Treatment outcomes, comorbid disorders and PTSD

治疗结果、合并症和创伤后应激障碍

• 批准号: 6959313
• 负责人: VIRGINIA GIL-RIVAS
• 金额: $ 6.63万
• 依托单位: UNIVERSITY OF NORTH CAROLINA CHARLOTTE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-10 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6959313
• 关键词: behavioral /social science research tag; comorbidity; gender difference; health care service utilization; human data; longitudinal human study; mental health services; posttraumatic stress disorder; psychological adaptation; psychological shock; psychological stressor; quality of life; statistics /biometry; substance abuse related disorder

DESCRIPTION (provided by applicant): The proposed study will examine the combined effects of trauma exposure and posttraumatic stress disorder (PTSD) on primary treatment outcomes among individuals with comorbid substance use disorders (SUDs) and severe mental illness (SMI) with attention to gender differences. Further analyses of a longitudinal sample of 400 individuals receiving services at 11 residential treatment programs will be conducted. The specific aims of this study include: 1a) to determine whether trauma exposure is associated with primary treatment outcomes at the 6- and 12-month follow-ups; 1b) to examine whether the association between trauma exposure and treatment outcomes is mediated by the presence of PTSD; to determine if the association between PTSD and treatment outcomes is mediated by changes in trauma related symptoms and psychological distress; 2) examine whether the participation in specific treatment services mediate and/or moderate the relationship between trauma exposure/PTSD and treatment outcomes; and 3) to examine whether the patterns of association identified for each of these aims differ by gender. Regression models based on the generalized estimating equations approach will be employed to examine the longitudinal relationship between the variables of interest. Several methodological strengths of the proposed study provide a unique opportunity to address gaps in the literature. Specifically: 1) the use of structured clinical interviews to diagnose SUDs, SMI, and PTSD according to DSM-IV criteria; 2) repeated assessment of the variables of interest; 3) a sample of individuals receiving concurrent substance abuse and mental health services; and 4) the inclusion of sufficient males and females to allow for simultaneous gender comparisons. In sum, the findings of the present study can aid in the development of treatment interventions that better address the needs of individuals with multiple comorbid disorders.

描述（由申请人提供）：拟议的研究将考察创伤暴露和创伤后应激障碍（PTSD）对共病物质使用障碍（sud）和严重精神疾病（SMI）患者主要治疗结果的综合影响，并注意性别差异。将对在11个住院治疗项目中接受服务的400人的纵向样本进行进一步分析。本研究的具体目的包括：1a)确定创伤暴露是否与6个月和12个月随访时的主要治疗结果相关；1b)研究创伤暴露与治疗结果之间的关联是否由PTSD的存在介导；确定创伤后应激障碍与治疗结果之间的关联是否由创伤相关症状和心理困扰的改变介导；2)研究是否参与特定治疗服务调解和/或调节创伤暴露/PTSD与治疗结果之间的关系；3)检查每个目标的关联模式是否因性别而异。基于广义估计方程方法的回归模型将被用来检验感兴趣的变量之间的纵向关系。提出的研究的几个方法学优势提供了一个独特的机会来解决文献中的空白。具体而言：1)根据DSM-IV标准，使用结构化临床访谈诊断sud、SMI和PTSD；2)重复评估感兴趣的变量；3)同时接受药物滥用和精神卫生服务的个体样本；4)包括足够的男性和女性，以便同时进行性别比较。总之，本研究的发现有助于开发治疗干预措施，更好地满足患有多种共病的个体的需求。