Prevention of PTSD by Early Treatment II: Telephone-Based CBT

通过早期治疗预防 PTSD II：基于电话的 CBT

• 批准号: 8267545
• 负责人: Arieh Y Shalev
• 金额: $ 13万
• 依托单位: HADASSAH-HEBREW UNIVERSITY MEDICAL CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8267545
• 关键词: Accidents; Accounting; Acute; Acute Post Traumatic Stress Disorder; Address; Adherence; Adult; Affect; Anniversary; Anxiety; Anxiety Disorders; Area; Budgets; Caring; Case-Control Studies; Chronic; Chronic Post Traumatic Stress Disorder; Clinical; Clinical Services; Clinical assessments; Cognitive Therapy; Communication; Communities; Consult; Control Groups; Counseling; Data Analyses; Data Reporting; Development; Development Plans; Disasters; Early treatment; Education; Emotional; Empirical Research; Evaluation; Event; Evidence based intervention; Evidence based treatment; Family; Focus Groups; Future; Gender; General Hospitals; Goals; Health; Hotlines; Human; Image; Individual; Institute of Medicine (U.S.); Interpersonal Violence; Intervention; Interview; Lead; Learning; Manuals; Marshal; Memory; Mental Health; Mental disorders; Modality; Molds; Monitor; Mood Disorders; Names; New York; Online Systems; Outcome Measure; Participant; Persons; Phase; Population; Population Study; Post-Traumatic Stress Disorders; Prevalence; Prevention; Principal Investigator; Protocols documentation; Randomized; Randomized Controlled Trials; Recommendation; Recovery; Registries; Reporting; Research; Research Infrastructure; Resistance; Resources; Sampling; Services; Staging; Structure; Surveys; Survivors; Symptoms; Telecommunications; Telephone; Testing; Time; TimeLine; Traffic accidents; Trauma; Veterans; Violence; Voice; War; Work; Writing; acute traumatic stress disorder; base; clinical care; design; disability; effective therapy; flexibility; follow-up; health care delivery; improved; insight; interest; open label; prevent; programs; psychologic; service utilization; theories; therapy design; therapy development; tool; treatment response

DESCRIPTION (provided by applicant): The goal of the proposed work is to develop an early, telephone-based, trauma focused cognitive behavioral therapy intervention (ET-CBT) and evaluate its efficacy in preventing post-traumatic stress disorder (PTSD). PTSD is frequent, disabling and treatment resistant. Current evidence supports the efficacy of face-to-face trauma-focused cognitive behavioral therapy (CBT) in preventing PTSD. The required clinical resources are limited, however, particularly in war, terror or disaster-affected areas. Finding ways to deliver CBT via remote telecommunications is a high priority. Telephone based CBT has been successfully delivered in anxiety and mood disorders. Studies of populations under threat show that telephone support services are widely used. The proposed work will adapt an existing CBT protocol for telephone based delivery, pre- test a preliminary version of the intervention for consistency, feasibility and acceptance; develop an advanced version and evaluate it in a large randomized controlled trial (RCT). Following a preliminary evaluation that established it feasibility, tolerance and potential for beneficial effect, an open-label study will evaluate 20 survivors and establish the intervention's manual. Eminent consultants will participate in designing the intervention and monitoring its implementation. For the RCT, we will screen 1500 survivors of traumatic events, from a general hospital ER trauma registry, randomize the first 200 who have Acute Stress Disorder (ASD) or Acute PTSD to either ET-CBT (n=100) or no-treatment condition (n=100), provide ET-CBT to the former within a month of the traumatic event, and compare the two groups at three months. Survivors with PTSD at three months will receive face-to- face CBT. A second evaluation, at eight months will examine the stability of recovery with ET- CBT and added beneficial effect of in-person CBT in who did not respond to ET-CBT. This proposal is molded on the R34 mechanism entitled "Mental Health Consequences of Violence And Trauma (PA PAR-07-315)" that encourages the development of new or adapted interventions. It addresses to the Institute of Medicine (IOM) 2007 recommendation to "Promote specific research on early intervention in PTSD." The successful development of ET-CBT will contribute to solving a major service-delivery problem and provide a new tool for preventing PTSD. It will enable timely treatment to survivors in war and disaster-affected areas. The proposed interventions can be readily converted to web-based vehicles of voice- and image communication, available to a growing segment of the population.

描述（由申请人提供）：拟议工作的目标是开发一种早期的，基于电话的，以创伤为重点的认知行为治疗干预（ET-CBT），并评估其在预防创伤后应激障碍（PTSD）方面的疗效。创伤后应激障碍是常见的，致残和治疗抵抗。目前的证据支持面对面创伤集中认知行为疗法（CBT）在预防PTSD中的疗效。然而，所需的临床资源是有限的，特别是在战争、恐怖或灾害影响地区。寻找通过远程电信提供CBT的方法是一个高度优先事项。基于电话的CBT已成功地用于焦虑和情绪障碍。对受威胁人口的研究表明，电话支助服务得到广泛使用。拟议的工作将调整现有的CBT协议，用于基于电话的交付，预先测试干预措施的初步版本的一致性，可行性和可接受性;开发高级版本并在大型随机对照试验（RCT）中对其进行评估。在初步评估确定其可行性，耐受性和潜在的有益效果后，一项开放标签研究将评估20名幸存者并制定干预手册。知名顾问将参与设计干预措施并监测其执行情况。在随机对照试验中，我们将从综合医院急诊创伤登记处筛选1500名创伤事件幸存者，将前200名患有急性应激障碍（ASD）或急性PTSD的患者随机分为ET-CBT（n=100）或无治疗条件（n=100），在创伤事件发生后一个月内为前者提供ET-CBT，并在三个月内比较两组。三个月后患有PTSD的幸存者将接受面对面的CBT。第二次评估，在八个月时，将检查ET-CBT恢复的稳定性，以及对ET-CBT没有反应的人进行面对面CBT的额外有益效果。该提案是在题为“暴力和创伤的心理健康后果”的R34机制（PA PAR-07-315）的基础上提出的，该机制鼓励制定新的或经调整的干预措施。它针对医学研究所（IOM）2007年的建议“促进对创伤后应激障碍早期干预的具体研究”。“ET-CBT的成功开发将有助于解决一个主要的服务提供问题，并为预防PTSD提供一个新的工具。它将使战争和受灾地区的幸存者能够得到及时治疗。拟议的干预措施可以很容易地转换为基于网络的语音和图像通信工具，供越来越多的人口使用。