Integrated Early Intervention for Alcohol Use Disorder and Posttraumatic Stress Disorder Following Sexual Assault

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ABSTRACT The overall objective of the proposed Mentored Patient-Oriented Research Career Development Award (K23) is to support Dr. Christine Hahn in acquiring the skills necessary to become an independent investigator with a program of research focused on the development of interventions for alcohol use disorder (AUD) and comorbid mental health conditions, in particular posttraumatic stress disorder (PTSD). AUD and PTSD frequently co-occur among people who experience traumatic life events, such as sexual assault. There is a lack of established evidence-based interventions, however, to reduce AUD and PTSD among recent victims. The proposed study directly addresses this clinical gap by testing the novel integration of two, evidence-based, cognitive-behavioral interventions for AUD and PTSD to be delivered in five sessions beginning in the six weeks following sexual assault. In Phase 1, we will adapt the intervention using an iterative process informed by expert feedback. In Phase 2, we will conduct an open label trial (n = 10) to finalize the treatment protocol. In Phase 3, we will use the treatment protocol in a pilot randomized controlled trial among 54 recent sexual assault victims to evaluate feasibility and preliminary efficacy in reducing AUD severity and PTSD symptoms. Ecological momentary assessments (EMA) will be used to assess alcohol use, craving, and affect during the five-week treatment phase. The candidate has assembled a team of experienced mentors with expertise in AUD, PTSD, sexual assault, psychotherapy development, clinical trials, and ecological momentary assessment. On-site mentors (Drs. Sudie Back, Kathleen Brady, Michael Saladin) have extensive knowledge in developing and conducting clinical trials of behavioral and pharmacological interventions for co-occurring AUD and PTSD. Dr. Saladin has expertise in real-time data collection methods in addiction research. Off-site mentors (Dr. Barbara Rothbaum at Emory University and Dr. Brian Marx at Boston University) will provide additional guidance on early, brief interventions to reduce AUD and PTSD symptoms following sexual assault. The mentorship, formal coursework, seminars, and national conference attendance afforded by the K23 award will ensure that the candidate achieves the following career goals: (1) Gain new knowledge in AUD mechanisms and interventions; (2) Develop skills in designing and implementing clinical trials for AUD and co-occurring PTSD; (3) Increase statistical skills with multilevel and longitudinal data analyses; (4) Enhance understanding of research ethics; and (5) Continue professional development through manuscript writing, professional presentations, and grant writing. The candidate will complete the proposed K23 activities at the Medical University of South Carolina, which has a strong track record of commitment to the advancement of early stage AUD investigators. The proposed K23 activities will ultimately prepare Dr. Hahn to lead a program of rigorously-designed AUD treatment outcome research.