Skills Training /Exposure in Childhood Abuse PTSD

儿童虐待创伤后应激障碍 (PTSD) 的技能培训/暴露

• 批准号: 7095911
• 负责人: Marylene Cloitre
• 金额: $ 41.26万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-15 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7095911
• 关键词: adult human (21+); child abuse; clinical research; cognitive behavior therapy; combination therapy; domestic violence; emotions; experience; female; human therapy evaluation; interpersonal relations; interview; mental health counseling; patient oriented research; posttraumatic stress disorder; psychological tests; questionnaires; sex abuse; sign /symptom; training; women' s health

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.

描述（由申请人提供）：创伤后应激障碍（PTSD）是一种 使人衰弱且经常患有慢性焦虑症并伴有严重的精神疾病 合并症。 PTSD 的终生患病率估计为 10% 女性为 5%，男性为 5%。与 PTSD 相关的最常见的创伤 妇女中存在儿童期虐待问题。与童年虐待相关的创伤后应激障碍 (PTSD) 相关 情绪调节和人际交往严重障碍 发挥作用。儿童受虐者存在显着的功能障碍 患有创伤后应激障碍（PTSD）的幸存者，例如糟糕的工作和人际关系历史、 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，这个人口 精神卫生服务领域的代表性明显过高。治疗研究 对于这组PTSD患者来说是迫切需要的。 首席研究员在 NIMH 资金的支持下，开发了一种治疗方法 直接而有力地解决 PTSD 中的三个不同问题领域 与童年虐待相关：情绪管理问题、人际关系 问题和创伤后应激障碍。该治疗分为两个阶段，提供 8 情感和人际调节技能培训课程（STAIR） 随后进行 8 次改良版长时间暴露 (MPE) 治疗。 随机对照试验的结果发现所有方面都有显着改善 三个目标领域。 拟议研究的主要目的是确定这是否 双组分治疗优于仅使用其中一种的治疗 治疗成分。与成人发病创伤相关的 PTSD 研究发现 联合治疗并不能提供任何优于其治疗的益处 成分。然而，干预措施的具体问题性质也 顺序而不是同时实施治疗 成分，表明这种联合治疗可能会产生更好的结果 与同类单组分治疗相比。 一百五十 (150) 名因童年虐待而患有创伤后应激障碍 (PTSD) 的女性将接受治疗 随机分配至三种有效治疗方法之一：STAIR/MPE，一种 MPE 治疗条件和 STAIR 治疗条件。主要结果 变量将针对三个问题领域：影响管理、 人际功能和创伤后应激障碍症状。我们还将评估 每种治疗的可行性通过脱落率和是否存在来衡量 不良反应是通过治疗过程中症状恶化来衡量的。