Psychological First Aid for Victims of Crime

描述(由申请人提供)：成年人的犯罪受害在美国是一个主要的公共卫生问题，会导致严重的负面后果和非同寻常的长期成本。数据显示，多达三分之一的成年人一生中至少经历过一次暴力犯罪(强奸/性侵犯、身体攻击或武装抢劫)，接触暴力的人有患上慢性、衰弱的精神健康问题的风险，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度流行突出表明，需要循证干预措施，这些干预措施可以很容易地传播，供社区服务提供者在受到创伤后实施。在为犯罪受害者的慢性精神健康问题制定和验证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，无法满足这一人群的急性未得到满足的心理健康需求。急性干预是在事件发生的短暂时间附近实施的，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急性干预研究有限，但研究人员最近开发了一种称为心理急救(PFA)的急性干预措施，适用于暴露在自然灾害或其他灾难性事件中的个人。尽管PFA前景看好，并得到了专家的支持，但它尚未得到评估，这可能是因为在受灾人群中进行治疗研究存在许多障碍。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，犯罪受害者是更容易接触到的人群，对犯罪受害者进行的PFA检查提供了一个独特的机会，来评估这一有希望但目前未经检验的急性干预措施。因此，R34项目的目的是实施和完善针对犯罪受害者的PFA的全面随机对照试验所需的研究方案。具体地说，该项目将在研究中实施和审查招募、评估和留住急性犯罪受害者的议定书的可行性(目标1)。还将完成对治疗研究至关重要的其他前期工作，包括开发和评价PFA保真度仪器(目标2)，完善和测试培训辅助专业人员达到高水平PFA保真度的方案(目标3)。最后，将进行一项受控的初步研究，以检查PFA对关键精神健康结果的影响(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，为以犯罪受害者为对象的更大规模的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.