COGNITIVE/BEHAVIOR THERAPY FOR PTSD/AUD ADOLESCENT GIRLS

申请者摘要：建议的研究是出于发展的需要 青春期女孩双重诊断的有效治疗 创伤后应激障碍(PTSD)和酒精使用障碍(AUD)。 目前患有创伤后应激障碍的青春期女孩估计占澳大利亚疾病的40%。 治疗样本(是青春期男孩的三倍多)。 似乎有一种严重的公共卫生需要最早进行干预 对于患有这种双重诊断的青少年来说，预防慢性 这些疾病的病程一直持续到成年。到目前为止，还没有有效的治疗方法 因为这个庞大的人口已经被确定了。我们建议适应 对于青春期女孩来说，一个现有的人工认知行为群体 专为创伤后应激障碍的综合治疗而设计的疗法 和酒精/药物障碍。这种疗法初步证明效果很好。 成年女性创伤后应激障碍和创伤后应激障碍患者结局研究的经验发现 酒精/药物使用障碍，并将在拟议的研究中定制以 解决青春期女孩的发展和主题问题。这 24个疗程，结构化治疗提供密集的认知排练， 行为和人际应对技能，使用经验上的技巧 在教育文献中进行验证，使治疗变得可用和 引人入胜。它对成本敏感(即，分组格式)，已于 实际经验和实证结果的基础，以及目标主题 被认为是患有这种双重诊断的女性的中心(例如，如何设置 人际关系中的界限)。它的主要目标是 戒酒戒毒，减少创伤后应激障碍症状。我们也 建议进行一项探索性对照结果研究，比较 调整CB治疗以适应照常治疗(TAU)控制条件， 每种情况下16名门诊青春期女孩使用序贯队列 设计和3个月的随访。这项研究将评估 在条件内和条件之间进行适应的团体治疗：减少 酒精/药物使用，创伤后应激障碍症状，以及其他精神和功能障碍 变量；在CB治疗中，将探索患者的水平 对治疗和知识获取的满意度/联盟 治疗中出现的CBT应对技能的自我报告使用情况。在……里面 此外，这项研究可以(A)估计治疗的效果大小 与对照条件相比，酒精使用量减少 作为主要结果衡量标准；和(B)提供初步心理测量 在青少年样本中验证两种工具的理论上 源自这种治疗：治疗师依从性量表和一名患者 “治疗的核心组成部分”量表，它试图衡量假设 治疗的作用机制。

APPLICANT'S ABSTRACT: The proposed study arises from the need to develop effective treatment for adolescent girls with the dual diagnosis of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Adolescent girls with current PTSD Are estimated to comprise 40% OF AUD treatment samples (more than three times the rate for adolescent boys). There appears to be a serious public health need to intervene as early as possible for adolescents with this dual diagnosis to prevent the chronic course of these disorders into adulthood. As yet, no effective treatment for this substantial population has been identified. We propose to adapt for adolescent girls an existing manualized cognitive behavioral group therapy that was specifically designed for the integrated treatment of PTSD and alcohol/drug disorders. The therapy has evidenced strong initial empirical findings in an outcome study of adult women with PTSD and alcohol/drug use disorder, and would be customized in the proposed study to address the developmental and thematic concerns if adolescent girls. This 24 session, structured therapy offers intensive rehearsal of cognitive, behavioral, and interpersonal coping skills, using techniques empirically validated in the educational literature to make the treatment accessible and engaging. It is cost-sensitive (i.e., a group format), has been revised on the basis of actual experience and empirical results, and targets topics believed central for females with this dual diagnosis (e.g., how to set boundaries in interpersonal relationships). Its primary goals are abstinence from alcohol and drugs and reduction in PTSD symptoms. We also proposed to conduct an exploratory controlled outcome study comparing the adapted CB treatment to a treatment-as-usual (TAU) control condition, with 16 outpatient adolescent girls per condition using a sequential cohorts design and a 3-month follow-up. The study would evaluate the impact of the adapted group treatment within and between conditions in: reducing alcohol/drug use, PTSD symptoms, and other psychiatric and functioning variables; and within the CB treatment, would explore patient's level of satisfaction/alliance with the therapy and knowledge acquisition and self-reported use of CBT coping skills presented in the treatment. In addition, the study could (a) estimate the effect size of the treatment condition compared to the control condition, with reduction in alcohol use as the primary outcome measure; and (b) provide initial psychometric validation in an adolescent sample of two instruments that are theoretically derived from this treatment: a therapist adherence scale and a patient "core components of treatment" scale, which attempts to measure hypothesized mechanisms of action of the therapy.