TREATMENT OF CHRONIC PTSD SECONDARY TO TRAFFIC ACCIDENTS

描述(改编自申请人的摘要)：证据来自几个 调查表明，创伤后应激障碍(PTSD)可能是 在美国最普遍的精神问题，而且有相当大的 创伤后应激障碍病例的比例可能继发于机动车事故 (MVAS)。到目前为止，发表的关于这一人群的治疗报告 都是不受控制的，除了一个早期控制的 一项干预试验，未能发现短期治疗的优势 得不到治疗。(后一种发现可能是由于相当大的 MVA术后前6至9个月的自发缓解率，确定 在提交这项提案的调查人员的工作中。)其他受控对象 对创伤后应激障碍治疗的评估主要集中在非常慢性的病例，如 越南退伍军人和强奸受害者。 这些研究人员建议评估一个简短的(十次会议)多组分 他们试行、实施的认知行为治疗方案 由经验丰富的社区治疗师提供，相比之下，简短的(10 会议)支持性心理治疗和等待名单控制，在 对105名最近(6至24个月)患者进行的对照临床试验 MVA后)，但技术上为慢性创伤后应激障碍或严重亚综合征创伤后应激障碍 仅次于机动车事故。调查人员将筛查 大约320名寻求医疗救治的MVA受害者 MVA术后24个月以上，以确定和招募105名样本； 这将包括最近6个月后(少于6个月)的重新评估 案子。评估员对治疗情况视而不见，将评估所有接受治疗的人 治疗后和随访3和12的受试者和等待名单对照 几个月来，使用了帽子、寿命和各种心理测试。轮候名单 对照组将在接受认知行为治疗后 重新评估。

DESCRIPTION (Adapted from applicant's abstract): Evidence from several surveys indicates that posttraumatic stress disorder (PTSD) may be one of the most widespread psychiatric problems in the USA, and that a sizeable proportion of PTSD cases may arise secondary to motor vehicle accidents (MVAs). To date, the published reports of treatment with this population have been uncontrolled, with the exception of one controlled early intervention trial which failed to find an advantage of brief treatment over no treatment. (The latter finding may be due to a fairly sizeable spontaneous remission rate over the first 6 to 9 months post-MVA, identified in the work of the investigators submitting this proposal.) Other controlled evaluations of treatment of PTSD have focused on very chronic cases such as Vietnam veterans and on rape victims. These investigators propose to evaluate a brief (ten session) multicomponent cognitive behavioral treatment regimen which they have piloted, administered by experienced community-based therapists, in comparison to a brief (ten session) supportive psychotherapy and a waiting list control, in a controlled clinical trial using 105 individuals with recent (6 to 24 months post MVA) but technically chronic PTSD or severe sub-syndromal PTSD secondary to a motor vehicle accident. The investigators will screen approximately 320 MVA victims who sought medical attention and who are less than 24 months post-MVA in order to identify and recruit the sample of 105; this will include reassessment after 6 months for recent (less than 6 month) cases. Assessors, blind to treatment condition, will evaluate all treated subjects and wait list controls at post-treatment and follow-ups of 3 and 12 months using the CAPS, LIFE, and various psychological tests. Waiting list controls will receive the cognitive behavioral treatment after their reassessment.