A First-Line Community-Based Mindfulness Trauma Intervention

描述（由申请人提供）：本申请“基于正念的创伤干预：治愈整个人”概述了一项研究计划，用于开发服务的干预发展：探索性研究补助金（R34）。我们的总体目标是通过获得新的知识和技能，以开发和测试一种可访问的，量身定制的和文化上适当的基于正念的干预措施，以解决低收入，少数民族妇女面临亲密伴侣暴力的巨大心理健康差距适合作为一线干预或在非精神卫生社区设置交付。正念被描述为“将一个人的全部注意力集中在当下的体验上”（Marlatt & Kristeller，1999，第68页）。正念干预已经被开发出来，以解决一系列的身体和心理健康问题（Baer，2003）。然而，没有一个解决创伤人群的需要。暴力的破坏性影响延伸到精神和身体健康问题。值得注意的是，暴力被《2010年健康人》确定为十大主要健康指标之一。创伤后应激障碍是IPV的一个特别普遍的结果，一些研究报告超过四分之三的受虐妇女符合诊断标准（例如，Jones，2001;肯普，et al. 1995）。为了缩小显着的心理健康差距，将进行三项使用不同方法的相互关联的研究，以开发和试点测试适应的基于正念的创伤干预。该应用程序有三个具体目标，所有这些目标都与NIMH R34的声明使命一致：1）为PTSD和其他创伤相关心理（抑郁症，躯体症状，生活质量）开发基于正念的创伤干预。制定干预措施将包括编写干预和培训手册，制定干预措施的忠实度措施，并对干预措施进行可行性和问责制的预试验; 2）对遭受亲密伴侣暴力的低收入、主要是非洲裔美国妇女进行干预措施的试点测试，并审查潜在的调解人（正念、应对自我效能、社会支持）的改善结果，以及3）对管理干预的成本进行试点测试措施。这项试点研究将为一项严格的大规模临床试验提供初步数据，以检查基于正念的创伤干预的自我报告和生物学结果。正念被描述为“将一个人的全部注意力带到当下的体验上”（Marlatt & Kristeller，1999，第68页）。“基于正念的创伤干预措施：治愈整个人”应用程序的目的是开发和测试一种基于正念的干预措施，这种干预措施在社区环境中适合有亲密伴侣暴力史和正在经历创伤后应激障碍症状的妇女。该应用程序有三个具体目标，所有这些目标都与NIMH R34的声明使命一致：1）为PTSD和其他创伤相关的心理疾病开发基于正念的创伤干预。（抑郁、躯体症状、生活质量）; 2）对遭受亲密伴侣暴力的低收入非洲裔美国妇女进行干预措施的试点测试，以及3）测量管理干预的成本。这项试点研究将为一项严格的大规模临床试验提供初步数据，以检查基于正念的创伤干预的自我报告和生物学结果。

DESCRIPTION (provided by applicant): This application, "Mindfulness-Based Trauma Interventions: Healing the Whole Person" outlines a research program for developing an Intervention Development to Services: Exploratory Research Grant (R34). Our overall goal is to address the huge mental health care disparity for low-income, minority women exposed to intimate partner violence by obtaining new knowledge and skills in order to develop and test an accessible, tailored, and culturally-appropriate mindfulness-based intervention suitable as a first-line intervention or delivery in non-mental health community settings. Mindfulness is described as "bringing one's complete attention to the present experience on a moment- to-moment basis" (Marlatt & Kristeller, 1999, p. 68). Mindfulness interventions have been developed to address an array of physical and mental health problems (Baer, 2003). However, none address the needs of trauma populations. The devastating effects of violence extend to both mental and physical health problems. Notably, violence has been identified as one of the ten leading health indicators in Health People 2010. PTSD is a particularly prevalent outcome of IPV, with some studies reporting more than three- quarters of battered women meeting diagnostic criteria (e.g., Jones, 2001; Kemp, et al. 1995). To narrow the remarkable mental health disparities gap, three interrelated studies using different methodologies will be conducted to develop and pilot test an adapted mindfulness-based trauma intervention. This application has three specific aims all of which are congruent with the stated mission of the NIMH R34: 1) to develop a mindfulness-based trauma intervention for PTSD and other trauma-related psychological (depression, somatic symptoms, quality of life). Intervention development will include writing intervention and training manuals, developing measures of intervention fidelity, and pre-piloting the intervention for feasibility and accountability; 2) to pilot test the interventions with low-income, predominately African-American women exposed to intimate partner violence and to examine potential mediators (mindfulness, coping self- efficacy, social support) of improved outcomes, and 3) to pilot test measures of the cost of administering the intervention. This pilot study will provide preliminary data for a rigorous large scale clinical trial to examine both self-report and biological outcomes of the mindfulness-based trauma intervention. Mindfulness is described as "bringing one's complete attention to the present experience on a moment-to-moment basis" (Marlatt & Kristeller, 1999, p. 68). The purpose of the application, "Mindfulness-Based Trauma Interventions: Healing the Whole Person" is to develop and test a mindfulness-based intervention that is appropriate and suitable in community settings for women with a history of intimate partner violence and who are experiencing symptoms of posttraumatic stress disorder. This application has three specific aims all of which are congruent with the stated mission of the NIMH R34: 1) to develop a mindfulness-based trauma intervention for PTSD and other trauma-related psychological (depression, somatic symptoms, quality of life); 2) to pilot test the interventions with low-income, African-American women exposed to intimate partner violence, and 3) to measure the cost of administering the intervention. This pilot study will provide preliminary data for a rigorous large scale clinical trial to examine both self- report and biological outcomes of the mindfulness-based trauma intervention.