PREVENTION OF PTSD IN ADULT BURN PATIENTS

预防成年烧伤患者的创伤后应激障碍

• 批准号: 6196368
• 负责人: JOANN DIFEDE
• 金额: $ 21.19万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-07-15 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6196368
• 关键词: behavioral /social science research tag; burns; clinical research; cognition; coping; counseling; disease /disorder prevention /control; human subject; human therapy evaluation; posttraumatic stress disorder; psychological tests; psychotherapy; questionnaires; social support network

This study which, is being submitted in response to PA-99-134 a request for Exploratory/Developmental Grants (R21) for Mental Health Intervention Research, will be conducted at the New York Presbyterian Hospital Regional Burn Center which offers a large heterogeneous population representing both minorities (40 percent) and women (25 percent), where 41 percent of injuries are work-related, and where an alliance between the surgical staff and proposed research team have been well established. Though studies suggest rates of chronic PTSD as high as 45 percent one-year post-burn, there have been no treatment studies of PTSD following burns nor have there been any studies attempting to prevent PTSD in burn patients through early intervention. The principle aim of this study is to adapt, implement, and evaluate a program for the prevention of chronic PTSD in burn survivors. To accomplish these goals, adults consecutively admitted to the Burn Center will be screened for severe PTSD symptoms and Acute Stress Disorder (ASD) within two weeks of their injury. Those with severe PTSD symptoms or a diagnosis of ASD will undergo a comprehensive clinical assessment including the SCID, CAPS, PTSD- SS and a battery of self-report questionnaires that assess social support, coping style, cognitive schemas, ASD and PTSD symptoms. Participants will be randomized to either the prevention program or a supportive counseling control condition (SC). Those in the BP will receive four two-hour prevention sessions. These sessions will be comprised of four techniques psychoeducation, relaxation training, prolonged exposure to traumatic memories, and cognitive restructuring that have proven effective for reducing both severe acute and chronic PTSD symptoms in rape, criminal assault, and motor vehicle accident survivors. To determine the efficacy of the intervention, rates of PTSD and severity of PTSD symptoms in the BP will be compared to rates and severity of symptoms in the SC control condition. Among those burned at work, time to return to work will be compared between the two groups. Results may help fill a gap in the existing literature regarding the efficacy of early intervention for the prevention of PTSD in burn patients. Results will also provide preliminary data on the cost-effectiveness of an early intervention program.

这项研究是为了回应 PA-99-134 心理健康干预研究探索性/发展拨款 (R21) 的请求而提交的，将在纽约长老会医院区域烧伤中心进行，该中心提供大量异质人群，代表少数民族（40％）和女性（25％），其中41％的伤害与工作有关，并且外科手术人员和拟议的研究团队之间已经建立了良好的联盟。尽管研究表明烧伤后一年慢性 PTSD 的发病率高达 45%，但目前还没有针对烧伤后 PTSD 的治疗研究，也没有任何研究试图通过早期干预来预防烧伤患者的 PTSD。 本研究的主要目的是调整、实施和评估一项预防烧伤幸存者慢性创伤后应激障碍的计划。为了实现这些目标，连续入住烧伤中心的成年人将在受伤后两周内接受严重创伤后应激障碍 (PTSD) 症状和急性应激障碍 (ASD) 的筛查。 那些有严重 PTSD 症状或诊断为 ASD 的人将接受全面的临床评估，包括 SCID、CAPS、PTSD-SS 和一系列评估社会支持、应对方式、认知模式、ASD 和 PTSD 症状的自我报告问卷。参与者将被随机分配到预防计划或支持性咨询控制条件（SC）。 BP 人员将接受四次为期两小时的预防课程。 这些课程将包括心理教育、放松训练、长期接触创伤记忆和认知重建四种技术，这些技术已被证明可以有效减少强奸、犯罪袭击和机动车事故幸存者的严重急性和慢性创伤后应激障碍症状。为了确定干预的效果，将 BP 中的 PTSD 发生率和 PTSD 症状的严重程度与 SC 对照条件下的症状发生率和严重程度进行比较。 在那些在工作中烧伤的人中，将比较两组返回工作岗位的时间。结果可能有助于填补现有文献中有关早期干预预防烧伤患者创伤后应激障碍的功效的空白。 结果还将提供有关早期干预计划的成本效益的初步数据。