Treatment of Battered Women with PTSD in Shelters

描述(由申请者提供)：本申请是对以患者为导向的研究职业发展奖(K23)的申请，该奖项将使约翰逊博士能够开始制定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研究路线。亲密伴侣暴力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后果。创伤后应激障碍(PTSD)在遭受虐待的妇女中非常常见，尤其是那些住在家庭暴力庇护所的妇女。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她们及其子女的能力。然而，还没有研究系统地和经验性地评估收容所中遭受虐待的妇女的创伤后应激障碍的治疗。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)加深对治疗发展过程的了解，重点是在自然主义环境下开发和评估创伤后应激障碍治疗的方法；(2)获得与患有创伤后应激障碍的受虐妇女进行研究并为其提供临床治疗的专业知识；(3)更好地了解家庭暴力对受虐妇女子女的影响，以及这如何影响受虐妇女的治疗需求；(4)学习适用于衡量家庭暴力影响的儿童评估新技术；(5)在研究设计、方法和统计分析方面发展更高级的技能，特别是与临床试验相关的技术；(6)改进赠款撰写和手稿准备技能。这些培训目标将通过(1)布朗大学医学院可用的资源，(2)Caron Zlotnick、Ernest Jouriles、Ronald Seifer和Cris Sullivan博士提供的高质量指导，以及聚集的顾问团队(Mary Ann duton和Janice Krupnick博士)的专业知识，(3)重点课程、培训和临床经验，以及(4)拟议的研究项目来实现。拟议的研究计划涉及进一步开发和实证测试收容所中患有创伤后应激障碍或阈值下创伤后应激障碍的受虐妇女的新治疗方法。建议的治疗，通过赋权(HOPE)帮助克服创伤后应激障碍(HOPE)，结合了关于受虐妇女、创伤和创伤后应激障碍的经验和理论文献。这是一种强调稳定和赋权的九个疗程的个人认知行为疗法。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，并制定HOPE治疗师培训程序以及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结合标准收容服务和单独提供标准收容服务的情况。

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.