Cognitive Behavior Therapy for PTSD and Medical Unexplained Physical Symptoms (MU

描述(申请人提供)：此申请是最后一次重新提交以患者为导向的研究职业发展奖(K-23)，该奖项将为我提供必要的培训，使我成为一名独立研究科学家，具有为患有创伤后应激障碍(PTSD)和共生医学不明原因身体症状(MUPS)的拉丁裔患者开发和评估具有文化能力的认知行为治疗的专业知识。创伤后应激障碍和MUP都是常见的、衰弱的和慢性的心理障碍，与社会和职业功能受损有关。到目前为止，还没有开发出或测试出治疗这两组症状的治疗方法，尽管研究和临床证据表明，这两组症状往往是由于创伤而同时出现的，而且遭受创伤并患有创伤后应激障碍的患者比那些没有被诊断为创伤后应激障碍的患者更有可能经历MUPS。与普通人群相比，拉美裔人报告的创伤暴露、创伤后应激障碍和MUPS水平更高。他们在治疗研究中被系统性地忽视了，特别是创伤后应激障碍的治疗，他们不太可能获得或参与精神卫生保健。我最初的目标是调整和整合现有的治疗创伤后应激障碍和MUPS的认知行为疗法，并收集关于适应性治疗的可行性、可接受性和有效性的初步数据。我的培训目标是1)提高我设计和实施随机临床试验的技能，以便适应治疗方式，开发新的治疗方法，并测试PTSD合并MUP的既定治疗方法；2)继续增强我在现象学方面的知识，发展评估创伤后应激障碍和躯体化障碍的技能；3)扩展在初级保健中对拉丁裔人群进行治疗研究的能力；4)成为一名注册认知行为治疗师，使我能够监督大型临床试验的治疗师；5)接受研究伦理方面的培训，包括与来自弱势背景的参与者一起进行研究的伦理问题；以及6)提高我的赠款撰写和稿件准备技能。相关性(见说明)：尽管美国的拉丁裔人数不断增加，但对于拉丁裔精神障碍患者的文化胜任治疗，缺乏实质性的临床知识。他们报告说，与普通人群相比，创伤后应激障碍和医学上无法解释的身体症状水平更高。该项目将提供一种新的治疗方法，以减少衰弱障碍，并有望深入了解与服务不足的少数群体的治疗结果有关的社会文化因素。

DESCRIPTION (provided by applicant): This application is the last resubmission to request a Mentored Patient-Oriented Research Career Development Award (K-23) that will provide me with necessary training to become an independent research scientist with expertise in developing and evaluating culturally competent cognitive behavioral treatment for Latino patients with posttraumatic stress disorder (PTSD) and co-occurring Medical Unexplained Physical Symptoms (MUPS). Both PTSD and MUPS are common, debilitating, and chronic psychological disorders that are associated with impaired social and occupational functioning. No treatment, to date, has been developed or tested to treat both groups of symptoms despite research and clinical evidence suggesting that these two groups of symptoms often co-occur as a result of trauma and that patients who suffer from trauma and develop PTSD are more likely to experience MUPS than those who do not have PTSD diagnoses. Latina/os report higher levels of trauma exposure, PTSD, and MUPS relative to the general population. They have been systematically neglected from treatment studies, especially treatment for PTSD, are less likely to access or engage in mental health care. My initial goal is to adapt and integrate existing cognitive behavioral treatments for PTSD and for MUPS and to collect preliminary data on the feasibility, acceptability, and efficacy of the adapted treatment. My training goals are 1) to advance my skills in designing and implementing randomized clinical trials in order to adapt treatment modalities, develop new treatment, and test established treatment for PTSD with comorbid MUPS; 2) continue enhancing my knowledge in phenomenology and developing skills in assessment of PTSD and somatization disorder; 3) extend competence in conducting treatment research with Latino populations in primary care; 4) become a certified cognitive behavioral therapist that will allow me to supervise therapists for large clinical trials; 5) receive training in research ethics, including ethical issues conducting research with participants who come from disadvantaged backgrounds; and 6) improve my grant-writing and manuscript preparation skills. RELEVANCE (See instructions): Despite the increasing numbers of Latinos in the United States, there is a dearth of substantial clinical knowledge about culturally competent treatments for Latino patients with mental disorders. They report higher levels of PTSD, and Medical Unexplained Physical Symptoms relative to the general population. This project will provide a novel treatment to reduce debilitating disorders and holds promise for providing insight into the socio-cultural factors associated with treatment outcomes among underserved minorities.