Treatment of Battered Women with PTSD in Shelters

描述（由申请人提供）：本申请是对指导患者导向研究职业发展奖（K23）的请求，这将使约翰逊博士能够开始在家庭暴力对受虐妇女及其子女的创伤性影响的评估和治疗方面开发一个程序化的研究线。亲密伴侣暴力是一个普遍存在的社会问题，对妇女和儿童都会产生消极的心理影响。创伤后应激障碍（PTSD）在受虐妇女中极为常见，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损害受虐妇女有效获取资源并建立自己和子女的能力。然而，没有研究系统地、经验性地评估庇护所中受虐妇女PTSD的治疗。因此，迫切需要对这一弱势群体进行治疗研究。约翰逊博士的培训目标是：(1)增加对治疗发展过程的理解，重点是在自然环境中开发和评估创伤后应激障碍治疗的方法；(2)获得对患有创伤后应激障碍的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)学习适用于儿童的新的评估技术，以衡量遭受家庭暴力的影响；(5)在研究设计、方法和统计分析方面发展更高级的技能，特别是与临床试验有关的技术；(6)提高拨款写作和手稿准备技能。这些培训目标将通过(1)布朗大学医学院提供的资源，(2)博士提供的高质量指导来实现。Caron Zlotnick, Ernest Jouriles， Ronald Seifer和Cris Sullivan，以及集结的顾问团队的专业知识(dr。玛丽·安·达顿（Mary Ann Dutton）和珍妮丝·克鲁普尼克（Janice Krupnick）),(3)重点课程作业、培训和临床经验，以及(4)拟议的研究项目。拟议的研究计划包括进一步开发和实证测试一种新的治疗方法，用于治疗庇护所中患有创伤后应激障碍或阈下创伤后应激障碍的受虐妇女。建议的治疗方法，帮助克服创伤后应激障碍通过授权（HOPE）结合了实证和理论文献对受虐妇女，创伤，和创伤后应激障碍。这是一个九期的个人认知行为治疗，强调稳定和授权。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，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、可行性和疗效，将HOPE与标准收容所服务相结合与单独的标准收容所服务进行比较。

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.