Cognitive-Behavior Therapy for Khmer Refugees: A Randomized Controlled Trial

高棉难民的认知行为疗法：随机对照试验

• 批准号: 7318930
• 负责人: DEVON HINTON
• 金额: $ 39.38万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-17 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7318930
• 关键词: Acute; Anger; Anxiety; Arousal; Behavioral; Behavioral Model; Belief; Blood Vessels; Buddhism; Cause of Death; Cessation of life; Characteristics; Clinic; Cognition; Cognitive; Cognitive Therapy; Communities; Condition; Controlled Study; Cues; Disease; Distress; Dreams; Erythrocyte Ghost; Esthesia; Event; Feedback; Fright; Generalized Anxiety Disorder; Generations; Grant; Guidelines; Guilt; Heart; Heart Arrest; Hypnagogic Hallucination; Image; Intervention; Investigation; K-Series Research Career Programs; Life; Long-Term Effects; Measures; Mediating; Mediator of activation protein; Mental Depression; Minority Groups; Modeling; Muscle relaxation phase; Nature; Nightmare; Panic; Panic Attack; Panic Disorder; Participant; Patients; Personal Satisfaction; Pharmaceutical Preparations; Population; Post-Traumatic Stress Disorders; Predisposition; Principal Investigator; Process; Psychopathology; Psychopharmacology; Psychotherapy; REM Sleep; Randomized Controlled Trials; Rate; Recording of previous events; Refugees; Relative (related person); Research; Research Personnel; Resistance; Self Efficacy; Self Perception; Severities; Slave; Sleep; Sleep Paralysis; Staging; Starvation; Stroke; Study Section; Supportive care; Surveys; Symptoms; Testing; Therapeutic Intervention; Torture; Trauma; Treatment Efficacy; United States; United States National Institutes of Health; base; cognitive change; experience; follow-up; insanity; killings; medical specialties; neglect; pol genes; programs; psychosocial; response; size; stress related disorder; theories; therapy development; trial comparing

DESCRIPTION (provided by applicant): The proposed project represents the next step in treatment development of our manualized, culturally sensitive cognitive-behavior therapy for Cambodian refugees with PTSD who have had an incomplete response to medications and supportive psychotherapy. The initial treatment development was supported by a K award to the principal investigator (K23, MH066253). This will be the principal investigator's first independent R-01, hence meeting the NIH guidelines for new investigator designation. One recent survey found that over 50% of Cambodians in a community setting met PTSD criteria, and another survey, that over 50% of Cambodian patients in a specialty clinic still met PTSD criteria, even after years of treatment, including adequate trials of psychopharmacology and supportive therapy. Despite the ample evidence of the efficacy of CBT for the treatment of PTSD among English-speaking groups, there are only five controlled studies of treatment efficacy among refugee populations. Three of those five studies were conducted by our group (two among Cambodian refugees, one among Vietnamese refugees). There is no study of the efficacy of CBT for treating PTSD in a minority group in the United States, other than our three studies of Cambodian and Vietnamese refugees. In our preliminary study, we completed NIH-defined stages of psychosocial treatment development. Based on extensive research among Cambodian refugees, we developed a manualized treatment. Among Cambodian refugees, the treatment was piloted in a small randomized controlled trial (RCT), comparing to waitlist, and then, in a medium-sized RCT, also comparing to waitlist. In a small pilot, also a RCT comparing to waitlist, efficacy was demonstrated for Vietnamese refugees with treatment-resistant PTSD. In these studies, we found the manualized treatment to be well accepted and efficacious (with large effect sizes), as assessed by standardized assessment measures, such as the Clinician-Administered PTSD Scale (CAPS). The proposed grant would allow us to further investigate the efficacy of our manualized CBT intervention for Cambodian refugees with treatment-resistant PTSD, building on our earlier studies, by conducting the next logical step of empirical investigation: a comparison of our manualized treatment to another active treatment condition.

描述（由申请人提供）：拟议的项目代表了我们手动敏感的，具有文化敏感的认知行为疗法的下一步，该疗法对PTSD的柬埔寨难民对药物的反应不完整和支持性心理治疗。最初的治疗开发得到了主要研究人员的K奖（K23，MH066253）的支持。这将是首席研究员的第一个独立R-01，因此符合新研究人员指定的NIH指南。最近的一项调查发现，在社区环境中，超过50％的柬埔寨人符合PTSD标准，另一项调查是，在专业诊所中，超过50％的柬埔寨患者仍符合PTSD标准，即使经过多年的治疗，包括精神药理学和支持治疗的适当试验。尽管有足够的证据表明CBT在讲英语的群体中对PTSD的治疗有效，但在难民人群中，只有五项对治疗疗效的对照研究。这五项研究中有三项是由我们的小组进行的（柬埔寨难民中有两项，其中一项是越南难民）。除了我们三项对柬埔寨和越南难民的研究以外，没有研究CBT在美国少数群体中治疗PTSD的功效。在我们的初步研究中，我们完成了NIH定义的社会心理治疗发展阶段。根据柬埔寨难民之间的广泛研究，我们开发了一种手动治疗。在柬埔寨难民中，在一项小型随机对照试验（RCT）中进行了治疗，与候补名单进行了比较，然后在中等大小的RCT中与候补名单进行了比较。在一个小型飞行员中，也是与候补名单相比的RCT，证明了具有耐药性PTSD的越南难民的功效。在这些研究中，我们发现手动治疗是通过标准化评估指标（例如临床医生管理的PTSD量表（CAPS））评估的。拟议的赠款将使我们能够进一步研究我们手动的CBT干预对柬埔寨难民对耐药性PTSD的疗效，这是基于我们较早的研究，通过进行下一个经验研究的逻辑步骤：对我们手动治疗与另一种主动治疗条件的比较。