Improving Effectiveness: Treatment Outcome Research

描述（由申请人提供）：本申请旨在通过根据参与者的需要改变干预的持续时间和内容，提高现有治疗策略（认知加工疗法）的有效性，以补救犯罪受害者中的创伤后应激障碍。次要目标是确定实现良好终末状态功能所需治疗持续时间的预测因素，包括个体和创伤变量、认知和情感变量以及轴II病理学。最后，通过包括男性参与者的样本，将测试CPT的普遍性。预计这些修改将加快CPT向社区实践的传播，从而使更多的创伤受害者受益。将50名受试者随机分配至改良CPT条件或设计用于控制每日监测和时间推移影响的活动监测、最小注意力条件。利用半交叉设计，将对照条件交叉至活性治疗，允许在研究中重复。将整个治疗样本（N = 50）与接受严格的12个疗程方案驱动CPT的样本（N = 50）进行比较，该CPT是在同一研究中心使用相同的主要结局指标进行的最新研究过程中进行的。研究参与者将接受一系列访谈和自我报告措施，其中包括1。临床医生管理PTSD量表，2.）DSM-IV轴I和II障碍的结构化临床访谈，3。标准化创伤访谈，4。）PTSD诊断量表，5。）贝克抑郁量表- II，6。）创伤相关内疚量表，7。）Pennebaker边缘系统痴呆量表。受试者将通过使用每日日记监测进展，并在治疗前、治疗期间的三个状态检查点、治疗后和三个月随访点接受正式评估。进行拟议的研究将有重要的意义，推进生态的有效性和有效性的应用研究创伤后应激障碍。

DESCRIPTION (provided by applicant): This application seeks to increase the effectiveness of an existing treatment strategy, cognitive processing therapy (CPT), for the remediation of Posttraumatic Stress Disorder among crime victims by varying the duration and content of the intervention in accordance with participants' needs. A secondary goal is to identify predictors of duration of treatment necessary to achieve good end state functioning, including individual and trauma variables, cognitive and emotional variables, and Axis II pathology. Finally, by including a sample of male participants, the generalizability of CPT will be tested. It is anticipated that these modifications will speed the dissemination of CPT to community practice thus benefiting more trauma victims. Fifty subjects will be randomly assigned to either the modified CPT condition or to a symptom-monitoring, minimal attention condition designed to control for the effects of the daily monitoring and the passage of time. Utilizing a semicrossover design, the control condition will be crossed over to the active treatment, allowing for a replication within the study. The entire treated sample (N = 50) will be compared to a sample (N = 50) receiving strict 12- session protocol-driven CPT through the course of a recent study conducted at the same site using the same primary outcome measures. Participants in the study will be administered a battery of interviews and self-report measures which include 1.) Clinician Administered PTSD Scale, 2.) Structured Clinical Interview for DSM-IV Axis I & II Disorders, 3.) Standardized Trauma Interview, 4.) PTSD Diagnostic Scale, 5.) Beck Depression Inventory - II, 6.) Trauma-Related Guilt Inventory, 7.) Pennebaker Inventory of Limbic Languidness. Subjects will monitor progress through use of daily diaries as well as undergo formal assessments at pre-treatment, at three status checkpoints during therapy, at post-treatment, and at a three month follow-up point. Conducting the proposed study will have important implications on advancing the ecological validity and effectiveness of applied research on PTSD.