Improving Effectiveness: Treatment Outcome Research

描述（由申请人提供）：本申请旨在提高现有治疗策略的有效性，认知处理疗法（CPT），通过根据参与者的需要改变干预的持续时间和内容，来纠正犯罪受害者的创伤后应激障碍。第二个目标是确定达到良好终状态功能所需的治疗时间的预测因子，包括个体和创伤变量、认知和情感变量以及轴II病理。最后，通过包括男性参与者的样本，CPT的普遍性将被测试。预计这些修改将加速CPT在社区实践中的传播，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进的CPT条件或症状监测，最小注意力条件，旨在控制日常监测和时间流逝的影响。利用半交叉设计，对照条件将被交叉到积极治疗，允许在研究中进行复制。整个治疗样本（N = 50）将与最近在同一地点使用相同主要结果测量方法进行的一项研究中接受严格的12期方案驱动的CPT的样本（N = 50）进行比较。本研究的参与者将接受一系列访谈和自我报告测量，其中包括1。临床医师管理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边缘慵懒量表。受试者将通过使用每日日记来监测进展，并在治疗前、治疗期间的三个状态检查点、治疗后和三个月的随访点接受正式评估。本研究的开展对提高PTSD应用研究的生态效度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.