Treatment for inner city adolescent girls with CSA-PTSD

描述（由申请人提供）：遭受性虐待的青春期女孩患创伤后应激障碍的几率很高，在情绪调节和社交能力方面表现出明显的障碍。此外，青少年的创伤后应激障碍是青少年滥用药物、自杀和再次受害的一个强大的危险因素。因此，在这一多重负面生活结果风险增加的时期，公共卫生方面有必要进行干预。到目前为止，还没有有效的治疗方法来解决患有创伤后应激障碍的青春期女孩的多重需求。我们建议将一种经验验证的、人为的认知行为治疗方法应用于青春期女孩，这种治疗方法是为不同种族的与童年虐待有关的创伤后应激障碍妇女开发的。治疗由两个连续的部分组成：情感和人际功能技能训练（STAIR）的十个阶段模块和通过想象暴露（IE）的创伤事件的情绪处理的六个阶段模块。将指定为期5个月的公开试验期，以完成和完善治疗适应。治疗过程的评估（通过录像）和每周的病例咨询会议将用于监测和记录治疗的实施，并对治疗进行必要的改变。这项工作之后将进行一项初步的随机结果研究。总共74名被诊断为PTSD的青春期女孩将被随机分配到认知行为治疗（STAIR/IE）或常规强化治疗（E-TAU），后者由相同数量的非结构化形式的治疗组成，是典型的创伤青少年社区治疗。STAIR/IE和E-TAU的疗效将在治疗后和三个月的随访中进行评估，使用评估三个目标结果的措施：1)情绪管理技能，2)社会能力和3)创伤后应激障碍症状。

DESCRIPTION (provided by applicant): Adolescent girls who have been sexually abused are known to develop PTSD at substantially high rates and display significant impairments in emotion regulation and social competence. In addition, PTSD in adolescence is a powerful risk factor for substance abuse, suicidality, and revictimization in the teen years. Thus, there is a serious public health need to intervene during this period of heightened risk for multiple negative life outcomes. As yet, there is no effective treatment that addresses the multiple needs of adolescent girls with PTSD. We propose to adapt for adolescent girls an empirically validated, manualized cognitive-behavioral treatment that was developed for an ethnically diverse population of women with PTSD related to childhood abuse. The treatment is composed of two sequential components: a ten-session module of skills training in affective and interpersonal functioning (STAIR) and a six-session module of emotional processing of the traumatic events via imaginal exposure (IE). A five-month open-trial period will be designated to complete and refine the treatment adaptation. Assessment of treatment sessions (by video recordings) and weekly case consultation meetings will be used to monitor and document treatment delivery and make necessary changes to the treatment. This effort will be followed by a preliminary randomized outcome study. A total of 74 adolescent girls with a diagnosis of PTSD will be randomly assigned to either the cognitive-behavioral treatment (STAIR/IE) or to an enhanced treatment as usual (E-TAU) that consists of an identical number of sessions in an unstructured format typical of community treatment for traumatized youth. The efficacy of STAIR/IE and E-TAU will be assessed at post-treatment and at three-month follow-up using measures assessing the three targeted outcomes: 1) emotion management skills, 2) social competence and 3) PTSD symptoms.