Improving Effectiveness: Treatment Outcome Research

说明(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，提高现有治疗战略--认知处理疗法(CPT)--的有效性，以补救犯罪受害者的创伤后应激障碍。第二个目标是确定实现良好的最终状态功能所需的治疗持续时间的预测因素，包括个人和创伤变量、认知和情绪变量以及Axis II病理。最后，通过包括一名男性参与者的样本，将检验CPT的泛化能力。预计这些修改将加快将CPT传播到社区实践的速度，从而使更多的创伤受害者受益。50名受试者将被随机分配到改良的CPT条件或症状监测的最低注意力条件下，旨在控制日常监测的效果和时间的流逝。利用半微生物设计，对照条件将被交叉到主动治疗，允许在研究中重复。整个处理样本(N=50)将与接受严格12会话协议驱动的CPT的样本(N=50)进行比较，通过最近在同一地点进行的一项研究，使用相同的主要结果衡量标准。这项研究的参与者将接受一系列访谈和自我报告措施，其中包括1。)临床医生使用创伤后应激障碍量表，2。)DSM-IV轴I和II障碍的结构化临床访谈，3.)标准化创伤面谈，4)创伤后应激障碍诊断量表，5)Beck Depression Inventory-II，6.创伤相关内疚问卷，7。)Pennebaker关于边缘疲倦的清单。受试者将通过使用每日日记来监测进展情况，并在治疗前、治疗期间的三个状态检查站、治疗后和三个月的随访点接受正式评估。开展这项拟议研究将对提高创伤后应激障碍应用研究的生态有效性和有效性具有重要意义。

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.