CBT for PTSD Among Public-Sector Consumers

公共部门消费者针对创伤后应激障碍 (PTSD) 的 CBT

• 批准号: 6688956
• 负责人: BARTLEY CHRISTOPHER FRUEH
• 金额: $ 15.9万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6688956
• 关键词: CBT; PTSD; Among; Public; Sector

DESCRIPTION (provided by applicant): This is a revision of an R21 proposal to develop a multi-component cognitive behavioral treatment (CBT) program for posttraumatic stress disorder (PTSD) among public sector consumers with PTSD and severe mental illness (SMI). Data show that trauma victimization (up to 98%) and PTSD (up to 43%) are highly prevalent among persons with SMI (e g, schizophrenia) who are treated within the public sector. Among the general population PTSD is associated with nearly the highest rate of medical and other service use, and therefore may be one of the costliest mental disorders. Evidence also shows that individuals with PTSD tend to receive inadequate mental health services. Thus, it is clear that trauma has a prominent impact on the public health. Despite a growing awareness of the significant impact of traumatic experiences on persons treated within state-funded mental health systems, there is a striking lack of empirical data regarding effective interventions for these consumers with PTSD and SMI. In fact, although effective psychosocial treatments have been developed for other traumatized groups (e.g., male combat veterans, female rape victims), little effort has been made to adapt these treatments for persons who are treated within large state-funded mental health systems. Thus, there is a pressing need for the development and evaluation of appropriate treatments designed specifically for use with this population in this of practice setting. The specific aims of this proposal are to (1) develop a comprehensive treatment program and treatment manual for PTSD among public sector consumers with PTSD and SMI, adapting existing components of CBT interventions (education, exposure therapy, social skills training) for PTSD, (2) train public sector therapists in the use of this treatment manual and evaluate therapist competence and adherence to following the manual, and (3) conduct a pilot study with public sector consumers with PTSD and SM! in order to evaluate outcome variables that fall into four domains-- PTSD symptoms, social functioning, symptoms of other psychiatric conditions (e g, psychosis), and treatment credibility and satisfaction. This proposal is responsive to the NIMH objectives described in Healthy People 2010 (Objectives 18 9 and 18 10) and the Bridging Science and Service report recommendation regarding the need for research that characterizes promising interventions and service settings (recommendation #10).

描述（由申请人提供）：这是 R21 提案的修订版，旨在针对患有 PTSD 和严重精神疾病 (SMI) 的公共部门消费者的创伤后应激障碍 (PTSD) 制定多成分认知行为治疗 (CBT) 计划。数据显示，在公共部门接受治疗的 SMI（例如精神分裂症）患者中，创伤受害（高达 98%）和 PTSD（高达 43%）非常普遍。在普通人群中，创伤后应激障碍 (PTSD) 与医疗和其他服务使用率几乎最高有关，因此可能是成本最高的精神疾病之一。有证据还表明，患有创伤后应激障碍的人往往得不到足够的心理健康服务。因此，很明显，创伤对公众健康具有显着影响。尽管人们越来越认识到创伤经历对在国家资助的心理健康系统中接受治疗的人的重大影响，但对这些患有 PTSD 和 SMI 的消费者进行有效干预的经验数据却严重缺乏。事实上，尽管已经针对其他受创伤群体（例如男性退伍军人、女性强奸受害者）开发了有效的心理社会治疗方法，但很少有人努力将这些治疗方法适用于在大型国家资助的心理健康系统中接受治疗的人。因此，迫切需要开发和评估专门为该人群在实践环境中使用而设计的适当治疗方法。该提案的具体目标是 (1) 为患有 PTSD 和 SMI 的公共部门消费者制定 PTSD 综合治疗计划和治疗手册，调整针对 PTSD 的 CBT 干预措施的现有组成部分（教育、暴露疗法、社交技能培训），(2) 培训公共部门治疗师使用本治疗手册，并评估治疗师的能力和遵守手册的情况，(3) 开展 对患有 PTSD 和 SM 的公共部门消费者进行试点研究！为了评估属于四个领域的结果变量——创伤后应激障碍症状、社会功能、其他精神疾病的症状（例如精神病）以及治疗可信度和满意度。该提案响应了《2010 年健康人民》中描述的 NIMH 目标（目标 18 9 和 18 10）以及科学与服务桥梁报告关于需要进行研究来描述有希望的干预措施和服务设置的建议（建议 10）。