Treatment of PTSD in Residents of Battered Women's Shelters

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): Intimate partner violence (IPV) is a pervasive social problem associated with high rates of posttraumatic stress disorder (PTSD). Moreover, PTSD is associated with considerable morbidity and a higher risk of re- abuse in victims of IPV. Domestic Violence Shelters provide an integral resource for IPV victims in that they provide emergency shelter, support, and access to community resources that can aid in their establishing long- term safety for themselves and their children. However, PTSD symptoms can compromise battered women's ability to access and effectively use these vital personal and social resources, effectively establishing safety for themselves and their children. Despite the fact that annually 300,000 battered women and children access shelter services, and domestic violence shelters provide a prime time to initiate psychological treatment, virtually no research has systematically investigated the treatment of PTSD in residents of battered women's shelters. To address this gap in the literature, we have developed a shelter-based treatment for victims of IPV with PTSD, Helping to Overcome PTSD through Empowerment (HOPE). HOPE is a brief cognitive-behavioral treatment that that adopts an empowerment approach to treatment, emphasizing stabilization and safety, goals consistent with the theoretical and empirical literature on battere women and PTSD. HOPE is a novel treatment in that it adopts an empowerment approach to treating PTSD and emphasizes stabilization and safety; important needs of residents of battered women's shelters with PTSD. In this application we propose to expand upon our pilot work with HOPE and test the efficacy of HOPE relative to supportive therapy (i.e., Present Centered Therapy, PCT) in a sample of 186 female residents of battered women shelters with IPV- related PTSD. In an effort to facilitate future dissemination of HOPE, sessions will be delivered by community therapists and the study will be conducted in a range of shelter systems. Furthermore, the current proposal, unlike our pilot work, will compare HOPE to an attention matched control condition, have a longer follow-up period in order to determine whether positive findings are sustained over time, will assess the impact of HOPE on child abuse potential, will incorporate objective measures of stress responding (e.g., attentional biases and physiological reactivity to trauma cues), will explore novel mediators and moderators of treatment, and will include a cost-effectiveness analysis. Findings will be used to inform a future dissemination study of HOPE.