Treatment for inner city adolescent girls with CSA-PTSD

描述（由申请人提供）：已知遭受性虐待的少女以相当高的比率发展PTSD，并在情绪调节和社交能力方面表现出显着的障碍。此外，青春期的创伤后应激障碍是青少年滥用药物、自杀和再次受害的一个重要危险因素。因此，在这一多重负面生活结果风险增加的时期，有严重的公共卫生需要进行干预。到目前为止，还没有有效的治疗方法可以满足患有创伤后应激障碍的青春期女孩的多种需求。我们建议调整青春期女孩的经验验证，手动认知行为治疗，开发了一个种族多元化的人口与创伤后应激障碍的妇女与儿童虐待。治疗由两个连续的组成部分：情感和人际功能技能训练（STAIR）的10个会话模块和通过想象暴露（IE）的创伤事件的情感处理（IE）的6个会话模块。将指定一个为期五个月的开放试验期，以完成和完善治疗适应。治疗过程的评估（通过视频记录）和每周病例咨询会议将用于监测和记录治疗交付，并对治疗进行必要的更改。这项工作之后将进行初步的随机结果研究。共有74名诊断为PTSD的青春期女孩将被随机分配到认知行为治疗（STAIR/IE）或常规增强治疗（E-TAU），其中包括相同数量的非结构化格式的会话，这是创伤青少年社区治疗的典型形式。将在治疗后和三个月随访时使用评估三个目标结果的措施评估STAIR/IE和E-TAU的疗效：1）情绪管理技能，2）社交能力和3）PTSD症状。

DESCRIPTION (provided by applicant): Adolescent girls who have been sexually abused are known to develop PTSD at substantially high rates and display significant impairments in emotion regulation and social competence. In addition, PTSD in adolescence is a powerful risk factor for substance abuse, suicidality, and revictimization in the teen years. Thus, there is a serious public health need to intervene during this period of heightened risk for multiple negative life outcomes. As yet, there is no effective treatment that addresses the multiple needs of adolescent girls with PTSD. We propose to adapt for adolescent girls an empirically validated, manualized cognitive-behavioral treatment that was developed for an ethnically diverse population of women with PTSD related to childhood abuse. The treatment is composed of two sequential components: a ten-session module of skills training in affective and interpersonal functioning (STAIR) and a six-session module of emotional processing of the traumatic events via imaginal exposure (IE). A five-month open-trial period will be designated to complete and refine the treatment adaptation. Assessment of treatment sessions (by video recordings) and weekly case consultation meetings will be used to monitor and document treatment delivery and make necessary changes to the treatment. This effort will be followed by a preliminary randomized outcome study. A total of 74 adolescent girls with a diagnosis of PTSD will be randomly assigned to either the cognitive-behavioral treatment (STAIR/IE) or to an enhanced treatment as usual (E-TAU) that consists of an identical number of sessions in an unstructured format typical of community treatment for traumatized youth. The efficacy of STAIR/IE and E-TAU will be assessed at post-treatment and at three-month follow-up using measures assessing the three targeted outcomes: 1) emotion management skills, 2) social competence and 3) PTSD symptoms.