Treatment for inner city adolescent girls with CSA-PTSD

描述(由申请人提供)：众所周知，遭受性虐待的青春期女孩患创伤后应激障碍的比率相当高，并在情绪调节和社交能力方面表现出严重的障碍。此外，青春期的创伤后应激障碍是青少年滥用药物、自杀和再次受害的强大危险因素。因此，在多个负面生活后果的高风险时期，存在严重的公共卫生干预需要。到目前为止，还没有有效的治疗方法来解决患有创伤后应激障碍的青春期女孩的多种需求。我们建议为青春期女孩调整一种经验性验证的、手动的认知行为治疗，该治疗是为患有与儿童期虐待有关的创伤后应激障碍的不同种族女性群体开发的。治疗由两个连续的部分组成：情感和人际功能技能训练(STAIR)的十节课模块和通过想象暴露(IE)对创伤事件进行情绪处理的六节课模块。将指定为期五个月的开放试验期，以完成和完善治疗适应。将利用对治疗过程的评估(通过录像)和每周的病例会诊会议来监测和记录治疗的实施情况，并对治疗作出必要的改变。在这一努力之后，将进行初步的随机结果研究。共有74名被诊断为创伤后应激障碍的青春期女孩将被随机分配到认知行为治疗(STAIR/IE)或一如既往的强化治疗(E-TAU)，后者包括相同数量的疗程，以非结构化形式进行，这是创伤青年社区治疗的典型形式。STAIR/IE和E-TAU的疗效将在治疗后和三个月的随访中使用评估三个目标结果的措施进行评估：1)情绪管理技能，2)社交能力和3)创伤后应激障碍症状。

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.