性别角色，包括与男性参与基于夫妇的IPV治疗相关的当地环境影响 在公共卫生保健。第二个目标是调整IPC-C，通过解决以下问题来减少女性伴侣的CMD： IPV和夫妇功能的改善。第三个目的是确定使用的可接受性和可行性 夫妻人际咨询（IPC-C），以减少妇女的CMD和夫妇的IPV。本研究 适用于国际上和美国经历过夫妻暴力的低资源人群， 心理健康治疗差距由于其重点是亲密伴侣，干预也有可能 有益于儿童的健康和福祉。

Intimate partner violence (IPV), a potent risk factor for depression, anxiety, and Post-traumatic Stress Disorder (common mental disorders; CMDs), is a devastating public health problem with the highest rates occurring in sub-Saharan Africa. Mental health interventions that aim to reduce IPV often fail to include men, which could be addressed by treatment in a couple modality. Yet, couple-based treatments often exclude couples who are living with IPV. The goal of this K23 Award is to expand the candidate’s skillset and prepare her to conduct independent research on couple-based mental health interventions for CMDs that address social determinants, such as IPV, to improve mental health outcomes and sustainability of gains. The proposed training program involves mentorship from leading experts, coursework and workshops, attending and presenting at scientific conferences, and developing collaborative manuscripts for publication to develop competency in (1) engagement and mental health treatment of men; (2) adaptation of an evidence-based treatment for CMDs to address IPV in couples; (3) methods and analyses of randomized controlled trials for couples; and (4) skills for a successful career as an independent investigator. These training goals and activities will align with the aims of a research study in Mozambique, one of the poorest countries in the world with a significant mental health treatment gap. Half of women in Mozambique endorsed being exposed to IPV in the past year, and there are high prevalence rates of CMDs. The candidate is Project Director of PRIDE (Partnerships in Research to Implement and Disseminate Sustainable and Scalable EBPs, U19MH113203), a collaborative project with the Mozambique Ministry of Health that is scaling- up comprehensive mental health care across a province using Interpersonal Counseling (IPC) to treat CMDs. Scale-up, however, has not considered the coordinated treatment of CMDs and the co-occurring problem of IPV among couples. The overall goal of the research plan is to investigate the feasibility of reducing CMDs in women through a couple-based treatment that addresses CMDs and situational IPV (discord between intimate partners that escalates to physical violence). This study has three specific aims. The first aim is to identify gender roles including local contextual influences relevant to engaging men in couple-based treatment of IPV in public MH care. The second aim is to adapt IPC-C to reduce CMDs in female partners through resolution of IPV and improvement of couple functioning. The third aim is to determine acceptability and feasibility of using Interpersonal Counseling for Couples (IPC-C) to reduce CMDs in women and IPV in couples. This study has applicability for low-resource populations internationally and the US that experience couple-based violence and a mental health treatment gap. With its focus on intimate partners, the intervention also has the potential to benefit health and wellbeing of children.