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Understanding and testing recovery processes for PTSD and alcohol use following sexual assault

了解和测试性侵犯后创伤后应激障碍和酗酒的恢复过程

基本信息

批准号：
10229470
负责人：
MICHELE A BEDARD-Gilligan
金额：
$ 48.69万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10229470
关键词：
Address Affective Alcohol consumption Alcohols Anhedonia Animals Behavioral Biological Chronic Chronic Post Traumatic Stress Disorder Clinical Clinical Trials Design Depression and Suicide Development Early Intervention Exposure to Extinction (Psychology)Fright Health Care Costs Human Impairment Individual Intervention Lead Learning Link Maintenance Measures Memory Mental Health Outcome Participant Patient Self-Report Patients Performance Phase Post-Traumatic Stress Disorders Process Psychopathology Randomized Randomized Clinical Trials Recovery Regulation Reporting Research Research Design Resistance Rewards Risk Role Safety Signal Transduction Stress Survivors Symptoms System Testing Time Trauma Treatment Efficacy Woman Yin-Yang active control alcohol misuse alcohol use disorder assault base binge drinking brief intervention clinical decision-making comparative efficacy coping design drinking effective intervention efficacious treatment efficacy testing experience follow-up improved intervention effect neurotransmission novel personalized predictions post-traumatic stress prevent response sexual assault skills skills training substance misuse telehealth trauma exposure

项目摘要

PROJECT SUMMARY Following sexual assault, many individuals will develop chronic problems including posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD). Intervention provided soon after assault can decrease the risk of developing chronic psychopathology and associated negative consequences. Interventions that address common underlying mechanisms of PTSD and alcohol use, such as fear and reward systems, have strong potential utility as efficacious and accessible interventions for clinicians treating patients recently exposed to sexual assault. This proposal is designed to test fear and reward as crucial processes underlying recovery following sexual assault and elucidate the most efficacious treatment targets. Employing experimental tasks (safety-signal learning paradigm and probabilistic reward task) to capture baseline underlying vulnerabilities in fear and reward systems respectively will allow for exploration of how these processes impact recovery. A randomized clinical trial (N = 180) will be conducted to test efficacy of intervention approaches that target PTSD or alcohol use compared to supportive telehealth. In addition, a phased study design will allow for exploration of efficacy of primary and secondary intervention approaches to test the questions of 1) whether it is more efficacious to target PTSD or alcohol use first; and 2) whether it is necessary to target both PTSD and alcohol use to facilitate recovery or if one is sufficient. This proposal is significant in exploring transdiagnostic mechanisms implicated in recovery following sexual assault, fear and reward, and using a novel design to compare efficacy, ordering, and necessity of two distinct intervention approaches.

项目概要性侵犯后，许多人会出现慢性问题，包括创伤后应激障碍障碍（PTSD）和酒精使用障碍（AUD）。攻击发生后立即提供干预可以减少发展为慢性精神病理学和相关负面后果的风险。干预措施旨在解决 PTSD 和饮酒的共同潜在机制，例如恐惧和奖励系统，具有很强的对于治疗最近接触过的患者的临床医生来说，作为有效且易于使用的干预措施的潜在效用性侵犯。该提案旨在测试恐惧和奖励作为恢复的关键过程性侵犯后并阐明最有效的治疗目标。使用实验任务（安全信号学习范式和概率奖励任务）捕获基线潜在漏洞恐惧和奖励系统将分别允许探索这些过程如何影响恢复。一个将进行随机临床试验（N = 180）以测试针对目标的干预方法的有效性创伤后应激障碍（PTSD）或饮酒与支持性远程医疗的比较。此外，分阶段的研究设计将允许探索主要和次要干预方法的功效，以测试以下问题：1）是否首先针对 PTSD 或酒精使用更有效； 2）是否有必要同时针对 PTSD 和使用酒精以促进康复，或者如果一种就足够了。该提案对于探索跨诊断具有重要意义涉及性侵犯、恐惧和奖励后恢复的机制，并使用新颖的设计比较两种不同干预方法的功效、顺序和必要性。