Skills Training /Exposure in Childhood Abuse PTSD

描述（由申请人提供）：创伤后应激障碍（PTSD）是一种 使人衰弱的，经常是慢性的焦虑症，伴有严重的精神疾病 科摩罗。PTSD的终生患病率估计为10%， 女性和男性的5%。与创伤后应激障碍相关的最常见创伤 是童年虐待。与童年虐待有关的创伤后应激障碍 情绪调节和人际关系方面存在严重障碍 功能儿童期虐待存在明显的功能障碍 患有PTSD的幸存者，如不良的工作和关系史， 养育子女，以及以人身攻击形式再次受害的高风险， 性侵犯和家庭暴力。毫不奇怪，这一人口是 在心理健康服务中的比例明显过高。治疗研究 对这类PTSD患者的治疗是迫切需要的。 在NIMH基金的支持下，首席研究员开发了一种治疗方法， 直接有力地解决了创伤后应激障碍的三个不同问题领域， 与儿童期虐待有关：情绪管理问题，人际关系 问题和创伤后应激障碍治疗分为两个阶段，提供8 情感和人际调节技能培训课程（STAIR） 随后进行8次改良版延长暴露（MPE）。 一项随机对照试验的结果发现， 三个目标领域。 这项研究的主要目的是确定这是否 双组分处理上级仅利用其中一种的处理。 治疗成分。与成人创伤相关的创伤后应激障碍研究发现 联合治疗并不提供任何上级它们的益处， 件.然而，干预措施针对具体问题的性质也 治疗的顺序而不是同时进行 成分，表明这种联合治疗可能会产生更好的结果 比可比的单一组分治疗。 一百五十（150）名患有与儿童虐待有关的创伤后应激障碍的妇女将被 随机分配至三种活性治疗之一：STAIR/MPE，MPE 处理条件和STAIR处理条件。主要结局 变量将针对三个问题域：影响管理， 人际功能和创伤后应激障碍症状我们亦会评估 每种治疗的可行性，以辍学率和是否存在 在治疗过程中通过症状恶化测量的副作用。

Description (provided by applicant): Post-traumatic Stress Disorder (PTSD) is a debilitating and often chronic anxiety disorder with serious psychiatric comorbidity. The lifetime prevalence of PTSD is estimated at 10 percent among women and 5 percent for men. The most frequent trauma associated with PTSD among women is childhood abuse. PTSD related to childhood abuse is associated with substantial disturbance in emotion regulation and interpersonal functioning. There is significant functional impairment among childhood abuse survivors with PTSD such as poor work and relationship histories, problems in parenting, and high risk for revictimization in the form of physical assault, sexual assault and domestic violence. Not surprisingly, this population is significantly over-represented in mental health services. Treatment research for this group of PTSD patients is urgently needed. The principal investigator, supported by NIMH funds, has developed a treatment that directly and vigorously addresses three distinct problem domains in PTSD related to childhood abuse: emotion management problems, interpersonal problems, and PTSD. The treatment, organized into two phases, provides 8 sessions of skills training in affect and interpersonal regulation (STAIR) followed by 8 sessions of a modified version of prolonged exposure (MPE). Results of a randomized controlled trial found significant improvement in all three targeted areas. The primary aim of the proposed study is to determine whether this two-component treatment is superior to treatments utilizing only one of the treatment components. Studies of PTSD related to adult-onset traumas have found that combination treatments do not provide any benefit superior to their components. However, the problem-specific nature of the interventions as well the sequential rather than simultaneous implementation of the treatment components, suggest that this combination treatment may produce better outcomes than comparable single-component treatments. One hundred and fifty (150) women with PTSD related to childhood abuse will be randomly assigned to one of three active treatments: STAIR/MPE, an MPE treatment condition, and a STAIR treatment condition. The primary outcome variables will target the three problem domains: affect management, interpersonal functioning and PTSD symptoms. We will also assess the feasibility of each treatment as measured by dropout rates and the presence of adverse effects as measured by symptom worsening over the course of treatment.