Treatment of Battered Women with PTSD in Shelters

描述（由申请人提供）：本申请是一个指导的病人为导向的研究职业发展奖（K23），这将使博士的请求。约翰逊开始开发一个研究的评估和治疗家庭暴力对受虐妇女及其子女的创伤影响的方案线。亲密伴侣的暴力行为是一个普遍存在的社会问题，对妇女和儿童都有负面的心理影响。创伤后应激障碍（PTSD）在受虐妇女中极其常见，尤其是在家庭暴力庇护所中的受虐妇女。创伤后应激障碍的症状可能会损害受虐妇女有效获得资源并建立自己和孩子的能力。然而，没有研究系统地和经验性地评估创伤后应激障碍的治疗在受虐妇女在庇护所。因此，迫切需要对这一弱势群体的治疗进行研究。约翰逊博士的培训目标是：（1）增加对治疗开发过程的理解，重点是在自然环境中开发和评估创伤后应激障碍治疗方法的方法，（2）获得对创伤后应激障碍受虐妇女进行研究和提供临床治疗的专业知识，（3）更好地了解遭受家庭暴力对被殴打妇女的子女的影响，以及这对被殴打妇女的治疗需求有何影响;（4）学习新的评估技术，为儿童适当的测量暴露于家庭暴力的影响，（5）开发更先进的研究设计，方法和统计分析的技能，特别是与临床试验相关的技术，和（6）提高赠款写作和手稿准备技能。这些培训目标将通过以下方式实现：（1）布朗大学医学院的可用资源，（2）Caron Zlotnick、Ernest Jouriles、罗纳德塞弗和Cris Sullivan博士提供的高质量指导，以及顾问团队的专业知识（玛丽安达顿和贾尼斯Krupnick），（3）重点课程，培训和临床经验，（4）拟议的研究项目。拟议的研究计划涉及进一步开发和经验测试一种新的治疗方法，用于治疗收容所中患有创伤后应激障碍或亚阈值创伤后应激障碍的受虐妇女。建议的治疗，帮助克服创伤后应激障碍通过授权（希望）纳入了经验和理论文献的受虐妇女，创伤和创伤后应激障碍。这是一个九疗程的个人认知行为治疗，强调稳定和赋权。具体的研究目的是：（1）完善HOPE及其手册，获得治疗程序的临床经验，并开发HOPE治疗师培训程序和依从性和能力评定量表;（2）在随机对照研究中评估HOPE的初始可接受性，可行性和有效性，比较HOPE与标准庇护服务的结合与单独的标准庇护服务。

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) that will enable Dr. Johnson to begin developing a programmatic line of research in the assessment and treatment of the traumatic effects of domestic violence on battered women and their children. Intimate partner violence is a pervasive social problem with negative psychological consequences for both women and children. Posttraumatic Stress Disorder (PTSD) is extremely common in battered women, especially those in domestic violence shelters. Symptoms of PTSD may compromise battered women's ability to effectively access resources and establish them and their children. However, no research has systematically and empirically evaluated the treatment of PTSD in battered women in shelters. Thus, research on treatment with this vulnerable population is sorely needed. Dr. Johnson's training goals are to: (1) Increase understanding of treatment development process, with a focus on methods for developing and evaluating treatments for PTSD in naturalistic settings, (2) Acquire expertise in conducting research with, and providing clinical treatment for, battered women with PTSD, (3) Develop a better understanding of the effects of exposure to domestic violence on the children of battered women and how this impacts the treatment needs of battered women; (4) Learn new assessment techniques for children appropriate for measuring the effects of exposure to domestic violence, (5) Develop more advanced skills in research design, methodology, and statistical analyses, particularly techniques relevant to clinical trials, and (6) Improve grant writing and manuscript preparation skills. These training goals will be achieved through (1) the resources available at the Brown University Medical School, (2) the high quality mentorship provided by Drs. Caron Zlotnick, Ernest Jouriles, Ronald Seifer, and Cris Sullivan, and the expertise of the assembled consultant team (Drs. Mary Ann Dutton and Janice Krupnick), (3) focused coursework, trainings, and clinical experiences, and (4) the proposed research project. The proposed research plan involves further developing and empirically testing a new treatment for battered women in shelters with PTSD or subthreshold PTSD. The proposed treatment, Helping to Overcome PTSD through Empowerment (HOPE) incorporates the empirical and theoretical literature on battered women, trauma, and PTSD. It is a nine session individual cognitive-behavioral treatment that emphasizes stabilization and empowerment. The specific research aims are to: (1) Refine HOPE and its manual, gain clinical experience with the treatment procedures and develop HOPE therapist training procedures and adherence and competence rating scales and (2) Evaluate the initial acceptability, feasibility, and efficacy of HOPE in a randomized controlled study, comparing HOPE combined with standard shelter services to standard shelter services alone.