Cognitive Behavior Therapy for PTSD and Medical Unexplained Physical Symptoms (MU

描述（由申请人提供）：本申请是最后一次重新提交申请辅导患者为导向的研究职业发展奖（K-23），这将为我提供必要的培训，成为一名独立的研究科学家，在开发和评估文化能力的认知行为治疗与创伤后应激障碍（PTSD）和共同发生的医学不明原因的身体症状（MUPS）的拉丁美洲患者的专业知识。创伤后应激障碍和MUPS都是常见的、使人衰弱的慢性心理障碍，与社会和职业功能受损有关。迄今为止，还没有开发或测试治疗这两组症状的治疗方法，尽管研究和临床证据表明这两组症状通常是由于创伤而共同发生的，并且患有创伤并发展为PTSD的患者比那些没有PTSD诊断的患者更有可能经历MUPS。Latina/os报告相对于普通人群的创伤暴露、PTSD和MUPS水平较高。他们在治疗研究中被系统地忽视，特别是创伤后应激障碍的治疗，他们不太可能获得或参与精神卫生保健。我的初步目标是调整和整合现有的认知行为治疗PTSD和MUPS，并收集初步数据的可行性，可接受性和适应性治疗的有效性。我的培训目标是1）提高我在设计和实施随机临床试验方面的技能，以适应治疗方式，开发新的治疗方法，并测试合并MUPS的PTSD的既定治疗方法; 2）继续提高我在现象学方面的知识，并发展PTSD和躯体化障碍评估的技能; 3）扩展在初级保健中对拉丁美洲人群进行治疗研究的能力; 4）成为一名经过认证的认知行为治疗师，这将使我能够监督大型临床试验的治疗师; 5）接受研究伦理方面的培训，包括与来自弱势背景的参与者进行研究的伦理问题; 6）提高我的赠款写作和手稿准备技能。相关性（参见说明）：尽管在美国的拉丁裔人数越来越多，但缺乏关于拉丁裔精神障碍患者的文化能力治疗的大量临床知识。他们报告说，相对于普通人群，他们有更高水平的创伤后应激障碍和无法解释的身体症状。该项目将提供一种新的治疗方法，以减少使人衰弱的疾病，并有望深入了解与服务不足的少数群体的治疗结果有关的社会文化因素。

DESCRIPTION (provided by applicant): This application is the last resubmission to request a Mentored Patient-Oriented Research Career Development Award (K-23) that will provide me with necessary training to become an independent research scientist with expertise in developing and evaluating culturally competent cognitive behavioral treatment for Latino patients with posttraumatic stress disorder (PTSD) and co-occurring Medical Unexplained Physical Symptoms (MUPS). Both PTSD and MUPS are common, debilitating, and chronic psychological disorders that are associated with impaired social and occupational functioning. No treatment, to date, has been developed or tested to treat both groups of symptoms despite research and clinical evidence suggesting that these two groups of symptoms often co-occur as a result of trauma and that patients who suffer from trauma and develop PTSD are more likely to experience MUPS than those who do not have PTSD diagnoses. Latina/os report higher levels of trauma exposure, PTSD, and MUPS relative to the general population. They have been systematically neglected from treatment studies, especially treatment for PTSD, are less likely to access or engage in mental health care. My initial goal is to adapt and integrate existing cognitive behavioral treatments for PTSD and for MUPS and to collect preliminary data on the feasibility, acceptability, and efficacy of the adapted treatment. My training goals are 1) to advance my skills in designing and implementing randomized clinical trials in order to adapt treatment modalities, develop new treatment, and test established treatment for PTSD with comorbid MUPS; 2) continue enhancing my knowledge in phenomenology and developing skills in assessment of PTSD and somatization disorder; 3) extend competence in conducting treatment research with Latino populations in primary care; 4) become a certified cognitive behavioral therapist that will allow me to supervise therapists for large clinical trials; 5) receive training in research ethics, including ethical issues conducting research with participants who come from disadvantaged backgrounds; and 6) improve my grant-writing and manuscript preparation skills. RELEVANCE (See instructions): Despite the increasing numbers of Latinos in the United States, there is a dearth of substantial clinical knowledge about culturally competent treatments for Latino patients with mental disorders. They report higher levels of PTSD, and Medical Unexplained Physical Symptoms relative to the general population. This project will provide a novel treatment to reduce debilitating disorders and holds promise for providing insight into the socio-cultural factors associated with treatment outcomes among underserved minorities.