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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：
10679059
负责人：
MICHELE A BEDARD-Gilligan
金额：
$ 51.38万
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/10679059
关键词：
Address Affective Alcohol consumption Alcohols Anhedonia Animals Behavioral Biological Chronic Chronic Post Traumatic Stress Disorder Clinical Clinical Trials Design Development Diagnostic Disparate Early Intervention Exposure to Extinction Fright Health Care Costs Human Impairment Individual Intervention Lead Learning Link Maintenance Measures Memory Mental Depression Mental Health Mental Health Services Outcome Participant Patient Self-Report Patients Performance Phase Post-Traumatic Stress Disorders Process Psychopathology Randomized Recovery Regulation Reporting Research Research Design Resistance Rewards Risk Risk Reduction Role Safety Signal Transduction Stress Survivors Symptoms System Testing Time Trauma Treatment Efficacy Woman Yin active control alcohol misuse alcohol use disorder assault 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 intervention post-traumatic stress prevent randomized, clinical trials response sexual assault skills skills training substance misuse suicidal telehealth theories 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.

项目总结在性侵犯之后，许多人会发展成慢性问题，包括创伤后应激障碍精神障碍(PTSD)和酒精使用障碍(AUD)。攻击后不久提供的干预可以减少患上慢性精神病的风险和相关的负面后果。干预措施，解决创伤后应激障碍和酗酒的共同潜在机制，如恐惧和奖励系统，有很强的作为临床医生治疗新近暴露的患者的有效和可获得的干预措施的潜在效用性侵犯。这项提议旨在测试恐惧和奖励作为复苏基础的关键过程。跟踪性侵犯，并阐明最有效的治疗目标。采用实验任务 (安全信号学习范例和概率奖励任务)以捕获潜在的基线漏洞恐惧和奖励系统将分别让人们探索这些过程是如何影响复苏的。一个将进行随机临床试验(N=180)，以测试干预方法的有效性创伤后应激障碍或酒精使用与支持性远程健康相比。此外，阶段性研究设计将允许探讨一次干预和二次干预方法的有效性，以检验1)是否首先针对创伤后应激障碍或酒精使用更有效；以及2)是否有必要同时针对创伤后应激障碍和酒精使用使用酒精以促进康复，或者如果一杯酒就足够了。这一建议对探索跨诊断具有重要意义性侵犯、恐惧和奖励后的康复机制，并使用一种新的设计来比较两种不同干预方法的有效性、顺序性和必要性。