Interpersonal Therapy for Veterans with PTSD

患有创伤后应激障碍 (PTSD) 退伍军人的人际治疗

• 批准号: 9198732
• 负责人: M. Tracie Shea
• 金额: --
• 依托单位: PROVIDENCE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-01-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9198732
• 关键词: Address; Air; Behavior; Cognitive; Comorbidity; Conflict (Psychology); Couples; Couples Therapy; Data; Development; Diagnosis; Emotional; Environment; Evidence based intervention; Evidence based treatment; Exhibits; Family; Feeling suicidal; Friends; Individual; Intervention; Logistics; Mediating; Mediator of activation protein; Mental Depression; Minority; Numbness; Post-Traumatic Stress Disorders; Price; Psychotherapy; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Retreatment; Risk; Risk Factors; Risk Reduction; Self Destructive Behavior; Severities; Social Adjustment; Social Network; Social Reinforcement; Social isolation; Social support; Suicide; Suicide prevention; Symptoms; System; Testing; Trauma; Trauma recovery; Unmarried; Veterans; Withdrawal; base; experience; family support; improved; interpersonal therapy; intimate partner violence; prevent; primary outcome; public health relevance; reduce symptoms; resilience; satisfaction; seal; secondary outcome; social; suicidal risk; suicide rate; tool; treatment planning

 DESCRIPTION (provided by applicant): The strong relationship between posttraumatic stress disorder (PTSD) and interpersonal problems is well documented. PTSD is highly associated with relationship discord, increased intimate partner violence, and difficulties in connecting with others, leading to social isolation. These types of conflicts, as well as the social withdrawal that is common among Veterans with PTSD, diminish the Veteran's opportunities for interaction with supportive others, and serve as a barrier to successful posttraumatic adjustment. Treatments that have been "rolled out" nationally in VAMCs, e.g., Prolonged Exposure, Cognitive Processing Therapy, and Trauma- Focused CBT, do not directly target these relationship difficulties. Furthermore, data show that only a limited number of Veterans has fully engaged with these interventions. Evidence-based interventions of couples therapy are available, but are not logistically feasible for many couples and do not address the problems of those who are socially isolated. This application proposes a randomized clinical trial of Interpersonal Psychotherapy (IPT-PTSD) as a treatment for Veterans with PTSD and relationship problems. Pilot data suggest that this type of treatment may provide a useful alternative strategy for Veterans who would prefer an individual, relationship-focused approach. We propose comparing IPT-PTSD with Prolonged Exposure (PE), an evidence based treatment for PTSD used in the VHA system. We hypothesize that IPT-PTSD will be statistically equivalent to PE in reducing PTSD symptom severity, and superior to PE in improving interpersonal functioning. IPT-PTSD is also hypothesized to be more effective than PE in improving social adjustment and quality of life. Exploratory analyses will examine whether IPT-PTSD is more effective than PE in reducing suicidal ideation, and will examine hypothesized mediators of improvement in PTSD symptoms in IPT-PTSD.

 描述(由申请人提供)： 创伤后应激障碍(PTSD)与人际问题之间的密切关系是有据可查的。创伤后应激障碍与关系不和谐、亲密伴侣暴力增加以及与他人沟通困难导致社交孤立密切相关。 这些类型的冲突，以及患有创伤后应激障碍的退伍军人中常见的社交退缩，减少了退伍军人与支持性他人互动的机会，并成为成功进行创伤后适应的障碍。已经在VAMC中“推广”的治疗方法，例如长期暴露、认知处理疗法和创伤为重点的CBT，并不直接针对这些关系困难。此外，数据显示，只有数量有限的退伍军人充分参与了这些干预措施。夫妇治疗的循证干预是可用的，但对许多夫妇来说在逻辑上是不可行的，也没有解决那些被社会孤立的人的问题。本申请提出了一项人际心理治疗的随机临床试验(IPT-PTSD)，用于治疗患有PTSD和人际关系问题的退伍军人。试点数据表明，这种类型的治疗可能为倾向于个人、以关系为重点的方法的退伍军人提供了一种有用的替代策略。我们建议将IPT-PTSD与长期暴露(PE)进行比较，后者是VHA系统中使用的一种基于证据的PTSD治疗方法。我们假设IPT-PTSD在降低创伤后应激障碍症状严重程度方面与PE在统计学上相同，而在改善人际功能方面优于PE。IPT-PTSD在改善社会适应和生活质量方面也被认为比体育更有效。探索性分析将检验IPT-PTSD在减少自杀意念方面是否比PE更有效，并将检验IPT-PTSD中PTSD症状改善的假设中介因素。