Developing Group Treatments for Acute Stress Disorder

开发急性应激障碍的团体治疗方法

• 批准号: 6623624
• 负责人: ROSE T ZIMERING
• 金额: $ 15.75万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-01 至 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6623624
• 关键词: behavioral /social science research tag; clinical research; cognitive behavior therapy; group counseling; group therapy; handbook; human subject; longitudinal human study; occupational hazard; occupational psychology; occupational stressor; posttraumatic stress disorder; psychological tests; psychometrics; psychotherapy; technology /technique development

DESCRIPTION (provided by applicant): The terrorist attacks of September 11, 2001 tragically demonstrate that civilian exposure to traumatic events has reached significant and unprecedented proportions in American society. Prior to 9/11/01, rates of post-traumatic stress disorder (PTSD) had reached nine percent in the general population and twice that in populations with repetitive exposure to critical incidents, such as emergency rescue workers (e.g. firefighters). The recent terrorist attacks and the continued threat of attacks against Americans at home underscore a pressing need to examine prevention models in addition to treatment models to avert the growing incidence of this disabling psychiatric disorder and its precursor- acute stress disorder. Acute stress disorder (ASD) is a new DSM-IV diagnostic disorder targeted to identify individuals who suffer from serious stress reactions that may develop into PTSD in the first four weeks following a trauma or disaster. Consequently, effective treatments for ASD may provide an important avenue for secondary prevention of PTSD. In fact, cognitive behavioral treatment of individuals with ASD has resulted in significant reductions in the later development of PTSD. Although this CBT represents the clinical state of the art in individual post trauma psychological interventions, no empirical studies exist that have evaluated their efficacy for group treatment. Group treatment following trauma or disasters involving many individuals, such as airline, terrorist or natural disasters, will be the most efficient public health intervention to treat acute stress reactions in survivors, and prevent the chronic and debilitating disorder of PTSD. In the proposed project, two standardized group treatment manuals for ASD will be developed: a cognitive behavioral treatment and a psychoeducational treatment. Feasibility and outcome of the two treatment manuals will be systematically tested in a group of 80 Boston metropolitan firefighters who exhibit ASD symptoms following exposure to a critical on-duty incident. Participants who exhibit acute stress symptoms will be randomly assigned 72-96 hours post event to one of the two group treatment conditions. Outcome evaluation will include psychological, physical health and work performance indices. Psychometric evaluations will be conducted at baseline preceding the critical incident, pretreatment, post-treatment and at one and three months following treatment completion. Long-term research objectives for an NIMH R01 submission include a large-scale group treatment outcome study for PTSD prevention following trauma exposure and a prospective study of pre- and post-trauma factors related to ASD and PTSD in a population of firefighter recruits.

描述（由申请人提供）：2001 年 9 月 11 日的恐怖袭击悲惨地表明，美国社会中平民遭受创伤性事件的比例已达到前所未有的程度。 2001 年 9 月 11 日之前，普通人群中创伤后应激障碍 (PTSD) 的发病率已达到 9%，而反复接触重大事件的人群（例如紧急救援人员（例如消防员））的发病率是这一比例的两倍。最近的恐怖袭击和针对美国人的持续袭击威胁强调，除了治疗模式之外，还迫切需要检查预防模式，以避免这种致残性精神疾病及其前身急性应激障碍的发病率不断上升。急性应激障碍 (ASD) 是一种新的 DSM-IV 诊断障碍，旨在识别患有严重应激反应的个体，这些反应可能在创伤或灾难后的前 4 周内发展为 PTSD。因此，自闭症谱系障碍的有效治疗可能为创伤后应激障碍的二级预防提供重要途径。事实上，对 ASD 患者进行认知行为治疗可以显着减少 PTSD 的后期发展。尽管这种 CBT 代表了个人创伤后心理干预的临床最新水平，但尚无实证研究评估其团体治疗的功效。涉及多人的创伤或灾难（例如航空灾害、恐怖袭击或自然灾害）后的团体治疗将是治疗幸存者急性应激反应并预防创伤后应激障碍（PTSD）慢性衰弱性疾病的最有效的公共卫生干预措施。在拟议的项目中，将制定两套自闭症谱系障碍标准化团体治疗手册：认知行为治疗和心理教育治疗。两份治疗手册的可行性和结果将在 80 名波士顿大都会消防员中进行系统测试，这些消防员在经历过严重的执勤事件后表现出自闭症谱系障碍 (ASD) 症状。表现出急性应激症状的参与者将在活动后 72-96 小时内被随机分配至两组治疗条件之一。结果评估将包括心理、身体健康和工作绩效指标。心理测量评估将在危急事件之前、治疗前、治疗后以及治疗完成后一到三个月时的基线进行。 NIMH R01 提交的长期研究目标包括针对创伤暴露后预防 PTSD 的大规模团体治疗结果研究，以及对新招募消防员群体中与 ASD 和 PTSD 相关的创伤前和创伤后因素的前瞻性研究。