Psychological First Aid for Victims of Crime

描述（由申请人提供）：在美国，成人犯罪受害是一个主要的公共卫生问题，会导致显著的负面后果和非凡的长期成本。数据表明，多达三分之一的成年人在其一生中至少遭受过一次暴力犯罪（强奸/性侵犯、人身攻击或武装抢劫），遭受暴力侵害的个人有可能出现慢性、使人衰弱的精神健康问题，包括创伤后应激障碍、抑郁症和药物滥用。犯罪受害者中精神病理学的高流行率强调了基于证据的干预措施的必要性，这些干预措施可以很容易地传播给社区服务提供者，以便在创伤暴露后实施。在制定和验证针对犯罪受害者慢性精神健康问题的正式治疗方案方面取得了相当大的进展。相比之下，与拟议的研究相关的是，有效的干预措施尚未得到验证，以解决这一人群未得到满足的急性心理健康需求。急性干预是在接近事件的短期内实施的，其最终目的是降低长期创伤相关困难的风险。尽管对犯罪受害者的紧急干预研究有限，但研究人员最近为遭受自然灾害或其他灾难性事件的个人开发了一种称为心理急救（PFA）的紧急干预。尽管PFA很有前景，也得到了专家的倡导，但由于在灾难人群中进行治疗研究可能存在许多障碍，PFA尚未得到评估。重要的是，PFA的组成部分也直接适用于暴力犯罪的受害者。此外，与灾难受害者相比，犯罪受害者是一个更容易接近的人群，对犯罪受害者的PFA进行检查提供了一个独特的机会来评估这种有希望但目前未经检验的急性干预措施。因此，这个R34项目的目的是实施和完善犯罪受害者PFA的全面随机对照试验所需的研究方案。具体而言，该项目将实施并审查在研究中招募、评估和保留急性犯罪受害者的协议的可行性（目标1）。对治疗研究至关重要的其他初步工作也将完成，包括开发和评估PFA保真度仪器（目标2）以及改进和测试培训辅助专业人员以达到高水平PFA保真度的协议（目标3）。最后，将进行一项对照试点研究，以检查PFA对主要心理健康结果的影响（目标4）。如果这项研究的结果足够有希望，研究方案将进一步完善，为更大规模的犯罪受害者PFA随机对照试验做准备。

DESCRIPTION (provided by applicant): Criminal victimization among adults represents a major public health problem in the U.S. that results in significant negative outcomes and extraordinary long-term costs. Data indicate that as many as one-third of adults have been the victim of at least one violent crime (rape/sexual assault, physical assault, or armed robbery) during their lifetime, and individuals exposed to violence are at risk for developing chronic, debilitating, mental health problems, including posttraumatic stress disorder, depression, and substance abuse. The high prevalence of psychopathology among victims of crime underscores the need for evidence-based interventions that can be readily disseminated for community-based service providers to implement after trauma exposure. Considerable progress has been made in the development and validation of formal treatment programs for chronic mental health problems among crime victims. In contrast, and pertinent to the proposed study, effective interventions have not been validated for addressing the acute unmet mental health needs of this population. Acute interventions are implemented in short temporal proximity to the event with the ultimate aim of reducing risk for longer- term trauma-related difficulties. Despite the limited research on acute interventions for crime victims, researchers recently developed an acute intervention called Psychological First Aid (PFA) for individuals exposed to natural disasters or other catastrophic events. Although promising and advocated by experts, PFA has not yet been evaluated, due likely to the many barriers to conducting treatment research with disaster populations. Importantly, the components of PFA are also directly applicable to victims of violent crime. Further, crime victims are a much more readily accessible population relative to victims of disaster, and an examination of PFA with victims of crime provides a unique opportunity to evaluate this promising but currently untested acute intervention. Thus, the purpose of this R34 project is to implement and refine research protocols that would be required for a full-scale randomized controlled trial of PFA for crime victims. Specifically, this project wll implement and examine the feasibility of a protocol for recruiting, assessing, and retaining acute crime victims in the study (Aim 1). Additional preliminary work that is essential for treatment research will also be completed, including the development and evaluation of a PFA fidelity instrument (Aim 2) and the refinement and testing of protocols for training paraprofessionals to a high level of PFA fidelity (Aim 3). Finally, a controlled pilot study will be conducted to examine the effects of PFA on key mental health outcomes (Aim 4). If the findings from this study are sufficiently promising, the research protocols will be further refined in preparation for a larger randomized controlled trial of PFA with victims of crime. PUBLIC HEALTH RELEVANCE: Criminal victimization among adults results in significant negative outcomes and extraordinary costs for individuals and society. An evidence-based approach is needed for responding to the immediate mental health needs of crime victims, and Psychological First Aid (PFA) represents a potentially promising acute intervention model for this population. However, considerable groundwork is required to evaluate PFA with victims of crime, and this project accomplishes that important preliminary work.