COGNITIVE/BEHAVIOR THERAPY FOR PTSD/AUD ADOLESCENT GIRLS

申请人摘要：拟议的研究源于开发 有效治疗青春期女孩的双重诊断， 创伤后应激障碍（PTSD）和酒精使用障碍（AUD）。 患有PTSD的青少年女孩估计占AUD的40% 治疗样本（青春期男孩比率的三倍以上）。 似乎有一个严重的公共卫生需要尽早干预， 对于患有这种双重诊断的青少年来说， 这些疾病进入成年期。 到目前为止，还没有有效的治疗方法 这一庞大的人口已经确定。 我们建议调整 对于青春期的女孩， 专门为PTSD综合治疗设计的治疗方法 和酒精/药物紊乱。 该疗法已经证明了强大的初始 一项对患有创伤后应激障碍的成年女性进行的结果研究的经验性发现， 酒精/药物使用障碍，并将在拟议的研究中定制， 解决少女的发展和专题问题。 这 24届会议，结构化治疗提供了密集的排练认知， 行为和人际应对技能，经验性地使用技术 在教育文献中得到验证，使治疗变得容易， 很吸引人 它是成本敏感的（即，a组格式），已修订， 根据实际经验和实证结果，提出课题目标 被认为是具有这种双重诊断的女性的中心（例如，如何设置 人际关系的界限）。 其主要目标是 戒酒和戒毒，减少创伤后应激障碍症状。 我们也 建议进行一项探索性对照结局研究， 将CB治疗调整为常规治疗（TAU）对照条件， 使用连续队列，每种疾病16名门诊少女 设计和3个月的随访。 这项研究将评估 适应组治疗内和之间的条件：减少 酒精/药物使用，PTSD症状，以及其他精神和功能 变量;在CB治疗中，将探索患者的 对治疗和知识获取的满意度/联盟， 自我报告的使用CBT应对技能在治疗中提出。 在 此外，该研究可以（a）估计治疗的效应量 与对照组相比， 作为主要结果测量;和（B）提供初始心理测量 在青少年样本中验证两种理论上 来自这种治疗：治疗师依从性量表和患者 “治疗的核心组成部分”量表，试图测量假设的 治疗的作用机制。

APPLICANT'S ABSTRACT: The proposed study arises from the need to develop effective treatment for adolescent girls with the dual diagnosis of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Adolescent girls with current PTSD Are estimated to comprise 40% OF AUD treatment samples (more than three times the rate for adolescent boys). There appears to be a serious public health need to intervene as early as possible for adolescents with this dual diagnosis to prevent the chronic course of these disorders into adulthood. As yet, no effective treatment for this substantial population has been identified. We propose to adapt for adolescent girls an existing manualized cognitive behavioral group therapy that was specifically designed for the integrated treatment of PTSD and alcohol/drug disorders. The therapy has evidenced strong initial empirical findings in an outcome study of adult women with PTSD and alcohol/drug use disorder, and would be customized in the proposed study to address the developmental and thematic concerns if adolescent girls. This 24 session, structured therapy offers intensive rehearsal of cognitive, behavioral, and interpersonal coping skills, using techniques empirically validated in the educational literature to make the treatment accessible and engaging. It is cost-sensitive (i.e., a group format), has been revised on the basis of actual experience and empirical results, and targets topics believed central for females with this dual diagnosis (e.g., how to set boundaries in interpersonal relationships). Its primary goals are abstinence from alcohol and drugs and reduction in PTSD symptoms. We also proposed to conduct an exploratory controlled outcome study comparing the adapted CB treatment to a treatment-as-usual (TAU) control condition, with 16 outpatient adolescent girls per condition using a sequential cohorts design and a 3-month follow-up. The study would evaluate the impact of the adapted group treatment within and between conditions in: reducing alcohol/drug use, PTSD symptoms, and other psychiatric and functioning variables; and within the CB treatment, would explore patient's level of satisfaction/alliance with the therapy and knowledge acquisition and self-reported use of CBT coping skills presented in the treatment. In addition, the study could (a) estimate the effect size of the treatment condition compared to the control condition, with reduction in alcohol use as the primary outcome measure; and (b) provide initial psychometric validation in an adolescent sample of two instruments that are theoretically derived from this treatment: a therapist adherence scale and a patient "core components of treatment" scale, which attempts to measure hypothesized mechanisms of action of the therapy.