CBT Treatment for PTSD and SUDs in Minority Youth

描述(由申请人提供)：本提案是为儿童和青少年精神病学家丽莎·福图纳博士颁发的以患者为导向的研究职业发展奖(K23)。福图纳博士的长期职业目标是成为一名独立研究人员，具备将经验支持的治疗方法转化为社区环境的技能，特别是针对患有精神疾病和药物使用障碍的少数族裔青少年。这项建议侧重于在遭受暴力的少数族裔青年中，在创伤后应激障碍(PTSD)的背景下治疗药物滥用。创伤后应激障碍是一种在人群中普遍存在的共生障碍，包括患有药物使用障碍的青少年。创伤后应激障碍与青少年开始和持续滥用药物、治疗结果不佳和社会功能不佳有关。有效的治疗方法是存在的，然而，在社区环境中不实施有效的治疗方法在药物滥用领域是一个有据可查的问题。少数族裔青年特别有可能得不到服务。这项研究建议1)评估认知行为疗法对有药物滥用的多元文化青年创伤后应激障碍(PTSD)的疗效；2)通过将这种循证治疗整合到社区组织的服务中，并超越传统的临床环境，改善获得这种基于证据的治疗的机会。本研究以Onken等人(1997)的行为疗法发展阶段模式为框架，以社区参与的方式，提出了一项针对14-18岁患有物质滥用障碍的少数族裔青少年的社区参与创伤后应激障碍CBT的1a&1b阶段研究。第LA阶段涉及对成瘾、少数族裔青年和社区环境的修改、程序规范和可行性测试。阶段Ib包括对改良干预措施的试点试验，并与等待名单上的三项结果指标进行比较：1)药物使用；2)创伤后应激障碍症状；3)消耗。如果有这些研究的数据支持，下一步就是对治疗进行疗效研究。

DESCRIPTION (provided by applicant): This proposal is a Mentored Patient-Oriented Research Career Development Award (K23) for Dr. Lisa Fortuna, a child and adolescent psychiatrist. Dr. Fortuna's long-term career goal is to be an independent researcher with skills in the translation of empirically supported treatments into community settings, particularly for minority adolescents with co-occurring psychiatric and substance use disorders. This proposal focuses on the treatment of substance abuse in the context of Post Traumatic Stress Disorder (PTSD) in violence exposed minority youth. PTSD is a prevalent co-occurring disorder in persons, including adolescents with substance use disorders. PTSD is associated with initiation and continuation of substance abuse, poor treatment outcomes and poor social functioning for youth. Effective therapies exist, however, the nonimplementation of efficacious therapies in community settings is a well-documented problem in the drug abuse field. Minority youth are at particular risk of not receiving services. This research proposes to 1) assess the efficacy of a cognitive behavioral treatment for Post Traumatic Stress Disorder (PTSD) with multicultural youth with substance abuse; and 2) improve access to this evidence based treatment by integrating it into the services of a community-based organization and to move beyond traditional clinical settings. Using the framework of the Onken et al (1997) Stage Model of Behavioral Therapy development, and community participatory methods, this research proposes a Stage 1a & 1b study of CBT for PTSD with minority adolescents ages 14-18 years with substance abuse disorders and in a community based organization setting. Stage la involves the modification, procedural specification and feasibility testing for addiction, minority youth and community setting. Stage Ib involves a Pilot Trial of the modified intervention compared to waiting list comparison on three outcome measures: 1) substance use; 2) PTSD symptoms; and 3) attrition. If supported by data from these studies, an efficacy study of the treatment is the next step.